Operating Characteristics Research Articles

Oral biofluid levels of Activin-A and interleukin-1beta in stage III periodontitis.

Activin-A belongs to the transforming growth factor-beta superfamily and is a multifunctional cytokine that plays a role in inflammation, immune response, tissue repair and regeneration. Proinflammatory cytokine interleukin-1beta (IL-1β) can increase Activin-A expression in various cell types. This study aims to evaluate gingival crevicular fluid (GCF) and salivary Activin-A and IL-β levels in stage III periodontitis. 23 patients with stage III periodontitis, 26 with gingivitis and 26 periodontally healthy individuals were included. Full-mouth clinical periodontal indices were recorded, unstimulated whole saliva and GCF samples were obtained, Activin-A and IL-1β total amounts were determined by ELISA. Statistical comparisons were performed using non-parametric tests. Receiver operating characteristics curve was used for estimating the area under the curve (AUC). Periodontitis group exhibited significantly lower GCF Activin-A levels but higher IL-1β levels than the periodontally healthy group (p < 0.05). Gingivitis group had similar GCF Activin-A and IL-1β levels to the periodontitis and periodontally healthy groups (p > 0.05). Salivary Activin-A and IL-1β concentrations were similar among study groups (p > 0.05). GCF Activin-A level showed an excellent diagnostic performance (an AUC value of 0.82 with 87% sensitivity) to discriminate periodontitis from periodontal health. For the first time, this study demonstrated oral biofluid levels of Activin-A in periodontal health and diseases. Within the limits of the study, it might be suggested that diseased sites in periodontitis are associated with reduced Activin-A and increased IL-1β levels in GCF. Reduced GCF Activin-A levels and the accompanying increase in IL-1β might be associated with diseased sites in stage III periodontitis.

Взаимосвязь миокинов и саркопенического ожирения с неалкогольной жировой болезнью печени при конституционально-экзогенном ожирении у детей

Obesity in children is associated with high risk for development and progression of nonalcoholic fatty liver disease (NAFLD). NAFLD has common pathogenetic mechanisms with sarcopenic obesity (SO), in the development of which such myokines as fibroblast growth factor 21 (FGF-21) and irisin play an important role. The study of their secretion peculiarities is relevant to the prospects of using myokines as diagnostic markers or indicators for drug therapy and physical activity control as well as in the development of target therapy for NAFLD. The connection between NAFLD and SO and changes in myokine profile in children is an understudied issue. The purpose of this research was to determine differences between groups of pediatric patients with the presence v. those with the absence of NAFLD in constitutional-exogenous obesity in myokine and SO levels. Methods used: a single-stage comparative single-center uncontrolled study of 95 children aged 12 to 18 y/o with constitutional-exogenous obesity: body mass index (BMI) standard deviation score (SDS)≥+2.0. Results: NAFLD was detected in 48% (n=50/95) [95% CI (42; 63)] of whom steatohepatitis was detected in 40% (n=20/50) [95% CI (26; 55)]. SO was detected in 96% (n=48/50) [95% CI (86; 99)] with NAFLD including children with steatohepatitis (n=20). The combination of SO with elevated FRF-21 levels and decreased irisin was associated with NAFLD (AUC=0.761, [95% CI (0.65; 0.87)]). The SO frequency was statistically significantly higher in NAFLD than in the SO absence (p&lt;0.001). The predictive ability of the SO presence in relation to the detection of NAFLD was found to be high (PCPR=96%, [95% CI (88; 99)]). FRF-21 values above 60 pg/mL (AUC=0.689, [95% CI (0.57; 0.81)]) and irisin values below 7.86 μg/mL (AUC=0.703, 95% CI (0.58; 0.82)]) were associated with the presence of NAFLD. When comparing operational characteristics, no differences were found for AUC value while the best performance was demonstrated by regression model and cut-off point of irisin equal to 7.86 μg/mL. Conclusion: SO combined with changes in myokine profile is associated with NAFLD. Identification of the main factors influencing the NAFLD development in childhood is crucial in preventing the progression of liver damage.

