Double Rate Research Articles

#2338 Potassium-competitive acid blocker use is associated with a lower risk of renal function deterioration compared to proton pump inhibitor use

Abstract Background and Aims Proton pump inhibitors (PPI) are commonly used drugs worldwide and have been linked to worsening renal function and incident chronic kidney disease. Recently, potassium-competitive acid blockers (P-CAB) have emerged as alternative gastric acid-reducing agents with a comparable effect as PPIs. However, little is known about the renal safety of P-CAB. We aimed to compare the renal outcomes of patients treated with P-CAB and those treated with PPI. Method We retrospectively identified all patients who were prescribed P-CAB (tegoprazan) or PPI (esomeprazole) for 30 days or more in outpatient clinics of a tertiary care center between 2019 and 2023. Longitudinal serum creatinine data and various demographic and clinical variables were collected. Renal outcomes were defined as creatinine doubling or decline in estimated glomerular filtration rate (eGFR) of 30%. Patients with baseline eGFR < 15 mL/min/1.73 m2 and those who do not have sufficient creatinine measures to assess renal outcomes were excluded. Cox proportional hazard analyses were performed for renal outcomes with adjustment of multiple clinical covariates. Results Among 8 436 patients with a mean followup of 21 months, 2 214 and 6 222 patients were treated with P-CAB and PPI, respectively, for esophageal and gastric diseases. P-CAB group showed lower rates of creatinine doubling (Log-rank P = 0.001) and decline of eGFR (Log-rank P = 0.001) compared to PPI group. P-CAB use was associated with a 0.50-fold (95% confidence interval [CI] 0.33–0.75) lower risk for creatinine doubling and 0.58-fold (95% CI 0.42–0.81) lower risk for eGFR decline in unadjusted analysis. After adjusting multiple covariates including baseline eGFR, prescription days, major comorbidities, and concomitant use of other medications, hazard ratios for creatinine doubling and eGFR decline were 0.64 (95% CI 0.42–0.98) and 0.73 (95% CI 0.53–1.02), respectively. Conclusion Use of P-CAB is associated with a lower risk for renal function deterioration compared to PPI. Given the renal safety concerns of PPIs, using P-CAB could be a relatively safer strategy for preserving kidney function in patients who need long-term gastric acid suppression. Further studies with a larger cohort incorporating other P-CABs are required to validate this finding.

Seasonal variation of background counting rates in liquid scintillation counting

A liquid scintillation background sample was measured daily in a custom-built TDCR counter for more than 17 months. The double and triple coincidence counting rates exhibit an annual sinusoidal fluctuation with a maximum in winter and a minimum in summer. Possible correlations with air temperature, air humidity, radon concentration and secondary cosmic radiation were investigated. The observation of a correlation with the ambient dose equivalent rate H˙*(10)SCR originating from the charged component of secondary cosmic radiation and an anti-correlation with the effective atmospheric temperature Teff suggest that the seasonal fluctuations in the background counting rate may be primarily driven by temporal variations in the muon flux at ground level. Additionally, a correlation was found with the indoor 222Rn concentration in air.

Spontaneous and treatment-related changes in calcitonin doubling rate of medullary thyroid cancer. Long-term experience in a patient with multiple endocrine neoplasia type 2B

Spontaneous and treatment-related changes in calcitonin doubling rate of medullary thyroid cancer. Long-term experience in a patient with multiple endocrine neoplasia type 2B

Data reduction strategy in the PandaX-4T experiment

The PandaX-4T experiment is designed for multiple purposes, including searches for solar neutrinos, weakly interacting massive particles, and rare double beta decays of xenon isotopes. The experiment produces a huge amount of raw data that needs to be stored for related physical analyses in a wide energy range. With the upgrading of the PandaX-4T experiment, the doubled sampling rate resulted in a larger data size, which challenges both the cost and the data processing speed. To address this issue, we propose a data reduction strategy by removing the noise tail of large signals and downsampling the remaining parts of them. This strategy reduces the requirement for storage by 65% while increasing data processing speed. The influences on physical analyses on different topics at different energy regions are negligible.

