Cutoff Rate Research Articles

Correlation of the Neutrophil-to-Lymphocyte Ratio with the Middle Ear Risk Index in Patients with Chronic Otitis Media.

This study aimed to investigate the neutrophil-to-lymphocyte ratio (NLR) and severity of the chronic otitis media according to middle ear risk index (MERI) scores. The NLR and middle ear risk index were calculated for 210 chronic otitis media (COM) patients retrospectively. NLR compared between COM patients and 159 participants in control group. Pearson correlation analysis was performed for NLR and MERI. In addition, The cut-off value, sensitivity, and specificity for NLR were determined in COM according to the severity of the disease with ROC analysis. The average of NLR in all patients was 1.94 ± 0.89. NLR was calculated as 2.05 ± 1.03 in the patients with COM and 1.79 ± 0.64 in the control group (p = 0.006, 95% CI 0.07-0.44, t test). According to the ROC analysis, the cut-off point was determined as 1.95 for moderate and severe disease in MERI. For the cut of a NLR = 1.95, sensitivity was calculated as 48.5% and the specificity 57.1% for moderate and severe COM. MERI score was found significantly higher in patients with postoperative graft perforation (p < 0.001, 95% CI 0.7-1.8). NLR has not related significantly with the MERI score according to linear regression analysis (p = 0.927). NLR was found to be significantly higher in chronic otitis media patients compared to the control group. But NLR was not related to the severity of the disease classified with MERI. The cut-off value, sensitivity and sensitivity rates of NLR obtained was not available for clinically use.

ANALYSIS OF RETURN AND RISK AND FEASIBILITY OF INVESTMENT IN SECURITIES IN FORMING AN OPTIMAL PORTFOLIO IN COMPANIES THAT INCLUDED IN THE LQ 45 INDEX OF THE INDONESIA STOCK EXCHANGE

Investment is the placement of a number of funds made at the present time to obtain profits in the future. This optimal portfolio research aims to determine the return and risk of the portfolio, as well as to determine the proportion of funds invested. The period used in this study is January 2018 to December 2020. The number of research samples is 29 samples. The data obtained are secondary data using the documentation method. The data analysis technique in this study uses a single index model to determine the stocks that make up the optimal portfolio. Stocks that are candidates for the optimal portfolio are stocks that have an ERB greater than or equal to the cut-off rate his. The optimal portfolio is formed by stocks that have an excess return to beta (ERB) of 0.0344 and a unique cut-off point (C*) of 0.0185. Based on the results of this study, there were 13 stocks that became the optimal portfolio. The expected return of the portfolio is 1.49% per month with a risk of 0.73%. The conclusion obtained is that rational investors will invest their funds into an optimal portfolio consisting of 13 stocks.

Developmental screening of three-year-old children with sickle cell disease compared to controls.

We previously found that neurodevelopmental deficits commonly occurred in three-year-olds with sickle cell disease (SCD), but clinical significance was uncertain because a comparison group was lacking. Our objective in the current study was to prospectively compare neurodevelopment in three-year-old children with SCD to an age-appropriate control group. The Brigance Preschool Screen II is a neurodevelopmental screening examination which can be administered in 15-20 min. SCD patients (Group 1) were compared with community controls of similar age and ethnicity enrolled in daycare/preschool (Group 2). SCD patients who were receiving hydroxycarbamide treatment were also compared (Group 3). Two hundred forty-five three-year-olds were evaluated: Group 1, 111; Group 2, 114; and Group 3, 20. The below cut-off rate on the Brigance test was higher in Group 1 (73%) than in Group 2 (61%; P = 0·04). In multivariate analysis of Group 1 patients, only lower household income and more persons living in the home were independent predictors of this. Patients with SCD and matched controls had high rates of 'failing' the Brigance test. The below cut-off rate in untreated children with SCD was associated with low household income and increased number of persons living in the home.

