Competitive Research Articles

A competing-risk nomogram for predicting gastric cancer-specific survival in patients over 70 years: A SEER-based study.

Cancer-specific survival in older patients with gastric cancer is competitively affected by death from other causes. This study aimed to investigate cancer-specific survival and associated risk factors by competing-risk analysis in older patients with gastric cancer. The data of this study are from the SEER database, using univariable and multivariable analysis of competitive risk model to weaken the impact of competitive events, explore the risk factors of cancer-specific survival, and developed a nomogram model. Then, the performance of the model is verified by C-index, ROC curve, calibration curve and DCA, and the new model is compared with the traditional TNM stage by NRI and IDI. Our study encompassed a total of 8183 patients, with 5731 in the training cohort and 2452 in the validation cohort. Univariable and multivariable analysis showed that age, years of diagnosis, race, site, SEER stage, TNM stage, surgery, radiation or chemotherapy, LNE, tumor grade and size are independent risk factors for cancer-specific survival in older patients with gastric cancer. Based on the risk factors, we developed a diagram model to predict cancer-specific survival. C-index, ROC curve, calibration curve and DCA also show good results. We compared the new model with the traditional TNM stage model, and the NRI and IDI showed the new model has been significantly improved. This study developed a nomogram to predict the cancer-specific survival of older patients with gastric cancer, which can accurately predict the prognosis and contribute to clinical treatment decision-making.

AN EFFICIENT METHOD TO EVALUATE AND ENHANCE SPORT JUDGES’ PERFORMANCE DURING COMPETITION: A CASE STUDY IN ACROBATIC GYMNASTICS

Who judges the gymnastics judges? How do we measure their accuracy and concordance? How do we know if the judging process is fair? The superior jury has this responsibility. However, they normally lack time to provide effective feedback during competitions. Using macro functions to process statistical and mathematical statements, we designed and validated an automated Excel-based tool called the Automatic Acrobatic Gymnastics Judges Individual Report Tool to evaluate judges’ performances quickly and easily during competition, automatically creating and exporting individual reports showing each judge’s accuracy and concordance performance on a daily basis, rather than after the competition is ended. We present empirical data for 76 experienced international judges evaluating acrobatic gymnastics routines in four major official events. A total of 1240 individual reports were analyzed and sent confidentially to the judges during the competition, and 952 were analyzed to evaluate whether this feedback was effective in improving judges’ performance during the competition. The tool provides efficient and easily understood evidence-based feedback on acrobatic gymnastics judges’ performance during competition, quickly and automatically creating, analyzing and sending individualized information to judges, thus helping with specific Technical Committee scoring control tasks during competitions. We suggest that judges' performances remain high or are enhanced after receiving daily evaluation during major competition events.

Advancing athlete safety through real-time ECG monitoring for enhanced cardiovascular health in sports performance

This research paper explores the implementation and efficacy of real-time electrocardiogram (ECG) monitoring systems for athletes, emphasizing their potential to significantly enhance safety and performance in sports settings. By utilizing advanced ECG technology, the study investigates how continuous, real-time heart rate and rhythm monitoring can aid in the immediate detection of cardiovascular anomalies during high-intensity activities. The research methodology incorporates the deployment of portable ECG devices in a controlled experimental setup, analyzing data from athletes during training sessions and competitive events. Results from the study highlight the system's ability to provide swift and accurate cardiac assessments, thereby enabling timely medical interventions. Moreover, the paper discusses the technical challenges associated with real-time ECG monitoring, such as signal interference and data accuracy, and addresses privacy and ethical considerations concerning the continuous collection of health data. The discussion extends to the implications of integrating such technology within sports medicine, suggesting that while the systems offer substantial benefits in monitoring and preventing cardiac issues, they also necessitate rigorous standards for data security and ethical oversight. The conclusion advocates for a balanced approach to the adoption of these technologies, proposing future research directions that focus on enhancing system reliability and integrating artificial intelligence to predict potential health risks proactively. This study contributes to the ongoing discourse in sports health technology by providing a comprehensive analysis of real-time ECG monitoring as a transformative tool for athlete healthcare management.