Spontaneous and Treatment-Related Changes of Serum Calcitonin in Medullary Thyroid Cancer: Long-Term Experience in a Patient With Multiple Endocrine Neoplasia Type 2B.

Medullary thyroid carcinoma (MTC) in MEN2B syndrome is associated with germline RET mutation. Patients harboring de novo mutations are usually diagnosed at more advanced disease stages. We present a young woman with Met918Th mutation diagnosed with stage IV MTC at age 10 years. The disease progressed despite total thyroidectomy and multiple surgical interventions for cervical lymph node recurrences, leading to distant metastases in the fifth year after the initial diagnosis. Subsequently, she underwent five different types of tyrosine kinase inhibitor (TKI) treatments. The 17-year disease course was divided into periods defined by four surgical interventions and sequential treatment intervals with four multikinase (sunitinib, vandetanib, cabozantinib, and lenvatinib) and one RET-selective TKI (selpercatinib). Tumor growth for different phases of spontaneous development and drug treatment intervals was characterized by changes in serial log-transformed calcitonin measurements (n = 114). Three operations (one for calcitonin-producing adrenal pheochromocytoma) were associated with drops in calcitonin levels. All of the nonselective TKIs were stopped due to adverse effects. As reflected by the negative calcitonin doubling rate, the best treatment response was observed with selpercatinib, which was associated with an initial large drop followed by a decreasing calcitonin trajectory over 514 days without any major side effects. This case of MEN2B medullary thyroid cancer with long-term survival presents how the effectiveness of different treatment modalities can be estimated using log-transformed calcitonin levels. Furthermore, our experience supports the view that serial calcitonin measurements may be more sensitive than radiological follow-up in advanced MTC. Our patient also represents a new case of rarely reported calcitonin-producing pheochromocytomas.

Adaptive neural network-based sliding mode control of rotary inverted pendulum system

This paper introduces a new adaptive neural network-based sliding mode control of rotary inverted pendulum system (RIPS) subject to model uncertainties and disturbances. First, the sliding mode control is designed using the double power rate reaching law. Second, an adaptive neural network (ANN) is exploited to deal with model uncertainties and disturbances. The weight matrices of the neural network are adaptively tuned. In the proposed control method the exact dynamic model of the RIPS is not required due to the exploitation of the universal property of the neural network. Moreover, the implementation of a double power-reaching law can greatly suppress the undesirable chattering. The convergence and stability analysis is validated using Lyapunov stability theory. Finally, the robustness and excellence of the proposed control strategy are verified by comparing the system performance with the existing SMC method and improved super-twisting SMC method.

Design and Implementation of Low Power and High Data Rate Edge Coded Signaling Architecture for IoT Devices

Abstract Edge coded signaling (ECS) is a recently introduced communication protocol designed for single-channel signaling among constrained internet of things (IoT) nodes. This study aims to enhance the data rate of ECS, without increasing the clock frequency or power consumption. The goal is to develop an improved protocol that maintains the inherent advantages of ECS while achieving a higher data rate. The proposed solution, double data rate ECS (DDR-ECS), leverages both pulse edges of the ECS pulse stream for information encoding, drawing an analogy to DDR memory systems. The study presents a detailed design of low-power architecture for the DDR-ECS transceiver. This design was synthesized using a 65 nm ASIC process to evaluate its performance in terms of power consumption, gate count, and data rate. The synthesis results demonstrate that the DDR-ECS transceiver preserves the key features of ECS, including tolerance to clock frequency variations and compatibility with lightweight cryptographic algorithms. It effectively doubles the dynamic data rate to the range of 12–73.5 Mb/s while consuming an equivalent power of 13 μW and occupying a compact form factor of only 1,755 gates. The introduction of DDR-ECS represents a significant advancement in the ECS protocol, offering a novel approach to doubling the data rate without increasing the clock frequency or power envelope. This innovation retains the simplicity and efficiency of ECS, providing an enhanced communication solution for constrained IoT nodes.