Optimization of RIS-Aided MIMO Systems Via the Cutoff Rate

The main difficulty concerning optimizing the mutual information (MI) in reconfigurable intelligent surface (RIS)-aided communication systems with discrete signaling is the inability to formulate this optimization problem in an analytically tractable manner. Therefore, we propose to use the cutoff rate (CR) as a more tractable metric for optimizing the MI and introduce two optimization methods to maximize the CR, assuming perfect knowledge of the channel state information (CSI). The first method is based on the projected gradient method (PGM), while the second method is derived from the principles of successive convex approximation (SCA). Simulation results show that the proposed optimization methods significantly enhance the CR and the corresponding MI.

Central Limit Theorem in high dimensions: The optimal bound on dimension growth rate

In this article, we try to give an answer to the simple question: “What is the optimal growth rate of the dimensionppas a function of the sample sizennfor which the Central Limit Theorem (CLT) holds uniformly over the collection ofpp-dimensional hyper-rectangles ?”. Specifically, we are interested in the normal approximation of suitably scaled versions of the sum∑i=1nXi\sum _{i=1}^{n}X_iinRp\mathcal {R}^puniformly over the class of hyper-rectanglesAre={∏j=1p[aj,bj]∩R:−∞≤aj≤bj≤∞,j=1,…,p}\mathcal {A}^{re}=\{\prod _{j=1}^{p}[a_j,b_j]\cap \mathcal {R}:-\infty \leq a_j\leq b_j \leq \infty , j=1,\ldots ,p\}, whereX1,…,XnX_1,\dots ,X_nare independentp−p-dimensional random vectors with each having independent and identically distributed (iid) components. We investigate the optimal cut-off rate oflog⁡p\log pbelow which the uniform CLT holds and above which it fails. According to some recent results of Chernozukov et al. [Ann. Probab. 45 (2017), pp. 2309–2352], it is well known that the CLT holds uniformly overAre\mathcal {A}^{re}iflog⁡p=o(n1/7)\log p=o\big (n^{1/7}\big ). They also conjectured that for CLT to hold uniformly overAre\mathcal {A}^{re}, the optimal rate islog⁡p=o(n1/3)\log p = o\big (n^{1/3}\big ). We show instead that under some suitable conditions on the even moments and under vanishing odd moments, the CLT holds uniformly overAre\mathcal {A}^{re}, whenlog⁡p=o(n1/2)\log p=o\big (n^{1/2}\big ). More precisely, we show that iflog⁡p=ϵn\log p =\epsilon \sqrt {n}for some sufficiently smallϵ&gt;0\epsilon &gt;0, the normal approximation is valid with an errorϵ\epsilon, uniformly overAre\mathcal {A}^{re}. Further, we show by an example that the uniform CLT overAre\mathcal {A}^{re}fails iflim supn→∞n−(1/2+δ)log⁡p&gt;0\limsup _{ n\rightarrow \infty } n^{-(1/2+\delta )} \log p &gt;0for someδ&gt;0\delta &gt;0. Therefore, with some moment conditions the optimal rate of the growth ofppfor the validity of the CLT is given bylog⁡p=o(n1/2)\log p=o\big (n^{1/2}\big ).

A microstrip planar lowpass filter with ultra-wide stopband using hexagonal-shaped resonators

Abstract A microstrip planar lowpass filter with ultra-wide stopband up to 40 GHz is presented. The filter is designed based on four types of hexagonal-shaped resonators, producing multiple transmission zeroes and extending the stopband. The high-impedance transmission line is folded to make the circuit more compact and form the coupling gaps between the adjacent resonators. A pair of folded open stubs are added to enhance the cut-off rate. As a result, an ultra-wide stopband with 23rd-harmonic suppression has been attained. A demonstration filter has been designed and fabricated with 3 dB cut-off frequency of 1.70 GHz. The measured results show that the relative stop bandwidth of the low-pass filter (LPF) is 182% with suppression level of 25 dB, covering 1.85–40 GHz. The functional area size of the filter is 21.50 × 21.70 mm, which corresponds to 0.198λ g × 0.200λ g (λ g is the guided wavelength at 3 dB cut-off frequency).

