Observational Database Research Articles

Impact of Surface Roughness Changes on Surface Wind Speed Over Western Europe: A Study With the Regional Climate Model RACMO

AbstractThe temporal trend of wind speed near the surface over land has been investigated over recent decades. A prevailing trend of decline was found in several studies for most areas in the Northern hemisphere, denoted as terrestrial stilling, with multiple causes being discussed. In this study, we focus on the impact of changes of surface roughness due to changes in land‐use and vegetation cover on this variable for western Europe using the regional climate model RACMO driven by ERA5 reanalysis. We conduct two simulations at climate scale, with and without changes in land‐use and vegetation on a yearly basis. We find that upper level large‐scale circulation slowing down results in declining near surface mean wind speed, and that increases in surface roughness due to changes in land use and vegetation cover play an important role in intensifying this declining trend from our simulations with RACMO. However, the trends inferred from the model simulations and ERA5 are not consistent with trends derived from gridded observations database E‐OBS. This could come from the complexity of integrating in‐situ measurements with uncorrectable inhomogeneity to derive E‐OBS.

An extensive database of airborne trace gas and meteorological observations from the Alpha Jet Atmospheric eXperiment (AJAX)

Abstract. The Alpha Jet Atmospheric eXperiment (AJAX) flew scientific flights between 2011 and 2018 providing measurements of trace gas species and meteorological parameters over California and Nevada, USA. This paper describes the observations made by the AJAX program over 229 flights and approximately 450 h of flying. AJAX was a multi-year, multi-objective, multi-instrument program with a variety of sampling strategies resulting in an extensive dataset of interest to a wide variety of users. Some of the more common flight objectives include satellite calibration/validation (GOSAT, OCO-2, TROPOMI) at Railroad Valley and other locations and long-term observations of free-tropospheric and boundary layer ozone allowing for studies of stratosphere-to-troposphere transport and long-range transport to the western United States. AJAX also performed topical studies such as sampling wildfire emissions, urban outflow and atmospheric rivers. Airborne measurements of carbon dioxide, methane, ozone, formaldehyde, water vapor, temperature, pressure and 3-D winds made by the AJAX program have been published at NASA's Airborne Science Data Center (https://asdc.larc.nasa.gov/project/AJAXTS9 (last access: 1 November 2022), https://doi.org/10.5067/ASDC/SUBORBITAL/AJAX/DATA001, Iraci et al., 2021a).

Development and evaluation of the channel routing model and parameters within the National Water Model

AbstractThe National Water Model (NWM) was deployed by the National Oceanic and Atmospheric Administration to simulate operational forecasts of hydrologic states across the continental United States. This paper describes the geospatial river network (“hydro‐fabric”), physics, and parameters of the NWM, elucidating the challenges of extrapolating parameters a large scale with limited observations. A set of regression‐based channel geometry parameters are evaluated for a subset of the 2.7 million NWM reaches, and the riverine compound channel scheme is described. Based on the results from regional streamflow experiments within the broader NWM context, the compound channel reduced the root mean squared error by 2% and improved median Nash–Sutcliffe efficiency by 16% compared with a non‐compound formulation. Peak event analysis from 910 peak flow events across 26 basins matched from the US Flash Flood Observation Database revealed that the mean timing error is 3 h lagged behind the observations. The routing time step was also tested, for 5‐min (default, operational setting) and 1‐h increments. The model was computationally stable and able to convey the flood peaks, although the hydrograph shape and peak timing were altered.

THE ROLE OF ISLAMIC RELIGIOUS EDUCATION TEACHERS IN INCREASING STUDENTS' RELIGIOUS AWARENESS

Religious awareness is an attitude, experience, feeling and religious behavior that occurs within a person which is organized in the mental system of the personality of each individual. Religion involves all the functions of the human body and soul, so religious awareness also includes affective, conative, cognitive and motor aspects. The involvement of the affective and conative aspects appears in the experience of God, religious feelings and longing for God. The cognitive aspect is seen in the attitude of faith and belief, while the involvement of motor functions can be seen from the actions and movements of religious behavior. The research methodology used in this study is a qualitative research method with observation-based data collection techniques. The aim of this study was to determine the teacher's role in building religious awareness in students. The results of his research are that teachers familiarize students with religious practices and habits, create affection and harmonious relationships between teachers and students, motivate students to memorize selected verses of the Al-Qur'an, provide understanding and awareness to students of the importance of Islamic Religious Education , accustom students to always apply commendable traits and good morals.