A design strategy for analyzing signal integrity in DDR3 bus of high speed embedded systems

A complex modern embedded system using a multi-core Central Processing Unit (CPU) toward a compact integrated design in a single Printed Circuit Board (PCB). One of the biggest challenges of the design is to meet the Signal Integrity for high speed Double Data Rate 3 Synchronous Dynamic Random-Access Memory (DDR3) bus. A typical strategy to solve the challenge is the simulation on the computer, but this is not always an effective solution as has a gap between simulation software and practical PCB. The gap is correlated to localized changes in copper density within the PCB and characterization of heterogeneous materials in PCB that could lead to differences in the real PCB. The purpose of the research presents an analysis methodology to design DDR) memory interfaces in high speed embedded systems, related to Signal Integrity and the impact of copper density on PCB trace impedances to overcome these challenges. Moreover, the presented design methodology is also applied to the next generation DDR as well as other styles of CPU.

Abstract 1226: Genomically encoded lineage plasticity drives resistance to EGFR targeted therapy in lung adenocarcinoma

Abstract EGFR-mutant lung adenocarcinoma (LUAD) represents 20% of all non-small cell lung carcinomas, with most patients presenting with incurable metastatic disease. Treatment with mutant-selective EGFR tyrosine kinase inhibitor (TKI) therapies such as osimertinib, the current standard of care for metastatic EGFR-mutant LUAD, results in greater overall and progression-free survival. However, all patients eventually relapse. Uncovering the mechanisms driving primary and acquired resistance to osimertinib is therefore critical to improving disease management. Here, we use clinical genomic sequencing (n=47) and single-nucleus RNA (snRNA) sequencing (n=62) to profile a cohort of unmatched treatment-naïve (n=26), on-treatment (n=6), and post-treatment relapsed (n=30) EGFR-mutant LUADs treated with osimertinib. Relapsed tumors are marked by increased tumor mutation burden, along with elevated rates of genome doubling and loss-of-heterozygosity. We derived expression-based signatures of LUAD, lung squamous cell carcinoma (LUSC), and small cell lung carcinoma (SCLC) and applied them to tumor cells across our cohort. Relapsed tumors had a marked decrease in LUAD gene signature expression compared to untreated tumors and accompanying increases in epithelial-mesenchymal transition (EMT) and stemness markers, consistent with dedifferentiation. Notably, tumors harboring secondary mutations to EGFR, MET, or other MAPK pathway genes and showing sustained MAPK signaling retained a more differentiated state. Patients lacking these secondary on-target or bypass mutations were more likely to experience relapse with histological transdifferentiation, marked by complete loss of LUAD signatures, and accompanying increases in LUSC or SCLC signatures. Phenotype matching of tumor cells to normal cells from the developing fetal lung revealed enrichment of airway progenitor populations in non-histologically transformed treatment-resistant patients, in contrast to a proportion of late bud-tip and club-like epithelial cells which predominated in treatment-naïve samples. In rare cases, we observed subpopulations of basal stem-like progenitors in otherwise well-differentiated pre-treatment tumors. In summary, single-cell mapping of histological and developmental phenotypes has revealed divergent evolutionary trajectories during the acquisition of resistance to osimertinib, defined by MAPK signaling reactivation or by loss of LUAD identity and histological transformation respectively. Citation Format: Matthew Zatzman, Alvaro Quintanal-Villalonga, Sohrab Salehi, Christina Falcon, Nicholas Ceglia, Sohrab P. Shah, Charles M. Rudin, Helena A. Yu. Genomically encoded lineage plasticity drives resistance to EGFR targeted therapy in lung adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1226.

Tumor growth manifested in two-fifths of low-risk papillary thyroid microcarcinoma patients during active surveillance: data from a tertiary center in China.

