Single Chart Research Articles

Predictive Factors for Mortality Following Major Lower Extremity Amputation.

Despite advances in techniques and care, major amputation bears a high risk for mortality. Previously identified factors associated with increased risk of mortality include amputation level, renal function, and pre-operative white cell count. A single center retrospective chart review was conducted identifying patients who had undergone a major amputation. Chi-squared, t-testing, and Cox proportional hazard modeling were performed examining death at 6months and 12months. Factors associated with an increased risk of six-month mortality include age (OR 1.01-1.05, P < .001), sex (OR 1.08-3.24, P < .01), minority race (OR 1.18-18.19, P < .01), chronic kidney disease (OR 1.40-6.06, P < .001), and use of pressors at the induction of anesthesia for index amputation (OR 2.09-7.85, P < .000). Factors associated with increased risk of 12month mortality were similar. Patients undergoing major amputation continue to suffer high mortality. Those patients who received their amputation under physiologically stressful conditions were more likely to die within 6months. Reliably predicting six-month mortality can assist surgeons and patients in making appropriate care decisions.

Effect of COVID-19 on Myasthenia Gravis (P2-8.006)

<h3>Objective:</h3> To describe the effects of COVID-19 on comorbid myasthenia gravis (MG) regarding common symptoms such as limb weakness, oculobulbar weakness, and respiratory failure by evaluating worsening MGFA scores or therapy escalation following COVID-19 infection. <h3>Background:</h3> Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating weakness that affects the limbs, oculobulbar muscles, and diaphragm. Therapies include steroids and immunosuppressants, placing patients at high risk of opportunistic infections. Certain triggers can worsen MG, such as medications and infections. We describe the outcomes of 36 patients with confirmed MG and COVID-19, with particular focus on changes in Myasthenia Gravis Foundation of America (MGFA) scores and treatment escalation following infection. <h3>Design/Methods:</h3> Single center retrospective chart review of 36 patients from March 2020-January 2022 with clinically or serologically confirmed MG and COVID-19 <h3>Results:</h3> Of these 36 patients, 20 (55.6%) were not vaccinated against COVID. Twelve patients (33%) had MGFA scores of 3 or 4. Nineteen patients (53%) were prescribed steroids and 18 patients (50%) were on alternate immunotherapy prior to diagnosis of COVID. A total of 5 patients (14%) had a change in baseline MGFA score. One patient’s MGFA score worsened from 1 to 2 and 4 patients required MG treatment escalation. <h3>Conclusions:</h3> Myasthenia gravis patients with higher premorbid MGFA scores, steroid use, or other immunosuppressive therapy would be expected to have worse clinical outcomes in their MG course following COVID infection. Our results indicate 14% of MG patients with COVID had a change from their baseline MGFA score. Our study results revealed higher premorbid MGFA scores or use of immunosuppressant therapy did not alter a patient’s MGFA score following COVID infection. These results are consistent with current literature that COVID infection has little impact on these patients. <b>Disclosure:</b> Dr. Sandhu has nothing to disclose. Dr. Quezada has nothing to disclose. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSI. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pharmawrite. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Small has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.

Early ambulation in solid intra abdominal organ injury following blunt abdominal trauma in paediatric patients

BackgroundUncertainty exists surrounding the optimal time for ambulation in paediatric patients who have been conservatively managed post intra-abdominal solid organ injury (IASOI) following blunt abdominal trauma, specifically the safety of early ambulation. This study aims to assess the safety of early ambulation in this population. MethodsA single centre retrospective chart review of paediatric patients 15 years old and younger over a 10-year period 01 January 2010 – 31 December 2020 was conducted. Data was collected regarding demographics, time to ambulation, mean length of stay (LOS), Mechanism of Injury (MOI), need for intervention (operative, interventional radiological or medical), opiate analgesia prescription on discharge, and time to return to full physical activity. Logistical regression using Fishers Exact test was used in statistical analysis. ResultsOf the 138 patients included in the study, 115 (83%) sustained an isolated IASOI and 23 (17%) a multiple IASOI. The mean grade of injury for both isolated and multiple IASOI was 3.0. The mean time to ambulation was 2.5 days in isolated IASOI and 2.8 in multiple IASOI. In isolated IASOI, with the exception of pancreatic injures for all other organs over all grades, the mean time to ambulation in children was prior to the grade + rule in days. There were 6 complications (4%) requiring intervention (operative or interventional radiology). There were no cases of delayed haemorrhage in our study population. ConclusionEarly ambulation in isolated IASOI is safe and does not lead to clot destabilization and further haemorrhage requiring intervention. Level of evidenceIII