Use of proton pump inhibitors (PPI) in glioblastoma (GBM) and relationship to overall survival in a national real-world evidence (RWE) database.

e14027 Background: Aldehyde dehydrogenase-1A1 ( ALDH1A1) mediates therapy resistance and poor prognosis in multiple cancers. In GBM, ALDH1A1 expression above vs. below the mean is associated with a significant reduction in survival.1 ALDH enzymes activate transcriptional programs that induce the cancer stem cell phenotype, detoxify anticancer drugs, and function as antioxidants by reversing lipid peroxidation and etheno-DNA adducts, thus conferring chemotherapy and radiation resistance. PPI have been shown to increase enzyme activity of ALDH1A1 up to 6-fold, suggesting a potentially hazardous effect on tumor biology and survival. However, no prospective randomized data are available to address these concerns. Thus, we turned to XCELSIOR, an observational database that prospectively collects medical records including medication usage. Methods: Patients with GBM were e-consented to XCELSIOR ( NCT03793088 ), a nationwide observational research protocol that leverages patient consent to permit gathering of medical records from all sites of care. Clinical data were abstracted from medical documents into a central EDC system, source-verified, and standardized to generate comprehensive longitudinal histories for aggregate analysis. Identified patient records permitted the definitive identification of dates of diagnosis and death. Overall survival (OS) was calculated and stratified based for PPI exposure, extent of surgical resection (EOR), and MGMT methylation status. Results: XCELSIOR contained 320 GBM patients from 222 treatment sites. We stratified patients based on exposure to PPI and assessed median OS (mOS). For the entire population, mOS was substantially better for patients not receiving PPI. (TABLE) The 5-yr survival was 29.9% [21.0 – 42] and 6.6% [1.4 – 32.0] for patients not receiving vs. receiving PPI. In a multivariate analysis considering EOR and MGMT methylation, PPI exposure yielded a hazard ratio (HR) of 1.57 (p=0.009). For the interaction of m-MGMT and PPI exposure together, the HR is 2.63 (p=0.043), significant as the HR of m-MGMT alone is 0.40 (p=0.0028). Conclusions: In this RWE dataset, PPI use in GBM appeared detrimental to survival. This is strongly consistent with the hypothesis that PPI antagonizes chemotherapy. Additionally, use of PPI appeared to completely abrogate the survival benefit of chemotherapy associated with methylated-MGMT. While we recognize the utility of PPI in managing acute UGI bleeding, these data suggest avoiding PPIs in GBM patients. 1) Schmidt-Graf F, et al. Neuro Oncol. 2012;14(12):1452–1464. [Table: see text]

Information society development study in the field of e-commerce

The development of information technologies and the transition to a digital economy have transformed the traditional business process models of organizations. New technological opportunities and changes in the way products are purchased and delivered over the past few years have led to an intense growth in e-commerce. Indicators of the dynamics of this area of development of the information society are included in the digital transformation strategy of the Russian Federation. The article discusses the trends in e-commerce and analyzes the factors influencing this sector of the economy. A database of federal statistical observations on the issues of monitoring the development of the information society in the Russian Federation was used. The interdependencies of development indicators that characterize e-commerce are analyzed in detail with indicators for such sections and subsections as «1.4. Economic environment», «2.6. Use of ICT in households and by the population» and «Use of computers and computer networks by organizations». In the course of the study, it was revealed that some of the development indicators of the IO RF, characterizing areas related to the characteristics of e-business, have stable interdependencies with the indicated indicators. This applies to the indicators chosen for the study «The share of the population that used the Internet to order goods and (or) services in the total population» and «The share of organizations that received orders for manufactured goods (works, services) via the Internet, in the total number of surveyed organizations». The tightness of the correlation is noted from noticeable to very high. There is a positive trend in the increase in the share of e-commerce. The indicator «The share of organizations that placed orders for goods (works, services) on the Internet in the total number of surveyed organizations» shows a weaker interdependence, and in some cases — a weak correlation or its absence. This is due to its weak changes in the studied time range.