To assess tumor growth using tumor doubling rate (TDR) during active surveillance (AS) in China. Between January 2016 and June 2020, a total of 219 patients with low-risk papillary thyroid microcarcinoma (PTMC) (aged 23-75 years) were consecutively enrolled in the AS program. Four sections of TDR, >0.5, 0.1~0.5, -0.1~0.1 and <-0.1, corresponded with four categories of tumor volume kinetics: rapid growth, slow growth, stable, and decreased size. We found that 10.5% of PTMCs exhibited rapid growth, 33.33% exhibited slow growth, 26.48% were stable, and 29.68% decreased in size. Tumor growth was associated with two factors: age and volume of PTMC at diagnosis. 85.72% of elderly patients (≥ 61 years old) had tumors that remained stable or even shrank and rapidly growing tumors were not found in them. When the volume was small (≤14.13 mm3), the proportion of rapid growth was high (41.67%), whereas when the volume was large (> 179.5 mm3), the proportion of non-growth was 68.75%. TDR may be a better metric for evaluating tumor growth in observational PTMCs. A certain proportion of PTMCs grow during the period of AS and tumor growth was associated with age and volume of PTMC at initial diagnosis. Therefore, how to block tumor growth during the AS period, especially for young patients and patients with early-stage PTMC (size ≤ 5mm), will be a new challenge.

Community-level predictors of doubled-up homelessness

ABSTRACT Existing research has examined the community-level factors associated with sheltered and unsheltered homelessness in the United States, generally finding that housing, labor market, and social safety net factors have significant associations with geographic variation in homelessness. Some definitions of homelessness include doubling up, defined as staying with others because of housing loss or economic hardship. We examine the community correlates of doubled-up homelessness across metropolitan areas using a measure that draws on American Community Survey microdata. We present evidence that area median rent and unemployment are positively associated with rates of doubling up among the population in or near poverty, and that income inequality and unemployment are positively associated with rates of doubling up in the total population. In contrast to recent studies of sheltered and unsheltered homelessness, we find a negative relationship between access to cash public assistance and doubling up rates within both the total population and those who are low income.

Mitochondrial function and reactive oxygen species production during human sperm capacitation: Unraveling key players.

Sperm capacitation is a critical process for male fertility. It involves a series of biochemical and physiological changes that occur in the female reproductive tract, rendering the sperm competent for successful fertilization. The precise mechanisms and, specifically, the role of mitochondria, in sperm capacitation remain incompletely understood. Previously, we revealed that in mouse sperm mitochondrial activity (e.g., oxygen consumption, membrane potential, ATP/ADP exchange, and mitochondrial Ca2+ ) increases during capacitation. Herein, we studied mitochondrial function by high-resolution respirometry (HRR) and reactive oxygen species production in capacitated (CAP) and non-capacitated (NC) human spermatozoa. We found that in capacitated sperm from normozoospermic donors, the respiratory control ratio increased by 36%, accompanied by a double oxygen consumption rate (OCR) in the presence of antimycin A. Extracellular hydrogen peroxide (H2 O2 ) detection was three times higher in CAP than in NC sperm cells. To confirm that H2 O2 production depends on mitochondrial superoxide ( ) formation, we evaluated mitochondrial aconitase (ACO2) amount, activity, and role in the metabolic flux from the sperm tricarboxylic acid cycle. We estimated that CAP cells produce, on average by individual, (59 ± 22)% more in the steady-state compared to NC cells. Finally, we analyzed two targets of oxidative stress: lipid peroxidation by western blot against 4-hydroxynonenal and succinate dehydrogenase (SDH) activity by HRR. We did not observe modifications in lipoperoxidation nor the activity of SDH, suggesting that during capacitation, the increase in mitochondrial H2 O2 production does not damage sperm and it is necessary for the normal CAP process.