The Novel Protein HSF1 Stress Pathway Inhibitor Bisamide CCT361814 Demonstrates Pre-Clinical Anti-Tumor Activity in Myeloma

IntroductionMultiple myeloma (MM) is a plasma cell malignancy, characterized by the constant production of immunoglobulins (Ig), making the tumor cells reliant on protein homeostasis for their survival. MM cells are therefore highly susceptible to therapies that target protein homeostasis, such as proteasome inhibitors. Several protein homeostasis mechanisms, when disturbed, converge on the heat shock pathway, a critical survival pathway for tumor cells comprising among other components molecular chaperones, the heat shock proteins (HSPs), and heat shock factor 1 (HSF1) - a master transcription factor and regulator of the heat shock response (HSR). Targeting HSP90 with small-molecule inhibitors has anti-myeloma activity (Stuhmer et al, 2009; Ishii et al, 2011), but leads to compensatory activation of the HSR, which makes inhibition of the HSR itself an attractive target. Recently, we discovered a chemical probe bisamide (CCT251236) that disrupts the HSF1 pathway (Cheeseman MD et al, 2017). This led to the identification of CCT361814 with bioavailability features compatible with clinical use. Here we present first data demonstrating marked antitumor activity by CCT361814 in MM.Methods and ResultsWe evaluated CCT361814 activity in 16 human myeloma cell line (HMCL) models including KMS11, KMS12BM, H929, L363 and RPMI-8226 using MTS cell proliferation assay and found that most HMCL cell lines displayed a GI50 in the nanomolar range (20-300nM, median GI50 147nM) whilst bone marrow stromal HS5 cells had a GI50 of around 700nM suggesting a therapeutic window. Cell lines with the t(11;14) translocation affecting CCND1 such as MOLP8, U266 and KMS12BM appeared to be particularly sensitive to the drug with median GI50 values of 88nM. Western blot analysis showed that CCT361814 caused a concentration-dependent loss of HSP27 and HSP72, as markers of HSF-1 pathway inhibition, and a reduced HSF1 phosphorylation at serine 326. Annexin V/DAPI staining was performed in 8 cell lines and demonstrated consistent induction of apoptosis in all lines, with MM1.S as an example showing a 9-fold increase in apoptosis compared to vehicle control (student's t-test, P=<0.0001). Increased autophagy was observed in L363 and RPMI-8226 cells as assessed by flow cytometry. This was also accompanied by increased cleaved caspase 3 and LC3 I-II conversion as detected by western blotting. Gene expression profiling was performed using Affymetrix U133 plus 2 arrays in L363, RPMI-8226 and KMS11 to observe any differentially expressed genes. Data were normalised using robust multi-array average (RMA) and analysed for differential gene expression using the limma package in R, employing a 2.5-fold change cut-off and significant false discovery rate adjusted p-values (P=<0.05). Overrepresentation enrichment analysis identified several upregulated genes belonging to the nucleic acid binding transcription factor activity molecular function including genes such as CEBP (P=0.02), DDIT3 (P=0.01), ATF3 (P=0.04) in all MM lines studied. DDIT3 and ATF3 along with other UPR markers such as XBP-1 splicing were also assayed by qRT-PCR and showed a significant upregulation in a dose-dependent manner in L363, KMS12BM, KMS11, RPMI-8226 and H929 cells (P=<0.05 for all). The analysis also revealed significantly downregulated genes belonging to chaperone binding group (P=0.024) and unfolded protein binding group (P=0.05) and genes encoding heat shock proteins such as HSPA8 (P=0.00011), HSPA1A (P=0.001) and HSP4L (P=0.03), consistent with functional work showing that CCT361814 affects the heat shock response.ConclusionsOur data shows that CCT361814 affects the heat shock pathway as evidenced by a concentration-dependent loss of HSP27 and HSP72 proteins and also has highly potent anti-myeloma activity in all HMCL models studied. Further functional validation of the gene expression data and assessing the effect of CCT361814 treatment in combination with clinically used drugs is underway. Our discovery of CCT361814 and its potent inhibition of the HSR in protein homeostasis-addicted MM cells makes it an attractive drug to be further evaluated in early phase clinical trials. DisclosuresWorkman:Institute of Cancer Research: Employment. Jones:Institute of Cancer Research: Employment. Kaiser:Celgene: Consultancy, Honoraria, Research Funding; BMS: Consultancy, Other: Travel expenses; Amgen: Consultancy, Honoraria; Takeda: Consultancy; Janssen: Honoraria; Chugai: Consultancy.