Human activities change suspended sediment concentration along rivers

Humans have drastically disrupted the global sediment cycle. Suspended sediment flux and concentration are key controls over both river morphology and river ecosystems. Our ability to understand sediment dynamics within river corridors is limited by observations. Here, we present RivSed, a database of satellite observations of suspended sediment concentration (SSC) from 1984 to 2018 across 460 large (>60 m wide) US rivers that provides a new, spatially explicit view of river sediment. We found that 32% of US rivers have a declining temporal trend in sediment concentration, with a mean reduction of 40% since 1984, whereas only 2% have an increasing trend. Most rivers (52%) show decreasing sediment concentration longitudinally moving downstream, typically due to a few large dams rather than the accumulated effect of many small dams. Comparing our observations with modeled ‘pre-dam’ longitudinal SSC, most rivers (53%) show different patterns. However, contemporary longitudinal patterns in concentration are remarkably stable from year to year since 1984, with more stability in large, highly managed rivers with less cropland. RivSed has broad applications for river geomorphology and ecology and highlights anthropogenic effects on river corridors across the US.

Breast cancer: Global patterns of incidence, mortality, and trends.

10528 Background: The global burden of cancer incidence and mortality including that of female breast cancer continues to increase largely because of the growth and aging of the population and adoption of western lifestyle behaviors that increase cancer risk. In this study, we summarize the current burden, trends, and survivorship of female breast cancer that account for nearly 12% of the cancer burden worldwide. Methods: Estimates of incidence and mortality in the year 2020 were obtained from Global Cancer Observatory (GLOBOCAN) database. GLOBOCAN provides country-specific estimates of cancer incidence, mortality, and prevalence for 185 countries or territories and 36 cancer types by age group and sex. For US rates, data from Surveillance, Epidemiology, and End Results (SEER) program were assessed. Rates are age-standardized (ASRs) (per 100,000 person-years) using the 1966 Segi-Doll World Standard Population. Geographic variability was assessed using 20 predefined world regions, and the 4-tier Human Development Index (HDI). Finally, we provide a prediction of the future burden of female breast cancer in 2040 based on demographic projections. Results: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide, with an estimated 2.3 million new cancer cases (1 in 4 new cancer cases) and 685,000 cancer deaths (1 in 6 deaths) in 2020. Breast cancer incidence rates varied by nearly 4-fold across WHO areas. The highest incidence rates (per 100,000) were found in Australia/New Zealand (95.5), Western Europe (90.7), and Northern America (89.4), while the lowest rates were in South-Central Asia (26.2), Middle and Eastern Africa (33), and Central America (39.5). In contrast, the highest breast cancer mortality rates were recorded in Melanesia (37.5), Polynesia and Western Africa (22.3), and the Caribbean (18.9), while the lowest rates were found in Eastern Asia (9.8), Central America (10.4), and Australia/New Zealand (12.1), a 2.8-fold difference. In the United States, the age-standardized breast cancer incidence rate (per 100,000) increased from 106 (1975) to 142 (1999), decreased to 128 (2004), and then slowly increased to 137 (per 100,000) in 2019. Similar broad temporal trend patterns were observed in other western countries. Incidence rates are rising in South America, Africa, and Asia where rates were historically low. Worldwide, an estimated 2,964,197 new female breast cancer cases are projected to occur in 2040, a 31% increase from the corresponding 2,260,127 cases in 2020. Conclusions: There is significant variation in female breast cancer incidence and mortality rates worldwide. Breast cancer incidence is increasing at different rates in various regions of the world. Mortality rates in many high HDI countries have been on the decline, in contrast to increasing rates in low HDI countries. This study also shows a substantial increase in new breast cancer diagnoses over the next two decades.

