Earlier Measurements Research Articles

An updated chronology for Umbeli Belli and its implications for the Middle and Later Stone Ages

We present a series of 12 OSL/IRSL dates that revise and complete the chronology of the important Middle (MSA) and Later Stone Age (LSA) site Umbeli Belli in KwaZulu-Natal, South Africa. These dates shift the previous radiometric ages thousands of years older than earlier measurements and play a key role in revising the cultural stratigraphy of KwaZulu-Natal. We also discuss how these dates bring the chrono- and cultural stratigraphy of southern Africa into clearer focus. The Robberg sequence of Umbeli Belli is now firmly dated to 21 ± 2 ka, whereas the preceding Early LSA assemblage dates to ~32 ka, representing one of the earliest dates for this cultural expression in the broader region. The final MSA assemblages from Layer 7 to 9 now date to between 35 ka and 40 ka, overlapping more tightly with comparable assemblages from Sibhudu, Umhlatuzana and other sites. Layer 10, which was previously also assigned to the final MSA, now dates to ~47–54 ka, placing the assemblage within the temporal range of the Late MSA. The new dates provide a good explanation for the clear differences in material culture between Layer 10 and the younger layers. We also present two new ages for the deeper horizons 11b and 12 at Umbeli Belli, dating to 76 ± 9 ka and 80 ± 9 ka, respectively.

The current landscape of cancer treatment scenario in Bangladesh

The current cancer scenario in Bangladesh presents a significant public health challenge. Cancer is the second leading cause of death in the country, with approximately 150,000 new cases diagnosed and 108,000 deaths annually. Bangladesh is facing several critical issues regarding cancer treatment like the lack of a national cancer control strategy and comprehensive cancer screening system, resulting in most patients being diagnosed at advanced stages, which reduces the chances of successful treatment. Early detection and prevention measures are crucial, but efforts in these areas remain inadequate in Bangladesh.

Influencing factors and risk prediction model for emergence agitation after general anesthesia for primary liver cancer.

General anesthesia is commonly used in the surgical management of gastrointestinal tumors; however, it can lead to emergence agitation (EA). EA is a common complication associated with general anesthesia, often characterized by behaviors, such as crying, struggling, and involuntary limb movements in patients. If treatment is delayed, there is a risk of incision cracking and bleeding, which can significantly affect surgical outcomes. Therefore, having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia, which is beneficial for improving patient prognosis. To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer. Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital (January 2020 to December 2023) was conducted. Post-surgery, the Richmond Agitation-Sedation Scale was used to evaluate EA presence, noting EA incidence after general anesthesia. Patients were categorized by EA presence postoperatively, and the influencing factors were analyzed using logistic regression. A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves. EA occurred in 51 (25.5%) patients. Multivariate analysis identified advanced age, American Society of Anesthesiologists (ASA) grade III, indwelling catheter use, and postoperative pain as risk factors for EA (P < 0.05). Conversely, postoperative analgesia was a protective factor against EA (P < 0.05). The area under the curve of the nomogram was 0.972 [95% confidence interval (CI): 0.947-0.997] for the training set and 0.979 (95%CI: 0.951-1.000) for the test set. Hosmer-Lemeshow test showed a good fit (χ 2 = 5.483, P = 0.705), and calibration curves showed agreement between predicted and actual EA incidence. Age, ASA grade, catheter use, postoperative pain, and analgesia significantly influence EA occurrence. A nomogram constructed using these factors demonstrates strong predictive accuracy.

Early postoperative growth hormone measurement as a predictive marker for acromegaly remission.

