Established Strategy Research Articles

Dispelling the L\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\sqrt{\\mathcal {L}} $$\\end{document} myth for the High-Luminosity LHC

Extrapolations of sensitivity to new interactions and standard model parameters critically inform the programme at the Large Hadron Collider (LHC) and potential future collider cases. To this end, statistical considerations based on inclusive quantities and established analysis strategies typically give rise to a sensitivity scaling with the square root of the luminosity, L\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\sqrt{\\mathcal {L}}$$\\end{document}. This suggests only a mild sensitivity improvement for LHC’s high-luminosity phase, compared to the collected data up to the year 2025. We discuss representative analyses in top quark, Higgs boson and electroweak gauge boson phenomenology and provide clear evidence that the assumption that the sensitivity in searches and measurement scales only with L\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\sqrt{\\mathcal {L}}$$\\end{document} at the High-Luminosity LHC is overly conservative at best, and unrealistic in practice. As kinematic coverage enables more targeted search strategies with sufficient statistical sensitivity, employing a multitude of features in data dispels the scaling based on more inclusive selections.

On symmetry adapted bases in trigonometric optimization

The problem of computing the global minimum of a trigonometric polynomial is computationally hard. We address this problem for the case, where the polynomial is invariant under the exponential action of a finite group. The strategy is to follow an established relaxation strategy in order to obtain a converging hierarchy of lower bounds. Those bounds are obtained by numerically solving semi-definite programs (SDPs) on the cone of positive semi-definite Hermitian Toeplitz matrices, which is outlined in the book of Dumitrescu Dumitrescu (2007). To exploit the invariance, we show that the group has an induced action on the Toeplitz matrices and prove that the feasible region of the SDP can be restricted to the invariant matrices, whilst retaining the same solution. Then we construct a symmetry adapted basis tailored to this group action, which allows us to block-diagonalize invariant matrices and thus reduce the computational complexity to solve the SDP.The approach is in its generality novel for trigonometric optimization and complements the one that was proposed as a poster at the ISSAC 2022 conference Hubert et al. (2022) and later extended to Hubert et al. (2024). In the previous work, we first used the invariance of the trigonometric polynomial to obtain a classical polynomial optimization problem on the orbit space and subsequently relaxed the problem to an SDP. Now, we first make the relaxation and then exploit invariance.Partial results of this article have been presented as a poster at the ISSAC 2023 conference Metzlaff (2023).

Food waste reduction, corporate responsibility and national policies: evidence from Europe

PurposeThis paper investigates strategies for addressing the global challenge of food loss and waste (FLW) within the food industry. It examines the relationship between corporate social responsibility (CSR) initiatives and state regulatory interventions for reducing FLW.Design/methodology/approachThis mixed method study utilizes a unique panel dataset which includes the 150 largest food industry companies in Italy, Norway and the UK. It combines quantitative data analysis with qualitative insights derived from corporate strategies and corporate communications.FindingsThe analysis reveals that food companies with an established CSR strategy and in particular companies whose CSR reports highlight their environmental and social achievements are more likely to achieve in effective FLW reduction. Additionally, national-level regulatory interventions guided by European Union waste strategies act as pivotal benchmarks and encourage stricter corporate food waste management policies.Practical implicationsThis research underscores the significance of CSR strategies and effective state regulation in the fight against FLW and offers policymakers and businesses valuable insights enabling development of robust strategies.Social implicationsBy emphasizing the interplay between CSR and regulatory intervention, this research contributes to the achievement of a more sustainable and efficient global food system that addresses both economic and ethical concerns and could have far-reaching societal and environmental implications.Originality/valueThe paper sheds light on the interplay between CSR initiatives and regulatory interventions for tackling FLW and emphasizes their synergistic impact on sustainable practices within the food industry.