Hierarchical ion interactions in the direct air capture of CO2 at air/aqueous interfaces.

The direct air capture (DAC) of CO2 using aqueous solvents is plagued by slow kinetics and interfacial barriers that limit effectiveness in combating climate change. Functionalizing air/aqueous surfaces with charged amphiphiles shows promise in accelerating DAC; however, insight into these interfaces and how they evolve in time remains poorly understood. Specifically, competitive ion interactions between DAC reagents and reaction products feedback onto the interfacial structure, thereby modulating interfacial chemical composition and overall function. In this work, we probe the role of glycine amino acid anions (Gly-), an effective CO2 capture reagent, that promotes the organization of cationic oligomers at air/aqueous interfaces. These surfaces are probed with vibrational sum frequency generation spectroscopy and molecular dynamics simulations. Our findings demonstrate that the competition for surface sites between Gly- and captured carbonaceous anions (HCO3-, CO32-, carbamates) drives changes in surface hydration, which in turn tunes oligomer ordering. This phenomenon is related to a hierarchical ordering of anions at the surface that are electrostatically attracted to the surface and their ability to compete for interfacial water. These results point to new ways to tune interfaces for DAC via stratification of ions based on relative surface propensities and specific ion effects.

Mobility of trace elements in a coastal contaminated site under groundwater salinization dynamics

Water pollution is a significant issue resulting from past long-term actions. The remediation projects carried out under law constraints for industrial plants, which have been the major contributors to environmental and water pollution, are currently providing a significant amount of data about contaminated soil, surface waters, and groundwater. Most of such plants worldwide are in coastal zones. Based on a significant amount of chemical and environmental data for a coastal contaminated site subject to variable groundwater salinization, this study aimed to understand the mobility of some trace elements because of coastal zone dynamics. Data concerned 688 groundwater samples, including As, Hg, Cd, Crtot, Cu, Ni, Pb, V, Se, Zn, pH, electrical conductivity, chlorides, total organic carbon and organic contaminants as quantitative variables, enhanced by additional qualitative variables such as groundwater salinity, season, water level, precipitation, and industrial activity type to make the dataset as representative as possible of the site under investigation. The study used robust multivariate statistical analyses to analyse the complex dataset and explain the relevant factors influencing contaminant behaviour under different environmental conditions. The Multivariate Statistical Analysis distinguished three clusters of trace elements with diverse reactivity to changes in groundwater salinization. The first includes Se, Cu, Crtot, V, and Ni, showing the highest correlation with electrical conductivity and chlorides because of their high affinity to form chloride or organic chloride complexes and for ion competition. Zn and Pb cluster in the second group: they are less reactive to groundwater salinization and more influenced by cation and anion competition and organic matter. The mobility of Hg and As (third cluster) significantly correlates with Fe and Mn, underlining the dominant role of reductive dissolution of trace elements-bearing minerals (Fe/Mn/Al-oxy-hydroxides) and metal-organic complexes. The correlation between the clustering of variables in groundwater and soils shows the influence of sediment structure, mineral composition, and physical and chemical soil conditions on the distribution in soils of trace elements and their transport to groundwater. The study proposes a valuable approach for assessing the effects of salinization in contaminated coastal aquifers. It supports planning multi-purpose characterization and monitoring campaigns of contaminated coastal sites and provides guidance on the correct associated remediation projects.