Mining Hypertension Predictors using Decision Tree: Baseline Data of Kharameh Cohort Study

Introduction: Hypertension is a serious chronic disease and an important risk factor for many health problems. This study aimed to investigate the factors associated with hypertension using a decision-tree algorithm. Methods: Methods: This cross-sectional study was conducted through the census in Kharameh City between 2014 and 2017. The study included 2510 hypertensive and 7840 non-hypertensive individuals. To create the decision tree, 70% of the cases were randomly allocated to the training dataset. In comparison, the remaining 30% were used as the testing dataset for the performance evaluation of the decision tree. Two models were assessed. In the first model (model I), 15 variables including age, gender, body mass index (BMI), years of education, occupation status, marital status, family history of hypertension, physical activity, total energy, number of meals, salt, oil type, drug use, alcohol use, and smoke entered into the model. in the second model (model II) 16 variables including age, gender, BMI and Blood factors as Hematocrit (HCT), Mean corpuscular hemoglobin concentration (MCHC), Platelet Count (PLT), Fasting blood sugar (FBS), Blood Urea Nitrogen (BUN), creatinine (Cr), triglycerides (TG), cholesterol (CHOL), Alkaline phosphatase (ALP), High-density lipoprotein (HDL), Gamma-glutamyl transpeptidase (GGT), low-density lipoproteins (LDL) and Urinary specific gravity (SG) were considered. A confusion matrix was used to measure the performance of the decision tree. Additionally, accuracy, sensitivity, specificity, and the receiver operating characteristics (ROC) curve were determined to compare the models. Results: For the model I, the accuracy, sensitivity, specificity and AUC value were 79.2%(77.8-80.6), 82.4%(80.1-84.5), 78.24%(76.4-80), and 0.80%(0.79-0.82), respectively. For model II, the corresponding values were 79.5%(78.2-80.8), 81.0%(78.3-83.6)79.0%(77.5-80.5)and 0.80%(0.79-0.81), respectively. Confusion matrix of model I showed that of the 1188 cases with hypertension in the training data set, 979 cases were classified correctly and, for model II of the 2812 non-hypertension cases, 2222 cases were classified correctly. Conclusion: We have suggested a decision tree model to identify the risk factors associated with hypertension. This model can be useful for early screening and improving preventive and curative health services in health promotion

Borrowing using historical-bias power prior with empirical Bayes

ABSTRACT Adaptively incorporating historical information into analyses of current data can improve the precision of inference without requiring additional new observation. Unfortunately, not all borrowing methods are suitable when limited historical studies are available. When a single historical study is available, the power priors control the amount of information to borrow via specification of a weight parameter that discounts the contribution of the historical data in a likelihood combined with current data. We develop a new type of conditional power prior called the historical-bias power prior using an empirical Bayes approach. It relaxes the assumption of the traditional power priors to allow for historical bias. Moreover, our new weight function controls the amount of borrowing and only borrows when historical data satisfy the borrowing criteria. This is achieved by embedding the Frequentist test-then-pool approach in the weight function. Hence, the historical-bias power prior builds a bridge between the Frequentist test-then-pool and the Bayesian power prior. In the simulation, we examine the impact of historical bias on the operating characteristics for borrowing approaches, which has not been discussed in previous literature. The results show that the historical-bias power prior yields accurate estimation and robustly powerful tests for the experimental treatment effect with good type I error control, especially when historical bias exists.

Lactate, lactate clearance, and lactate-to-albumin ratio in predicting mortality in patients with critical polytrauma: A retrospective observational study.