MP43-18 ADOLESCENT VARICOCELE: EFFECTS OF VEIN SIZE AND ARTERIAL FLOW RATE ON SEMINAL PARAMETERS

You have accessJournal of UrologyCME1 Apr 2023MP43-18 ADOLESCENT VARICOCELE: EFFECTS OF VEIN SIZE AND ARTERIAL FLOW RATE ON SEMINAL PARAMETERS Selin Ocal, Alina Sheikh, Joseph Pizzuti, Alexander Fang, Joseph Boroda, Steven Friedman, Ronnie Fine, Mark Horowitz, Ronnie Fine, Richard Sclussel, Lori Dyer, Paul Zelkovic, Jaime Freyle, Israel Franco, and Jordan Gitlin Selin OcalSelin Ocal More articles by this author , Alina SheikhAlina Sheikh More articles by this author , Joseph PizzutiJoseph Pizzuti More articles by this author , Alexander FangAlexander Fang More articles by this author , Joseph BorodaJoseph Boroda More articles by this author , Steven FriedmanSteven Friedman More articles by this author , Ronnie FineRonnie Fine More articles by this author , Mark HorowitzMark Horowitz More articles by this author , Ronnie FineRonnie Fine More articles by this author , Richard SclusselRichard Sclussel More articles by this author , Lori DyerLori Dyer More articles by this author , Paul ZelkovicPaul Zelkovic More articles by this author , Jaime FreyleJaime Freyle More articles by this author , Israel FrancoIsrael Franco More articles by this author , and Jordan GitlinJordan Gitlin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicocele severity has been associated with larger testicular vein size but the relationship to decreased fertility remains debatable. In clinical practice, largest vein diameter is used to screen for surgical intervention, yet more recent studies have found venous reflux patterns and total testicular volume (TTV) to be associated with total motile sperm count (TMSC). This study compares largest testicular vein size and arterial flow rates to identify patients at risk for reduced seminal parameters. METHODS: We conducted a retrospective single institution chart review over 14 years of 487 Tanner V adolescents. 148 met inclusion criteria of palpable, non-operated left sided varicoceles who underwent at least one SA and color doppler ultrasonography. Abnormal TMSC was defined by WHO 2010 criteria. Descriptive statistics, ROC analysis, univariate and multivariate logistic regression were performed using SPSS. RESULTS: Data on 148 Tanner V adolescent males with mean age 18.24±1.38 years were evaluated. Median diameter of largest left testicular vein was 3.5 mm (IQR 3.1-4.6), median peak systolic velocity (PSV) of left testicular artery was 10.4 cm/s (IQR 9.1-12.5), median end diastolic velocity (EDV) of left testicular artery was 5.1 cm/s (IQR 4.3-5.9), median value of PSV/EDV was 2.1 (IQR 1.8-2.3) and median TMSC was 37.4 million sperm/ejaculate (IQR 15.8-84.2). On ROC analysis regarding prediction of abnormal TMSC (<9 million sperm/ejaculate), left testicular PSV was found to have the greatest AUC at 0.73 (95% CI 0.62-0.85) with Youden index analysis determining cutoff of 10.22 cm/s while largest vein diameter was found to have an AUC of 0.48. On univariate logistic regression, PSV<10.22 cm/s resulted in a significantly greater likelihood of abnormal TMSC (OR: 5.51 [1.84-16.46], p=0.002), which persisted on multivariate logistic regression with adjustment for age (OR: 5.49 [1.83-16.43], p=0.002). CONCLUSIONS: Left testicular PSV was most significantly correlated to TMSC. PSV <10.22 cm/s was predictive of an abnormal TMSC. No significant association was found between larger veins and greater risk for abnormal TMSC. When assessing varicocele, left testicular artery PSV may help stratify future fertility risk, allowing for improved surveillance regarding surgical intervention. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e608 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Selin Ocal More articles by this author Alina Sheikh More articles by this author Joseph Pizzuti More articles by this author Alexander Fang More articles by this author Joseph Boroda More articles by this author Steven Friedman More articles by this author Ronnie Fine More articles by this author Mark Horowitz More articles by this author Ronnie Fine More articles by this author Richard Sclussel More articles by this author Lori Dyer More articles by this author Paul Zelkovic More articles by this author Jaime Freyle More articles by this author Israel Franco More articles by this author Jordan Gitlin More articles by this author Expand All Advertisement PDF downloadLoading ...

