Complete Data Set Research Articles

A Graduate Tracer Study for the Bachelor of Arts in Theology Program of King's College of the Philippines, Benguet

Acknowledging the requirements set forth by the Commission on Higher Education (CHED) and accrediting agencies, the researchers identified a crucial need for this study. This study examines the career trajectories and ministerial engagement of Bachelor of Arts in Theology graduates from King's College of the Philippines between 2014 and 2020, evaluating the applicability of their theological training. The research employed an explanatory sequential design, integrating descriptive surveys and semi-structured interviews to gather data from 89 graduates. Two of these 89 graduates were deceased, leaving 87 available for the study. Out of these, 87, 68 responded, providing complete data sets for analysis. Data was collected using a modified CHED tracer template via physical distribution, email, and online platforms. The analysis employed descriptive statistics and thematic analysis. Key findings indicate that 76.47% of graduates are in ministry roles such as senior pastors, youth leaders, and worship directors. Due to limited financial remuneration from small congregations, most graduates work part-time and seek supplementary secular employment. The curriculum demonstrated high applicability in teaching, personal development, and community relations, though pastoral counseling ranked slightly lower. Graduates acknowledged the program's effectiveness in preparing them for ministry and bi-vocational careers, including education and social services roles. The study highlights the dual applicability of the program to ministry and alternative careers, recommending enhancements to the internship period, curricular updates, and increased post-graduation support to address the financial and professional challenges faced by theology graduates.

Australian Naturopaths Approach to the Clinical Management of Patients Presenting with Sleep Disorders.

Objective: Naturopathic practitioners consult an estimated 6.2% of Australian adults, equating to 1,550,000 people receiving their care each year. Sleep is now recognized as a key pillar of health; however, nearly half of all Australian adults report inadequate sleep. Evidence suggests that many Australians consult naturopaths (NPs) for sleep-related problems and use complementary medicines (CMs) to manage these. However, NPs' clinical approach to caring for people living with sleep disorders has not been reported. Therefore, the aim of this study was to describe and understand the clinical assessment and treatment approaches used by NPs in their care of people living with sleep disorders. Materials and Methods: A cross-sectional online survey with a purposively sought sample. NPs were recruited via the practitioner research-based network. The participants received an email invitation containing a link to the survey along with a Participant Information Sheet. The online survey (Research Electronic Data Capture-see Supplementary Data S1) comprised multiple-choice, binary (yes/no) questions, or 5-point Likert scale-type questions structured across four sections related to: clinical assessment of patients, treatments used, interprofessional communication with conventional doctors, and demographics. Results: Sixty-seven complete data sets were analyzed. Most survey participants treated-one to three patients with sleep disorders weekly, being consulted primarily for insomnia (82%) and its treatment (98.5%). Comprehensive sleep health histories were commonly assessed. Additionally, 69% of participants reported that patients sought their services to complement conventional care. The most frequently used complementary medicine (CM) approaches included sleep hygiene counseling (75%) and meditation (64.7%). Vitamins, minerals, herbal medicines, and nutritional supplements were the most recommended CM medicines (92.6%). Referrals to conventional medicine professionals were minimal. Conclusion: Australian NPs are frequently consulted by people living with sleep disorders who are also using conventional medicines. Our study highlights the need for integrated models of health care tailored to patient needs that maximize potential benefits and reduce any harms associated with drug-CMs interactions. The provision of training to the Australian health care workforce of NPs that focuses on evidence-based behavioral treatments can improve access to these treatments for patients.

CT Multidimensional Radiomics Combined with Inflammatory Immune Score For Preoperative Prediction of Pathological Grade in Esophageal Squamous Cell Carcinoma.