Lactate is a product of anaerobic metabolism used to determine prognosis in critically ill trauma patients. This study investigates the mortality-predictive performance of lactate, lactate clearance, and lactate-to-albumin ratio (LAR) on admission in patients with polytrauma in a tertiary center's intensive care unit (ICU). Polytrauma patients in the ICU between June 2019 and June 2022 were evaluated. The diagnosis of polytrauma was made according to the Berlin criteria, a widely accepted and comprehensive system for classifying the severity of multiple injuries. Patients were classified into survivor and mortality groups. The predictive performance of lactate, lactate clearance (24th hour), and LAR for 28-day mortality was compared. The study included 176 patients. The median age of the entire population was 35 (24-50) years, and 78.4% (n = 138) were male. Motor vehicle accidents were the most common cause of polytrauma in patients (48.9%, n = 86). The most common head injuries were detected in the patients (59.1%, n = 104). In the mortality group, median lactate and lactate (24th hour) levels were significantly higher (P < .001). Median albumin and LAR values were significantly lower (P < .001). Although 24-hour lactate clearance was lower in the mortality group, no significant difference was detected (36.1% vs 42.3%, P = .052). In multivariate regression analysis, LAR was an independent predictor of mortality (P < .001). In receiver operating characteristics curve analysis, the cutoff value of lactate was ≥5.4, the area under the curve (AUC) was 0.75 (95% confidence interval [CI], 0.66-0.84), the cutoff value of lactate clearance was ≤39.2, AUC was 0.60, (95% CI, 0.51-0.69), and the cutoff value of LAR was value ≥1.50, AUC 0.83 (95% CI, 0.75-0.90). In critically ill polytrauma patients, LAR on ICU admission is an independent predictor of mortality and has acceptable prognostic value. LAR is superior to lactate and 24-hour lactate clearance in predicting mortality.

Metro train rescheduling approach during the transitional period

ABSTRACT Metro systems will inevitably be affected by train delays. Train delays during the peak to off-peak transitional period potentially lead to passengers being stranded. To address this problem, this study develops a train rescheduling model that comprehensively considers train delays, service cancellations, and the passenger service quality. The rescheduling strategy of adding temporary train services is particularly considered based on operational characteristics during the transitional period. Next, the model is transformed into a mixed-integer linear programming (MILP) model using linearization methods. To improve computational efficiency, a two-stage approach is proposed. Finally, numerical examples based on practical data from the Beijing Metro Yizhuang line are conducted to verify the effectiveness and efficiency of the proposed approach. The computational results show that the model proposed in this study can reduce the number of stranded passengers during the transitional period, and the two-stage approach can obtain high-quality feasible solutions in a short time.

Modeling and dynamic characteristics analysis of concentrating-receiver-heat exchanger system of sCO2 solar thermal power plant

In a supercritical carbon dioxide (sCO2) solar thermal power plant system using solid particle as the heat absorption and transfer medium, the concentrating-receiver-heat exchange coupled system composed of a heliostat field, solar particle receiver, and particle/sCO2 heat exchanger is one of the most important subsystems in the power plant system, and its dynamic characteristics directly affect the performance of the whole system. In this paper, taking the 200kWe sCO2 solar thermal power plant as the research objective, firstly, a discretized lumped parameter model of the coupled system was established to study the dynamic performance and operational characteristics based on the TRNSYS platform, and the following characteristics of some key parameters such as particle and sCO2 outlet temperature to the DNI variation were deeply studied without taking any control measures. The results indicate that the particle and sCO2 outlet temperature are positively correlated with the DNI variation and are highly sensitive, and the efficiency of the particle receiver is basically maintained at around 0.7 whether it is sunny or cloudy; Secondly, in order to achieve the rated outlet design parameters, the dynamic characteristics on June 13 and 15, 2023 with a PID control strategy were also studied. The results show that the particle outlet temperature can be maintained at 800 °C by controlling the particle inlet mass flowrate in the particle receiver, while the sCO2 outlet temperature can be guaranteed at 550 °C by adjusting the sCO2 inlet mass flowrate in the heat exchanger with the condition of mild DNI variation. Besides, it is also found that, the PID control is unlikely to be effective under severe DNI changes. Therefore, the addition of buffer particle tanks is essential to compensate for the intermittency of the DNI in the system design process.