Growth hormone (GH) has a short half-life and declines abruptly following somatotropinoma surgery, enabling its prompt measurement as an indicator of surgical success. This study assesses the predictive value of early postoperative GH levels for 3-month and >1-year remission of acromegaly. We conducted a retrospective search in our database of patients who had undergone transsphenoidal surgery of GH-secreting pituitary adenoma from January 2011 to June 2022. Only the patients who underwent the first pituitary surgery and had GH measurements on the fifth postoperative day were included. The 3-month and >1-year remission of acromegaly was defined as achieving the GH nadir of <0.4 μg/L during an oral glucose tolerance test and maintaining normal insulin-like growth factor 1 levels at the initial follow-up visit 3 months after surgery and throughout at least the first year postoperation. We included 63 patients in the analysis, with a median follow-up of 51.8 (13-155) months. The 3-month remission was achieved in 42 (66.7%) patients, and >1-year remission without additional therapy in 38 (60.3%) patients. Those who achieved >1-year remission had significantly lower fifth-day postoperative GH levels (0.59 [0.09-8.92] vs. 2.63 [0.25-24.64] μg/L, p < .001). Receiver-operating characteristic analysis revealed a significant value of fifth-day postoperative GH levels regarding the prediction of 3-month (area under the curve [AUC], 0.834; p < .0001) and >1-year (AUC, 0.783; p < .0001) acromegaly remission. The GH threshold of ≤1.57 μg/L yielded a sensitivity of 90.5% and a specificity of 71.4% at 3 months and 89.5% sensitivity and 60% specificity at the >1-year remission, respectively. Notably, all patients with fifth-day postoperative GH levels ≤0.23 μg/L exhibited remission of acromegaly throughout the follow-up period. Early postoperative GH measurement could be a reliable predictor of both 3-month and >1-year remission of acromegaly.

Development of a Multidisciplinary Care Pathway for Fracture Prevention in Men with Prostate Cancer at Initiation of Androgen Deprivation Therapy.

Fracture risk is increased in men with prostate cancer (PCa) receiving Androgen Deprivation Therapy (ADT). However, routine assessment of fracture risk is often not systematically applied. We aimed to establish a comprehensive care pathway for fracture prevention in men with PCa starting ADT. Therefore, a multidisciplinary working group designed and implemented a care pathway using the 'Knowledge to Action' framework, based on current Dutch guidelines for PCa, osteoporosis and fracture prevention, and an extensive literature review of other guidelines. The pathway was developed according to a five-step clinical approach including case finding, fracture risk assessment based on risk factors, bone mineral density test, vertebral fracture assessment, differential diagnosis, treatment, and annual follow-up. Our fracture prevention care pathway for patients with PCa at the time of ADT initiation was designed to promote a patient-centered, multidisciplinary approach to facilitate the implementation of early fracture prevention measures.

The impact of vitamin D status on lipid profiles and atherogenic dyslipidemia markers in children and adolescents with obesity

Background and aimAdequate serum vitamin D levels correlate with a more favorable lipid profile compared to deficient levels. Despite the well-established prevalence of vitamin D deficiency in children with obesity, studies investigating its influence on lipid profiles in this population are scarce. We explored the impact of vitamin D status on lipid profiles and markers of atherogenic dyslipidemia in a cohort of children and adolescents with obesity. Methods and resultsA total of 271 Caucasian children and adolescents with overweight/obesity and a control group of 54 pediatric patients with normal weight. All participants underwent outpatient visits for the assessment of clinical parameters and venous blood collection for biochemical analysis such as triglycerides (TG)/HDL-C ratio, LDL-C/HDL-C ratio, atherogenic index of plasma AIP), vitamin D level.Individuals with obesity displayed severe vitamin D deficiency (25-OH-D ≤10 ng/ml) at a higher frequency compared to those with normal weight (p = 0.03). In patients with overweight/obesity and low 25-OH-D levels show higher values of glycemia (p = 0.001), insulin resistance (HOMA-IR and TRYG p < 0.001), TG (p < 0.001), TG/HDL-C (p = 0.001), AIP (p < 0.001), SBP (p = 0.01), and DBP (p = 0.04). In normal-weight individuals with low 25-OH- D levels an increased values of glycemia (p = 0.01), insulin resistance (HOMA-IR p = 0.01 and TRYG p = 0.002), TG (p = 0.01), TG/HDL-C (p = 0.02), AIP (p = 0.01). A direct correlation between 25-OH-D levels and metabolic parameters is observed. ConclusionsA correlation between vitamin D levels and the lipid/atherosclerotic profile was recorded. Vitamin D deficiency may represent a preventable and easily treatable cardiometabolic risk factor, emphasizing the importance of early intervention and preventive measures.