Inflammation and immune biomarkers can promote angiogenesis and proliferation and metastasis of esophageal squamous cell carcinoma (ESCC). The degree of pathological grade reflects the tumor heterogeneity of ESCC. The purpose is to develop and validate a nomogram based on enhanced CT multidimensional radiomics combined with inflammatory immune score (IIS) for predicting poorly differentiated ESCC. A total of 266 ESCC patients from the retrospective study were included and randomly divided into a training set (N=186) and a validation set (N=80), and a complete data set (N=266), and overall survival was determined to follow up after surgery. The tumor imaging was segmented to form intratumoral and peritumoral 3mm areas of 3D volume of interest (VOI) on CT arterial and venous phases, and 3404 radiomics features were extracted. Finally, the radiomics scores were calculated for arterial phase intratumoral (aInRads), peritumoral 3mm (aPeriRads3), and venous phase intratumoral (vInRads), peritumoral 3mm (vPeriRads3). Logistic regression was used to fuse the four cohorts of scores to form a Stacking. Additionally, sixteen inflammatory-immune biomarkers were analyzed, including aspartate aminotransferase to lymphocyte ratio (ALRI), aspartate aminotransferase to alanine aminotransferase ratio (AAR), neutrophil times gamma-glutamyl transpeptidase to lymphocyte ratio (NγLR), and albumin plus 5 times lymphocyte sum (PNI), etc. Finally, IIS was constructed using ALRI, AAR, NγLR and PNI. Model performance was evaluated by area under receiver operating characteristic curve (AUC), calibration curve, and decision curve analyse (DCA). Stacking and IIS were independent risk factors for predicting poorly differentiated ESCC (P<0.05). Ultimately, three models of the IIS, Stacking, and nomogram were developed. Compared with the Stacking and IIS models, nomogram achieved better diagnostic performance for predicting poorly differentiated ESCC in the training set (0.881vs 0.835 vs 0.750), validation set (0.808 vs 0.796 vs 0.595), and complete data set (0.857 vs 0.823 vs 0.703). The nomogram achieved an AUC of 0.881(95%CI 0.826-0.924) in the training set, and was well verified in the validation set (AUC: 0.808[95%CI 0.705-0.888]) and the complete data set (AUC: 0.857[95%CI 0.809-0.897]). Moreover, calibration curve and DCA showed that nomogram achieved good calibration and owned more clinical net benefits in the three cohorts. KaplanMeier survival curves indicated that nomogram achieved excellent stratification for ESCC grade status (P<0.0001). The nomogram that integrates preoperative inflammatory-immune biomarkers, intratumoral and peritumoral CT radiomics achieves a high and stable diagnostic performance for predicting poorly differentiated ESCC, and may be promising for individualized surgical selection and management. The original manuscript contained in the research is included in the article. Further inquiries can be made directly to the corresponding author.

Spectrum of Clinical and Imaging Features of Children With GFAP Astrocytopathy.

Glial fibrillary acidic protein (GFAP) antibodies (abs) have been described primarily in adults with a spectrum of autoimmune-mediated diseases. In children, data on clinical and neuroradiologic features of children with autoimmune GFAP astrocytopathy are limited. The aim of this study was to describe the clinical and radiologic features in children with GFAP-ab-associated diseases. We retrospectively recruited children from 13 clinical centers between 2020 and 2023 who (1) tested positive for GFAP-ab in serum and/or CSF and (2) of whom a complete clinical and MRI data set was available. We identified and included 15 children (5 girls, 10 boys). The median age at onset was 9.9 years (range: 2-16 years). All children presented with features of AE or meningitis, acute cerebellitis, or transverse myelitis. CSF pleocytosis was common (13/15, median 245 cells/μL), and 13 (87%) of 15 harbored GFAP-abs in their CSF, 8 (53%) of whom did not have detectable GFAP-abs in their serum. MRI was abnormal in 15 (100%) of 15 children: Specific patterns included confluent lesions in the pons or caudate nucleus (11/15; 73%), peri-aqueductal regions (13/15; 87%), and spinal cord (6/10; 60%). 12 children had a favorable outcome (mRS score of </= 1). Two patients died in the acute phase or during follow-up. GFAP-ab-associated diseases encompass a wide spectrum of clinical presentation associated with a particular set of MRI features clearly distinct to other antibody-mediated diseases or MOGAD. We recommend that testing for GFAP-abs in serum and CSF be included in the workup of children with AE, particularly if brainstem involvement occurs.

Timing of intravenous dexamethasone and analgesia after brachial plexus block: a randomized, double-blind, placebo-controlled trial.