Diagnostic value of sFlt-1/PlGF-1 ratio and plasma PROK1 for adverse pregnancy outcomes in women with hypertensive disease of pregnancy.

Hypertensive disease of pregnancy (HDP) is one of the most important causes of increased maternal mortality and perinatal complications during pregnancy. We investigated the pregnancy outcomes of 156 HDP patients (65 gestational hypertension [GH], 13 chronic hypertension [CH], 74 preeclampsia-eclampsia [PE-EC], and 4 superimposed on PE [CH with PE]). In patients with different types of HDP, levels of soluble fms like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF)-1, and prokinin-1 (PROK1) were measured and compared. The predictive efficacy of these indicators was evaluated using receiving operating characteristics curves and area under the curve. Results showed that the PE cohort had a higher sFlt-1/PlGF ratio (46.12 [39.24, 68.85]) and PROK1 (498.84 [213.67, 678.30] pg/mL) level than the GH (sFlt-1/PlGF, 32.3 [21.98, 58.00], PROK1 300.77[250.0, 345.29]pg/mL) and CH cohort (sFlt-1/PlGF, 37.49 [32.68, 39.68], PROK1, 281.48 [229.25, 453.94]pg/mL). In the HDP cohort, 54 patients experienced adverse pregnancy events, and the sFlt-1/PlGF ratio, PROK1, and the combined indicators (sFlt-1/PlGF ratio and PROK1) were excellent predictors of adverse pregnancy events, especially for PE patients.

Development and validation of a prediction model for the prognosis of renal cell carcinoma with liver metastases: a population-based cohort study

BackgroundCurrent studies on the establishment of prognostic model for renal cell carcinoma (RCC) with liver metastases (LM) were scarce. This study aimed to develop nomograms to predict the prognosis of RCC with LM.MethodsPatients diagnosed with RCC between 2010 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) database were selected. The eXtreme Gradient Boosting (XGBoost) and Random Forest (RF) machine learning algorithms were used to screen for the most influential factors affecting prognosis, and the Venn diagram method was employed for further refinement. Subsequently, a nomogram related to brain metastases was constructed. The performance of the nomograms was evaluated through receiver operating characteristics (ROC) curves, calibration plots, C-index, time-dependent C-index, and decision curve analysis (DCA). Kaplan–Meier (K-M) survival curves were used to provide additional verification of the clinical efficacy of the nomogram.ResultsThis research comprised 2,395 RCC patients with LM. The Venn diagram demonstrated that age, histological type, grade, AJCC T stage, AJCC N stage, surgery, chemotherapy, marital status, and lung metastasis were highly relevant variables to patients with LM. The AUC, C-index, calibration curves, and DCA curves showed excellent performance of the nomogram. Additionally, the prognostic nomogram accurately classified RCC with LM patients into low- and high-risk groups for mortality.ConclusionThis study developed a novel nomogram to predict the prognostic factors of RCC with LM, providing a valuable reference for making accurate clinical decisions.

Study on hollow cathode discharge mode with high flow rate

Abstract Hall and ion propulsion systems at power levels of ten kilowatts or higher are in development or application stages in recent years, yet research on the operational characteristics of corresponding hollow cathodes remains incomplete. This study conducts experimental research using a hollow cathode with a rated condition of 15 sccm of krypton gas and 10 A of current. By supplying a larger flow rate, the study expands the range of discharge currents to investigate changes in the discharge modes. The plume plasma characteristics and spatial distributions under various conditions were measured using a Langmuir single probe mounted on a planar two-dimensional displacement platform. The experimental results indicate that at krypton flow rates of 25 sccm and 30 sccm, as the current increases, the anode voltage and discharge oscillations increase at first but decrease later. The discharge mode transitions from low-current spot mode to plume mode, and then back to spot mode at high current. The increase in anode voltage and oscillations during the first transition phase is gradual and continuous, while the decrease during the second transition phase is abrupt. Conditions of 10 A, 12.5 A, and 20 A were selected to represent these three modes for single-probe plume spatial diagnostics. The results indicate that in the high-current spot mode, the axial potential gradient is significantly reduced compared to the radial gradient, and the cathode plasma plume is more collimated. This study shows that at high flow rates, hollow cathodes may exhibit nonlinear impedance and undergo multiple discharge mode transitions, with each transition phase displaying distinct characteristics.