ESTRATÉGIAS DE CONFORTO AMBIENTAL PARA QUADRAS FECHADAS VOLTADAS A ESPORTES DE ALTO RENDIMENTO

Sports architecture, with its particularities, is essential to optimize the efficiency of environments, considering the specific needs of each sport. This article addresses environmental comfort strategies applied to indoor courts intended for high-performance sports, highlighting the importance of an architecturally planned environment to ensure the well-being of athletes and optimize their performance. The study focuses on thermal, visual, acoustic and ergonomic aspects, and analyzes how each of these factors influences sports performance. In addition, it explores the interaction between the body and the physical environment, proposing solutions that favor the creation of functional and comfortable spaces for sports practice and competitive events. The research, of a bibliographic and exploratory nature, brings together concepts of environmental psychology and athletic performance, in addition to highlighting the construction strategies of ventilation, lighting and acoustic control that can be applied to indoor courts with the aim of promoting human well-being. The work proposes solutions so that sports centers offer adequate conditions for sports practice, supporting the creation of environments that favor both the satisfaction and the enhancement of the performance of athletes. From this study, it is possible to define the importance of the preparation and competition environment in the performance of high-performance athletes, and architecture, linked to environmental comfort, is shown to be a tool for the development of these spaces, essential for success in national and international sports competitions.

Reactive Fluorescent and Colorimetric Probe for Highly Selective and Sensitive Detection of Hg2+ in Real Water Samples.

Construction of efficient chemosensors for highly specific and sensitive detection of mercury ions remains a great challenge. In this work a highly selective and sensitive probe CY was designed and synthesized by using coumarin fluorophore as the matrix and thioacetal moiety as the reactive recognition site for Hg2+. By virtue of the thiophilicity of Hg2+, probe CL could be hydrolyzed to deprotect and the thioacetal was transformed to the acyl group after the addition of Hg2+, the blue-green fluorescence was quenched and meanwhile the solution changed from light green to yellow. The detection limit of probe CY for Hg2+ was as low as 6.8 nM, and it could completely react with Hg2+ within 3min. Moreover, probe CY exhibited good resistance against interference from competitive metal ions and biothiols, high stability in pH 1-11 and applicability for fluorogenic and chromogenic dual-modal detection of Hg2+ in real water samples over a broad range of pH 5-10.

Polyethyleneimine assisted zeolitic imidazolate frameworks foam embed silver to enhance the uranium recovery from seawater

The powder structure, poor surface wettability and biofouling significantly limited the application potential of ZIFs (zeolitic imidazolate frameworks) in uranium extraction from seawater. Herein, a superhydrophilic polyethyleneimine assisted zeolitic imidazolate frameworks foam embed silver (CPEZ8A) was successfully prepared by simple chemical cross-linking and in-situ growth methods to explore the effects of hydrophilic matrix and silver antimicrobial agent on the uranium adsorption properties of ZIFs materials. The mechanical property and water contact angle test of CPEZ8A foam were performed to confirm its higher compression stress (with 1.314 MPa) and surface superhydrophilic. Moreover, CPEZ8A foam displayed an excellent resistance to biological attachment after 7 days in algae solution. Importantly, CPEZ8A showed the maximum U (VI) uptake capacity (775.19 mg/g) with 4.37 times of pure ZIF-8 at nearly seawater pH and retained relative high U-uptake amount during the broad pH range (4.0–9.0). Ion competition experiments were also investigated to verify the CPEZ8A foam excellent selectivity (Kd = 15,072.1 mL/g). Notably, the removal rate of CPEZ8A foam reach 81.31 % in natural seawater and remain nearly 80 % in simulated contaminated seawater. Therefore, this work provides an effective strategy to develop highly efficient ZIFs adsorbents for uranium capture.

Development of mesoporous silica-based active coatings for methylmercury removal: Towards enhanced active packaging

Active coatings capable of selectively removing pollutants are an innovative approach against human exposure to pollutants via food. This study aimed to develop an active coating capable of removing methylmercury from liquid food media. Thiolation of mesoporous silica particles modified via (3-Mercaptopropyl)trimethoxysilane increased their mercury adsorption capacity to 100 mg/g. The particles were successfully integrated into industrial, epoxy and polyurethane coatings but the induced mercury adsorption efficiency in the coatings was dependent on their type of binder. Scanning electron microscopy and energy-dispersive X-ray results revealed that the silica particles were entrapped within the coatings but remained more accessible to the external media in the industrial and polyurethane coatings. Thermogravimetric analysis confirmed the successful integration of the components. The kinetics of adsorption showed that the adsorption of methylmercury was achieved within a time range of 20-240 min, depending on the binder used in the coating. The methylmercury adsorption ability of the coatings was preserved in different food simulants and in the presence of competitive ions and in an environment comprising cysteine. In vitro biosafety assays on different cell lines showed no negative effect from the silica modification on the safety of the coatings.