Cosmological test of dark energy parametrizations within the framework of Horava-Lifshitz gravity via baryon acoustic oscillation

We conduct an investigation to explore late-time cosmic acceleration through various dark energy parametrizations (Wettrich, Efstathiou, and Ma-Zhang) within the Horava-Lifshitz gravity framework. As an alternative to general relativity, this theory introduces anisotropic scaling at ultraviolet scales. Our primary objective is to constrain the key cosmic parameters and baryon acoustic oscillation (BAO) scale, specifically the sound horizon (rd ), by utilizing 24 uncorrelated measurements of BAOs derived from recent galaxy surveys spanning a redshift range from z = 0.106 to z = 2.33. Additionally, we integrate the most recent Hubble constant measurement by Riess in 2022 (denoted as R22) as an extra prior. For the parametrizations of Wettrich, Efstathiou, and Ma-Zhang, our analysis of BAO data yields sound horizon results of rd = 148.1560 ± 2.7688 Mpc, rd = 148.6168 ± 10.2469 Mpc, and rd = 147.9737 ± 10.6096 Mpc, respectively. Incorporating the R22 prior into the BAO dataset results in rd = 139.5806 ± 3.8522 Mpc, rd = 139.728025 ± 2.7858 Mpc, and rd = 139.6001 ± 2.7441 Mpc. These outcomes highlight a distinct inconsistency between early and late observational measurements, analogous to the H 0 tension. A notable observation is that, when we do not include the R22 prior, the outcomes for rd tend to be in agreement with Planck and SDSS results. Following this, we conducted a cosmography test and comparative study of each parametrization within the Lambda Cold Dark Matter paradigm. Our diagnostic analyses demonstrate that all models fit seamlessly within the phantom region. All dark energy parametrizations predict an equation of state parameter close to = –1, indicating a behavior similar to that of a cosmological constant. The statistical analysis indicates that neither of the two models can be ruled out based on the latest observational measurements.

Neutron spectrum measurements near KAMINI reactor south beam vault door using nested neutron spectrometer.

KAlpakkam MINI reactor (KAMINI) is a 233U fuelled research reactor has various neutron irradiation locations for experimental purposes. The pit at the south beam end of KAMINI reactor is being extensively utilised for neutron attenuation experiments in prospective shielding materials as well as for neutron radiography. During reactor operation, it will be closed by a movable shield. A vault door is located above the shield and the movable shield is used to attenuate streaming neutrons and gamma-rays during reactor operation. Even with the shield, there exists significant dose because of streaming neutrons and gamma rays. Its variation depends on the power of the reactor. The neutron and gamma dose rates close to the south beam vault door have recently been found to be 275-300μSv/h and 175-200μSv/h, respectively, when the reactor is operating at 10kW. In order to characterise the streaming neutron spectra of vault door place for the first time, measurements are done using the Nested Neutron Spectrometer. Along with the neutron flux, neutron mean energy and ambient dose-equivalent rate are also measured and compared with earlier measurements carried out inside the south beam pit. It is observed that the presence of paraffin shield reduces the neutron average energy from 370 to 178keV. Apart from energy reduction, 10kW normalised neutron flux of south beam pit is also attenuated by the shield by 25000 times and it is found that the neutron spectrum of the measured location is also more thermalized. Neutron reference data of the location are generated.

Prognostic value of serum high-mobility group box 1 in neonates with neonatal encephalopathy.

This study aimed to investigate the diagnostic potential of serum high-mobility group box 1 (HMGB1) in neonatal encephalopathy (NE). A retrospective study was conducted, analyzing 216 neonates diagnosed with NE. The neonates were divided into two groups based on their outcomes at 28 days. Serum HMGB1 levels were compared between the two groups. ROC analysis was used to determine the predictive value of HMGB1. At 28 days, 174 infants had a good prognosis, while 42 had a poor prognosis. Infants with a poor prognosis had higher serum HMGB1 concentrations within 24 h of birth. Multifactorial analysis revealed that extremely preterm birth, extremely low birth weight, an Apgar score of 0-3 at 5 min, premature rupture of membranes by the mother, moderate to severe NE, and serum HMGB1 > 6.14 ng/mL are independent risk factors for poor prognosis. HMGB1 has predictive value for short-term prognosis with an area under the curve of 0.79. Elevated HMGB1 levels in the acute phase of NE are associated with poor short-term neonatal outcomes. The decrease in HMGB1 concentrations over time correlates with a good prognosis; whereas an increase suggests a poor prognosis. Early measurement of serum HMGB1 could aid in the prognostic assessment of neonates with NE. Although serum HMGB1 has emerged as a potential predictor of neonatal outcomes in neonatal encephalopathy, the relationship of HMGB1 levels to neonatal encephalopathy severity remains unclear. The current results demonstrate that infants with a poor prognosis had higher serum HMGB1 concentrations within 24 h of birth. Importantly, elevated serum HMGB1 levels in the acute phase of neonatal encephalopathy are associated with poor short-term neonatal outcomes. Our findings reveal the clinical values of HMGB1 in the prediction of neonatal outcomes in NE patients.