Risk-Return Analysis on Optimum Portfolio Selection of Islamic Stocks

&lt;p&gt;&lt;em&gt;This study aims to determine the optimum portfolio category and analyze the risk-return on a formed portfolio. Data was taken from eighteen listed companies indexed by Jakarta Islamic Index during 2015-2018. Stock returns are calculated based on the closing price at the end of each month in the period. Sharia Certificate of Bank Indonesia is a proxy of risk-free return, while the market return is measured by the value of the Jakarta Islamic Index. Stocks are sorted by the value of excess return to beta (ERB) from highest to lowest, and to obtain optimal stock portfolio candidates, and the ERB value must be compared with the cut-off rate value. Seven issuers qualify for forming the optimum portfolio of shares. The results show that the optimum portfolio return is greater than the expected return and the expected risk-free return. When compared between individual stock returns and portfolio stock returns, some individual stocks provide higher returns than portfolio returns. However, the risk of individual shares was also higher than the risk of the portfolio. This finding proves that risk can be reduced optimally in Islamic stocks selection by forming an optimum portfolio.&lt;/em&gt;&lt;/p&gt;

Molecular portrait of platelets from patients with severe asthma

Asthma is a chronic inflammatory disease characterized by bronchial hyperresponsiveness, immune cell infiltration into the airways, airway remodeling and mucus overproduction. Platelets are small anucleated cells known for their role in hemostasis and thrombosis. However, they also exhibit immune and pro-inflammatory functions. Few studies suggest their involvement in the pathophysiology of asthma. The objective of our study was to analyze the transcriptomic profile of platelets from patients with severe asthma compared to non asthmatic subjects. Blood samples were collected from 5 severe asthma patients and 5 non asthmatic controls. Platelets were purified using immunomagnetic separation (Miltenyi Biotec). Total RNA was extracted and analyzed using whole genome U133 Plus 2.0 GeneChip Affymetrix microarrays. Significance analysis of microarray was used to analyze the array data with 2-fold cut-off and false discovery rate (FDR < 5%). Principal component analysis (PCA) was performed using R software. Cluster and Treeview software packages were used for the hierarchical clustering analysis. The gene ontology (GO) enrichment analysis, the biological processes and networks of differentially expressed genes were analyzed through the use of Ingenuity Pathway Analysis. The molecular signature of platelets from severe asthmatics was significantly different from the healthy subjects. Specifically, platelets from severe asthma patients were characterized by over-expression of genes related to inflammatory response and infection including CD9, CD36, CD164, SERPINB1 , PANX1 and IFITM3 . In addition, mRNA transcripts of factors controlling metabolism and transport of molecules such as phospholipase A1 ( PLAAT1 ) and leucine rich repeat ( LRRC32 ) were up-regulated in platelets from severe asthma patients. Conversely, several genes, implicated in cell death and survival ( EHMT1 , ABCC1 , HMOX1 , GSTP1 , EIF3 ), were down-regulated. Functional annotation of the differentially expressed genes revealed dysregulation of the Th1 and Th2 activation pathways ( CD28 , IL12 , TSLPR , PI3 K) that play a critical role in the adaptive immunity and therefore impact the pathophysiology of asthma. Transcriptome profiling of platelets from severe asthma patients and non-asthmatic controls allowed us to unravel the molecular basis of their special features and to determine candidate genes differentially expressed in these studied groups. This study presents a comprehensive resource to constitute a base for future investigations on the role of platelets in patients with severe asthma.

Performance of Diagnostic Scores in Thrombotic Microangiopathy Patients in the Intensive Care Unit: A Monocentric Study.