Effect of rehabilitation on renal outcomes after acute kidney injury associated with cardiovascular disease: a retrospective analysis

BackgroundAcute kidney injury (AKI) incidence is extremely high worldwide, and patients who develop AKI are at increased risk of developing chronic kidney disease (CKD), CKD progression, and end-stage kidney disease (ESKD). However, there is no established treatment strategy for AKI. Based on the idea that exercise has a stabilizing effect on hemodynamics, we hypothesized that rehabilitation would have beneficial renal outcomes in patients with AKI associated with cardiovascular disease. Therefore, the purpose of this study was to determine whether rehabilitation can stabilize hemodynamics and positively impact renal outcomes in patients with AKI associated with cardiovascular disease.MethodsIn total, 107 patients with AKI associated with cardiovascular disease were enrolled in this single-center retrospective study and were either assigned to the exposure group (n = 36), which received rehabilitation at least once a week for at least 8 consecutive weeks, or to the control group (n = 71). Estimated glomerular filtration rate was assessed at baseline before admission, at the lowest value during hospitalization, and at 3, 12, and 24 months after enrolment. Trends over time (group × time) between the two groups were compared using generalized estimating equations. Moreover, congestive status was assessed by amino-terminal pro-B-type natriuretic peptide (NT-proBNP), and the effect of rehabilitation on congestion improvement was investigated using logistical regression analysis.ResultsThe time course of renal function after AKI, from baseline to each of the three timepoints suggested significant differences between the two groups (p < 0.01). However, there was no significant difference between the two groups at any time point in terms of percentage of patients who experienced a 40% estimated glomerular filtration rate reduction from that at baseline. The proportion of patients with improved congestion was significantly higher in the exposure group compared with that in the control group (p = 0.018). Logistic regression analysis showed that rehabilitation was significantly associated with improved congestion (p = 0.021, OR: 0.260, 95%CI: 0.083–0.815).ConclusionOur results suggest that rehabilitation in patients with AKI associated with cardiovascular disease correlates with an improvement in congestion and may have a positive effect on the course of renal function.

Outcome evaluation of technical strategies on reduction of patient waiting time in the outpatient department at Kilimanjaro Christian Medical Centre—Northern Tanzania

BackgroundThe Tanzania healthcare system is beset by prolonged waiting time in its hospitals particularly in the outpatient departments (OPD). Previous studies conducted at Kilimanjaro Christian Medical Centre (KCMC) revealed that patients typically waited an average of six hours before receiving the services at the OPD making KCMC have the longest waiting time of all the Zonal and National Referral Hospitals. KCMC implemented various interventions from 2016 to 2021 to reduce the waiting time. This study evaluates the outcome of the interventions on waiting time at the OPD.MethodsThis is an analytical cross-sectional mixed method using an explanatory sequential design. The study enrolled 412 patients who completed a structured questionnaire and in-depth interviews (IDI) were conducted among 24 participants (i.e., 12 healthcare providers and 12 patients) from 3rd to 14th July, 2023. Also, a documentary review was conducted to review benchmarks with regards to waiting time. Quantitative data analysis included descriptive statistics, bivariable and multivariable. All statistical tests were conducted at 5% significance level. Thematic analysis was used to analyse qualitative data.ResultsThe findings suggest that post-intervention of technical strategies, the overall median OPD waiting time significantly decreased to 3 h 30 min IQR (2.51–4.08), marking a 45% reduction from the previous six-hour wait. Substantial improvements were observed in the waiting time for registration (9 min), payment (10 min), triage (14 min for insured patients), and pharmacy (4 min). Among the implemented strategies, electronic medical records emerged as a significant predictor to reduced waiting time (AOR = 2.08, 95% CI, 1.10–3.94, p-value = 0.025). IDI findings suggested a positive shift in patients' perceptions of OPD waiting time. Problems identified that still need addressing include, ineffective implementation of block appointment and extension of clinic days was linked to issues of ownership, organizational culture, insufficient training, and ineffective follow-up. The shared use of central modern diagnostic equipment between inpatient and outpatient services at the radiology department resulted in delays.ConclusionThe established technical strategies have been effective in reducing waiting time, although further action is needed to attain the global standard of 30 min to 2 h OPD waiting time.

Percutaneous mechanical support in catheter ablation of ventricular arrhythmias: hype or hope?