Observational study of missing SOFA score data frequency in RCTs relative to ICU length of stay

The Sequential Organ Failure Assessment, also known as SOFA score, was introduced to assess organ dysfunction of critical ill patients. However, understanding the impact of missing SOFA scores in randomized controlled trials and how this affect the validity and applicability of the SOFA score as a surrogate endpoint for predicting mortality has been a matter of interest. To address this, a secondary analysis of a systematic review was conducted to quantify the relationship between SOFA scores and the prediction of mortality in critically ill adults in randomized controlled trials (RCTs). The systematic review being referred to included 87 RCTs with a total of 12,064 critically ill patients. This analysis focused on missing SOFA score data in relation to the length of stay on the intensive care unit (ICU) and the methods used to handle missing data. SOFA score measurements from the included studies were categorized into three time frames: Early (t ≤ 4 days), Intermediate (t = 5–10 days) and Late (t > 10 days) measurement. Only one study reported a complete data set for calculating the SOFA score for an Early measurement. When considering all methods used to address missing data, 32% of studies still had missing data for Early measurements, and this percentage increased to 64% for Late measurements. These findings suggested that, over time, the number of studies with incomplete data sets has been increasing. The longer a patient is treated on the ICU, the higher the number of missing data which can impact the validity of SOFA score analyses. There was no clear trend towards a specific method for compensating missing data. An exemplary calculation demonstrated that ignoring missing data may lead to an underestimated variability of the treatment effect. This, in turn, could bias the interpretation of study results by policy- and clinical decision-makers. Overall, there are several limitations that need to be considered when using SOFA score as a surrogate endpoint for mortality. When employed as an outcome, the SOFA score is frequently missing and most studies do not adequately describe the amount or nature of missing data, or the methods used to handle missing data in the analysis.

Swedish teacher conceptions of assessment: a focus on improving outcomes

ABSTRACT Understanding teachers’ conceptions of assessment is a key objective in supporting assessment practices that lead to improved learning outcomes. Thus, inventories capable of identifying teachers’ assessment conceptions are important. The Teachers Conceptions of Assessment (TCoA) inventory was an early and influential measure of teacher assessment conceptions, but replication studies have shown that the model may be affected by policy and practice context. In the present study, a Swedish adaptation of the TCoA was administered twice, 18 months apart. A sample of 249 teachers were matched across the 2 time-points and their self-reported scores were analysed with confirmatory factor analysis and invariance testing. With good correspondence to the data, six of the nine factors in the TCoA were completely replicated and one factor was partially replicated. The model had sufficient similarity between time points to permit mean score comparisons, which were largely equivalent between times. The study indicates that the Swedish Teacher Conceptions of Assessment adaptation can be used reliably in Swedish primary and lower secondary schools as measure of teacher conceptions of the uses of assessment.

Genetically predicted 1091 blood metabolites and 309 metabolite ratios in relation to risk of type 2 diabetes: a Mendelian randomization study.