Early thrombotic thrombocytopenic purpura (TTP) recognition is critical as this disease is almost always lethal if not treated promptly with therapeutic plasma exchanges. Currently, as ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity is not widely available in emergency, scores have been developed to help differentiating TTP from other thrombotic microangiopathies (TMAs). The aim of this work was to study the accuracy of these diagnostic scores in the intensive care unit (ICU) setting. Performance of both Coppo and PLASMIC scores was studied in a cohort of adult TMA patients requiring admission to one university hospital ICU from 2006 to 2017. Receiver operating characteristic (ROC) curves were established, and confidence intervals of the area under the curve (AUC) were determined. Multivariate logistic regression analysis was performed to identify parameters specifically associated with TTP, to compare diagnostic scores and to elaborate more accurate diagnostic models. During the study period, 154 TMA patients required ICU admission, including 99 (64.2%) TTP and 55 (35.7%) non-TTP patients. AUC under the ROC curve in predicting TTP was 0.86 (95% confidence interval [CI]: 0.81-0.92) for the Coppo score, 0.67 (95% CI: 0.58-0.76) for the PLASMIC score, and 0.86 (95% CI: 0.81-0.92) for platelet count alone. Platelet count ≤20 G/L, determined as the best cut-off rate for thrombocytopenia, performed similarly to the Coppo score and better than the PLASMIC score to differentiate TTP from non-TTP patients, both using AUC ROC curve and logistic regression. In a monocentric cohort of TMA patients requiring ICU admission, the PLASMIC score had limited performance for the diagnosis of TTP. The performance of the Coppo score was good but similar to a single highly discriminant item: platelet count ≤20 G/L at admission.

Divergence Radii and the Strong Converse Exponent of Classical-Quantum Channel Coding With Constant Compositions

There are different inequivalent ways to define the R\'enyi capacity of a channel for a fixed input distribution $P$. In a 1995 paper Csisz\'ar has shown that for classical discrete memoryless channels there is a distinguished such quantity that has an operational interpretation as a generalized cutoff rate for constant composition channel coding. We show that the analogous notion of R\'enyi capacity, defined in terms of the sandwiched quantum R\'enyi divergences, has the same operational interpretation in the strong converse problem of classical-quantum channel coding. Denoting the constant composition strong converse exponent for a memoryless classical-quantum channel $W$ with composition $P$ and rate $R$ as $sc(W,R,P)$, our main result is that \[ sc(W,R,P)=\sup_{\alpha>1}\frac{\alpha-1}{\alpha}\left[R-\chi_{\alpha}^*(W,P)\right], \] where $\chi_{\alpha}^*(W,P)$ is the $P$-weighted sandwiched R\'enyi divergence radius of the image of the channel.

Process Design for the Production of Prebiotic Oligosaccharides in an Enzyme Membrane Bioreactor: Interaction between Enzymatic Reaction and Membrane Filtration

AbstractAppropriately designed and operated enzyme membrane bioreactors (EMBRs) can fully utilize the activity of free, soluble enzymes while maximizing enzyme reusability and simultaneously removing the enzyme‐free product in situ. A filtration model system was applied to determine critical EMBR design factors suitable for continuous enzymatic production of prebiotic fructo‐oligosaccharides. The filtration flux and separation efficiency were investigated in terms of the membrane cutoff rating. In addition, the influence of operational conditions on enzyme activity was also determined.

Decision-Making in the Capital Budgeting Context – Effects of Type of Decision Aid and Increases in Information Load

This paper experimentally investigates how different types of decision aids interact with increases in data load in a structured capital budgeting decision-making task. The experiment employed a 2x2 between-subjects design and was run in a course on management control systems with 136 master’s degree students at a German university. Subjects were tasked with reviewing investment proposals that contained differing amounts of information (low vs. high data load, i.e., irrelevant information cues in addition to those relevant for the decision). The second manipulation referred to the type of decision aid – either a detailed, rules-based capital budgeting guideline with clear cut-off rates, or the advice to employ generally accepted criteria for investment decision-making. The dependent variables investigated were perceived task complexity, decision accuracy, and decision confidence. Increases in data load led to an increase in perceived task complexity. There was only limited evidence for experimental conditions affecting decision accuracy. The group of subjects relying on the capital budgeting manual reported significantly higher decision confidence. Implications for practice on how to provide decision-makers with information for investment decision-making are derived.