National income and macro-economic correlates of the double burden of malnutrition: an ecological study of adult populations in 188 countries over 42 years

The double burden of malnutrition (DBM) represents a growing global challenge with adverse health and economic consequences. We aimed to investigate the associative roles of national income (gross domestic product per capita [GDPPC]) and macro-environmental factors on the DBM trends among national adult populations. In this ecological study we assembled extensive historical data on GDPPC from the World Bank World Development Indicators database and population-level DBM data of adults (aged ≥18 years) from the WHO Global Health Observatory database in 188 countries over 42 years (1975-2016). In our analysis, a country was considered to have the DBM in a year when adult overweight (BMI ≥25·0 kg/m2) and underweight (BMI <18·5 kg/m2) prevalence was each 10% or more in that year. We used a Type 2 Tobit model to estimate the association of GDPPC and selected macro-environmental factors (globalisation index, adult literacy rate, female share in the labour force, share of agriculture in the national gross domestic product [GDP], prevalence of undernourishment, and percentage of principal display area mandated to be covered by health warnings on cigarette packaging) with DBM in 122 countries. We find a negative association between GDPPC and the likelihood of a country having the DBM. However, conditional on its presence, DBM level exhibits an inverted-U shaped association with GDPPC. We found an upward shift in DBM levels from 1975 to 2016 across countries at the same level of GDPPC. Among the macro-environmental variables, share of females in the labour force and share of agriculture in the national GDP are negatively associated with DBM presence in a country, whereas the prevalence of undernourishment in the population is positively associated. Further, globalisation index, adult literacy rate, share of females in the labour force, and health warnings on cigarette packaging are negatively associated with DBM levels in countries. DBM level in national adult populations rises with GDPPC until US$11 113 (in 2021 constant dollar terms) and then starts declining. Given their current GDPPC levels, most low-income and middle-income countries are thus unlikely to have a decline in the DBM levels in the near future, ceteris paribus. Those countries will also be expected to experience a higher DBM level at similar levels of national income than were historically experienced by the current high-income countries. Our findings point to a further intensification of the DBM challenge in the near future for the low-income and middle-income countries as they continue to have income growth. None.

Real-world outcomes of brexucabtagene autoleucel (brexu-cel) for relapsed or refractory (R/R) mantle cell lymphoma (MCL): A CIBMTR subgroup analysis by prior treatment.

7507 Background: Brexu-cel is a CAR T therapy approved for adult patients (pts) with R/R MCL. In a 3-year follow-up of ZUMA-2 (Wang et al., 2022), ORR was 91% (CR 68%). Median DOR, PFS and OS were 28.2, 25.8 and 46.6 mo respectively. Here, we describe real-world outcomes of brexu-cel by receipt of prior BTK inhibitor (BTKi), bendamustine, autoHCT, and 1-2 vs ≥ 3 prior lines of therapy. Methods: From 07/2020-08/2022, 397 pts receiving brexu-cel for R/R MCL from 79 US centers were registered in the CIBMTR observational database. In this analysis, 272 were included (median follow-up 6.6 mo; range 0.3-16.5), excluding pts with prior non-HCT cellular therapy (n = 7), missing data on prior treatment, or no follow-up. Descriptive analyses were used for all outcomes. Results: Median age was 65.8 years (range 34.1-84.9); pts were mostly male (78%). Prior to infusion, 7% had ECOG PS ≥ 2; 76% had clinically significant comorbidities; 4% had extranodal CNS involvement. At diagnosis, Ki-67 ≥ 30%, Ki-67 ≥ 50% and TP53/17p deletion were seen in 69% (n = 111/160), 44% (n = 70/160) and 19% (n = 29/153) of pts respectively. Pts had a median of 4 lines of prior therapy (range 1-12; 6% as 2L). Prior to leukapheresis, 87% were BTKi-exposed; 54% received bendamustine; 31% were autoHCT recipients. Median time from leukapheresis to infusion was 28 d (IQR 26-34 d), during which 18% received bridging therapy. ORR for all was 89% (CR 78%). At 6 mo, cumulative incidence of relapse/PD was 21%; DOR, PFS and OS were 76%, 73% and 83% respectively. Grade ≥ 3 (ASTCT consensus) CRS and ICANS occurred in 9% and 27% of pts (88% and 62% for any grade). Most CRS (94%) and ICANS (79%) resolved within 3 weeks. Prolonged cytopenia by 30 d occurred in 23% pts. NRM at 100 d and 180 d were 3% and 6% respectively, mainly due to infections. ORR for BTKi-naïve (n = 36) vs -exposed (n = 233) pts was 85% (CR 79%; 6-mo DOR 84%) vs 89% (CR 77%; 6-mo DOR 74%); for pts with (n = 145) vs without (n = 124) prior bendamustine was 88% (CR 75%; 6-mo DOR 75%) vs 89% (CR 80%; 6-mo DOR 77%); for pts with (n = 83) vs without (n = 188) prior autoHCT was 90% (CR 82%; 6-mo DOR 83%) vs 88% (CR 76%; 6-mo DOR 72%). Higher CR rates were seen in pts with brexu-cel as 2/3L (n = 56) vs 4L+ (n = 213) (91% vs 74%; ORR 92% vs 88%; 6-mo DOR 77% vs 75%). Similar safety profiles were seen regardless of prior BTKi or autoHCT. Pts with prior bendamustine had fewer Grade ≥ 3 ICANS (19% vs 36%) but more prolonged cytopenia (29% vs 16%) vs pts without. Conclusions: These early findings suggest that real-world outcomes of brexu-cel are consistent regardless of prior BTKi, bendamustine, or autoHCT. Use of brexu-cel in earlier lines may help achieve a higher CR rate. Further studies with longer follow-up are warranted to contextualize response rates in relation to long-term clinical benefits of brexu-cel. Updated data with longer follow-up will be reported at the time of presentation. SK and NA contributed equally.