The addition of intravenous dexamethasone can significantly prolong analgesia and reduce opioid-related side effects after brachial plexus blockade, but the most effective administration time is yet unknown. The objective of this study is to determine if the timing of administration of dexamethasone affects the duration of analgesia after supraclavicular brachial plexus block. This is a double-blind, placebo-controlled, randomized trial performed at a single-center, tertiary academic health sciences center. Patients were randomly assigned to one of four treatment groups to receive dexamethasone 8 mg intravenously (or normal saline infusions) at 1-hour preblock, at the time of the block, and 1 or 2 hours postblock. 197 patients were randomized and received the intervention (in one of four treatment groups) between January 2018 and November 2023. 39 patients were excluded due to loss to follow-up and unavailability of primary outcome data. The remaining 158 patients have complete data sets and were analyzed. The time to first reported pain was not significantly different between groups (p=0.904). Secondary outcomes including pain scores and opioid consumption, recovery scores and block recovery time did not vary significantly among groups up to 48 hours. Adverse effects such as postoperative neurological symptoms and nausea were similar across groups up to 3 months postoperatively. Our results suggest that perioperative administration of 8 mg of intravenous dexamethasone (from 1 hour prior and up to 2 hours postblock) provides similar duration of analgesia to administration at the time of brachial plexus block. NCT03394820.

A Country Risk Assessment from the Perspective of Cybersecurity in Local Entities

The number of vulnerabilities identified annually has increased substantially, thereby raising the risks associated with online services. The implementation of cybersecurity management measures in accordance with the European NIS2 Directive is optional at the local authority level. This study analyzes the external perimeter of nearly 7000 municipalities and proposes a simplified security framework that provides a comprehensive view of security across regions. A complete data set was assembled on the Technological and Competence profiles of all municipalities in Spain over a two-year period. The data were gathered from the external perimeter in relation to security, availability and SEO posture areas. A survey was conducted to determine the level of concern among citizens regarding cybersecurity issues in online municipal services, with 188 respondents. Some regions were identified as exhibiting particularly high and homogeneous levels of security. In contrast, other regions were found to be below the expected level. The presence of supra-local entities, such as the “Diputaciones”, has been demonstrated to facilitate the harmonization of regional security, while simultaneously reducing technological fragmentation and operational expenditure.

Tracking the long-term timing accuracy of the X-Ray Telescope on board the Neil Gehrels Swift Observatory

Context. The Neil Gehrels Swift Observatory has been operational since November 2004. Its X-ray Telescope (XRT), operating in the 0.3–10.0 keV range, is designed to provide detailed position, timing, and spectroscopic information. Aims. The calibration procedure for assessing the absolute timing accuracy of XRT was described in a previous paper. Here we update the past analysis using the complete data set of the Crab pulsar observations up to October 2022 and using a new version of the data-processing software package that includes corrections to several issues that could have affected the previous results. Methods. We evaluate the accuracy of the Crab pulse period determination using the folding technique and the pulse-phase analysis and compare our results with the values derived from radio observations. We also check the absolute time reconstruction, measuring the phase position of the main peak in the Crab profile and comparing it with the value reported in the literature, which is based on Rossi X-Ray Timing Explorer (RXTE) observations. Results. We find that the accuracy in period determination for the Crab pulsar is of the order of a few picoseconds for the observations with the largest data time span. The absolute time reconstruction, measured using the position of the main pulse peak, shows that the main peak precedes the phase of the position reported in the literature for RXTE by ~263 µs on average. This corresponds to 0.982 in phase, with an observed dispersion of ±0.02 in phase values. We also find that observations very close in time (down to ~1 day separation) show a significant variation in absolute phase.

Bridging Global Context Interactions for High-Fidelity Pluralistic Image Completion.