Multi-chart schemes for detecting a range of variance changes

ABSTRACT This article considers how CUmulative SUM (CUSUM) and Exponentially Weighted Moving Average (EWMA) multi-charts were used to monitor the variance (variability). Multi-chart schemes are a combination of several single charts that detect changes in a process quickly. We give a theoretical equation to arrive at the optimality of the CUSUM multi-chart for the variance. Simulation studies and asymptotic analyses show that the CUSUM multi-chart has better performance than the EWMA multi-chart in detecting variance shifts in an normal observations. The variance change problem has diverse and attractive application areas; we give a real example in the field of agriculture that monitors the price variability of maize to demonstrate the practicality of the schemes.

A Practical Guide to Relugolix: Early Experience With Oral Androgen Deprivation Therapy.

Relugolix is the newest form of androgen deprivation therapy (ADT) approved for prostate cancer. However, as an oral drug, several real-world concerns exist, particularly medication compliance, safety with other androgen receptor-targeted agents, and financial burden to patients. A single institution retrospective chart review was conducted evaluating all patients who were prescribed relugolix for any prostate cancer indication from January 1, 2021 to January 31, 2022. Demographic data, cardiac risk factors, concomitant therapy usage, and PSA/testosterone levels, were abstracted from the chart review. Adverse effects were obtained by examining progress notes. Compliance was assessed by clinic notes as well as prescription fills by specialty pharmacy records. The reasons patients did not fill or discontinued the medication were noted. Hundred and one patients were prescribed relugolix, and 91 patients consented to research. Seventy-one (78%) patients filled the prescription to relugolix, with a median follow-up of 5 months. Prescription fill data were available for 45 (63%) patients, with 94% of days covered. The most commonly reported reason not to fill was cost at 50%. Sixty-six (93%) patients reported never missing a dose. PSA levels were available in 71 (100%) patients with 69 (97%) showing stable or improved PSA. Testosterone levels were available in 61 (86%) of patients, which showed 61 (100%) stable or successful castration. Twenty-four (34%) patients used relugolix in combination. No new major safety signals were seen in combination therapy. Nineteen (27%) patients had switched to another form of ADT. Fifteen of these (79%) felt similar or better on relugolix therapy. Compliance with relugolix seemed acceptable. No major new safety signals were seen, even in combination. Among patients who switched therapy, most tolerated relugolix similarly or better than the previous form of ADT. The cost was a major reason for patients not initiating and for discontinuing therapy.

An efficient adaptive r-MD multivariate single control chart for nonlinear multiple quality characteristics

An efficient multivariate single control chart to simultaneously monitor ‘location or mean’ and ‘scale or variabilities’, based on individual observations of multiple quality characteristics (MQC), is a continuous research endeavour. Compared to rational subgroups, time-ordered individual sample observations of MQC are common in manufacturing. However, few researchers proposed parametric and nonparametric multivariate control charts to monitor individual observations in this context. The proposed parametric approach has limited applicability due to the restrictive distribution assumption of MQC. In addition, most of the suggested parametric or nonparametric approaches recommend multiple charts to monitor process ‘location’ and ‘scale’ parameters simultaneously. Multiple charts can increase the control complexities and overall false-alarm-rate . MQC can also have significant nonlinear correlation structures and follow unknown or nonnormal distributions in real-life scenarios. Single parametric or nonparametric multivariate charts for individual observations can exhibit poor performance in such situations. In this study, an adaptive Mahalanobis depth and k-nearest neighbour (k-NN) rule-based r-AMD chart is proposed and verified to address the lacuna mentioned above. Monte-Carlo simulation studies are used to evaluate the performance of the r-AMD chart. Four real-life manufacturing scenarios are also considered to validate the suitability and superiority of r-AMD over the existing ‘r-MD’ and other competing charts.