Simulation of extreme rainfall events in Uruguay: Role of initialization and large scale dynamics

We investigate the role of initial conditions in the simulation of extreme rainfall events in summer (December–January-February) in Uruguay using RegCM4.7. Although extreme events are defined for the south of the country, considering the dimensions of these kind of events, the validation is performed in a larger region. Firstly, the quality of the observational database is analyzed and filtered. Then, RegCM4.7 is run in two different modes. The first mode is weather like (WL), where the model is initialized with reanalysis 24 h before the extreme event date. The second one is climate mode (CM), that simulates 5 months (starting 1st October) and their initial conditions are realistic only for the first day. Then, simulated rainfall were compared to the observations with Taylor diagrams, Spearman correlations and accumulated values. The difference in the ability of both modes is associated to the role of initial conditions. Overall, half of the extreme events were simulated with good skill in WL while CM was able to skillfully simulate 28% of the events. This difference is attributed to the better simulation of atmospheric circulation in WL, especially in low levels. However, in some particular cases, relevant atmospheric variables were more realistic in CM and its rainfall simulations did also. Finally, we found that in CM, most of the model's skill comes from the large scale circulation anomalies associated with ENSO teleconnections in subtropical South America.

Real-world program-based lung cancer care.

6581 Background: Low dose CT screening (LDCT) and lung nodule programs (LNP) promote early lung cancer detection, improve survival; Multidisciplinary Care Programs (MDC) promote guideline-concordance. The impact of such program-based care on ‘real-world’ population-level lung cancer survival and mortality is uncertain. We evaluated program-based lung cancer care versus care outside structured programs in a large community healthcare system. Methods: We linked prospective observational databases for LDCT, LNP and MDC with the Tumor Registry of Baptist Cancer Center facilities across Mississippi, Arkansas and Tennessee, categorizing all lung cancer patients between 2011 and 2021, according to program- (LDCT, LNP, MDC) versus non-program-based care. We compared stage distribution, care patterns, survival and mortality by standard statistical methods. Results: Of 12,089 patients, 250 (2%), 1236 (10%), 1045 (7%) and 9558 (79%) were diagnosed through the LDCT, LNP, MDC or no program, respectively; non-program-based care sequentially diminished from 96% in 2011 to 67% in 2021, diagnosis through LDCT increased from 0.3% to 7%, LNP from 0.9% to 21%; and MDC alone decreased from a high of 13% in 2015 to 5% in 2021. Black persons, 28% of the whole cohort, were 13% of LDCT, 25% of LNP, 31% of MDC, and 28% of non-program-based care recipients (p = 0.0005). Median (IQR) tumor size was 20mm (13 – 34), 25mm (17 – 44), 35mm (20 – 55) and 35mm (20 – 55), respectively (p &lt; 0.0001); 40-46% of patients across programs had adenocarcinoma; clinical stage was I or II in 58%, 48%, 38% and 29% and IV in 16%, 27%, 31% and 42% in the respective programs (p &lt; 0.0001). 