Higher Benefits Research Articles

Exploring the Benefits of e-Extension Tools: Perspectives from Extension Personnel

This study, conducted in Uttar Pradesh during 2023-2024, aims to evaluate the benefits of e-Extension tools among extension personnel in Uttar Pradesh, focusing on Krishi Vigyan Kendra (KVKs) host by Acharya Narendra Deva University of Agriculture and Technology (ANDUAT). Uttar Pradesh was selected purposively due to its high number of KVKs, totalling 89, and the study focused on those hosted by Acharya Narendra Deva University of Agriculture and Technology (ANDUAT), which has the maximum number of KVKs in the state. Data were collected from 137 extension personnel using a Google Form questionnaire. The findings reveal a predominantly positive perception of e-Extension tools, with a majority recognizing their advantages in promoting communication, enhancing extension work, and providing quick access to agricultural information. Specifically, 67.15% of respondents perceived high benefits, while 26.28% perceived medium benefits, and only 6.57% perceived low benefits. Despite these positive perceptions, concerns were noted regarding the cost-effectiveness and ability of e-Extension tools to address all technical problems, as well as their impact on interpersonal relationships between extension personnel and farmers.

Development and Validation of a Predictive Model for Postoperative Intracranial Infections in Neurosurgery with Risk Factor Analysis

BackgroundCurrently, the diagnosis of post-neurosurgical intracranial infection is mainly dependent on cerebrospinal fluid (CSF) bacterial culture which has the disadvantages of time-consuming, low detection rate and easy to be affected by other factors. These disadvantages bring some difficulties to early diagnosis. Therefore, it is very important to construct a nomogram model to predict the risk of infection to provide a basis for early diagnosis and treatment. MethodThis retrospective study analyzed post-neurosurgical patient data from the Fourth Affiliated Hospital of Harbin Medical University between January 2019 and September 2023. The patients were randomly assigned in an 8:2 ratio into the training cohort and the internal validation cohort. In the training cohort, initial screening of relevant indices was conducted via univariate analysis. Subsequently, the least absolute shrinkage and selection operator (Lasso) logistic regression identified significant potential risk factors for inclusion in the nomogram model. The model's discriminative ability was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), and its calibration was evaluated through calibration plots. The clinical utility of the model was determined using decision curve analysis (DCA) and further validated by the internal validation cohort. ResultsMultivariate logistic regression analysis of the training cohort identified seven independent risk factors for postoperative intracranial infection: duration of postoperative external drainage (odds ratio [OR] 1.19, P=0.005), continued fever (OR 2.11, P=0.036), CSF turbidity (OR 2.73, P=0.014), CSF pressure (OR 1.01, P=0.018), CSF total protein level (OR 1.26, P=0.026), CSF glucose concentration (OR 0.74, P=0.029), and postoperative serum albumin level (OR 0.84, P<0.001). Using these variables to construct the final model. The AUC value of the model was 0.868 in the training cohort and 0.900 in the internal validation cohort. Calibration and the DCA curve indicated high accuracy and clinical benefit of the nomogram, findings that were corroborated in the validation cohort. ConclusionThis study successfully developed a novel nomogram for predicting postoperative intracranial infection, demonstrating excellent predictive performance. It offers a pragmatic tool for early diagnosis of intracranial infection.

Establishment and optimization of urban ecological network based on ecological regulation services aiming at stability and connectivity

Establishing an urban ecological network is a means to improve the ecological environment and enhance sustainable urban development amidst rapid urbanization. Based on the demand of eco-city, morphological spatial pattern analysis (MSPA), ecological regulation services value (ERSV), and landscape connectivity have been combined to identify ecological resources with high connectivity and ecological benefits in this study. Using the Minimum Cumulative Resistance (MCR) model, ecological corridors have been constructed and ecological critical nodes have been identified. In addition, the urban ecological network has then been optimized from the overall layout and local key nodes based on the circuit theory to balance the ecological livability and species diversity in the eco-city. The main conclusions could be demonstrated as follows: (1) 76.45% of the high ecological regulation service value areas have been identified as core areas. (2) The distribution of ecological corridors has been found uneven with significant disparities (3) The connectivity indices, especially the line point rate (β) index, have increased by 21.66%, while the robustness has increased by 75.44%. Overall, the combined methods have been used to establish and optimize the ecological network within the limited space to balance the ecological livability and biodiversity. The results of this study could provide a scientific reference for the optimization of urban ecological space and promote sustainable development in the eco-city.