We introduce PICFormer, a novel framework for Pluralistic Image Completion using a transFormer based architecture, that achieves both high quality and diversity at a much faster inference speed. Our key contribution is to introduce a code-shared codebook learning using a restrictive CNN on small and non-overlapping receptive fields (RFs) for the local visible token representation. This results in a compact yet expressive discrete representation, facilitating efficient modeling of global visible context relations by the transformer. Unlike the prevailing autoregressive approaches, we proposed to sample all tokens simultaneously, leading to more than 100× faster inference speed. To enhance appearance consistency between visible and generated regions, we further propose a novel attention-aware layer (AAL), designed to better exploit distantly related high-frequency features. Through extensive experiments, we demonstrate that the PICFormer efficiently learns semantically-rich discrete codes, resulting in significantly improved image quality. Moreover, our diverse image completion framework surpasses State-of-the-Art methods on multiple image completion datasets.

Measurement of Physical Activity Divided Into Inside and Outside the Home in People With Parkinson's Disease: A Feasibility Study.

In people with Parkinson's disease (PD), quantitative assessment of activities inside and outside the home is crucial for planning effective rehabilitation tailored to a person's living conditions and characteristics. We examined the feasibility of combining a physical activity metre and a daily activity diary for people with PD. Physical activity was evaluated using a triaxial accelerometer and recorded in a daily activity diary by the participant. The feasibility outcome was the data adoption rate, which was the physical activity rate calculated from the activity metre wearing time and the missing times from the daily activity diary. Of the 10 participants, nine had a complete data set (adoption rate 90%). The mean physical activity metre wearing time was 14.12 ± 2.26 h/day, with a mean missing time of 25.7 ± 18.1 min/day in the daily activity diary. Combining a physical activity metre and a daily activity diary is feasible in people with PD, particularly when planning rehabilitation protocols to enhance daily physical activity.

A Reduced Modeling Approach for Making Predictions with Incomplete Data Having Blockwise Missing Patterns

Incomplete data with blockwise missing patterns are commonly encountered in analytics, and solutions typically entail listwise deletion or imputation. However, as the proportion of missing values in input features increases, listwise or columnwise deletion leads to information loss, whereas imputation diminishes the integrity of the training data set. We present the blockwise reduced modeling (BRM) method for analyzing blockwise missing patterns, which adapts and improves on the notion of reduced modeling proposed by Friedman, Kohavi, and Yun in 1996 as lazy decision trees. In contrast to the original idea of reduced modeling of delaying model induction until a prediction is required, our method is significantly faster because it exploits the blockwise missing patterns to pretrain ensemble models that require minimum imputation of data. Models are pretrained over the overlapping subsets of an incomplete data set that contain only populated values. During prediction, each test instance is mapped to one of these models based on its feature-missing pattern. BRM can be applied to any supervised learning model for tabular data. We benchmark the predictive performance of BRM using simulations of blockwise missing patterns on three complete data sets from public repositories. Thereafter, we evaluate its utility on three data sets with actual blockwise missing patterns. We demonstrate that BRM is superior to most existing benchmarks in terms of predictive performance for linear and nonlinear models. It also scales well and is more reliable than existing benchmarks for making predictions with blockwise missing pattern data. Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijds.2022.9016 .

High Variability of Lateral Extra-articular Tenodesis Femoral Tunnel Position With Landmark-Based Techniques

Background: The utilization of lateral extra-articular tenodesis (LET) augmentation for anterior cruciate ligament reconstruction has increased. Various fixation points have been recommended based on tactile and anatomic landmarks; however, there is limited reporting of the accuracy or precision of these techniques in clinical practice. Purpose/Hypothesis: The purpose of this study was to evaluate whether LET fixation points identified using anatomic landmarks and tactile techniques would fall within a predefined radiographic zone. It was hypothesized that the majority of LET fixation points would be inside the radiographic zone. Study Design: Cross-sectional study; Level of evidence, 4. Methods: Postoperative lateral knee radiographs of patients who underwent anterior cruciate ligament reconstruction with LET using a landmark-based technique without fluoroscopy between January 2018 and September 2023 were reviewed. Fixation points were measured by 2 raters based on their distance from an extension of the posterior femoral cortex line (PFCL) distally and a line perpendicular to the PFCL at the posterior condylar flare (PCF). Patients were excluded if the tunnel position could not be identified or if postoperative radiographs were malrotated. The mean LET position and percentage of points within the radiographic isometric zone, defined as 4 ± 4 mm posterior and 4 ± 3 mm anterior to the PFCL and 6 ± 4 mm distal and 20 ± 5 mm proximal to the PCF were calculated. Results: Complete data sets were obtained for 47 cases. The mean LET position was 6.4 ± 7.1 mm (range, –9 to 27.3 mm) anterior to the PFCL and 1.8 ± 7.6 mm (range, –16.7 to 12.6 mm) proximal to the PCF. Overall, 53% of LET fixation points were within the predefined radiographic zone. Of the malpositioned tunnels (n = 22), their locations relative to the radiographic zone were anterior (n = 18), posterior (n = 2), proximal (n = 1), and anterior and distal (n = 1). Conclusion: This study found large variation in the location of LET fixation points, and almost half of fixation points were outside the predefined radiographic zone. Accurate and precise tunnel placement is one of multiple factors that may be important to minimize the risk of lateral compartment overconstraint, anterior cruciate ligament graft failure, and anisometry leading to LET graft loosening.