2609 patients (21.6%) had surgery, including 49.2%, 37.7%, 36.1% and 17.2% in LDCT, LNP, MDC and non-program-based care respectively, among whom aggregate pathologic stage was I in 76%, 71%, 54% and 60% (p = 0.0005). Surgery was the sole treatment modality in 27.6%, 21.5%, 12.9% and 10.6%, respectively (p &lt; 0.0001). Despite higher proportions with more advanced pathologic stage, 30.8% of recipients of non-program-based care received adjuvant therapy, compared to 42% among recipients of program-based care, including 39.0%, 37.1% and 49.3% in LDCT, LNP and MDC, respectively (p &lt; 0.0001); 8.7% of patients in programs received no treatment, compared to 20.1% of non-program-based care. Aggregate 5-year overall survival rates were 60% (95% CI: 52% - 69%), 45% (95% CI: 42% - 49%), 30% (95% CI: 27% - 33%), and 18% (95% CI: 17% - 19%), respectively (p &lt; 0.0001). Adjusting for age, sex, race, patient-level rurality and histology, with non-program-based care as reference, the aHR were 0.3 (95% CI: 0.234 – 0.373), 0.51 (95% CI: 0.464 – 0.556, and 0.66(95% CI: 0.607 – 0.712). Results were consistent even without patients who received no treatment. Conclusions: Program-based care was associated with more favorable lung cancer characteristics, better quality of care and survival. Disseminating program-based care should be explored as a matter of urgent public policy.

Hydrological forecasting at impact scale: the integrated ParFlow hydrological model at 0.6 km for climate resilient water resource management over Germany

In the context of the repeated droughts that have affected central Europe over the last years (2018–2020, 2022), climate-resilient management of water resources, based on timely information about the current state of the terrestrial water cycle and forecasts of its evolution, has gained an increasing importance. To achieve this, we propose a new setup for simulations of the terrestrial water cycle using the integrated hydrological model ParFlow/CLM at high spatial and temporal resolution (i.e., 0.611 km, hourly time step) over Germany and the neighboring regions. We show that this setup can be used as a basis for a monitoring and forecasting system that aims to provide stakeholders from many sectors, but especially agriculture, with diagnostics and indicators highlighting different aspects of subsurface water states and fluxes, such as subsurface water storage, seepage water, capillary rise, or fraction of plant available water for different (root-)depths. The validation of the new simulation setup with observation-based data monthly over the period 2011–2020 yields good results for all major components of the terrestrial water cycle analyzed here, i.e., volumetric soil moisture, evapotranspiration, water table depth, and river discharge. As this setup relies on a standardized grid definition and recent globally available static fields and parameters (e.g., topography, soil hydraulic properties, land cover), the workflow could easily be transferred to many regions of the Earth, including sparsely gauged regions, since ParFlow/CLM does not require calibration.

Changes in the distribution of annual maximum temperatures in Europe

Abstract. In this study we detect and quantify changes in the distribution of the annual maximum daily maximum temperature (TXx) in a large observation-based gridded data set of European daily temperature during the years 1950–2018. Several statistical models are considered, each of which analyses TXx using a generalized extreme-value (GEV) distribution with the GEV parameters varying smoothly over space. In contrast to several previous studies which fit independent GEV models at the grid-box level, our models pull information from neighbouring grid boxes for more efficient parameter estimation. The GEV location and scale parameters are allowed to vary in time using the log of atmospheric CO2 as a covariate. Changes are detected most strongly in the GEV location parameter, with the TXx distributions generally shifting towards hotter temperatures. Averaged across our spatial domain, the 100-year return level of TXx based on the 2018 climate is approximately 2 ∘C (95 % confidence interval of [2.03,2.12] ∘C) hotter than that based on the 1950 climate. Moreover, averaged across our spatial domain, the 100-year return level of TXx based on the 1950 climate corresponds approximately to a 6-year return level in the 2018 climate.