PENJARINGAN BAKAT SISWA-SISWI SMP/MTS PADA CABANG OLAHRAGA ATLETIK MELALUI MADRASAH ISLAMIC COMPETITION (MIC) 2024

The lack of athletic competitions in Jember Regency, causing a decrease in achievement. Therefore, Madrasah Islamic Competition (MIC) cooperates with PASI (Indonesian Athletics Association) Jember Regency to organise competitions, one of which is athletic sports, especially running numbers. Madrasah Islamic Competition (MIC) is a competition event held by MAN 2 Jember to facilitate the talents and potential of junior high school / middle school students throughout Besuki Prefecture. One of the branches contested is the 100 m and 400 m run. Talent screening in this athletic sport is the main focus, with the aim of identifying and developing the potential of young athletes who can represent their schools and regions in larger competitions. This service activity aims to make it easier for PASI (All Indonesian Athletics Association) Jember Regency to choose athletes who are eligible to compete in the PORPROV (Provincial Sports Week). This service method uses several stages including; (1) Preparation Stage, (2) Implementation Stage, (3) Evaluation and Reporting Stage. This service activity aims to facilitate the coaches and administrators of PASI (All Indonesian Athletics Association) Jember Regency in selecting athletic athletes to be prepared for the PORPROV (Provincial Sports Week) event. So that students have the motivation to be selected to join the Jember Regency contingent in facing the event.

Software System SPDIAL

Spiroid gears are direct competitors to traditional technical solutions - worm and hypoid gears; and they have proven themselves in a large number of specific technical applications, providing greater strength, smaller size, and easier production. However, their design process is much less subject to being typical and standard and to resulting in simple engineering techniques. In fact, effective solutions can be obtained only by actually researching the space of parameters. An indispensable tool for this is a computer-aided design and research system. The paper presents the summary of such a system SPDIAL+ for worm-type gears (worm, QN-gears, spiroid) developed at Izhevsk scientific school in the field of gears and gearboxes. In particular, the possibilities of designing a conjugated gear, choice of gearwheel cutting parameters, analysis of gears under the action of errors and loads are considered. The role and results of applying the program as the main tool for research, design and innovations like new varieties of gears, their new properties in specific applications, new methods and techniques of tooth machining are shown.

Developing Graduate Attributes Through Competitive Gameplay and Learning Theories

The term competitive gameplay or gaming is predominantly associated with esports. Esports, a synonym, or abbreviation for electronic sports is an industry that has a global outreach with a lucrative market. This is accentuated by the event driven, business model focus and organised competitive events, often involving sponsorship. These additional characteristics associated with esports is what distinguishes it from traditional or casual gaming. Though esports games can be played individually, they are predominantly viewed as a team activity. Beyond the debate as to whether esports can be classified as a sport, it is an area that has attracted a significant amount of academic research. Research areas have often included esports psychology, esports player health and nutrition and esports management. Some research studies have also reviewed how esports have the potential to e.0quip esports players with relevant 21st century skills such as critical and lateral thinking. One area where esports appears to be under researched is in the relationship between competitive gameplay and learning theories. It can be argued that this is an important consideration when delivering esports from an educational perspective. The aim of this paper is to provide a scoping review of the esports literature identifying empirical research associated with competitive gaming and graduate attributes. Esports game genres will be explored from a gameplay perspective demonstrating via learning theory examples how these games can facilitate graduate attributes in players. Exploring the domain of esports game genres, learning theories and meta-skills, the paper presents a conceptual model illustrating the interrelationship between these areas. The paper also has practical value to educators, who may be as yet unfamiliar with esports, informing them of the subject’s educational benefits from a graduate attribute and employability perspective.