Linguistic and clinical validation of the Chinese version of the Acute Cystitis Symptom Score (ACSS) questionnaire in Taiwanese women with uncomplicated acute cystitis

Purpose: The Acute Cystitis Symptom Score (ACSS) questionnaire is designed to diagnose acute cystitis in women. By quantifying the severity of symptoms, ACSS provides objective diagnostic criteria. The aim of this study is to translate the ACSS questionnaire into a Chinese version and validate its clinical use for diagnosing acute cystitis in Taiwanese women. Materials and methods: After rigorously translating the ACSS questionnaire into traditional Chinese used by the Mandarin-speaking Taiwanese people, it was clinically validated. Women aged 20 and above with suspected acute cystitis were recruited as the patients, and healthy women undergoing health check-ups as controls. Discriminative ability was assessed by comparing ACSS scores between the 2 groups, and the optimal diagnostic cutoff was determined using receiver operating characteristics analysis. In the patient group, treatment response was evaluated as patient-reported outcome by comparing ACSS scores pretreatment and posttreatment. Results: A total of 89 and 43 participants were recruited for the patient and control groups, respectively. The total score of typical symptoms between the patient and the control groups was significantly different (P &lt; 0.001). After antibiotic treatment, the total score of typical symptoms in the patient group significantly decreased (P &lt; 0.001). Using receiver operating characteristics curve analysis, the best cutoff score for diagnosing acute cystitis was 4, with a sensitivity and a specificity of 75.3% and 95.3%, respectively. Conclusion: After clinical validation, the Chinese version of the ACSS questionnaire can now be used as a symptom-oriented diagnostic and patient-reported outcome tool for acute cystitis in the Mandarin-speaking female population in Taiwan.

Deciphering white matter microstructural alterations in catatonia according to ICD-11: replication and machine learning analysis

AbstractCatatonia is a severe psychomotor disorder characterized by motor, affective and cognitive-behavioral abnormalities. Although previous magnetic resonance imaging (MRI) studies suggested white matter (WM) dysconnectivity in the pathogenesis of catatonia, it is unclear whether microstructural alterations of WM tracts connecting psychomotor regions might contribute to a better classification of catatonia patients. Here, diffusion-weighted MRI data were collected from two independent cohorts (whiteCAT/replication cohort) of patients with (n = 45/n = 13) and without (n = 56/n = 26) catatonia according to ICD-11 criteria. Catatonia severity was examined using the Northoff (NCRS) and Bush-Francis (BFCRS) Catatonia Rating Scales. We used tract-based spatial statistics (TBSS), tractometry (TractSeg) and machine-learning (ML) to classify catatonia patients from tractometry values as well as tractomics features generated by the newly developed tool RadTract. Catatonia patients showed fractional anisotropy (FA) alterations measured via TractSeg in different corpus callosum segments (CC_1, CC_3, CC_4, CC_5 and CC_6) compared to non-catatonia patients across both cohorts. Our classification results indicated a higher level of performance when trained on tractomics as opposed to traditional tractometry values. Moreover, in the CC_6, we successfully trained two classifiers using the tractomics features identified in the whiteCAT data. These classifiers were applied separately to the whiteCAT and replication cohorts, demonstrating comparable performance with Area Under the Receiver Operating Characteristics (AUROC) values of 0.79 for the whiteCAT cohort and 0.76 for the replication cohort. In contrast, training on FA tractometry resulted in lower AUROC values of 0.66 for the whiteCAT cohort and 0.51 for the replication cohort. In conclusion, these findings underscore the significance of CC WM microstructural alterations in the pathophysiology of catatonia. The successful use of an ML based classification model to identify catatonia patients has the potential to improve diagnostic precision.