Global incidence and mortality trends of corpus uteri cancer and associations with gross domestic product, human development index, lifestyle, and metabolic risk factors.

To evaluate the worldwide distribution, risk factors, and temporal trends of corpus uteri cancer for different countries and age groups. Data relating to corpus uteri cancer in 2020 were retrieved from the Global Cancer Observatory database. Data from Cancer Incidence in Five Continents and the WHO mortality database were used for trend analysis. Age-standardized rates (ASR, per 100 000 persons) were calculated for incidence and mortality. Joinpoint regression analysis was used to estimate the 10-year annual average percent change (AAPC). A total of 417 367 new cases and 97 370 new deaths of corpus uteri cancer were reported globally in 2020. The highest incidence was observed in high-income countries. Higher ASR of mortality of corpus uteri cancer was associated with a higher gross domestic product per capita, higher Human Development Index, and higher prevalence of smoking, alcohol drinking, physical inactivity, obesity, hypertension, diabetes, and lipid disorders. There was a substantial increasing trend of corpus uteri cancer, with the largest AAPC in incidence found in Japan, followed by India, Chile, Korea, and Thailand. The incidence and mortality of corpus uteri cancer have been increasing substantially for the past 10 years. Intensive lifestyle modifications are needed, especially among younger women.

Association Between Industry Sponsorship of Spine-Related Clinical Trials, Publication Status, and Research Outcomes.

Observational Database Study. Prospective clinical trials in spinal surgery are expensive to conduct, especially when randomized, appropriately powered, and/or multicentered. Industry collaborations generate symbiotic relationships promoting technological advancement; however, they also allow for bias. To the authors' knowledge, there is no known analysis of correlations between industry sponsorship and publication rates of spine-related clinical trials. This observational work evaluates such potential associations. The ClinicalTrials.gov database was queried with terms spine, spinal, spondylosis, spondylolysis, cervical, lumbar, and compression fracture over an 11-year period. Design characteristics and outcomes were recorded from 822 spine surgery-related trials. Trials were stratified based on funding source and intervention class. Groups were compared via two-tailed chi-square test of independence or Fisher's exact test (α = .05), based on completion status and publication rates of positive vs negative results. Industry-sponsored spine-related clinical trials were more likely to be terminated than their non-industry-sponsored counterparts (P < .001). Of the trials achieving publication, industry-sponsored trials reported positive results at a higher rate than did trials without industry funding (P = .037). Clinical trials examining devices were more likely to be terminated than those studying other intervention classes (P = .001). High termination rates and positive result publication rates among industry-sponsored clinical trials in spinal surgery likely reflect industry's influence on the research community. Such partnership alleviates financial burden and provides accessibility to cutting-edge innovation. It is essential that all parties remain mindful of the significant bias that funding source may impart on study outcome.

Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database

BackgroundDespite evidence suggesting a higher risk of barotrauma during COVID-19-related acute respiratory distress syndrome (ARDS) compared to ARDS due to other causes, data are limited about possible associations with patient characteristics, ventilation strategy, and survival.MethodsThis prospective observational multicenter study included consecutive patients with moderate-to-severe COVID-19 ARDS requiring invasive mechanical ventilation and managed at any of 12 centers in France and Belgium between March and December 2020. The primary objective was to determine whether barotrauma was associated with ICU mortality (censored on day 90), and the secondary objective was to identify factors associated with barotrauma.ResultsOf 586 patients, 48 (8.2%) experienced barotrauma, including 35 with pneumothorax, 23 with pneumomediastinum, 1 with pneumoperitoneum, and 6 with subcutaneous emphysema. Median time from mechanical ventilation initiation to barotrauma detection was 3 [0–17] days. All patients received protective ventilation and nearly half (23/48) were in volume-controlled mode. Barotrauma was associated with higher hospital mortality (P < 0.001) even after adjustment on age, sex, comorbidities, PaO2/FiO2 at intubation, plateau pressure at intubation, and center (P < 0.05). The group with barotrauma had a lower mean body mass index (28.6 ± 5.8 vs. 30.3 ± 5.9, P = 0.03) and a higher proportion of patients given corticosteroids (87.5% vs. 63.4%, P = 0.001).ConclusionBarotrauma during mechanical ventilation for COVID-19 ARDS was associated with higher hospital mortality.