Metabolic dysregulation represents a defining characteristic of Type 2 diabetes (T2DM). Nevertheless, there remains an absence of substantial evidence establishing a direct causal link between circulating blood metabolites and the promotion or prevention of T2DM. In addressing this gap, we employed Mendelian randomization (MR) analysis to investigate the potential causal association between 1,091 blood metabolites, 309 metabolite ratios, and the occurrence of T2DM. Data encompassing single-nucleotide polymorphisms (SNPs) for 1,091 blood metabolites and 309 metabolite ratios were extracted from a Canadian Genome-wide association study (GWAS) involving 8,299 participants. To evaluate the causal link between these metabolites and Type 2 diabetes (T2DM), multiple methods including Inverse Variance Weighted (IVW), Weighted Median, MR Egger, Weighted Mode, and Simple Mode were employed. p-values underwent correction utilizing False Discovery Rates (FDR). Sensitivity analyses incorporated Cochran's Q test, MR-Egger intercept test, MR-PRESSO, Steiger test, leave-one-out analysis, and single SNP analysis. The causal effects were visualized via Circos plot, forest plot, and scatter plot. Furthermore, for noteworthy, an independent T2DM GWAS dataset (GCST006867) was utilized for replication analysis. Metabolic pathway analysis of closely correlated metabolites was conducted using MetaboAnalyst 5.0. The IVW analysis method utilized in this study revealed 88 blood metabolites and 37 metabolite ratios demonstrating a significant causal relationship with T2DM (p < 0.05). Notably, strong causal associations with T2DM were observed for specific metabolites: 1-linoleoyl-GPE (18:2) (IVW: OR:0.930, 95% CI: 0.899-0.962, p = 2.16 × 10-5), 1,2-dilinoleoyl-GPE (18:2/18:2) (IVW: OR:0.942, 95% CI: 0.917-0.968, p = 1.64 × 10-5), Mannose (IVW: OR:1.133, 95% CI: 1.072-1.197, p = 1.02 × 10-5), X-21829 (IVW: OR:1.036, 95% CI: 1.036-1.122, p = 9.44 × 10-5), and Phosphate to mannose ratio (IVW: OR:0.870, 95% CI: 0.818-0.926, p = 1.29 × 10-5, FDR = 0.008). Additionally, metabolic pathway analysis highlighted six significant pathways associated with T2DM development: Valine, leucine and isoleucine biosynthesis, Phenylalanine metabolism, Glycerophospholipid metabolism, Alpha-Linolenic acid metabolism, Sphingolipid metabolism, and Alanine, aspartate, and glutamate metabolism. This study identifies both protective and risk-associated metabolites that play a causal role in the development of T2DM. By integrating genomics and metabolomics, it presents novel insights into the pathogenesis of T2DM. These findings hold potential implications for early screening, preventive measures, and treatment strategies for T2DM.

Model-informed drug development of envafolimab, a subcutaneously injectable PD-L1 antibody, in patients with advanced solid tumors.

Envafolimab is the first and only globally approved subcutaneously injectable PD-L1 antibody for the treatment of instability-high (MSI-H) or DNA mismatch repair deficient (dMMR) advanced solid tumors in adults, including those with advanced colorectal cancer that has progressed after treatment with a fluoropyrimidine, oxaliplatin, and irinotecan. The aim of this investigation was to examine the pharmacokinetic and exposure-response (E-R) profile of envafolimab in patients with solid tumors to support the approval of fixed and alternative dose regimens. In this study, a population pharmacokinetic (PopPK) modeling approach will be employed to quantitatively evaluate intrinsic and extrinsic covariates. Additionally, PopPK-estimated exposure parameters were used to evaluate E-R relationship for safety and efficacy to provide a theoretical basis for recommending optimal treatment regimens. Simulations were performed on the dosing regimens of body weight-based regimen of 2.50 mg/kg QW, fixed dose 150 mg QW, and 300 mg Q2W for the selection of alternative dosing regimens. Data from 4 clinical studies (NCT02827968, NCT03101488, NCT03248843, and NCT03667170) were utilized. The PopPK dataset comprised 182 patients with 1810 evaluable envafolimab concentration records. Finally, a one-compartment model incorporating first-order absorption, first-order linear elimination, and time-dependent elimination according to an Emax function was found to accurately describe the concentration-time data of envafolimab in patients with advanced solid tumors. Creatinine clearance and country were identified as statistically significant factors affecting clearance, but had limited clinical significance. A relative flat exposure-response relationship was observed between early measures of safety and efficacy to verify that no dose adjustment is required. Simulation results indicated that 2.50 mg/kg QW, 150 mg QW, and 300 mg Q2W regimen yield similar steady-state exposure. No statistically significant difference was observed between weight-based and fixed dose regimens. Model-based simulation supports the adoption of a 150 mg weekly or 300 mg biweekly dosing regimen of envafolimab in the solid tumor population, as these schedules effectively balance survival benefits and safety risks.

The role of lexical and prosodic characteristics of mothers' child-directed speech for the early vocabulary development of Italian children with cochlear implants.