Predictive Value of Risk Factors for Chronic Idiopathic Thrombocytopenic Purpura in Patients with Acute Type of Disease

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disease in which autoantibodies react with platelet surface antigens and results in mild to severe thrombocytopenia due to decreased platelet count or inhibition of platelet production. Given the relatively high prevalence of ITP among children and the lack of standard diagnostic testing for the diagnosis of chronic disease, this study evaluated the predictive value of risk factors for chronic ITP in hospitalized patients.&#x0D; METHODS: This prospective cohort study was performed on 65 children with ITP who referred to Ali Asghar and Rasool Akram Hospitals in Tehran, Iran, during the years 2017 and 2018. Relationships between different risk factors, including age of diagnosis, gender, white cell count, primary platelet count, mean platelet volume (MPV), history and type of the previous patient infection, FCG gene mutation, and type of FCG mutation with a chronic disease incidence were investigated using multiple logistic regression model.&#x0D; RESULTS: Of 65 patients, 31 (47.69%) were male and 34 (52.31%) were female included in the study. Twenty-eight patients (43.08%) had acute ITP and 37 (56.92%) had chronic ITP. Frequency of FCG gene mutation in patients with chronic and acute type ITP was 16.36% and 7.27%, respectively (p = 0.51). No association was found between the history of the previous infection and its type with the chronic incidence of ITP. The multiple logistic regression model showed that three factors, including the absolute number of lymphocytes, age of diagnosis, and primary white blood cells (WBC) count were directly linked to chronic ITP. Furthermore, three factors of platelet, sex, and MPV were indirectly related to chronic ITP. In addition, the absolute number of lymphocytes, age of diagnosis and primary WBC count were significantly associated with chronic ITP. The receiver operating characteristic analysis showed that the cutoff rate of these factors was 0.31. Further analysis of these risk factors in comparison with the gold standard demonstrated that the diagnostic sensitivity and specificity of these risk factors for chronic ITP were 73.08% and their specificity was 88.57%, indicating the high importance and predictive power of these risk factors.&#x0D; CONCLUSIONS: According to the results of this study, for the first time in Iran, six risk factors, including the absolute number of lymphocytes, age at diagnosis, sex, MPV level, platelet level at time of diagnosis, and primary WBC count were considered as the most important risk factors affecting the incidence of chronic ITP. Of course, more comprehensive studies can definitely lead to more comprehensive models.

ESG controversies and controversial ESG: about silent saints and small sinners

Based on an extensive international dataset containing Thomson Reuters environmental, social and corporate governance (ESG) rating, as well as Thomson Reuters newest controversies and combined score of an average of 2500 companies in the years 2002–2018, this article contributes to the existing discourse of the relationship between corporate social performance and corporate financial performance (CFP) by examining the Fama and French (J Financ Econ 116(1):1–22, 2015) five-factor risk-adjusted performance of positive screened best and worst portfolios, based on a 10% cutoff, respectively, for equally, value- and rank-weighted strategies in the European, US and global market. Furthermore, the controversies score allows us to examine the mid-to-long-term effects of scandals on the CFP without having to rely on the event study methodology. Even though a value-weighted strategy does not show any significant abnormal returns, we examined a significant outperformance for equally weighted worst ESG portfolios and best controversies strategies. These results strongly indicate that this is, on the one hand, driven by low-rated smaller companies (“small sinners”) and clean-coated firms with regard to controversies (“silent saints”) on the other hand. The findings hold for several robustness checks such as adjusting the cutoff rates or splitting the dataset across time.

Changes in physicochemical profiles and quality of apple juice treated by ultrafiltration and during its storage.