The Use of Diuretics in Infants with Established or Evolving Bronchopulmonary Dysplasia and Its Impact on the Duration of Home Oxygen Therapy.

Bronchopulmonary dysplasia (BPD), defined according to the level of respiratory support and supplemental oxygen administered at 36 weeks postmenstrual age, has multi-factorial causes. Diuretics have been used to prevent or treat established BPD and are the most frequently prescribed medication for the management of severe BPD. There is significant variation in the use of diuretics, and there is limited evidence showing improvement in medium to long term outcomes. We explored whether the use of diuretics in infants with BPD reduced the duration of HoT in a service that uses a unified protocol-driven pathway to monitor and wean HoT. A retrospective cohort study of 281 infants with BPD discharged home with oxygen therapy between 2001 and 2018. Of the 281 infants, 154 had complete data sets and were included in the study population. Forty-nine infants (31.8%) were exposed to at least one diuretic, and 105 infants (68.2%) were not exposed to any. There was no difference in the duration of HoT in infants exposed to diuretics compared to those who were unexposed. Infants exposed to diuretics had a significantly longer length of stay (LoS) in the hospital compared to unexposed infants (P < .001). We conclude that in a setting of a service in which diuretics are actively discontinued post-discharge and in which weaning of HoT is driven by a unified protocol, the use of diuretics pre-discharge does not reduce the duration of HoT.

Multiple Data Imputation Methods Advance Risk Analysis and Treatability of Co-occurring Inorganic Chemicals in Groundwater.

Accurately assessing and managing risks associated with inorganic pollutants in groundwater is imperative. Historic water quality databases are often sparse due to rationale or financial budgets for sample collection and analysis, posing challenges in evaluating exposure or water treatment effectiveness. We utilized and compared two advanced multiple data imputation techniques, AMELIA and MICE algorithms, to fill gaps in sparse groundwater quality data sets. AMELIA outperformed MICE in handling missing values, as MICE tended to overestimate certain values, resulting in more outliers. Field data sets revealed that 75% to 80% of samples exhibited no co-occurring regulated pollutants surpassing MCL values, whereas imputed values showed only 15% to 55% of the samples posed no health risks. Imputed data unveiled a significant increase, ranging from 2 to 5 times, in the number of sampling locations predicted to potentially exceed health-based limits and identified samples where 2 to 6 co-occurring chemicals may occur and surpass health-based levels. Linking imputed data to sampling locations can pinpoint potential hotspots of elevated chemical levels and guide optimal resource allocation for additional field sampling and chemical analysis. With this approach, further analysis of complete data sets allows state agencies authorized to conduct groundwater monitoring, often with limited financial resources, to prioritize sampling locations and chemicals to be tested. Given existing data and time constraints, it is crucial to identify the most strategic use of the available resources to address data gaps effectively. This work establishes a framework to enhance the beneficial impact of funding groundwater data collection by reducing uncertainty in prioritizing future sampling locations and chemical analyses.

Micronutrient Status During Military Training and Associations With Musculoskeletal Health, Injury, and Readiness Outcomes.