A periodic-like table of space groups.

There are about 100 chemical elements, and 200 space groups, rounding to the nearest hundreds. The elements, by virtue of the iconic periodic table, which hangs in schoolrooms worldwide, are part of our common culture. Few on the outside of solid-state science and discrete mathematics know of the remarkable enumeration of the space groups and how they organize solids, the chemical elements included, that can be conformed to translationally periodic lattices in three dimensions. Perhaps the comparative inaccessibility of space groups to non-specialists can be attributed to the absence of a single chart that captures and organizes the space groups in a glance, as does the periodic table for the chemical elements? Here is designed a periodic-like table of the space groups. The symmorphic space groups are organized as the coordinates of two non-linear, non-orthogonal axes that capture the point group symmetry and the order of the group, the multiplicity of general positions. The related non-symmorphic groups are treated as 'isotopes' of the symmorphic groups and are enumerated with a subscript. The intent is to inspire better designs and to bring the crystallographic space groups to the attention of a wider audience.

Folliculocentric lymphocytic hypersensitivity reactions in CLL/SLL patients: A unique clinicopathologic entity amongst non-specific hypersensitivity reactions.

Cutaneous hypersensitivity eruptions in chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) are a clinically and histologically heterogeneous group that can either precede, occur with, or follow the development of a hematologic malignancy. Therefore, establishing the diagnosis requires careful clinical and pathologic correlation and an understanding of the broad spectrum of presentations. Data is lacking on the correlation of skin disease with molecular/cytogenetic risk profiling of the tumor. The aims of this study were to characterize the clinical, histological, and genetic aberrations in recurrent cutaneous hypersensitivity reactions in patients with CLL/SLL. A single site academic retrospective chart review of medical records, histopathology, molecular and cytogenetic data in CLL/SLL patients who developed biopsy-proven cutaneous hypersensitivity reactions. Five hundred one new diagnoses of CLL/SLL with 73 patients requiring cutaneous biopsies for skin lesions or rashes were identified. With exclusion criteria, 20 biopsies were identified from 17 patients (mean age, 69.6years, females=9) with unexplained cutaneous eruptions. These were commonly pruritic, erythematous papules above the waist. Most biopsies had a prominent superficial, deep dermal eosinophilic infiltrate (85%), with a robust T-cell predominant dermal infiltrate in 40%. Five out of 17 patients (29%) had a predominately folliculocentric CD4+ T-cell infiltrate; all occurring on the head and neck. Overall, the prevalence of cutaneous hypersensitivity eruptions requiring biopsy was 3.4% (n=17), and the prevalence of folliculocentric CD4+ T-cell infiltrate was 1% (n=5). Cutaneous hypersensitivity reactions in CLL/SLL are heterogeneous; however, folliculotropic CD4+ T-cell infiltrates may be seen in a small but distinct clinical subset of patients. Commonly tested cytogenetic aberrations in CLL/SLL do not appear to be correlated with the presence of cutaneous hypersensitivity reactions.

A joint monitoring of the process mean and variance with a generally weighted moving average maximum control chart

Single control charts are widely used to control assignable causes that shift the process due to variations in the mean and the dispersion. In the present article, the exponentially weighted moving average maximum (EWMA-Max) control chart is extended to the new single generally weighted moving average maximum (referred as GWMA-Max) control chart for joint monitoring of the process mean and variability. The proposed chart is compared with the EWMA-Max and DEWMA-Max charts in terms of the run-length performance measures. The results reveal that the GWMA-Max chart is very efficient in detecting small shifts in the process mean and variability concurrently. Finally, a practical implementation of the GWMA-Max chart is displayed using real and simulated datasets.