Unusually high thermal conductivity in suspended monolayer MoSi2N4

Two-dimensional semiconductors with high thermal conductivity and charge carrier mobility are of great importance for next-generation electronic and optoelectronic devices. However, constrained by the long-held Slack’s criteria, the reported two-dimensional semiconductors such as monolayers of MoS2, WS2, MoSe2, WSe2 and black phosphorus suffer from much lower thermal conductivity than silicon (~142 W·m–1·K–1) because of the complex crystal structure, large average atomic mass and relatively weak chemical bonds. Despite the more complex crystal structure, the recently emerging monolayer MoSi2N4 semiconductor has been predicted to have high thermal conductivity and charge carrier mobility simultaneously. In this work, using a noncontact optothermal Raman technique, we experimentally measure a high thermal conductivity of ~173 W·m–1·K–1 at room temperature for suspended monolayer MoSi2N4 grown by chemical vapor deposition. First-principles calculations reveal that such unusually high thermal conductivity benefits from the high Debye temperature and small Grüneisen parameter of MoSi2N4, both of which are strongly dependent on the high Young’s modulus induced by the outmost Si-N bilayers. Our study not only establishes monolayer MoSi2N4 as a benchmark 2D semiconductor for next-generation electronic and optoelectronic devices, but also provides an insight into the design of 2D materials for efficient heat conduction.

Teacher evaluations of interethnic bullying of an Arab student: The role of perceiving refugees as a threat or benefit

AbstractInterethnic bullying that targets ethnic minority students has serious consequences for the lives of victimized students. Teachers’ evaluations of the bullying are critical because teacher intervention can stop bullying and improve the adjustment of victimized students. Because the literature has documented partially overlapping biases against people of Arab ethnicity and people with refugee backgrounds, this study investigated whether teachers’ attitudes toward refugees play a role in their evaluations of the interethnic bullying of an Arab student. Teachers (n = 373; 77% female) who participated in the study filled the Threats–Benefits Inventory (TBI) that measured two types of attitudes toward refugees (perceiving refugees as a threat and perceiving refugees as a benefit) and evaluated a hypothetical vignette of interethnic bullying targeted at an Arab student. SEM analysis, controlling for gender, age, and contact with refugees, indicated that teachers’ attitudes toward refugees were not associated with their perceptions of the interethnic bullying as wrong or with their willingness to intervene. However, viewing refugees as a source of high threat or low benefit was consistently associated with lower recognition of the negative outcomes of the interethnic bullying. Moreover, a greater willingness to intervene positively associated with female gender and increasing age. The study suggests that teachers’ attitudes toward refugees may contribute to underestimating negative outcomes of interethnic bullying among students. To foster appropriate evaluations of interethnic bullying, teacher education should aim to promote understanding of different marginalized groups and to reduce biases against people with refugee backgrounds.

The Impact of Marketing in Increasing the Level of Competitiveness for Agro-Food Products in Albania

The climate that prevails in Albania and the type of agricultural land are favorable for new cultures and agricultural products that have higher benefits than other products that have been cultivated so far. Developing and increasing the capacities of existing products is one of the main components in a small or medium-sized company. A progressive company should preemptively address the planning and expansion of its product range and diversity of culture where it operates in order to remain competitive in the market. To achieve this, companies nowadays need to implement the most effective marketing strategies. Marketing is increasingly emerging as the most significant aspect for companies in the agro-food sector, serving as the primary means of customer orientation, with arguments as to why they should choose a company's products or services over other competitors. With the advancement of technology, the utilization of marketing and its elements is increasing more and more, as the best way to achieve the desired profit, target performance and competitiveness in the market. The purpose of this paper is the analysis of the existing situation in the development of the competitiveness of agro-food products as a result of the application of marketing, through which the market will be studied and make the agricultural producer aware of the increase of their performance in the market, through the production of quality and cost-effective products. The results reveal that agro-food production companies and farms have started to apply marketing in various forms, both in social and traditional media, creating better competitive positions in the market and increased production capacities allowing for the substitution of imported products with local products. Consequently, it has influenced the increase in consumer confidence in Albanian products and brands.