A Fluorescent Probe for Hydrazine Based on 4-hydroxycoumarin with High Selectivity and Sensitivity

Background: Therefore, the development of reliable analytical techniques with high selectivity and sensitivity to detect hydrazine is required for the protection of human health and safety. Objectives: Traditional methods for detecting N2H4 are frequently time-consuming, less accurate, and unsuitable for the analysis of living systems. Numerous fluorescent probes for hydrazine have been produced and gained some valuable results recently. The creation of a simple fluorescent probe for hydrazine detection is the goal of this project Method: In this study, 300 µL of probe 3-methyl-2-oxo-2H-chromen-7-yl propionate (MOCP) was mixed with an equivalent amount of the solution of each analyte to obtain the measurement solution. Following a 10-minute room temperature incubation period, the fluorescence spectra of the resultant solution were recorded. Results: The fluorescence intensity of the probe was noticeably enhanced when N2H4 was added to the probe, but almost no fluorescence enhancement was observed when other competitive ions were added. Conclusion: A hydrazine fluorescent probe based on 4-hydroxycoumarin fluorophore was developed. The probe MOCP displayed high sensitivity and selectivity for hydrazine, with a color change from colourless to blue for detection by the naked eye. Moreover, it demonstrated a low detection limit of 20 nM and a fast reaction time of 30 s.

The adsorption of cesium by sulfonic acid functionalized hollow mesoporous silica microspheres

With the development of nuclear industry, radioactive elements such as 137Cs put a threat on the water environment. It is a challenging task to remove the Cs+ in the nuclear wastewater. In the current study, we prepared a new Cs+-adsorbing material by introducing sulfhydryl group onto the surface of hollow mesoporous silica microspheres, then oxidizing the sulfhydryl group to sulfonic acid group. The obtained HMSS-SO3H material had an excellent adsorption capacity for Cs+ in the aqueous solution, with an adsorption capacity of 51.53 mg g−1 in 30 min. Characterization approaches, such as FT-IR and EDS, were used to confirm the result of modification. Adsorption experiments were carried out under. The influence of various parameters on the adsorption process was investigated under the conditions of changing pH, temperature, and time. The effect of competitive ions was also explored. The results indicated that the adsorption process followed the pseudo-second-order model and the main adsorption mechanisms are electrostatic interaction and coordination. The material had a best adsorption performance at a neutral pH. The adsorption process could well-fit the Langmuir's model, with a theoretical maximum adsorption capacity of 81.31 mg g−1. And the adsorption capacity was slightly affected by competing ions such as Mg2+ and Ca2+. The results indicate that the HMSS-SO3H prepared in this study is a promising adsorbent for Cs+, with the advantages of high adsorption capacity, fast adsorption rate and high selectivity.

Rapid and selective separation of heavy metal ions from aquatic medium using a bidentate functionalized hybrid material

Low-cost mesoporous silica material, functionalized with a bidentate pyrazolyl pyridine metal acceptor and presenting a high specific surface area of 417 m²/g, was synthesized (mSi-L3) using a two-step procedure and characterized in detail to confirm the successful covalent binding onto silica surface. Notably, mSi-L3 exhibited strong selectivity for PbII among CdII and CuII ions, and displayed rapid metal ion removal, typically less than 10 min, from water samples.The influence of various environmental parameters on the adsorption process, such as pH, contact time and temperature, was systematically investigated. Optimal adsorption of metal ions was achieved at pH 6, as lower pH values reduced the availability of active sites due to competitive hydronium ion presence. Kinetic studies indicated that the adsorption process adhered to the pseudo-second-order model, suggesting a chemisorption mechanism. Temperature significantly influenced the adsorption capacity, with increased temperatures enhancing metal ion removal and confirming the endothermic nature of the process. The isotherm study suggests that the Langmuir model accurately describes the adsorption process, confirming that CuII, CdII and PbII ions are adsorbed as a monolayer on the homogeneous surface of m-SiL3 material, implying that the material has uniform adsorption sites where each metal ion occupies a distinct site without interaction with neighbouring ions. These findings underscore the importance of optimizing environmental conditions to maximize the efficiency of mSi-L3 for heavy metal removal. Also, mSi-L3 demonstrated excellent stability, with only a slight (∼1−3 %) decrease in functional groups on its surface after multiple regeneration cycles. Extensive analytical studies conducted with real water samples provided further evidence of the stability and effectiveness of mSi-L3 for the separation of metal trace elements of lead, copper and cadmium.