Micronutrient status, specifically vitamin D and iron, represent modifiable factors for optimizing military readiness. The primary purpose of this investigation was to determine associations between micronutrient deficiency (i.e.,iron status and 25-hydroxy-vitamin D [25(OH)D]) and operationally relevant outcomes (i.e.,skeletal health, musculoskeletal injury) at baseline and post-10weeks of arduous military training. A total of 227 (177 men, 50 women) Marine Officer Candidates School (OCS) candidates who completed OCS training with complete data sets were included in this analysis. Vitamin D and iron status indicators were collected at two timepoints, pre (baseline) and post OCS. Musculoskeletal outcomes at the mid- and proximal tibial diaphysis were assessed via peripheral quantitative computed tomography. Micronutrient status declined following OCS training in men and women and was associated with musculoskeletal outcomes including greater bone strength (strength strain index) at the mid-diaphysis site in those with optimal status (M = 38.26mm3, SE = 15.59) versus those without (M = -8.03mm3, SE = 17.27). In women (p = .037), endosteal circumference was greater in the deficient group (M = 53.26mm, SE = 1.19) compared with the optimal group (M = 49.47mm, SE = 1.31) at the proximal diaphysis. In men, greater baseline hepcidin concentrations were associated with an increased likelihood of suffering musculoskeletal injury during training. Vitamin D and iron status declined over the course of training, suggesting impaired micronutrient status. Differences in musculoskeletal outcomes by micronutrient group suggests optimal vitamin D and ferritin concentrations may exert beneficial effects on bone fatigability and fracture reduction during military training.

Tensor Learning Meets Dynamic Anchor Learning: From Complete to Incomplete Multiview Clustering.

Multiview clustering (MVC), which can dexterously uncover the underlying intrinsic clustering structures of the data, has been particularly attractive in recent years. However, previous methods are designed for either complete or incomplete multiview only, without a unified framework that handles both tasks simultaneously. To address this issue, we propose a unified framework to efficiently tackle both tasks in approximately linear complexity, which integrates tensor learning to explore the inter-view low-rankness and dynamic anchor learning to explore the intra-view low-rankness for scalable clustering (TDASC). Specifically, TDASC efficiently learns smaller view-specific graphs by anchor learning, which not only explores the diversity embedded in multiview data, but also yields approximately linear complexity. Meanwhile, unlike most current approaches that only focus on pair-wise relationships, the proposed TDASC incorporates multiple graphs into an inter-view low-rank tensor, which elegantly models the high-order correlations across views and further guides the anchor learning. Extensive experiments on both complete and incomplete multiview datasets clearly demonstrate the effectiveness and efficiency of TDASC compared with several state-of-the-art techniques.

TOMMicroNet: Convolutional Neural Networks for Smartphone-Based Microscopic Detection of Tomato Biotic and Abiotic Plant Health Issues.

The image-based detection and classification of plant diseases has become increasingly important to the development of precision agriculture. We consider the case of tomato, a high-value crop supporting the livelihoods of many farmers around the world. Many biotic and abiotic plant health issues impede the efficient production of this crop, and laboratory-based diagnostics are inaccessible in many remote regions. Early detection of these plant health issues is essential for efficient and accurate response, prompting exploration of alternatives for field detection. Considering the availability of low-cost smartphones, artificial intelligence-based classification facilitated by mobile phone imagery can be a practical option. This study introduces a smartphone-attachable 30× microscopic lens, used to produce the novel tomato microimaging data set of 8,500 images representing 34 tomato plant conditions on the upper and lower sides of leaves as well as on the surface of tomato fruits. We introduce TOMMicroNet, a 14-layer convolutional neural network (CNN) trained to classify biotic and abiotic plant health issues, and we compare it against six existing pretrained CNN models. We compared two separate pipelines of grouping data for training TOMMicroNet, either presenting all data at once or separating the data into subsets based on the three parts of the plant. Comparing configurations based on cross-validation and F1 scores, we determined that TOMMicroNet attained the highest performance when trained on the complete data set, with 95% classification accuracy on both training and external data sets. Given TOMMicroNet's capabilities when presented with unfamiliar data, this approach has potential for the identification of plant health issues.