Comprehensive energy footprint of electrified fleets: School bus fleet case study

This paper proposes a comprehensive framework for estimating the energy footprint and benefits of electrified vehicle fleets prior to their deployment. To support this analysis, it introduces a control-oriented electric bus simulator model that not only captures driving power requirements but also incorporates a thermal model for cabin behavior and a Heating Ventilation and Air Conditioning (HVAC) system for heating and cooling. By analyzing current bus routes and road terrain data, the energy demand and economic effects are estimated, taking into account the current operational characteristics of school buses. As a case study, it examines the potential advantages of electrifying school bus fleets in the Central School District in Ohio, USA, with a focus on energy savings and environmental impact reduction. Our findings suggest that transitioning to electric school buses could achieve up to 76% energy savings compared to gasoline buses and 67% energy savings compared to diesel buses. Economically, when converted to operational costs, this results in a savings of 52%–65% compared to gasoline and 27%–47% compared to diesel under the average price rate. The accuracy of our model is calibrated using actual operational data from school bus fleets. Furthermore, this study provides foundational insights into the charging requirements through the energy footprint analysis. This study contributes to the advancement of sustainable transportation by presenting comprehensive preliminary analysis results for vehicle electrification through a specific case study. It emphasizes the practical implementation of electric school buses and optimized vehicle efficiency, aligning with broader eco-friendly initiatives in the transportation sector.

Temporal asynchrony analysis for dynamic operation of hydraulic-thermal-electricity multiple energy networks based on holomorphic embedding method

Analyzing the operational states of multiple energy networks (MEN) in multi-energy systems is crucial for ensuring system stability. The dynamic operational characteristics of different energy flows pose challenges for computational analysis. Traditional steady-state methods are inadequate for addressing the dynamics of MEN, especially when dealing with temporal discrepancies between hydraulic and thermal flows in thermal networks (TN) and the heterogeneity between TN and electrical networks. Therefore, this paper proposes a novel holomorphic embedding method (HEM) based on multi-stage decomposition method. The developed HEM constructs a time coefficient matrix and utilize inner-outer loop recursion to handle the time lag between thermal flow and hydraulic flow in the TN. Additionally, we reconstruct a holomorphic matrix, integrating hydraulic flow to bridge thermal and electric power flows, thereby improving the operational heterogeneity among different networks. Real-case simulations show that when the Taylor expansion order in HEM is equal to 4, the proposed method achieves a mere 1% discrepancy from actual operational data, enhancing computational efficiency by 60% compared to the Newton-Raphson method. Moreover, in this real-case, the TN exhibits a maximum delay response time of 180s compared to electrical networks. Exploiting this delay time effectively increases renewable energy generation within multi-energy systems by 961.58kW per day.

Local epicardial robotic-enhanced hybrid ablation efficacy predictors for persistent atrial fibrillation