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery.

Cancer-specific survival (CSS) in multiple primary colorectal cancer (MPCC) patients is competitively affected by death from other causes. This study aimed to investigate CSS and associated risk factors by competing risk analysis in MPCC patients. The data of this study is from the SEER database. Using univariable and multivariable analysis of the competitive risk model to weaken the impact of competitive events, it explores the risk factors of CSS and develops a nomogram model. Then, the performance of the model is verified by the ROC curve, calibration curve, and DCA. The study encompasses a total of 8931 patients, with 6255 in the training cohort and 2676 in the validation cohort. Univariable and multivariable analyses showed that sex, Tumor Node Metastasis (TNM) stage, and tumor grade are independent risk factors for cancer-specific survival in MPCC patients. Based on the risk factors, we developed a diagram model to predict CSS. ROC curve, calibration curve, and DCA also show good results. In conclusion, a nomogram is developed that serves as a valuable tool for predicting CSS in MPCC patients, providing clinicians with crucial insights for personalized treatment planning.

Effect of sulfur on synergistic corrosion behavior of Q235 and 16Mn steel in sodium aluminate solution

In this study, the corrosion electrochemistry and corrosion behavior of two steels were studied under the simulated alumina production conditions. The corrosion rate of 16Mn steel is greater than that of Q235 steel. The effect of S2− concentration on corrosion rate was significantly higher than that of S2O32−. The synergistic corrosion rates of Q235 and 16Mn steels increase at first and then decrease with the sulfur content, and the peak value appears when the concentration of S2− and S2O32− is 4 g/L and 3 g/L respectively. There are two main types of corrosion products: one is surface octahedral grain, which is composed of Fe2O3, Fe3O4 and Al2O3.The other is the interlayer corrosion between the surface layer and the matrix, which is composed of FeS, FeS2 and NaFeO2.The formation mechanism of the corrosion and corrosion mechanism were obtained by analyzing the phenomenon of ion competitive adsorption. Further validation and analysis of ion competition adsorption phenomenon were conducted using first-principles calculations based on density functional theory (DFT). The formation of corrosion products on the steel surface was investigated at an ion level, and the adsorption energies of OH− and S2− at the top site of Fe(110) surface were calculated. It was found that S2− is more likely to be adsorbed on the Fe(110) surface compared to OH−. The corrosion mechanism of steel is discussed preliminarily.

Selective divalent/monovalent ion partitioning in cation exchange membranes

The selective partitioning of divalent and monovalent counterions through cation exchange membranes immersed in 2:1 and 1:1 binary salt solutions remains unclear, especially at the molecular level. We present a theoretical framework that quantifies these membranes’ sorption of divalent and monovalent ions, incorporating condensed and free variants to reconcile deviations from the ideal Donnan picture observed in published experimental data. This framework explores the membranes’ global and local selective ion sorption characteristics by assessing the effects of competitive ion condensations, where these counterions compete to bind to the fixed charge groups. First, we calculate the thermodynamic property—the global partition ratio—of the membranes immersed in these binary salt solutions, quantifying the partitioning between the binary salt solutions and the membranes. Our theoretical results successfully capture the published experimental partitioning data for membranes immersed in equimolar and non-equimolar 2:1 and 1:1 binary salt solutions. Furthermore, the Donnan potential of the membranes reciprocally changes with the total concentration of 2:1 and 1:1 external salt solutions. However, for the non-equimolar systems at a constant low total concentration, varying the binary solution concentration ratio of 2:1 to 1:1 salts maintains a strong electric potential intensity due to high ionic imbalance. Second, we quantify the local partitioning of the sorbed counterions that are condensed on the crosslinked polymeric chains and those that are mobile in the interstitial solution of the membrane, a variable that is difficult to access experimentally. Accordingly, we can fractionate the sorbed ions into condensed and free states, which mutually govern the membrane’s kinetic and thermodynamic (global and local partitioning) properties.