Variability in the vocabulary outcomes of children with cochlear implants (CIs) is partially explained by child-directed speech (CDS) characteristics. Yet, relatively little is known about whether and how mothers adapt their lexical and prosodic characteristics to the child's hearing status (before and after implantation, and compared with groups with normal hearing (NH)) and how important they are in affecting vocabulary development in the first 12 months of hearing experience. To investigate whether mothers of children with CIs produce CDS with similar lexical and prosodic characteristics compared with mothers of age-matched children with NH, and whether they modify these characteristics after implantation. In addition, to investigate whether mothers' CDS characteristics predict children's early vocabulary skills before and after implantation. A total of 34 dyads (17 with NH, 17 with children with CIs; ages = 9-32 months), all acquiring Italian, were involved in the study. Mothers' and children's lexical quantity (tokens) and variety (types), mothers' prosodic characteristics (pitch range and variability), and children's vocabulary skills were assessed at two time points, corresponding to before and 1 year post-CI activation for children with CIs. Children's vocabulary skills were assessed using parent reports; lexical and prosodic characteristics were observed in semi-structured mother-child interactions. Results showed that mothers of children with CIs produced speech with similar lexical quantity but lower lexical variety, and with increased pitch range and variability, than mothers of children with NH. Mothers generally increased their lexical quantity and variety and their pitch range between sessions. Children with CIs showed reduced expressive vocabulary and lower lexical quantity and variety than their peers 12 months post-CI activation. Mothers' prosodic characteristics did not explain variance in children's vocabulary skills; their lexical characteristics predicted children's early vocabulary and lexical outcomes, especially in the NH group, but were not related to later language development. Our findings confirm previous studies on other languages and support the idea that the lexical characteristics of mothers' CDS have a positive effect on children's early measures of vocabulary development across hearing groups, whereas prosodic cues play a minor role. Greater input quantity and quality may assist children in the building of basic language model representations, whereas pitch cues may mainly serve attentional and emotional processes. Results emphasize the need for additional longitudinal studies investigating the input received from other figures surrounding the child and its role for children's language development. What is already known on the subject Mothers' CDS is thought to facilitate and support language acquisition in children with various language developmental trajectories, including children with CIs. Because children with CIs are at risk for language delays and have acoustic processing limitations, their mothers may have to produce a lexically simpler but prosodically richer input, compared to mothers of children with NH. Yet, the literature reports mixed findings and no study to our knowledge has concurrently addressed the role of mothers' lexical and prosodic characteristics for children's vocabulary development before implantation and in the first 12 months of hearing experience. What this study adds to the existing knowledge The study shows that mothers of children with CIs produce input of similar quantity but reduced variety, and with heightened pitch characteristics, compared to mothers of children with NH. There was also a general increase in mothers' lexical quantity and variety, and in their pitch range, between sessions. Only their lexical characteristics predicted children's early vocabulary skills. Their lexical variety predicted children's expressive vocabulary and lexical variety only in the NH group. What are the practical and clinical implications of this work? These findings expand our knowledge about the effects of maternal input and may contribute to the improvement of early family-centred intervention programmes for supporting language development in children with CIs.

Machine learning opportunities to predict obstetric haemorrhages

Obstetric hemorrhages (OH) are the main preventable cause of morbidity, mortality and cases of "near miss" among obstetric complications worldwide. Early preventive measures based on the OH prediction allow to profoundly reduce the rate of female mortality and morbidity as well as prevent the economic costs of patient intensive care, blood transfusion, surgical treatment and long-term hospitalization. Postpartum haemorrhage (PPH) is the most frequent obstetric haemorrhage determined by one of the four causes: a uterine tonus disorder, maternal birth trauma, retention of placenta parts and blood-clotting disorder. There is still a need for the continued search for an accurate and reliable prediction method despite multiple attempts to develop an effective system for predicting OH. The solution to this may be reasonably considered an innovative method such as artificial intelligence (AI) including computer technologies capable of obtaining conclusions similar to human thinking. One of the particular AI variants is presented by machine learning (ML), which develops accurate predictive models using computer analysis. Machine learning is based on computer algorithms, the most common among them in medicine are the decision tree (DT), naive Bayes classifier (NBC), random forest (RF), support vector machine (SVM), artificial neural network (ANNs), deep neural network (DNN) or deep learning (DL) and convolutional neural network (CNN). Here, we review the main stages of ML, the principles of algorithms action, and the prospects for using AI to predict OH in real-life clinical practice.