MILK QUALITY OF ETAWA BREEDING GOATS SEEN FROM CALIFORNIA MASTITIS TEST, ALCOHOL TEST, REDUCTASE TEST, AND BOILING TEST IN RAKA ETAWA FARMING

Milk is a food product of animal origin that has high benefits. The main requirement for milk consumption by the public is good milk quality. This study aims to determine the quality of Etawa breeding goat milk as seen from the California mastitis test, alcohol test, reductase test, and boiling test at Raka Etawa Farm and see the relationship between the California mastitis test (CMT) with the alcohol test, reductase, and boiling test. This study was conducted in a descriptive observational. Sampling using purposive sampling method with sample criteria taken is milk from goat mothers who are in the lactation period. In this study it was found that of the 30 milk samples taken, based on the results of the California mastitis test, there were 15 samples of milk of Etawa breeding goats (50%) experiencing the incidence of subclinical mastitis level III, 11 milk samples (36,7%) experiencing the incidence of subclinical mastitis level II, and as many as 4 milk samples (13,3%) did not experience the incidence of subclinical mastitis. Based on the alcohol test, 26 milk samples (80%) showed positive results and as many as 4 milk samples (20%) showed negative results. The reductase test results showed that 24 samples (80%) had a reductase time of 2 hours and 6 samples (20%) showed a reductase time of 1 hour. The boiling test results showed that 26 milk samples (86,7%) were positive and 4 milk samples (13,3%) had negative results. There was no significant relationship between the CMT test and alcohol test and the CMT test and reductase test (P &gt; 0.05). There was a significant relationship between the CMT test and boiling test (P &lt; 0.05) on the quality of milk of Etawa breeding goats at Raka Etawa Farm. It can be concluded that the majority of Etawa breeding goat milk at Raka Etawa Farm is of poor quality. Cage hygiene, cleaning the udder before milking, and always using gloves during milking need to be considered to produce good quality milk by applicable standards.

A Study on Fish Consumption Pattern among Pregnant Women in Kashmir Valley

Fish is one of the most important sources of animal protein, vitamins, minerals and fatty acids, essential for the maintenance of health and metabolism. Besides, fish is reckoned as an ideal diet for expectant and lactating women owing to its high nutritional value and health benefits. In this paper, in order to assess the fish consumption pattern among the pregnant women of Kashmir, the current study was carried out in Kashmir valley of J&amp;K region during June 2023. We explained the purpose of study to the respondents and after taking their consent, we chose 200 respondents at random on the basis of consecutive sampling procedure during the study period using a well- designed validated questionnaire and via direct personal interviews. The data collected from our survey was analysed statistically and interpreted using appropriate statistical tools. The study revealed that majority of the respondents consumed fish occasionally during pregnancy. The major reason for inappreciable consumption was found to be the lack of awareness about the health benefits of fish during this phase. Moreover, consumption pattern of fish was related to the educational background of the respondents as comparatively higher percentage of respondents who consumed fish was found to be educated. However the consumption pattern was not significantly associated with the family status. Hence, the study elicits the need to effectively communicate the benefits of fish consumption in order to encourage proper nutrient intake among pregnant and lactating mothers and their children.