Catheter ablation (CA) has become an established treatment strategy for managing recurrent ventricular tachycardias (VTs) in patients with structural heart disease. In recent years, percutaneous mechanical circulatory support (PMCS) devices have been increasingly used intra-operatively to improve the ablation outcome. One indication would be rescue therapy for patients who develop haemodynamic deterioration during the ablation. However, more efforts are focused on identifying subjects who are at high risk of such deterioration and could benefit from the pre-emptive use of the PMCS. The third reason to use PMCS could be the inability to identify diffuse substrate, especially in non-ischaemic cardiomyopathy. This paper reviews available experiences using various types of PMCS in different clinical scenarios. Although PMCS allows mapping during VT, it does not significantly influence acute outcomes and not convincingly long-term outcomes. On the contrary, the complication rate appears to be higher in PMCS cohorts. Our data suggest that even in patients with severe left ventricular dysfunction, the substrate modification can be performed without the need for general anaesthesia and risk of haemodynamic decompensation. In end-stage heart failure associated with the electrical storm, implantation of a left ventricular assist device (or PMCS with a transition to the left ventricular assist device) might be the preferred strategy before CA. In high-risk patients who are not potential candidates for these treatment options, radiotherapy could be considered as a bail-out treatment of recurrent VTs. These approaches should be studied in prospective trials.

Genomic profiling of a multi-lineage and multi-passage patient-derived xenograft biobank reflects heterogeneity of ovarian cancer

Ovarian cancer (OC) manifests as a complex disease characterized by inter- and intra-patient heterogeneity. Despite enhanced biological and genetic insights, OC remains a recalcitrant malignancy with minimal survival improvement. Based on multi-site sampling and a multi-lineage patient-derived xenograft (PDX) establishment strategy, we present herein the establishment of a comprehensive PDX biobank from histologically and molecularly heterogeneous OC patients. Comprehensive profiling of matched PDX and patient samples demonstrates that PDXs closely recapitulate parental tumors. By leveraging multi-lineage models, we reveal that the previously reported genomic disparities of PDX could be mainly attributed to intra-patient spatial heterogeneity instead of substantial model-independent genomic evolution. Moreover, DNA damage response pathway inhibitor (DDRi) screening uncovers heterogeneous responses across models. Prolonged iterative drug exposure recapitulates acquired drug resistance in initially sensitive models. Meanwhile, interrogation of induced drug-resistant (IDR) models reveals that suppressed interferon (IFN) response and activated Wnt/β-catenin signaling contribute to acquired DDRi drug resistance.

Reckoning applications of Z-iteration: Data dependence and solution to a delay Caputo fractional differential equation

In this study, we focus on demonstrating the stability of the three-step Z-iterative scheme within the context of weak contraction mappings as defined by Berinde. Further, we attain results concerning stability, data dependence, and error accumulation of the Z-iterative scheme. This article also includes a comparison of the convergence rates among various established iterative strategies. Several illustrative numerical examples are furnished to validate the accuracy and reliability of our findings. In the same spirit, we present an application that utilises the Z-iterative technique on Banach spaces to attain the solution of a delay Caputo fractional differential equation, building upon our primary findings.

Modified SMILE (mSMILE) is active in the treatment of pediatric Epstein-Barr virus-associated natural killer/T-cell lymphoma: a single center experience, case series.

The Epstein-Barr virus-associated natural killer (NK) and T-cell lymphoma (EBV + NK/T cell lymphoma) is a severe illness mainly affecting children and young adults, often resulting in a poor prognosis. To date, there is no consensus on an established treatment strategy. This study aims to evaluate the efficacy and safety of the mSMILE (modified steroid, methotrexate, ifosfamide, L-asparaginase, and etoposide) chemotherapy regimen in treating EBV+ NK/T-cell lymphoma and to provide insights into potential treatment outcomes. In this study, we conducted a retrospective analysis of the clinical data and treatment outcomes for patients with EBV + NK/T cell lymphoma treated at Children's Hospital of Nanjing Medical University between July 2017 and January 2022. These patients received at least two cycles of the mSMILE chemotherapy, in which a single dose of pegaspargase was substituted for 7 doses of L-asparaginase per cycle. Eight patients were included in the study: one with extranodal NK/T-cell lymphoma, one with primary nodal NK/T-cell lymphoma, and six with Systemic EBV+ NK/T cell lymphoma of childhood. The results showed that five patients achieved complete remission, two achieved partial remission, and one showed progressive disease, resulting in a complete remission rate of 62.5% and an overall response rate of 87.5%. The 3-year overall survival (OS) and event-free survival (EFS) rates were 87.5% and 75%, respectively. The most common adverse reactions associated with chemotherapy were hematologic toxicities of stages III to IV. Nonhematologic adverse reactions mainly included impaired liver function, infections, and oral mucositis, which were resolved with aggressive anti-infective therapy. Based on our clinical experience, the mSMILE appears to be a safe and effective treatment option for EBV + NK/T-cell lymphoma, meriting further investigation in late-phase clinical trials.