O-203 Comparing viable and non-viable IVF early pregnancy measurements: does knowledge of gestational age using date of ET potentially change miscarriage diagnosis guidelines in IVF patients

Abstract Study question In IVF pregnancies with known embryo transfer (ET) dates, can gestational age as well as ultrasound measurements be used to diagnose miscarriage? Summary answer Early pregnancy measurements vary at fixed gestational ages based on ET. However, there is a specific time cut-off where an empty gestational sac indicates miscarriage. What is known already Current guidelines state that when ultrasound findings show a pregnancy of unknown viability, a repeat scan must be performed either 7 or 14 days later (depending on the presence of an embryo or gestation sac size) to confirm viability, irrespective of the LMP based gestational age. This definition only considers ultrasound measurements, and even when the pregnancy dates thought to be certain and based on day of ET date, there are no exceptions to this guidance. Study design, size, duration This was a retrospective cohort study within a London tertiary unit, Wolfson Clinic, Hammersmith Hospital, Imperial College Healthcare NHS Trust over a 36-month time period. We collated data from both fresh and frozen cycle IVF pregnancies over four years: Jan 1st 2019 to December 31st 2021. Participants/materials, setting, methods In this unit, patients undergoing fresh or frozen IVF cycles, have an embryo transfer at Day3-6 of development. We included any patient with a confirmed intrauterine pregnancy at first scan (5-8 weeks gestation) for analysis of pregnancy outcomes. The data collected included date of embryo transfer (ET), embryo age at transfer, and early pregnancy measurements using ultrasound. The endpoint was viability at the 11-14 week dating scan. Main results and the role of chance 1161 IVF embryo transfers were included in the study, 677 (58.3%) frozen and 484 (41.7%) fresh cycles. 892 (76.8%) remained viable at 11-14 weeks and 269 (23.2%) were non-viable. Pregnancies resulting in viable pregnancies had a range of CRL (≤16mm) and empty mean gestation sac diameter (MSD) (≤11mm) measurements at each expected age by ET date (≤8 weeks gestation). At 49 days CRL varied from 1mm to 17mm, and at 42 days empty MSD measurements varied from 7 to 18mm. This shows that a range in embryo and gestation sac sizes will be seen in subsequently shown to be viable pregnancies despite the apparent exact gestation being known based on ET. This may relate to both differing embryo growth rates and timing of implantation. A Kolmogorov-Smirnov test was applied to compare the viable and miscarriage cohort CRL measurements in relation to expected age by ET. The result: 0.610, p-value=1.33 x10-15, demonstrated a significant difference in embryo size between viable and non-viable pregnancies with known ET dates. All pregnancies where the scan showed an empty gestational sac (n = 157) at 47 days gestation by ET date, had a 100% positive predictive value with a 100% specificity (CI:90.1-100.0) for miscarriage. Limitations, reasons for caution The sample was powered to 0.9, significance level 0.05. Analysis demonstrated 100% positive predictive value with 100% specificity (CI:90.1-100.0), to confirm miscarriage with an empty gestation sac ≥47days age by ET date. A larger cohort size from different centres is needed to reduce the confidence interval and confirm the findings. Wider implications of the findings There is significant variation in CRL and MSD size between viable pregnancies of the same gestational age by ET. However, we found &amp;gt;47 days gestation an empty gestation sac resulted in miscarriage. If confirmed in larger studies this may permit women to be given an earlier definitive diagnosis of miscarriage. Trial registration number Audit registration GRM_104 Imperial Healthcare NHS Trust

Emotion processing in concrete and abstract words: evidence from eye fixations during reading

ABSTRACT We replicated and extended the findings of Yao et al. [(2018). Differential emotional processing in concrete and abstract words. Journal of Experimental Psychology: Learning, Memory, and Cognition, 44(7), 1064–1074] regarding the interaction of emotionality, concreteness, and imageability in word processing by measuring eye fixation times on target words during normal reading. A 3 (Emotion: negative, neutral, positive) × 2 (Concreteness: abstract, concrete) design was used with 22 items per condition, with each set of six target words matched across conditions in terms of word length and frequency. (e.g. shocking, reserved, fabulous) and concrete (e.g. massacre, calendar, treasure) target words appeared (separately) within contextually neutral, plausible sentences. Sixty-three participants each read all 132 experimental sentences while their eye movements were recorded. Analyses using Gamma generalised linear mixed models revealed significant effects of both Emotion and Concreteness on all fixation measures, indicating faster processing for emotional and concrete words. Additionally, there was a significant Emotion × Concreteness interaction which, critically, was modulated by Imageability in early fixation time measures. Emotion effects were significantly larger in higher-imageability abstract words than in lower-imageability ones, but remained unaffected by imageability in concrete words. These findings support the multimodal induction hypothesis and highlight the intricate interplay of these factors in the immediate stages of word processing during fluent reading.