Long-term Survivorship and Outcomes of Patients Without Dysplasia Undergoing Capsular Repair During Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Background: There is a paucity of literature evaluating long-term outcomes and survivorship of patients undergoing primary hip arthroscopy with capsular repair for femoroacetabular impingement syndrome (FAIS). Purpose: To report 10-year survivorship and patient-reported outcomes (PROs) after primary hip arthroscopy with capsular repair for FAIS and evaluate the effect of capsular repair in patients at the highest risk for conversion to arthroplasty. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing primary hip arthroscopy with capsular repair between October 2008 and February 2011. Patients with a minimum 10-year follow-up on the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale for pain (VAS) scores were selected. The preoperative and minimum 10-year follow-up Hip Outcome Score—Sports Specific Subscale (HOS-SSS) scores were also reported, if available. Patients with ipsilateral hip surgery, worker’s compensation, Tönnis osteoarthritis grade >1, and hip dysplasia (lateral center-edge angle <25°) were excluded. Survivorship, PROS, and clinical benefit—minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS)—were reported. An additional propensity-matched subanalysis was performed on patients at the highest risk for conversion to arthroplasty, comparing patients undergoing capsular repair to patients with unrepaired capsules. Results: A total of 145 (n = 130 patients) out of 180 eligible hips (n = 165 patients) had a minimum 10-year follow-up (80.6%). Also, 126 hips (86.9%) belonged to women, and 19 hips (13.1%) belonged to men. The mean patient age was 30.3 ± 12.9 years. The survivorship rate was 91% at the 10-year follow-up. The cohort experienced significant improvements (P < .001) in the mHHS, NAHS, HOS-SSS, and VAS for pain scores. Moreover, the cohort achieved high rates of the PASS for the mHHS (89.8%), high rates of the MCID for the mHHS (82.4%), and high rates of the MCID for VAS for pain (80.6%) scores. In the propensity-matched subanalysis performed on patients with the highest risk for arthroplasty, 29 hips with capsular repair were matched to 81 hips with unrepaired capsules. While both groups experienced significant improvements in all PROs (P < .05), the group without capsule repair trended toward a higher conversion to arthroplasty rate when compared with the repair group. In addition, an odds ratio was calculated for the likelihood of converting to arthroplasty after having an unrepaired capsule compared with capsular repair (2.54 [95% CI, 0.873-7.37]; P = .087). Conclusion: Patients undergoing primary hip arthroscopy with capsular repair experienced a high survivorship rate of 91% at a minimum 10-year follow-up. Patients who did not convert to arthroplasty saw favorable improvements in PROs and achieved high clinical benefit rates. In addition, among those patients at the highest risk for conversion to arthroplasty, a trend toward greater survivorship was observed with capsular repair.

Strategic opportunities for nature-based solutions: Lessons for policy and practice from cross-city comparisons

Nature-based solutions (NbS) can address urban infrastructure challenges exacerbated by climate change (e.g., flooding) and contribute to citizens’ quality of life, supporting both environmental and social policy goals. Despite those advantages, NbS can be a difficult ‘sell’ for policy makers in a wider context of social uncertainty and austerity. To support greater insight into the issues affecting market uptake, this scoping study draws on data from a EU Horizons project. The experience of government and business stakeholders in six cities (Liverpool, Valladolid, Izmir, Mantua, Ludwigsburg, and Medellin), serve as illustrative cases of market uptake from the NbS provider perspective. Drawing on interview, survey and secondary data, three strategic drivers (and barriers) of NbS investment emerged: Socio-cultural, financial and governance. At operational level, four types of NbS (Grand, customized, large scale and niche) and four types of strategic opportunities emerged: Tolerable (low cost: low benefit), Ruinous (high cost: low benefit), Best case (low cost: high benefit) and Aspirational (high cost: high benefit). On the supply side, funding and maintenance capabilities are the primary barriers to NbS implementation. On the demand side, insight into public perception of NbS is crucial. Drawing from this data, the three pillars of successful NbS projects are: (1) Relevant policy frameworks (global, national and municipal), (2) supporting mechanisms and resources for public-private partnerships and (3) engaging all stakeholders through targeted communications emphasizing all forms of value.

Effect of p16 immunohistochemical expression (exp) on irinotecan in metastatic colorectal cancer (mCRC): A translational analysis of the TRIBE and TRIBE2 studies.