Modelling the future climate impacts on hydraulic infrastructure development in tropical (peri-)urban region: Case of Kigali, Rwanda

The current global climate has shown a significant change, mostly resulting from human-induced activities. Frequent experiences of extreme rainstorms, deadly landslides, and floods followed by the destruction of roads, bridges, drainage, buildings, agriculture, and other infrastructures have been appearing across the globe along with extensive socio-economic effects including human lives losses whereby tropical Africa is among the greatly affected regions. Several studies in the region acclaim the increase of climate-related extremes due to a gradual climate variation. Hence, this study aimed to evaluate how existing water structures might respond to the future climate, which is getting more severe and frequent in the region. The study was conducted on the Nyabugogo River catchment (NRC), covering a huge part of the Kigali metropolitan area. It was carried out through a downscaled global climate model (CMIP6 GCM) projection coupled with a joint SWAT + hydrological model and HEC-RAS hydrodynamic simulation. The study showed that the annual precipitation in Kigali might keep increasing, resulting in increased risks of extreme weather events. The study identified up to 38% (+514.9 mm) annual precipitation increment, which resulted in more than a doubled flow rate (+28.0 m3/s) increment by the end of the century under a high greenhouse gas emission scenario (ssp585). As a result, hydrodynamic simulations revealed that the Bridge-1 in NRC might fail to accommodate the 50-year return peak storm under ssp585. Henceforth, there is a need to adopt high GHG emission scenarios in critical infrastructure development. Further, enforcing green-grey infrastructures in flood risk-low resilient areas is recommended to improve climate resilience. Thus, the results of this study might prove useful in climate-resilient infrastructure development and other pre-emptive adaptation practices, most importantly building anticipated resilience against climate-related hazards.

Improvement of cell transistors in high-k/metal-gate peripheral transistors technology for high-performance graphic memories

We investigated characteristics and reliabilities of cell transistors (Cell Tr) in graphics double data rate 7 (GDDR7) DRAM with high-k/metal gate (HKMG) peripheral transistors (Peri Tr), and we suggest the robust and reliable Cell Tr for the HKMG peripheral (Peri) scheme. In the latest graphic DRAMs, the HKMG Peri scheme is equipped to achieve the highest speed at the lowest power consumption, so the Cell Tr must operate stably at a lower driving voltage than other memories. Furthermore, the intrinsic properties of Cell Tr are negatively affected by the reduced thermal budget in the gate-first HKMG Peri scheme. In this paper, we propose a suitable Cell Tr to overcome the influence of the gate-first HKMG Peri scheme and the lowest driving voltage. In addition, we verify the segmental properties of node resistance in Cell Tr and the mechanism of the last data-in PRE command period (tRDL) degradation in graphic memories.

TRPS1 modulates chromatin accessibility to regulate estrogen receptor alpha (ER) binding and ER target gene expression in luminal breast cancer cells.

Common genetic variants in the repressive GATA-family transcription factor (TF) TRPS1 locus are associated with breast cancer risk, and luminal breast cancer cell lines are particularly sensitive to TRPS1 knockout. We introduced an inducible degron tag into the native TRPS1 locus within a luminal breast cancer cell line to identify the direct targets of TRPS1 and determine how TRPS1 mechanistically regulates gene expression. We acutely deplete over 80 percent of TRPS1 from chromatin within 30 minutes of inducing degradation. We find that TRPS1 regulates transcription of hundreds of genes, including those related to estrogen signaling. TRPS1 directly regulates chromatin structure, which causes estrogen receptor alpha (ER) to redistribute in the genome. ER redistribution leads to both repression and activation of dozens of ER target genes. Downstream from these primary effects, TRPS1 depletion represses cell cycle-related gene sets and reduces cell doubling rate. Finally, we show that high TRPS1 activity, calculated using a gene expression signature defined by primary TRPS1-regulated genes, is associated with worse breast cancer patient prognosis. Taken together, these data suggest a model in which TRPS1 modulates the genomic distribution of ER, both activating and repressing transcription of genes related to cancer cell fitness.

Electro-Nuclear Dynamics of Single and Double Ionization of H2 in Ultrafast Intense Laser Pulses.