Comparing the prognosis of esophageal adenocarcinoma with bone and liver metastases: A competing risk analysis.

About half of the patients with esophageal cancer are presenting with metastasis at initial diagnosis. However, few studies have concerned on the prognostic factors of metastatic esophageal adenocarcinoma (mEAC). This research aimed to investigate the effects of single bone metastasis (BM) and single liver metastasis (LM) on prognosis of mEAC patients. Data were obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program database. We compared the effects of LM and BM on overall survival (OS), EAC-specific survival (CSS), and EAC-specific death (EASD) by multivariate Cox regression, Kaplan-Meier analysis, and competing risk regression models. A total of 1,278 EAC patients were recruited in this study. Of which 78.95% (1009/1278) were EASD, and 12.68% (162/1278) were non-EAC-specific death (non-EASD). In multivariate Cox regression analysis, surgery, chemotherapy, and AJCC.T2 (vs. T1) were identified as protective factors for OS&CSS, while divorced/separated, single/unmarried (vs. married), grade III-IV (vs. grade I-II) and BM (vs. LM) were identified as risk factors. Competing risk regression analysis further confirmed that surgery and chemotherapy were beneficial to the patients with mEAC, and BM (vs. LM) was a risk factor for mEAC patients when considering the existence of the competitive risk events. Our study indicated that mEAC patients with BM face a worse prognosis compared to those with LM. Additionally, surgery and chemotherapy emerge as protective factors for mEAC patients. These findings offer evidence-based insights for clinical management and contribute to the field.

BRICS and G7: Global Competition

The goals and policies of the BRICS contradict the policy of the unipolar world, which perpetuates the dependence of developing countries on highly developed countries. This fact makes the BRICS and G7 international associations direct competitors with mutually opposite goals and interests. In such a formulation of the issue, strengthening and increasing the competitiveness of one integration association should lead to weakening and reducing the competitiveness of another integration association. Recently, the size of countries and the size of their populations have not been considered key factors in their competitiveness. However, if we talk about the BRICS member countries, they use these two advantages as a basis for economic growth. The area of the territory of the BRICS countries was 1.85 times the area of the G7, and the population was more than 4 times as of the end of 2022. The current trend towards the entry of new member countries into the BRICS should lead to an even greater advantage in these indicators. The economic growth of the BRICS countries is based on the use of resources and investments, while the economic growth of the G7 countries is based on accumulated wealth, military and political influence in the world. A comparison of the two integration associations in terms of real GDP growth PPP shows that the annual GDP growth of the BRICS countries exceeds the GDP growth of the G7 countries. In addition, the real GDP growth of the BRICS countries is outpacing the growth of global GDP. Key indicators characterizing the size and pace of economic growth indicate the potential for further development of the BRICS and strengthening its competition with the G7 integration bloc. The BRICS countries have shown good economic growth rates even despite the external and internal challenges associated with the crisis in the global economy and numerous economic sanctions. At the same time, the economic development of the BRICS countries is not only quantitative, but also qualitative. Unlike the G7, it is based on the formation and expansion of a free trade system within the integration bloc and the formation of economic institutions that allow overcoming trade barriers between the countries of the association, as well as increasing investment through the New Development Bank created within the BRICS. The success of development and interaction of countries within BRICS attracts new member countries. In 2024, four more countries joined the BRICS bloc, such as Iran, the United Arab Emirates, Egypt and Ethiopia, and currently many more countries are taking the initiative and wish to become members of the integration association. However, competition in the Challenger-Leader format, in addition to incentives for economic growth on the basis of fair competition, simultaneously creates incentives for mutual economic, political and military blocking of the development of countries of the competing bloc, which creates great risks of slowing down global economic development in the future.