3562 Background: CDKN2A encodes the inhibitor of the cyclin-dependent kinases p16 and is frequently methylated in colorectal cancer, thus reducing the exp levels of p16 protein. In pre-clinical models of colorectal cancer cells, the demethylation of CDKN2A gene induces topoisomerase I upregulation increasing the sensitivity to irinotecan. In metastatic colorectal cancer (mCRC) pts, the role of p16 expression has been poorly investigated. Methods: Tumour samples of pts randomized in the phase III TRIBE2 study comparing upfront FOLFOXIRI/bevacizumab (bev) versus (vs) FOLFOX/bev were assessed for p16 immunohistochemical exp. A validation analysis in patients treated with FOLFIRI/bev in the TRIBE study was conducted. Results: Out of 679 patients enrolled in the TRIBE2 study, 231 tumours were assessed for p16 exp. Overall, 152 (66%), and 79 (34%) were classified as positive (pos) (IHC 2+ and 3+) and negative (neg) (IHC 0 and 1+), respectively. In the p16 pos group, 69 (45%) and 83 (55%) pts received FOLFOXIRI/bev and FOLFOX/bev, respectively, while in the p16 neg cohort, FOLFOXIRI/bev was administered in 37 (47%) and FOLFOX/bev in 42 (53%) cases. Pts with p16 neg tumours had more frequently an ECOG-PS of 1-2 (16% vs 6%, p=0.0098) and a BRAF mut tumour (26% vs 7%, p=0.0002). No PFS difference was observed between p16 neg and pos patients, while a trend for a longer OS was shown in favour of p16 pos pts (25.5 vs 21.3 months; HR: 0.74, 95%CI: 0.53-1.02, p=0.068) that was not confirmed at the multivariate analysis (p=0.61). Among patients with p16 pos tumours, those treated with FOLFOXIRI/bev reported longer PFS (12.8 vs 9.4 months, HR: 0.55, 95%CI: 0.39-0.78, p=0.0008) and OS (30.0 vs 21.4 months, HR: 0.66, 95%CI: 0.46-0.95, p=0.026) than those receiving FOLFOX/bev. On the other hand, no significant difference was observed among p16 neg patients in terms of both PFS (9.0 vs 9.4 months, HR: 0.91, 95%CI: 0.57-1.46, p=0.69) and OS (21.3 vs 19.5 months, HR: 0.95, 95%CI: 0.58-1.57, p=0.85), thus suggesting a differential treatment effect according to p16 exp (pinteraction for PFS =0.12; pinteraction for OS =0.19). Among patients treated with FOLFIRI/bev in the TRIBE study (N=58) patients with p16 pos tumours reported longer PFS and OS than those with p16 neg. (HR for PFS: 0.45, 95%CI: 0.22-0.92, p=0.026; HR for OS: 0.41, 95%CI: 0.20-0.85, p=0.013). Conclusions: In mCRC, p16 pos exp seems associated with higher benefit from irinotecan. Prospective confirmation in independent randomized series is warranted.

Sustainability performance of enhanced weathering across countries: A triple bottom line approach

Enhanced weathering (EW) is a promising negative emission technology involving the application of crushed silicate rocks to croplands for carbon capture. There is limited research about the broad sustainability impacts in rolling out this intervention on a large scale. This research assesses the triple bottom line sustainability of EW in eight top-emitting countries using an extended input-output model. Results indicate that overall sustainability performance of EW is influenced by each country's environmental and social metrics than the economic. Compared to developed countries (UK, France, Germany, USA), emerging economies (Brazil, Russia, India, China) show relatively lower economic sustainability due to high working hours impact but benefit from higher socio-economic contributions. Improving practices, particularly reducing emissions, energy use, labour rights and health and safety risk for silicate rock production, is vital for better sustainability outcomes.

Maximizing value through optimized annual selection of Pareto-optimal wind turbine operating strategies

Wind turbines as an investment aim at turning an initial expense into a profit. Naturally, the aim of developers and operators alike is to create an economic benefit that is as high as possible. Little changes to a wind turbine structure are possible once it is built, and wind as the ultimate power source cannot be influenced. The only available means to achieve a high economic benefit is through improved operations and maintenance. We developed a method for optimizing the operation of wind turbines that builds on condition-based adaptation of the power setpoint. It aims at balancing loads and power generation such that lifetime is increased, and the total economic value is improved over simpler operating schemes. In this contribution, we extend the method with an annually varying selection of different optimal operating strategies from an initial multiobjective optimization. We show three case studies that highlight the potential of annual variation and the margin with which it improves on operating at nominal power and over a fixed optimized operating strategy. In each case study, the net present value can be improved slightly over a lifetime-constant operating point that is selected once from the Pareto-front.