Effects of various factors, such as membrane materials, molecular weight cutoff, transmembrane pressure (TMP), and cross flow rate (CFR) on flux and physicochemical properties of apple juice during ultrafiltration and storage have been investigated. Clarity, color, total phenols, total proteins, total sugars, total soluble solids (TSS), pH, and some specific polyphenols of juices were evaluated. Results show that at conditions of PES‐10 kDa, CFR 30 L/hr, and TMP 0.75 MPa, a clarified juice obtained with color 0.15 A, clarity 96.94%T, TSS 9.55 °Brix, pH 4.2, and total phenols, total proteins, and total sugars were 64.12 and 13.20 μg/ml and 50.70 mg/ml, respectively. Chlorogenic acid, epicatechin, phloridzin, catechin, and caffeic acid decreased differently from 32.63, 17.33, 3.25, 7.58, and 0.75 μg/ml to 17.24, 12.38, 1.79, 5.27, and 0.25 μg/ml, respectively. Storage in refrigeration for 4 weeks, clarity, total sugars, and total phenols reduced by 2.5%, 6.4%, and 16.6%, respectively, while TSS increased by 3.1%.

A review of factors influencing non-adherence to oral antineoplastic drugs.

Adherence to oral antineoplastic drugs is a complex phenomenon, and knowledge about the reasons that people with cancer do not adhere to their prescriptions is essential to inform adherence-related support in clinical and research contexts. This study aims to provide an up-to-date summary of the key reasons for non-adherence to oral antineoplatic drugs (OAD) in people with cancer. Electronic databases Medline, Embase, Emcare, and PsychINFO were searched for systematic reviews and studies published between January 2010 and March 2018. Data was analyzed and extracted by two independent reviewers. Three systematic reviews and two studies were included in the review. Key factors for non-adherence were classified as either modifiable or non-modifiable factors. Side effects, forgetfulness, and poor knowledge about OAD were identified as modifiable factors while co-payment, age, regimen complexity. and time since diagnosis were identified as non-modifiable factors. Most of the included studies focused on breast cancer and chronic myeloid leukemia (CML) patients. Low methodological quality and different adherence cut-off rates were observed in the included literature. More research with rigorous methodology and diverse cancer types is needed to increase evidence on the reasons for OAD non-adherence. However, findings from this study may serve to aid in drafting guidelines and suitable interventions for adherence-related support to OAD users.

A96 PERIOPERATIVE RATE OF CHANGE IN SODIUM CONCENTRATION AND ITS IMPACT ON LENGTH OF STAY IN CRITICAL CARE UNIT POST LIVER TRANSPLANTATION: BENCHMARKING FOR QUALITY MANAGEMENT PROGRAM

Abstract Aims The aim of this quality improvement project was to benchmark the rate of change in serum sodium (delta-Na) in the perioperative period for liver transplantation (OLT) to correlate it with neurological complications as well as length of stay in critical care unit. Methods Data for total of 46 patients who underwent liver transplantation in Halifax between January 2015 and December 2016 were extracted from Atlantic Multi-Organ Transplant Program and QEII-HSC Information Systems. Pre-operative, immediate post-operative and 24–48 hours post-operative serum sodium concentrations were entered into EXCEL worksheet. In addition post-transplant neurological complications were identified in addition to length of stay in critical care unit. Results During the review period, 23 males and 23 females underwent OLT. Their mean age was 56 yrs (ranging from 23 - 70 yrs). The primary indication for transplantation was cirrhosis (57%) and hepatocellular carcinoma (35%). Fatty liver disease was most common etiology for cirrhosis (46%), followed by PBC (27%), Alcohol-related (15%). Average natural MELD-Na score was 20 (with a range from 7 – 41). Average OR time was 7hr 23min (range 4hr 15min – 15hr). In 22% of patients, the rate of delta-Na levels were rapid (more than 8 mEq/L) between the pre-operative and immediate post-operative period. Only 2% of patients had more than 8 mEq/L change in their serum sodium levels between the first and second post-operative days. Prior to OLT 21 (46%) patients had hepatic encephalopathy but this was mild or controlled in the majority of patients. In 8 (17%) patients there was multiple-etiology encephalopathy/delirium in the post-operative period. None of these patients developed neurological deficits. Only in 3 patients, tremors were documented (probably multifactorial including calcineurin-inhibitor toxicity). In this project, none of these findings correlated with a high rate of delta-Na. The average number of days in critical care unit was 6 (range 1 – 62 days). There was no clear correlation between length of stay (surrogate marker for neurologic complications) and rate of delta-Na. Conclusions In this benchmarking project, we were unable to identify a specific cut-off rate for delta-Na to correlate with either neurologic complication or length of stay in critical care unit. Rapid correction of serum sodium is often associated with various neurologic complications including central pontine myelinosis. Larger data-base with more numbers of liver transplant patients are needed to show any significant relationship and optimize the electrolyte and volume management. Rapid change in serum sodium could not help with our attempt to classify this benchmarking metric into one of four categories: productivity, quality, time and cost-related. Funding Agencies NoneKEVORK M PELTEKIAN