State-of-the-Art and New Treatment Approaches for Spinal Cord Tumors.

Spinal cord tumors, though rare, present formidable challenges in clinical management due to their intricate nature. Traditional treatment modalities like surgery, radiation therapy, and chemotherapy have been the mainstay for managing these tumors. However, despite significant advancements, challenges persist, including the limitations of surgical resection and the potential side effects associated with radiation therapy. In response to these limitations, a wave of innovative approaches is reshaping the treatment landscape for spinal cord tumors. Advancements in gene therapy, immunotherapy, and targeted therapy are offering groundbreaking possibilities. Gene therapy holds the potential to modify the genes responsible for tumor growth, while immunotherapy harnesses the body's own immune system to fight cancer cells. Targeted therapy aims to strike a specific vulnerability within the tumor cells, offering a more precise and potentially less toxic approach. Additionally, novel surgical adjuncts are being explored to improve visualization and minimize damage to surrounding healthy tissue during tumor removal. These developments pave the way for a future of personalized medicine for spinal cord tumors. By delving deeper into the molecular makeup of individual tumors, doctors can tailor treatment strategies to target specific mutations and vulnerabilities. This personalized approach offers the potential for more effective interventions with fewer side effects, ultimately leading to improved patient outcomes and a better quality of life. This evolving landscape of spinal cord tumor management signifies the crucial integration of established and innovative strategies to create a brighter future for patients battling this complex condition.

Study Protocol of a Randomized, Two-Arm, Phase I/II Trial Investigating the Feasibility, Safety, and Efficacy of Local Treatment with US-Guided High-Intensity Focused Ultrasound in Combination with Palliative Chemotherapy in Inoperable Pancreatic Cancer.

Pancreatic adenocarcinoma (PaC) still has a dismal prognosis, and despite medical advances, a bleak 5-year survival rate of only 8%, largely due to late diagnosis and limited curative surgical options for most patients. Frontline palliative treatment shows some survival advantages. However, the high disease mortality is accompanied by high morbidity including cancer-related pain and additional symptoms, which strongly impair patients' quality of life (QOL). At present, there is no established strategy for local therapy for PaC primarily aiming to manage local tumor growth and alleviate associated symptoms, particularly pain. In recent years, non-invasive high-intensity focused ultrasound (HIFU) has shown promising results in reducing cancer pain and tumor mass, improving patients' QOL with few side effects. This is the first randomized controlled trial worldwide including 40 patients with inoperable pancreatic adenocarcinoma randomized into two groups: group A undergoing standard chemotherapy; and group B undergoing standard chemotherapy plus local HIFU treatment. This study aims to establish a robust evidence base by examining the feasibility, safety, and efficacy of US-guided HIFU in combination with standard palliative systemic therapy for unresectable PaC. Primary endpoint assessments will focus on parameters including safety issues (phase I), and local response rates (phase II).

Case report of two long term ovarian cancer survivors with brain metastases following multimodal treatment including chemotherapy, radiotherapy and maintenance olaparib: An institutional case series and literature review

Brain metastasis from ovarian cancer is a very rare condition with a poor prognosis. However, due to its rarity, there is no established treatment strategy. We present a case series of brain metastasis with ovarian cancer, focusing on two long-term survivors treated with multimodal therapy. Among the nine cases, the median survival time after brain metastases was six months (range: 0–58 months). Eight patients had high-grade serous carcinoma (HGSC). Three of the four patients who underwent genetic testing tested positive for germline BRCA2 (gBRCA2) mutation. Two patients survived longer than 4 years after the diagnosis of brain metastases. Both of these patients received chemotherapy, radiation therapy, and olaparib, a molecularly targeted drug, as maintenance therapy. This case series suggests that patients with gBRCA2 mutation-positive HGSC may be at a high risk of developing brain metastases. A multidisciplinary approach, including PARP inhibitors, may improve the prognosis of patients with brain metastases from ovarian cancer.