Ultra-fast catalytic oxidation of persulfate by waste fiber carbon with lattice distortion

Every year, a staggering 920,000 tons of chemical fiber textiles are discarded globally, presenting a pressing global challenge of how to extract their high-value utility. This research is dedicated to recovering carbon from waste chemical fiber textiles for catalytic oxidation and degradation of pharmaceutical intermediates in wastewater. Through the interaction of sulfonation and nitrogen doping, a synthetic fiber known as nitrogen-sulfonated doped carbon (SNBC) was skillfully synthesized, resulting in lattice distortion that effectively regulates the p-band center of the catalyst. The result was a significant increase in the interfacial electron transfer rate, which increased the surface electron transfer rate and catalytic removal rate of bisphenol AF by more than 6 times, while greatly reducing the number of oxidants required. This study provides an efficient method for the resource utilization of waste synthetic fiber textiles, which has the characteristics of low energy consumption and high economic benefit.

Clinical applicability of guideline-recommended molecular targets and genome-targeted cancer therapies.

11049 Background: Genomic testing has expanded the possibilities of precision medicine, particularly for advanced, treatment-resistant cancer cases. However, the clinical relevance of most genetic alterations remains uncertain, which can lead physicians to overestimate the benefits of tailored therapies. The National Comprehensive Cancer Network (NCCN) guidelines are cancer-specific treatment recommendations that often determine insurance coverage. We assessed the evidence for clinical benefit and actionability of molecular targets for genome-targeted cancer drugs recommended by NCCN. Methods: We identified genome-targeted therapies for solid cancers from the most recent NCCN guidelines. Trial design characteristics were obtained from publications supporting the NCCN recommendations. Genome target actionability was assessed with the European Society for Medical Oncology (ESMO) Scale for Clinical Actionability of molecular Targets (ESCAT). This ranges from genome alternation-therapy combinations that lead to improved outcomes (Tier I) to treatments with potential clinical relevance (Tiers II or III) to those with undetermined relevance (Tiers IV to X). Clinical benefit was evaluated using the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS). Molecular targets at ESCAT Tier I in combination with a given treatment associated with studies demonstrating substantial clinical benefit by ESMO-MCBS (Grades 4-5) were designated as high-benefit, while those linked to studies achieving an ESMO-MCBS Grade of 3 were categorized as promising but unproven. Results: We extracted411 recommendations from NCCN supporting 74 genome-targeted drugs targeting 50 driver alterations. Most recommendations (346/411, 84%) referred to clinical trial data, while one-sixth (65/411, 16%) relied on case reports or preclinical studies. Clinical trials were mostly Phase I or Phase II (271/346, 78%), single arm (262/346, 76%), and evaluated overall response rate as the primary endpoint (271/346, 78%). Over half of target recommendations had Tier I target actionability (246/411, 60%), over one-third were Tier II or III (142/411, 35%), and the rest were undetermined (23/411, 6%). Among 267 scorable trials,12% (32/267) demonstrated substantial clinical benefit (ESMO-MCBS Grades 4-5) and 45% (121/267) were Grade 3. When combining both frameworks,12% (32/267) genomic-based cancer treatments were high-benefit and 33% (88/267) were promising-but-unproven. Conclusions: About one-eighth of genome-targeted cancer therapies recommended in NCCN guidelines received a high benefit rating, while one-third were identified as having a promising but unproven substantial benefit according to the ESCAT and ESMO-MCBS frameworks. Ensuring NCCN recommendations are aligned with well-documented clinical benefits is crucial for promoting informed, evidence-based genomic-guided treatment decisions.