We present an efficient method for modeling the single and double ionization dynamics of the H2 molecule in ultrashort, intense laser fields. This method is based on a semianalytical approach to calculate the time-dependent single and double molecular ionization rates and on a numerical approach to describe the vibrational motion that takes place in the intermediate molecular ion H2+. This model allows for the prediction of the single and double ionization probabilities of the H2 molecule to be made over a wide range of frequencies and laser intensities with limited computational time while providing a realistic estimate of the energy of the products of the dissociative ionization and of the Coulomb explosion of the H2 molecule. The effect of vibrational dynamics on ionization yields and proton kinetic energy release spectra is demonstrated and, in the case of the latter, is discussed in terms of basic strong-field molecular fragmentation mechanisms.

The Epidermal Growth Factor, Anaplastic Lymphoma Kinase, and ROS Proto-oncogene 1 Mutation Profile of Non-Small Cell Lung Carcinomas in the Turkish Population: A Single-Center Analysis.

The management of non-small cell lung carcinomas (NSCLC) has changed with the identification of molecular pathways. We aimed to reveal the 3-year epidermal growth factor (EGFR), anaplastic lymphoma kinase (ALK), and ROS proto-oncogene 1 (ROS1) mutation profile in the Turkish population. The histopathological and molecular data of all NSCLC cases from our department between May 2019 and April 2022 were evaluated. Molecular testing was performed in 197 NSCLC cases, and results were obtained in 182 (92.4%) (M/F: 144/38, aged 39-86). Of these, 121 were diagnosed with adenocarcinoma, 36 with squamous cell carcinoma, and 25 with NSCLC-not otherwise specified. The EGFR mutation was seen in 21 (11.5%) cases (6 exon 19 deletions, 3 exon 18 [all codon 719], 2 exon 20, 8 exon 21 point mutations, 1 concurrent exon 19 deletion and exon 20 codon 790 M point mutation, and 1 concurrent exon 19 deletion and exon 21 point mutation). The double mutation rate of EGFR was 1.1%. The mean age of these patients was 63.4 (40-79), with 24% of all females (n = 9) and 8.3% of all males (n = 12). The ALK mutation was detected in 6 (3.3%) patients (M/F: 4/2, aged 45-82), whereas the ROS1 mutation was detected in 3 (1.7%) (M/F: 2/1, aged 40-64). It is well established in the literature that EGFR-activating mutation rates vary depending on regions and ethnic groups. We concluded that the EGFR-activating mutation rates of the Turkish population are similar to the European molecular data instead of the Asian. The ALK and ROS1 mutation rates also seem concordant with the literature.

Could Children's Myopization Have Been Avoided during the Pandemic Confinement? The Conjunctival Ultraviolet Autofluorescence (CUVAF) Biomarker as an Answer.

The objective of this study was to evaluate the association of the presence of conjunctival ultraviolet autofluorescence (CUVAF) with the level and progression of myopia and the impact of reduced sunlight exposure during the COVID-19 pandemic confinement (PC). A retrospective observational study was carried out using three cohorts, children (9-17 years old), young adults (18-25 years old), and adults (>40 years old) with myopia (≤0.75D) and at least three annual eye examinations (before and after PC). All participants underwent an automatic objective refraction and CUVAF area analysis. All the participants filled out a questionnaire regarding lifestyle and myopia history. The 298 recruited participants showed that during the PC, children's and young adults' myopia progression rate increased on average by -0.50 and -0.30 D/year, respectively, compared with the pre-pandemic level (p < 0.0001 and p < 0.01). A significantly greater progression was observed in those with low baseline myopia compared to those with moderate or high myopia (p < 0.01). CUVAF shows its protective effect associated with outdoor activity (OA) with regard to the age of onset of myopia and mean diopters (p < 0.01). In fact, although there were no differences in the increase in diopters between children with and without CUVAF during the PC, those who had CUVAF started with lower gains (-0.3 D/year) compared to those who did not (-0.5 D/year; p < 0.05). The myopia treatments (atropine drops, Ortho-K, and MiSight® contact lenses) showed a reduction effect in myopic progression rate post-PC in comparison with non-treated children (p < 0.0001, p < 0.0001 and p < 0.01, respectively). The strict restriction of OA during PC led to the rate of myopia progression doubling among children and young adults. This progression occurred mainly in children with previously low myopia, and CUVAF, as a biomarker of OA, reflects its potential to provide benefits in the form of recommended behavioral changes to protect against the development of myopia.