Influence of acute kidney injury and chronic kidney disease on 3-year clinical outcomes in patients with AMI treated by contemporary PCI and optimal medical therapy; insights from J-MINUET study

Abstract Background The influence of acute kidney injury (AKI) and chronic kidney disease (CKD) on long-term outcomes following AMI in the era of modern primary PCI with optimal-medical-therapy (OMT) is still in debate. Methods A total of 3,281 patients with acute myocardial infarction (AMI) were enrolled in the J-MINUET registry with primary PCI of 93.1% in STEMI Consecutive patients hospitalized within 48 h of onset of AMI at 28 Japanese medical institutions were enrolled in the J-MINUET study (UMIN000010037). AKI was defined as an increase in serum-creatinine ≥0.3mg/dL or ≥50% within-48h during-hospitalization. CKD was defined as estimated glomerular filtration-rate [eGFR]&amp;lt;60mL/min/1.73m2. Major adverse cardiac event (MACE) was defined as a composite of all-cause death, cardiac-failure, MI and stroke. Patients were divided into 4 groups based on the presence or absence of CKD and the occurrence or non-occurrence of AKI. The parameters were assessed by the Cox proportional hazards model. Differences were considered statistically significant at P&amp;lt;0.05. Results Of the 3,281 patients with AMI, 3220 patients had complete data set. The average age was 69±13 years old and 75.3% of the patients were male. Of the 3220 patients, 1375 patients had CKD (42.7%) and AKI occurred in 365 patients (11.3%) during the initial hospital stay. AKI more frequently occurred in 305 CKD patients (22.2%) than 60 non-CKD patients (3.3%) (p&amp;lt;0.0001). A total of 898 MACE occurred (27.4%) during follow-up period (median of 768days). Kaplan-Meier curves illustrated event-free survival for MACE over 3 years stratified by the 4 groups (Figure). Conclusions While both CKD without AKI and non-CKD with AKI showed similar effect on the incidence of MACE, the worst clinical outcome was observed in patients having AKI on pre-existed CKD.

Up-titration of Guideline Directed Medical Therapy (GDMT) and the occurrence of side effects in Heart Failure with reduced Ejection Fraction (HFrEF)

Abstract Background The ESC Guidelines recommend early, full-dose use of heart failure (HF) medications to enhance survival, but real-world application often faces delays and inconsistencies. Clinicians often fear side effects during up-titration to the recommended target dose (TD), i.e. hypotension, bradycardia, renal impairment, and hyperkalemia (HK). The dependency of side effects during dose escalation from the severity of HF remains unclear. Purpose This study aimed to evaluate the relationship between the occurrence of side effects during up-titration of HF medication and HF severity reflected by N-terminal pro B-type natriuretic peptide (NT-proBNP). Methods 425 patients with HFrEF and a complete data set of patient characteristics, medications and laboratory values at baseline (BL), 2 months (2M), and 6 months (6M) were included from our outpatient HF unit's prospective registry. Significant side effects were defined as: systolic blood pressure (SBP) &amp;lt;90mmHg, heart rate (HR) &amp;lt;50 beats per minute (bpm), potassium (K) &amp;gt;5.0mmol/l or K &amp;gt;5,5mmol/l and estimated glomerular filtration rate (eGFR) &amp;lt;30ml/min/1.73m2. Patients were categorized into three risk groups based on their NT-proBNP levels, i.e. low-risk with NT-proBNP &amp;lt;1000pg/ml, medium-risk with NT-proBNP 1000-2000pg/ml or high-risk with NT-proBNP &amp;gt;2000pg/ml. The occurrence of side effects was recorded and the development compared among the HF risk groups. Results Figure 1 shows up-titration of HF medication. Mean daily dosages of betablockers (BB), mineralocorticoid receptor antagonists (MRA) and renin-angiotensin-system inhibitors (RASi) increased significantly during follow-up (BL vs 2M and BL vs 6M, p&amp;lt;0.001 for all). The majority of patients received ≥50% of the recommended TDs at 6M (89% for BB, 83% for MRA, 88% for RASi and 91% for total mean TDs ≥50%), and the achieved daily dosages at 6M were largely comparable across the HF risk groups at 6M, except for RASi (p=0.030). Figure 2 depicts the side effects. Side effects developed almost exclusively at short-term within 2M except for lower SBP (Figure 2A). Newly developed side effects occurring after up-titration (2B) were even more rare and predominantly occurred within the highest NT-proBNP group. The occurrence of hypotension and bradycardia was infrequent and comparable within the HF risk groups. Renal dysfunction (at 6M p=0,041) and HK occurred predominantly in higher risk patients (HK at 2M p=0,001 and at 6M p&amp;lt;0,001). Conclusions Up-titration of HF medications is highly feasible, particularly in low- and medium-risk patients. Despite rare side effects such as hyperkalemia and renal impairment, up-titration remains unimpeded, especially in patients with NT-proBNP levels below 2000pg/ml. These findings emphasize the safety of up-titration in HF.