Peptide direct growth on poly(acrylic acid)/poly(vinyl alcohol) electrospun fibers coated with branched poly(ethylenimine): A solid-phase approach for scaffolds biofunctionalization

Due to their resemblance to the fibrillar structure of the extracellular matrix, electrospun nanofibrous meshes are currently used as porous and mechanically stable scaffolds for cell culture. In this study, we propose an innovative methodology for growing peptide sequences directly onto the surface of electrospun nanofibers. To achieve this, electrospun fibers were produced from a poly(acrylic acid)/poly(vinyl alcohol) blend that was thermally crosslinked and subjected to a covalent coating of branched poly(ethylenimine). The exposed amino functionalities on the fiber surface were then used for the direct solid-phase synthesis of the RGD peptide sequence. In contrast to established strategies, mainly involving the grafting of pre-synthesized peptides onto the polymer chains before electrospinning or onto the nanofibers surface, this method allows for the concurrent synthesis and anchoring of peptides to the substrate, with potential applications in combinatorial chemistry. The incorporation of this integrin-binding motive significantly enhanced the nanofibers' ability to capture human cervical carcinoma (HeLa) cells, selected as a proof of concept to assess the functionalities of the developed material.

Leveraging permutation testing to assess confidence in positive-unlabeled learning applied to high-dimensional biological datasets

BackgroundCompared to traditional supervised machine learning approaches employing fully labeled samples, positive-unlabeled (PU) learning techniques aim to classify “unlabeled” samples based on a smaller proportion of known positive examples. This more challenging modeling goal reflects many real-world scenarios in which negative examples are not available—posing direct challenges to defining prediction accuracy and robustness. While several studies have evaluated predictions learned from only definitive positive examples, few have investigated whether correct classification of a high proportion of known positives (KP) samples from among unlabeled samples can act as a surrogate to indicate model quality.ResultsIn this study, we report a novel methodology combining multiple established PU learning-based strategies with permutation testing to evaluate the potential of KP samples to accurately classify unlabeled samples without using “ground truth” positive and negative labels for validation. Multivariate synthetic and real-world high-dimensional benchmark datasets were employed to demonstrate the suitability of the proposed pipeline to provide evidence of model robustness across varied underlying ground truth class label compositions among the unlabeled set and with different proportions of KP examples. Comparisons between model performance with actual and permuted labels could be used to distinguish reliable from unreliable models.ConclusionsAs in fully supervised machine learning, permutation testing offers a means to set a baseline “no-information rate” benchmark in the context of semi-supervised PU learning inference tasks—providing a standard against which model performance can be compared.

LMIC-16. PRE-IRRADIATION CHEMOTHERAPY AND DELAYED RADIATION THERAPY IN INFANTS AND YOUNG CHILDREN WITH WITH CENTRAL NERVOUS SYSTEM EMBRYONAL TUMOURS

Abstract BACKGROUND Established strategies for infants and young children(IYC) with embryonal tumours of the central nervous system(CNSET) - autologous stem-cell rescue(ASCT) and intraventricular chemotherapy(IVCT) – are not universally available. We report the outcomes of IYC with CNSET treated using the strategy of surgery, pre-irradiation chemotherapy and delayed radiation. METHODS Children &amp;lt;3years diagnosed with CNSET- medulloblastoma(MB), atypical teratoid/rhabdoid tumour(ATRT), embryonal tumour with multilayered rosettes(ETMR), CNS primitive neuroectodermal tumours(PNET)- and pineoblastoma(PB),underwent standard evaluation and staging, maximal safe excision, pre-irradiation chemotherapy(cyclophosphamide, etoposide and carboplatin;CEJ) upto 36months of age and either ris-adapted craniospinal with boost or focal irradiation. We performed a retrospective intention-to-treat outcome analysis. RESULTS Of 117children &amp;lt;3years with CNSET treated January2011- December2022, 72 were treated with this strategy.The median age was 25months (range6-35), 49males,histology medulloblastoma-42(58%), ATRT-9(12.5%), PNET-8(11.1%), ETMR-8(11.1%) and PB-5(6.8%); 23(32%) metastatic.The median chemotherapy cycles were 6(range 1-15). 36 children went on to receive RT; CSI in 33 (20standard-dose,13reduced-dose) and focal in 3. At last follow-up, 27children are in remission, 43 have relapsed/progressed (9 received salvage treatment) and 2 died due to chemotherapy toxicity. The 3-year and 5-year event-free-survival(EFS) are 35% and 3-year and 5-year overall-survival(OS) are 41.8% and 40.2%. The 3-year EFS/OS for MB are 51.1%/ 62.8%,PNET 25%/25%,ATRT 11.1%/11.1%,ETMR 12.5%/12.5% and PB 0%. Only metastasis was prognostic in medulloblastoma (HR 2;95% CI 0.86-4.6 for EFS and HR 1.7;95% CI 0.67-4.5 for OS); age, molecular group and histology were not prognostic. Long-term follow-up (n=17) documented &amp;gt;grade2 late effects in all (endocrine-16, neurocognitive-8, vision-3, hearing -8 and neurological-10). CONCLUSION The use of moderate-intensity pre-irradiation chemotherapy is feasible and effective in infants and young children with CNSETs. Despite inferior outcomes compared to ASCT or IVCT,this strategy could be used in resource-limited settings.