Proactive framework for obsolescence management of electrical equipment in oil and gas industry

PurposeEnergy consumption has increased significantly since the 1970s, which has increased demand for sufficient infrastructure in the oil and gas industry. Many top-notch oil and gas companies invested in and equipped their facilities with high-capacity electrical equipment to meet high demand and benefit from high revenues. This is becoming a challenge nowadays for old facilities in the oil and gas industry, as most of the electrical equipment installed has reached or even exceeded its lifetime. Moreover, many of the original equipment manufacturers (OEMs) for electrical equipment from the 1980s are no longer in market today. Therefore, the aim of this study is to develop a proactive, cost-effective obsolescence management framework for electrical equipment in the oil and gas industry, considering the aging factor of the equipment.Design/methodology/approachFirstly, the study begins with gathering available information and identifying criteria. Secondly, the data collection is evaluated by subject-matter-experts (SMEs) in asset management field to ensure compliance with updated international standards and relevant regulatory requirements. Thirdly, a multi-criteria decision-making process is used to rank criteria. Finally, a scoring system is developed to measure the electrical equipment obsoleteness.FindingsThe developed framework will assist decision-makers in making informed decisions about maintenance, replacement or upgrades, using knowledge from previous studies and experts’ input. The result finding indicates that considering aging correction factors when measuring equipment obsoleteness leads to accurately and correctly predicting the electrical equipment obsoleteness score.Originality/valuePrevious studies have addressed obsolescence management without taking equipment age into account, regardless of how the equipment is performing. Thus, the lack of a comprehensive obsolescence management framework that accounts for both cost-effectiveness and the aging factor in the oil and gas industry poses a critical challenge.

Android Needs Analysis as A Mobile Learning Media in Special School

The study aims to collect data to measure the benefits and constraints of using Android smartphones as mobile learning in special education institutions and why they are needed. This study uses a descriptive quantitative method using a questionnaire distributed through google forms filled out by 62 teachers of special or inclusive schools in Indonesia. The data analysis method was carried out using SPSS 25 with the following instrument scale and category by Azwar (2014). The results of this study are that teachers experience high benefits of 62.9%, experience several obstacles, and show the highest score at moderate with 82.3% percent. The teacher also feels that using Android as a learning media is easy because various platforms are provided. However, apart from the benefits, teachers also experience several obstacles in their use, such as the lack of socialization or training, and concern about the negative impact on students with special needs.

Resistance to immune checkpoint inhibitors in colorectal cancer with deficient mismatch repair/microsatellite instability: misdiagnosis, pseudoprogression and/or tumor heterogeneity?

Colorectal carcinoma (CRC) with deficiency of the deficient mismatch repair (dMMR) pathway/microsatellite instability (MSI) is characterized by a high mutation load and infiltration of immune cells in the tumor microenvironment. In agreement with these findings, clinical trials have demonstrated a significant activity of immune checkpoint inhibitors (ICIs) in dMMR/MSI metastatic CRC (mCRC) patients and, more recently, in CRC patients with early disease undergoing neoadjuvant therapy. However, despite high response rates and durable clinical benefits, a fraction of mCRC patients, up to 30%, showed progressive disease when treated with single agent anti-programmed cell death 1 (PD-1) antibody. This article discusses the three main causes that have been associated with early progression of dMMR/MSI mCRC patients while on treatment with ICIs, i.e., misdiagnosis, pseudoprogression and tumor heterogeneity. While pseudoprogression probably does not play a relevant role, data from clinical studies demonstrate that some dMMR/MSI CRC cases with rapid progression on ICIs may be misdiagnosed, underlining the importance of correct diagnostics. More importantly, evidence suggests that dMMR/MSI mCRC is a heterogeneous group of tumors with different sensitivity to ICIs. Therefore, we propose novel diagnostic and therapeutic strategies to improve the outcome of dMMR/MSI CRC patients.

#1216 Comparable outcomes for old, older and very old deceased donors in old kidney transplant recipients