How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?

Uncomplicated joint replacement improves pain and other patient-reported outcome measures (PROMs) such as joint function scores and quality-of-life measures. However, the overall impact of periprosthetic joint infection (PJI) and its successful treatment on PROMs is poorly defined. In this study, we describe quality-of-life scores using the 12-item Short Form survey, version 2 (SF-12v2), collected as part of a large, prospective, observational study of PJI. (1) Do patients with newly diagnosed PJI have lower quality-of-life scores than the general age-matched population? (2) Are lower quality-of-life scores for patients with PJI sustained for ≥ 12 months? (3) What factors are associated with a good functional outcome at 12 months, defined by achieving a physical component summary (PCS) score of > 50 on the SF-12v2 (that is, above the age-adjusted population mean) or an increase of > 8.9 or more from baseline? The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort was a prospective, longitudinal, multicenter cohort study of 783 patients with newly diagnosed PJI recruited across 27 centers between July 2014 and December 2017. All participants were followed for 2 years. SF-12v2 scores were collected at diagnosis (baseline) and 3, 12, and 24 months after diagnosis. Treatment success was defined as being alive with no clinical or microbiological evidence of infection and no ongoing use of antibiotics for the index joint. After exclusion of 6.6% (52) who had died, 4.2% (33) with PJI of joints other than hips and knees, and those with incomplete data sets (200 [25.5%]), 498 patients had complete SF-12v2 data sets available. At baseline, the median (IQR) PCS score was 37 (30 to 46), which increased to 41 (34 to 49; p < 0.001) at 12 months. Both measures were lower than those for the general age-matched population norm. There was no further improvement in PCS scores between 12 and 24 months. By contrast, the median (IQR) mental component summary score of the SF-12v2 was similar to age-adjusted population norms (48 [37 to 57]) at baseline. Only 40% of patients with PJI achieved a good functional outcome at 12 months. After adjustment for other factors, treatment success of PJI increased the odds of a good functional outcome by 67% (95% CI 11% to 154%; p = 0.02). PJIs have a large effect on the PCS score of the SF-12v2 quality-of-life measure at baseline, which is sustained for at least 2 years. Successful treatment of PJI increases the likelihood of a good functional outcome. These data can be used to set expectations for patients presenting with PJI and can be used to inform future clinical studies in which quality-of-life measures are incorporated into clinical endpoints. Level II, therapeutic study.

Digital image correlation and infrared thermography data for seven unique geometries of 304L stainless steel

Material Testing 2.0 (MT2.0) is a paradigm that advocates for the use of rich, full-field data, such as from digital image correlation and infrared thermography, for material identification. By employing heterogeneous, multi-axial data in conjunction with sophisticated inverse calibration techniques such as finite element model updating and the virtual fields method, MT2.0 aims to reduce the number of specimens needed for material identification and to increase confidence in the calibration results. To support continued development, improvement, and validation of such inverse methods—specifically for rate-dependent, temperature-dependent, and anisotropic metal plasticity models—we provide here a thorough experimental data set for 304L stainless steel sheet metal. The data set includes full-field displacement, strain, and temperature data for seven unique specimen geometries tested at different strain rates and in different material orientations. Commensurate extensometer strain data from tensile dog bones is provided as well for comparison. We believe this complete data set will be a valuable contribution to the experimental and computational mechanics communities, supporting continued advances in material identification methods.