No ‘Wearing-Off Effect’ Seen with Fremanezumab in the Real-World: Retrospective, Claims-Based Analysis of Migraine-Related Healthcare Resource and Acute Medication Use (P12-12.005)

No ‘Wearing-Off Effect’ Seen with Fremanezumab in the Real-World: Retrospective, Claims-Based Analysis of Migraine-Related Healthcare Resource and Acute Medication Use (P12-12.005)

MGBase: The launch of an international electronic database for patients with Myasthenia Gravis (P7-8.014)

MGBase: The launch of an international electronic database for patients with Myasthenia Gravis (P7-8.014)

Identifying Key Components for Diagnosing Stiff Person Syndrome Spectrum Disorders: A Sensitivity and Specificity Study (P4-5.018)

<h3>Objective:</h3> To evaluate the sensitivity and specificity of clinical and paraclinical features of stiff person syndrome spectrum disorders (SPSD) to help aid in their diagnosis. <h3>Background:</h3> SPSD are a group of rare, disabling neuroimmunological disorders. SPSD is often challenging to diagnose since it can be insidious in nature and hallmark symptoms and signs are not readily identified by clinicians. Moreover, there is limited data on which clinical feature(s) and diagnostic test(s) are most helpful in making a diagnosis of SPSD. <h3>Design/Methods:</h3> The Johns Hopkins SPS center’s longitudinal observational database was used, which contains clinical characteristics, and diagnostic studies of people with SPSD. Patients with a diagnosis of either Classic SPS or SPS-plus phenotypes were compared to patients who were evaluated for SPSD but received an alternative diagnosis (control group). Each clinical and paraclinical feature important for a diagnosis of SPSD was evaluated for its sensitivity and specificity, and used to define its diagnostic odds ratio. <h3>Results:</h3> A total of 161 Classic SPS cases, 45 SPS-plus cases, and 66 controls were included. The most sensitive findings for classic SPS included clinical involvement of the lower extremities (98.1%), stress as a trigger for physical symptoms (96.8%), paravertebral stiffness/tightness (95.7%), and abnormal gait (91.4%). The most specific findings for SPS included characteristic EMG findings (98.3%), a high GAD65 antibody titer defined as &gt;1000IU/mL and/or &gt;20nmol/L (98.2%), and the presence of hyperlordosis on examination (87.1%). For SPS-plus, cerebellar and brainstem involvement were also highly specific (98.5% and 100%, respectively) as were the aforementioned paraclinical tests. Analyses are ongoing to assess whether major and minor criterion can be developed for a more accurate diagnosis leveraging the above data. <h3>Conclusions:</h3> This study identified key clinical and paraclinical tests that can help enhance diagnostic accuracy of SPSD. Further studies can help validate these findings and inform development of revised diagnostic criteria. <b>Disclosure:</b> Dr. Roy has nothing to disclose. Miss Hu has nothing to disclose. The institution of Dr. Wang has received research support from Genentech. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Autobahn. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Greenwich Biosciences. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Newsome has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. The institution of Dr. Newsome has received research support from Biogen. The institution of Dr. Newsome has received research support from Genentech/Roche. The institution of Dr. Newsome has received research support from Department of Defense. The institution of Dr. Newsome has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Newsome has received research support from National MS Society. The institution of Dr. Newsome has received research support from The Stiff Person Syndrome Research Foundation. Dr. Newsome has received personal compensation in the range of $5,000-$9,999 for serving as a Clinical adjudication committee member for clinical trial with medDay Pharmaceuticals. Dr. Newsome has received personal compensation in the range of $10,000-$49,999 for serving as a Lead PI for Clinical Trial with Roche.