Calcified Drusen Prevent the Detection of Underlying Choriocapillaris Using Swept-Source Optical Coherence Tomography Angiography.

In age-related macular degeneration (AMD), choriocapillaris flow deficits (CCFDs) under soft drusen can be measured using established compensation strategies. This study investigated whether CCFDs can be quantified under calcified drusen (CaD). CCFDs were measured in normal eyes (n = 30) and AMD eyes with soft drusen (n = 30) or CaD (n = 30). CCFD density masks were generated to highlight regions with higher CCFDs. Masks were also generated for soft drusen and CaD based on both structural en face OCT images and corresponding B-scans. Dice similarity coefficients were calculated between the CCFD density masks and both the soft drusen and CaD masks. A phantom experiment was conducted to simulate the impact of light scattering that arises from CaD. Area measurements of CCFDs were highly correlated with those of CaD but not soft drusen, suggesting an association between CaD and underlying CCFDs. However, unlike soft drusen, the detected optical coherence tomography (OCT) signals underlying CaD did not arise from the defined CC layer but were artifacts caused by the multiple scattering property of CaD. Phantom experiments showed that the presence of highly scattering material similar to the contents of CaD caused an artifactual scattering tail that falsely generated a signal in the CC structural layer but the underlying flow could not be detected. Similarly, CaD also caused an artifactual scattering tail and prevented the penetration of light into the choroid, resulting in en face hypotransmission defects and an inability to detect blood flow within the choriocapillaris. Upon resolution of the CaD, the CC perfusion became detectable. The high scattering property of CaD leads to a scattering tail under these drusen that gives the illusion of a quantifiable optical coherence tomography angiography signal, but this signal does not contain the angiographic information required to assess CCFDs. For this reason, CCFDs cannot be reliably measured under CaD, and CaD must be identified and excluded from macular CCFD measurements.

Predicting Out-of-Hospital Cardiac Arrest in the General Population Using Electronic Health Records.

The majority of out-of-hospital cardiac arrests (OHCAs) occur among individuals in the general population, for whom there is no established strategy to identify risk. In this study, we assess the use of electronic health record (EHR) data to identify OHCA in the general population and define salient factors contributing to OHCA risk. The analytical cohort included 2366 individuals with OHCA and 23 660 age- and sex-matched controls receiving health care at the University of Washington. Comorbidities, electrocardiographic measures, vital signs, and medication prescription were abstracted from the EHR. The primary outcome was OHCA. Secondary outcomes included shockable and nonshockable OHCA. Model performance including area under the receiver operating characteristic curve and positive predictive value were assessed and adjusted for observed rate of OHCA across the health system. There were significant differences in demographic characteristics, vital signs, electrocardiographic measures, comorbidities, and medication distribution between individuals with OHCA and controls. In external validation, discrimination in machine learning models (area under the receiver operating characteristic curve 0.80-0.85) was superior to a baseline model with conventional cardiovascular risk factors (area under the receiver operating characteristic curve 0.66). At a specificity threshold of 99%, correcting for baseline OHCA incidence across the health system, positive predictive value was 2.5% to 3.1% in machine learning models compared with 0.8% for the baseline model. Longer corrected QT interval, substance abuse disorder, fluid and electrolyte disorder, alcohol abuse, and higher heart rate were identified as salient predictors of OHCA risk across all machine learning models. Established cardiovascular risk factors retained predictive importance for shockable OHCA, but demographic characteristics (minority race, single marital status) and noncardiovascular comorbidities (substance abuse disorder) also contributed to risk prediction. For nonshockable OHCA, a range of salient predictors, including comorbidities, habits, vital signs, demographic characteristics, and electrocardiographic measures, were identified. In a population-based case-control study, machine learning models incorporating readily available EHR data showed reasonable discrimination and risk enrichment for OHCA in the general population. Salient factors associated with OCHA risk were myriad across the cardiovascular and noncardiovascular spectrum. Public health and tailored strategies for OHCA prediction and prevention will require incorporation of this complexity.