Prognostic Value of Systemic Arterial Lactate Levels in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract Background Acute myocardial infarction is the most severe manifestation of coronary artery disease, which causes more than 2.4 million deaths in the USA, more than 4 million deaths in Europe and northern Asia, and more than a third of deaths in developed nations annually. Objective To assess the prognostic value of systemic arterial lactate levels in patients with ST segment elevation myocardial infarction undergoing primary PCI and correlate with the results of primary PCI and 30 days MACE follow up. Patients and Methods This study included 300 patients who presented with documented STEMI and underwent reperfusion by successful primary PCI in Ain Shams University hospitals. Results There was statistically significant positive correlation found between serum lactate and (WBCs) count, (HbA1C) level and cardiac enzymes (CKtotal - CKmb – troponin) and negative correlation found between serum lactate and ejection fraction in echocardiography. Also, we found that other parameters were associated with MACE follow up in 30 days such as Killip class at admission, ST segment elevation resolution, heart block in ECG, lower ejection fraction, dyslipidemia, post-procedure TIMI flow, peri-procedural time intervals and occurrence of complications. Conclusion The value of an early lactate measurement in patients with STEMI is to be a part of the risk stratification of these patients and intensified medical care should be considered to patients with strongly elevated lactate levels. Also, increasing arterial lactate levels were associated with occurrence of MACE in 30 days, worse hemodynamics, lower ejection fraction in echocardiography, higher HbA1C level, large infarct area (cardiac biomarkers peak level), poor post-procedure TIMI flow and thrombus grade.

Cosmological constraints from the eBOSS Lyman-α forest using the PRIYA simulations

We present new cosmological parameter constraints from the eBOSS Lyman-α forest survey. We use a new theoretical model and likelihood based on the PRIYA simulation suite. PRIYA is the first suite to resolve the Lyman-α forest in a (120 Mpc/h)3 volume, using a multi-fidelity emulation technique. We use PRIYA to predict Lyman-α forest observables with ≲ 1% interpolation error over an 11 dimensional (9 simulated, 2 in post-processing) parameter space. We identify an internal tension within the flux power spectrum data. Once the discrepant data is removed, we find the primeval scalar spectral index measured at a pivot scale of k 0 = 0.78 Mpc-1 to be nP = 1.009+0.027 -0.018 at 68% confidence. This measurement from the Lyman-α forest flux power spectrum alone is in reasonable agreement with Planck, and in tension with earlier eBOSS analyses. The amplitude of matter fluctuations is σ 8 = 0.733+0.026 -0.029 at 68% confidence, in agreement with Dark Energy Survey weak lensing measurements and other small-scale structure probes and in tension with CMB measurements from Planck and ACT. The effective optical depth to Lyman-α photons from our pipeline is in good agreement with earlier high resolution measurements. We find a linear power at z = 3 and k = 0.009 s/km of Δ2 L = 0.302+0.024 -0.027 with a slope n eff = -2.264+0.026 -0.018. Our flux power spectrum only chains prefer a low level of heating during helium reionization. When we add IGM temperature data we find nP = 0.983 ± 0.020 and σ 8 = 0.703+0.023 -0.027. Our chains prefer an early and long helium reionization event, as suggested by measurements from the helium Lyman-α forest. In the near future we will use our pipeline to infer cosmological parameters from the DESI Lyman-α data.

Animal Models of Helicobacter pylori Infection and Vaccines: Current Status and Future Prospects.

Helicobacter pylori infection causes chronic gastritis, ulcers, and gastric cancer, making it a threat to human health. Despite the use of antibiotic therapy, the global prevalence of H. pylori infection remains high, necessitating early eradication measures. Immunotherapy, especially vaccine development, is a promising solution in this direction, albeit the selection of an appropriate animal model is critical in efficient vaccine production. Accordingly, we conducted a literature, search and summarized the commonly used H. pylori strains, H. pylori infection-related animal models, and models for evaluating H. pylori vaccines. Based on factors such as the ability to replicate human diseases, strain compatibility, vaccine types, and eliciting of immune responses, we systematically compared the advantages and disadvantages of different animal models, to obtain the informed recommendations. In addition, we have proposed novel perspectives on H. pylori-related animal models to advance research and vaccine evaluation for the prevention and treatment of diseases such as gastric cancer.