BackgroundHybrid ablation can manage persistent atrial fibrillation (PsAF) and long-standing persistent AF (LSPAF). Robotic-enhanced hybrid ablation (RE-HA) offers greater precision and stability. However, biophysical predictors of effective local epicardial radiofrequency ablation (ELRF) during epicardial ablation are unknown. ObjectiveThis study aimed to compare the time course of biophysical predictors of ELRF and no-ELRF during the first stage of RE-HA in patients with PsAF and LSPAF. MethodsWe conducted a dual-center retrospective cohort study involving 92 consecutive patients with PsAF or LSPAF who underwent RE-HA between January 2021 and May 2024. Epicardial electrogram disappearance, defined as a reduction of bipolar voltages to <0.05mV, baseline impedance (BI), and impedance drop (ID), were compared between ELRF and no-ELRF cases. Univariate and multivariate logistic regression models were used to identify predictive variables. Optimal cutoff values were determined using ROC curves. ResultsAmong 2,474 RF applications, significant predictors of ELRF included BI and ID at 1 and 8 s, with optimal cutoff values of <107, 5–17, and 0–7 Ω. The composite predictive model had an area under the receiver operating characteristics of 0.775, with 94% sensitivity, 53% specificity, and 65% accuracy. Our predictive ELRF score ranged 0–4, and Youden’s J test identifying a cutoff value of 3 as optimal. ConclusionBI and progressive ID were strong predictors of local epicardial RE-HA efficacy. The composite model was a reliable tool for early identification of ELRF, potentially reducing RF delivery and enhancing procedural efficiency. Larger prospective studies are needed to validate these findings.

Study on unsteady operation characteristics of soil heat storage and photovoltaic/thermal coupling system in summer

Study on unsteady operation characteristics of soil heat storage and photovoltaic/thermal coupling system in summer

The Mastocytosis Control Test: A Patient-Reported Outcome Measure Assessing Disease Control

BACKGROUNDMastocytosis is characterized by expanding neoplastic mast cells in organs such as the skin, bone marrow, and gastrointestinal tract. The release of mast cell mediators triggers cutaneous, gastrointestinal, and other symptoms. Currently, no validated mastocytosis-specific patient-reported outcome measure (PROM) exists to assess disease control. OBJECTIVEHere, we developed a disease-specific instrument, the Mastocytosis Control Test (MCT), for evaluating and monitoring disease control in patients with non-advanced disease. METHODSSix potential MCT items were generated using a combined approach consisting of a literature review, patient interviews, and expert input. Item selection and reduction were performed by impact analysis and inter-item correlation, followed by expert reviews and cognitive debriefings. In a validation study, the resulting MCT was tested for validity and reliability by assessing internal consistency, test-retest reliability, convergent validity, known-groups validity, and receiver operating characteristics (ROC) analysis. RESULTSTen patients participated in the item generation phase and 101 in the item reduction and validation phase. The final MCT consisted of five items. Our methods showed a valid total score, high internal consistency, and test-retest reliability. Convergent and known-groups validity demonstrated a strong correlation with related anchors. The ROC curve analysis suggested a cutoff value of ≥13 points to identify patients with good disease control. CONCLUSIONSThe MCT is a disease-specific, valid, and reliable PROM for adult patients with non-advanced disease. It may measure and monitor disease control in routine daily practice and clinical trials.

Temperature adaptive passive daytime radiative cooling: The impact of their essential properties on energy performance of different building types

Passive daytime radiative cooling (PDRC) materials can reduce building cooling demands during hot periods but increase heating needs in colder times, known as heating penalties, limiting their practicality. Temperature adaptive (TA) materials offer a solution, yet optimal TA PDRC properties, such as changes in reflectivity or emissivity from high surface temperature (HST) to low surface temperature (LST) states and the switch temperature at which these changes occur, are under-researched. To address this, a wavelength-dependent PDRC model was coupled with EnergyPlus to identify the optimal reflectivity or emissivity in HST and LST states and determine the appropriate switch temperature. Results show that different reflectivity and emissivity values are needed for various climates to maximize TA PDRC benefits. Switch temperatures from 15 °C to 30 °C primarily affect cooling benefits with minimal impact on heating penalties. Additionally, the heating penalty and cooling benefit of TA PDRC vary across building types, requiring alignment between TA PDRC operational characteristics and HVAC systems to optimize advantages. Among building types, malls benefit the most from PDRC application.

Prognostic Impact of Squamous Cell Carcinoma Antigen During Neoadjuvant Chemotherapy for Patients With Esophageal Squamous Cell Carcinoma Treated With Minimally Invasive Esophagectomy.