Modelling polarized pulsed LiDAR signals in scattering media: an approach for optimizing systems in real-world scenarios

Adverse weather conditions present a primary challenge for ground-based LiDAR imaging systems in outdoor applications. The use of polarization has been proposed as an effective filtering mechanism. However, the number of potential situations is large, complex and difficult to parameterize with accuracy. In such conditions, advanced simulation methods enable the testing of different experimental configurations and the determination of the best possible setup. With this purpose, a Monte Carlo algorithm is presented for modeling polarized pulsed LiDAR signals in turbid media. This algorithm is designed for immediate applicability, incorporating realistic media characterization and accounting for the attributes of existing prototypes. It allows testing various experimental configurations, managing optical obstacles, adjusting polarization arrangements, and different geometries of particles within the medium. The developed algorithm accurately characterizes backscattering signals, revealing their dependence on medium properties. A relationship between visibility and backscattering energy is identified, offering insights for sensor optimization. Polarization analysis highlights the efficacy of circular polarization in mitigating scattering effects and establishes a connection with the polarimetric characteristics of imaged targets. The algorithm's application to irregular particles reveals also an unexpected behavior of polarized light, challenging established strategies. These diverse use cases exemplify the algorithm's capability to model real-world circumstances, emphasizing its significance in predicting cutting-edge situations when designing optical systems for complex and demanding outdoor scenarios.

Translation techniques of the positive politeness utterances in the Pay It Forward movie

This descriptive qualitative research employed the methods of observation and auto-expert judgment for the data collection and applied Brown &amp; Levinson’s politeness theory (1987) and Molina &amp; Albir’s translation theory (2002) for the data analysis. This research focused on finding the positive politeness strategies and the translation techniques of the utterances obtained from Pay It Forward movie as the data source. Based on the findings of the research, there were 40 utterances with positive politeness strategies as the data under analysis. The research findings, among others, showed that the strategies of Intensify interest to hearer (17.50%) and Exaggerate (17.50%) were dominantly used in the Pay It Forward movie, while the translation strategy of Established equivalent (40.00%) was mostly used in the translation of positive politeness utterances in the movie. It can be concluded here that the translator translates the positive politeness utterances of the source language (English) into the target language (Indonesian) appropriately through the Established equivalent strategy without making any significant changes to maintain the meaning relatively the same in the Indonesian translation subtitles.

A Multi-Tissue Genome-Scale Model of Populus trichocarpa Elucidates Overexpression Targets for Improving Drought Tolerance

Abstract Populus trichocarpa (poplar) is a fast-growing model tree whose lignocellulosic biomass is a promising biofuel feedstock. Enhancing its viability and yield in non-arable drought-prone lands can reduce biomass cost and accelerate adoption as a biofuel crop. Data from extensive -omics and phenotypic studies were leveraged herein to reconstruct a multi-tissue (root, stem, and leaf) genome-scale model (GSM) of poplar, iPotri3463, encompassing 14,360 reactions, 12,402 metabolites, and 3,463 genes. Two condition-specific GSMs were extracted from iPotri3463: iPotri3016C (control) and iPotri2999D (drought), supported by condition-specific transcript levels and reaction essentiality for growth. Physiological constraints consistent with experimental measurements of drought-stressed plants were imposed to growth, photorespiration, and carbon assimilation rates. Calculated increased flux capacity through the violaxanthin cycle and GABA biosynthetic pathways agree with established key strategies for improving drought tolerance. Differential gene expression analysis was performed on existing transcriptomes of poplar under different watering regimes. Computational flux knockdown was applied to reactions with increased flux capacity under drought which were associated with at least one downregulated gene. Several such reactions were essential for maintaining observed biomass yield and their associated genes are candidates for overexpression to improve drought tolerance. Glutamine synthetase is one whose overexpression in poplar confirms in silico predictions. However, the two most promising candidates are genes encoding ferulate-5-hydroxylase, Potri.007G016400 and Potri.005G117500, as their overexpression in other plant species led to demonstrably improved drought tolerance while previous overexpression in poplar reduced biomass recalcitrance. iPotri3463 is the first poplar-specific whole-plant GSM and the second one available for a woody plant.