Abstract Background and Aims Old patients (≥ 65 years) make up almost 1/3 of the waiting list for kidney transplantation in the Netherlands, and this proportion continues to rise. These patients have a high waitlist mortality and benefit from early transplantation, even with kidneys from older or ‘marginal’ donors. Transplanting marginal donor kidneys may help to cut the proportion of elderly patients on the waiting list and improve clinical outcomes. More epidemiological support regarding the graft outcomes of old, older and very old donor kidneys is needed to support clinicians in accepting these kidneys. We therefore studied the outcomes of these kidneys in old recipients. Method Retrospective cohort study of all kidney transplant recipients ≥ 65 years with a deceased donor ≥ 65 years in the Netherlands between 2005 and 2022. Discarded kidneys from deceased donors ≥ 65 years in the same time period were included as well. Donors were categorized into old (65-69 years, OD), older (70-74, OD+) and very old (75+, OD++). Results We included 1301 transplantations from donors ≥ 65 years, of which 435 from an OD+ and 90 from an OD++. Median recipient age was 69 years (66 - 72), 67% was male. The transplanted OD+ and OD++ kidneys were more often from DBD donors (OD 42%, OD+ 51.3%, OD++ 70%, P &amp;lt; 0.01) with lower nadir creatinine compared to the OD kidneys (61.0 umol/l [51.0, 74.0] vs. OD+ 59.0 [49.0, 72.0] P = .034, vs OD++ 58.0 [49.0, 64.5] P = .021). Patient survival was similar for recipients of OD, OD+ and OD++ kidneys at one year (91% vs 89% vs 93%, respectively; Plog-rank = 0.3) and at five years (60% vs 60% vs 64%; Plog-rank = 0.2) after transplantation. Additionally, in multivariable Cox regression, donor age category was not associated with recipient mortality risk (Ref = OD. OD+: P = .7; OD++: P = .2). Death-censored graft survival was ≥92% in all groups after 1 year, and did not differ significantly between donor age categories (PGray's = 0.2). Results remained non-significant in multivariate Cox regression (Ref = OD, OD+: P = .942; OD++: p = 0.403). Kidneys offered but not accepted for transplantation (before procurement) had a higher serum nadir creatinine in comparison with transplanted kidneys (68 umol/L [56 - 84] vs 61 umol/L [51 - 78], P &amp;lt; .001), and were more often from DCD donors (79% vs 53%, P &amp;lt; .001). However, donor characteristics of many discarded kidneys resembled that of successfully transplanted kidneys. Conclusion Recipient and graft survival are good and similar for old patients receiving kidneys from old, older and very old deceased donors. These findings may contribute to a wider acceptance of kidneys from these donors.

Risk stratification and survival time of patients with gram-negative bacillary pneumonia in the intensive care unit.

Pneumonia is a common infection in the intensive care unit (ICU), and gram-negative bacilli are the most common bacterial cause. The purpose of the study was to investigate the risk factors for 30-day mortality in patients with gram-negative bacillary pneumonia in the ICU, construct a predictive model, and stratify patients based on risk to assess their short-term survival. Patients admitted to the ICU with gram-negative bacillary pneumonia at Fujian Medical University Affiliated First Hospital between January 2018 and September 2020 were selected. Patients were divided into deceased and survivor groups based on whether death occurred within 30 days. Multifactorial logistic regression analysis was used to identify independent risk factors for 30-day mortality in these patients, and a predictive nomogram model was constructed based on these factors. Patients were categorized into low-, medium-, and high-risk groups according to the model's predicted probability, and Kaplan-Meier survival curves were plotted to assess short-term survival. The study included 305 patients. Lactic acid (odds ratio [OR], 1.524, 95% CI: 1.057-2.197), tracheal intubation (OR: 4.202, 95% CI: 1.092-16.169), and acute kidney injury (OR:4.776, 95% CI: 1.632-13.978) were identified as independent risk factors for 30-day mortality. A nomogram prediction model was established based on these three factors. Internal validation of the model showed a Hosmer-Lemeshow test result of X2=5.770, P=0.834, and an area under the ROC curve of 0.791 (95% CI: 0.688-0.893). Bootstrap resampling of the original data 1000 times yielded a C-index of 0.791, and a decision curve analysis indicated a high net benefit when the threshold probability was between 15%-90%. The survival time for low-, medium-, and high-risk patients was 30 (30, 30), 30 (16.5, 30), and 17 (11, 27) days, respectively, which were significantly different. Lactic acid, tracheal intubation, and acute kidney injury were independent risk factors for 30-day mortality in patients in the ICU with gram-negative bacillary pneumonia. The predictive model constructed based on these factors showed good predictive performance and helped assess short-term survival, facilitating early intervention and treatment.