Platelet Count Doubling after One Course of Demethylated Drug Therapeutic Predicts the Treatment Response and Efficacy of Patients with Myelodysplastic Syndrome

To investigate the predictive value of platelet doubling (platelet count doubling) after one course of hypomethylating agents (HMA) on the treatment response and efficacy of myelodysplastic syndrome (MDS). Clinical and pathological data of 75 patients who received HMA in our hospital from January 2017 to March 2022 were collected and analyzed. All patients were divided into two groups according to whether their platelet count doubled after one course of treatment, including platelet doubling group and non-doubling group, and statistical analysis was performed to compare the treatment response and efficacy between the two groups. In addition, platelet count changes were compared between azacitidine and decitabine therapy. Compared with the non-doubling platelet count group, the ORR of the doubling platelet group was significantly better after 3 courses of treatment (P =0.002), and there was a statistically significant difference in the number of HI between the two groups (P =0.005). In addition, the median survival time (MST) was 26 months in the platelet doubling group and 11 months in the non-doubling group (P =0.001). The overall survival (OS) and 1- and 2-year survival rates of the platelet doubling group were also significantly better than those of the non-doubing group. Multivariate COX analysis showed that platelet count doubling was an independent predictor of OS in MDS patients after 1 course of treatment (P =0.013). There was no significant difference in the response rate of platelet count doubling between MDS patients treated with azacitidine and decitabine (33.3% vs 23.8%, P >0.05). Platelet count doubling after one course of treatment can be used as a predictor of response rate and survival of demethylated drug therapy in MDS patients. In addition, there was no significant difference in the response rate of platelets in MDS patients treated with azacitidine or dicetabine.

Influenza and Covid-19 Vaccination in 2023: a descriptive analysis in two Italian Research and Teaching Hospitals. Is the On-Site strategy effective?

Vaccinations represent an extremely effective tool for the prevention of certain infectious diseases - such as influenza and COVID-19 -, particularly for those categories at risk due to both their frail condition or professional exposure, such as healthcare workers. The aim of this study is to describe the course of the anti-influenza and anti-COVID-19 vaccination campaign at two Research Hospitals in Milan, Italy. Multicentre, cross-sectional study. For the 2023-24 vaccination campaign, the two facilities opted for two different approaches. At the Hospital A, two dif-ferent strategies for vaccinating healthcare workers were implemented: a fixed-site vaccination clinic and two mobile vaccination groups run by Public Health residents of the University of Milan. At the Hospital B, on the other hand, a single fixed-site outpatient clinic run by Public Health residents of the University of Milan was used. On the occasion of the campaign, a survey was also carried out using anonymous online questionnaires to investigate healthcare workers attitudes towards vaccination. A total of 1,937 healthcare workers were vaccinated: 756 were immunized against influenza only, 99 against COVID-19 only, and 1,082 against both. The results show a substantial difference in vaccination adherence among medical and nursing staff compared to other professional categories. In particular, the category with the highest vaccination adhesion turned out to be that of medical doctors with 55.7% adhesion while, on the contrary, the category with the lowest adhesion turned out to be that of auxiliary personnel characterized by 7.4% adhesion. At the same time, the comparison between the two hospital facilities showed a double adherence rate by the staff of Hospital A as regards both the flu vaccine (40.6% and 20.1%) and the anti-COVID-19 vaccine (26.4% and 12.3%). Finally, the survey showed that the attitude towards influenza vaccination is lower among auxiliary staff in terms of both knowledge and vaccination attitude. The results of the study show a vaccination adherence in line with that of previous years, although lower than the values recommended by the principal national and international Organizations. The analysis of the differences between the two facilities and the surveys carried out will allow for the implementation of targeted interventions to increase adherence in future campaigns.