Squamous cell carcinoma antigen (SCC) is widely used as a tumor marker for esophageal cancer. In this study, we investigated the relationship between SCC and long-term outcomes in patients with esophageal squamous cell carcinoma after neoadjuvant chemotherapy (NAC) followed by minimally invasive esophagectomy (MIE). Between 2010 and 2018, 124 patients with ESCC who underwent MIE after NAC (cisplatin plus 5-fluorouracil) were included. Patients were divided into low and high groups based on their pre-NAC SCC level, according to the cut-off value determined using a receiver operating characteristic curve. These two patient groups were further divided into subgroups by receiver operating characteristics according to whether SCC was low or high after NAC. For overall survival (OS), the cut-off value for SCC pre-NAC was 0.9 ng/ml. Ninety-six patients were in the high SCC group (≥0.9 ng/ml) and 28 patients were in the low SCC group (<0.9 ng/ml) prior to NAC. The patients were then divided into pre-NAC/post-NAC SCC subgroups accordingly: low/low SCC (n=7), low/high SCC (n=21), high/low SCC (n=53), and high/high SCC (n=43). The 5-year OS rates were 100%, 66.7%, 50.9%, and 32.6%, respectively. In the multivariate analysis for OS, a high/high pre-NAC/post-NAC SCC status was an independent prognostic factor for poorer OS, along with pathological N stage. For patients with esophageal squamous cell carcinoma treated with NAC followed by MIE, a high SCC level prior to NAC which was also high after NAC was an independent prognostic factor and might contribute to deciding the need for adjuvant therapy.

Applicability and Validity of the "Bronchiectasis Severity Index" (BSI) and "FACED" Score in Adult Aboriginal Australians.

The prevalence of bronchiectasis is significantly higher among adult Aboriginal Australians (the Indigenous peoples of Australia) compared to non-Aboriginal Australians. Currently, there is no well-established tool to assess bronchiectasis severity specific to Indigenous peoples. Nor has the applicability and validity of the two well-established bronchiectasis severity assessment tools - The "Bronchiectasis Severity Index" (BSI) and "FACED" scale been vigorously tested in an Indigenous population. This retrospective study evaluated the validity of the BSI and FACED amongst an adult Aboriginal Australian cohort with bronchiectasis in the Top End Northern Territory (NT) of Australia. Patients with CT confirmed bronchiectasis identified between 2011 and 2020, residing in the Top End of the NT were eligible to be enrolled. The primary endpoint of 4-year mortality was assessed via hospital records, and sensitivity and specificity of the BSI and FACED assessed against this using area under the curve (AUC) receiver operating characteristics analysis. For patients with missing data, a relative BSI / FACED score was used which divided the score recorded for that patient by the total potential score based on their available clinical data. A total of 456 adult Aboriginal Australian patients >18 years of age were included (55.5% female, median age 49 years). According to the BSI score 43.4% of patients were assessed to have mild, 30.5% moderate and 26.1% severe bronchiectasis (median score 4 (IQR 2, 8)). According to the FACED 80.9% were assessed to have mild, 17.8% moderate and 1.3% severe (median score of 1 (IQR 0, 2)). Four-year mortality was 11.2% (median age of death 55.6 years). Sensitivity and specificity of the BSI combining moderate and severe were 86.3 and 47.2% respectively, and for severe alone 51% and 77%. Sensitivity and specificity of the FACED combining moderate and severe were 21.6% and 81.2%, respectively, and for severe alone 2% and 98.8%. The AUC for the continuous total BSI was 0.703, and the FACED 0.515. Utilising a relative score, based only on data available for patients with missing data (ie lung function or BMI) resulted in slightly improved AUCs for both the BSI (0.717) and FACED (0.571). Both BSI and FACED bronchiectasis assessment tools may not be ideal in an Indigenous/Aboriginal people's context. However, it may be reasonable to utilise the relative BSI score in this population until Indigenous people's specific bronchiectasis severity assessment tools are developed.