Design and Analysis of Rotated-QAM Based Probabilistic Shaping Scheme for Rayleigh Fading Channels

Probabilistic shaping (PS) combined with bipolar amplitude shift keying modulation is a promising transmission scheme. However, such 1-dimensional PS scheme inevitably suffers shaping loss in Rayleigh fading channels due to the lack of signal diversity. In this paper, we design a rotated quadrature amplitude modulation based PS strategy. With the discrete inputs, the ergodic constellation constrained (CC) capacity is derived based on the mutual information conditioned on full channel state information available at the receiver, which is found to be mutually influenced by both the probability mass function (PMF) and the rotation angle (RA) of the input signals. Furthermore, the closed-form cutoff rate is also derived to simplify the analysis, which is the lower bound of the mutual information with finite decoding complexity. Correspondingly, the optimizations of RA and PMF are both considered for maximizing the ergodic CC capacity and the cutoff rate, respectively, where the single parameter RA is firstly obtained by the exhaustive search. And then, the optimal PMFs of the subproblem for the fixed RAs and the fixed constellation scaling factor are obtained. Furthermore, with this non-equiprobable transmission scheme, the closed-form pairwise error probability is derived for the first time, which also validates the superiority of the proposed PS scheme in comparison with the uniform schemes with elaborate rotations.

Валідація методики кількісного визначення флорфеніколу у зразках м’язів методом імуноферментного аналізу

Introduction. Amphenicols are a group of chemical compounds with antibacterial activity, including chloramphenicol (HAF), thiamphenicol (TAF), florfenicol (FF) and their derivatives. Florfenicol (FF) is a synthetic antimicrobial agent with a broad spectrum of action and is one of the most commonly used drugs in poultry, and was developed specifically for veterinary medicine. Given the wide range of activity of florfenicol, the high therapeutic effect combined with low toxicity makes it important for use in animal husbandry. The known method of enzyme-linked immunosorbent assay (ELISA) differs favorably from other screening methods by high sensitivity, specificity, simplicity and speed of performance, availability and stability of reagents, the ability to computer processing of measurement results and automation of test steps, which provides high test efficiency. The aim of the work. To validate the method of enzyme-linked immunosorbent assay to determine the residues of florfenicol in the samples of months of different species of animals (cattle, pigs, chickens, geese, turkeys, rabbits) and fish. Materials and methods. The research was conducted on the basis of the State Research Institute for Laboratory Diagnostics and Veterinary Sanitary Expertise. The material for the study was a solution of florfenicol with a concentration of 1 mg/liter. Results of research and discussion. It was found that the highest value (highest response) for control samples is 0.24 μg/kg and the lowest value for enriched samples (lowest response) - 3.62 μg/kg. According to the obtained results, none of the answers for the enriched samples coincides with the range of answers for the control samples. It follows that the detection ability (CCβ) for this screening method reduces or decreases 5.0 μg/kg The cut-off rate of this test is 3.62 μg/kg. Conclusions and prospects for further research. Validation characteristics have been established for the determination of florfenicol residues in muscle samples, such as: detection ability (CCβ) is 5.0 μg/kg, cut-off level is 3.62 μg/kg. The lowest content of florfenicol that can be determined is 0.2 μg/kg. The percentage of return for enriched samples of both groups is 93 %, which corresponds to the specified production.