Two-dimensional code enables visibly mapping herbal medicine chemome: an application in Ganoderma lucidum

BackgroundChemical profile provides the pronounced evidence for herbal medicine (HM) authentication; however, the chemome is extremely sophisticated. Fortunately, two-dimensional (2D) code, as a quick response means, is conceptually able to store abundant information, exactly fulfilling the chemical information storage demands of HMs.MethodsWe here attempted to denote both MS^1 and MS^2 dataset of HM with a single 2D-code chart. Measurement of Ganoderma lucidum that is one of the most famous HMs with LC–MS/MS was employed to illustrate the “coding-decoding” workflow for the conversion amongst MS/MS dataset, 2D-code, and chemical profile, and to evaluate the applicability as well. After data acquisition, and m/z value of each deprotonated molecular signal was divided into integer and decimal portions, corresponding to x and y coordinates of 2D-plot, respectively. On the other side, m/z values of all its fragment ions were exactly assigned to serial x values sharing an identical y value being equal to the precursor ion. 2D-code was thereafter produced by plotting these defined dots at a 2D-chart. Regarding a given 2D-code map, the entire chart (x coordinate: 0–600; y coordinate: 0–600) was fragmented into two regions by the line of y=x. MS^1 spectral signals always located below the line, whereas all fragment ions lay at the left zone. After extracting information from the edges of each square frame, m/z values of both precursor ion and fragment ions could be harvested and putatively deciphered to a compound through applying some empirical mass fragmentation rules.ResultsThe entire code of Ganoderma lucidum fruit bodies therefore corresponded exactly to a compound set. The elution program, even the employment of direct infusion, couldn’t significantly impact the code, and dramatical differences occurred between different species and amongst different parts of Ganoderma lucidum as well. Not only ganoderic acid cluster but also certain primary metabolites served as the diagnostic compounds towards species differentiation.Conclusion2D-code might be a meaningful, practical visual way for rapid HM recognition because it is convenient to achieve the conversion amongst MS/MS dataset, 2D-barcode plot, and the chemome.

Simultaneous monitoring of the mean vector and covariance matrix of multivariate multiple linear profiles with a new adaptive Shewhart-type control chart

There has been a growing interest in research regarding monitoring a process through a regression model (called a profile) rather than a simple quality characteristic. This paper proposes a new monitoring scheme to simultaneously monitor the multivariate multiple linear profiles’ parameters. This scheme is based on the Shewhart control chart concept and only has one single (max-type) control chart for monitoring regression coefficients and error’s variation, which uses a new statistic to improve the variability (error’s variance-covariance matrix) shift detection in multivariate profiles. To increase the sensitivity and capability of the proposed scheme, especially in detecting small to moderate shift sizes, we add a variable parameters (VP) adaptive scheme to the developed control chart as well, considering that no adaptive monitoring schemes have so far been developed for monitoring the multivariate multiple linear profiles and neither are there any VP adaptive features for all profile monitoring schemes. Next, we develop a Markov chain model to compute the time to signal and run length performance measures. After that, we perform extensive numerical analyses to first compare the proposed control chart with the best available control charts and then evaluate its performance under different shift scenarios as well as different dimensions. The results show that the new monitoring scheme performs well compared to the best available monitoring schemes, and more importantly, it is more applicable in real practice. Finally, an illustrative example is presented to show the implementation of the proposed scheme in practice.

Cylinder aeroacoustics: experimental study of the influence of cross-section shape on spanwise coherence length

New data and review of the spanwise coherence length is provided for flows over cylinders of different cross-sections: circular of diameter d, and rectangular of sectional aspect ratios (breadth (b) to height (d) ratio AR = b/d) of 1, 2 and 3. In the present measurements, the body has both d and spanwise length of 70d fixed, and the Reynolds number (based on d) range 6000–27,000 is covered. Two-point data are obtained from two hot-wire probes, one fixed in the symmetry plane and the other moving on the corresponding spanwise axis. Their position in a cross plane are deduced from preliminary measurement of the mean flow with a single probe, allowing fair comparisons between the different geometries and the introduction of uncertainty bars on coherence length values. At all tested regimes, a very good agreement is noticed between velocity-based and pressure-based coherence experimental data. Coherence length definitions are revisited, and the aeroacoustically consistent, integral length definition is selected, allowing fair synthesis of literature data into a single chart and empirical functions. Definitions for coherence decay models (e.g. Gaussian or Laplacian) are also adapted so that coherence length and coherence integral shall be equivalent. This preliminary work on coherence data and its spanwise integration enables transparent regressions and model selection. Generally, the Gaussian model is relevant for the lift peak, while the coherence exhibits a Laplacian decay at harmonics. On average, at peak Strouhal number, the coherence length for the circular and square cylinders is of 5d while it is of the order of 15d for the rectangular sections. It is concluded that the flow over those latter geometries is still a two-dimensional dynamics at the tone frequency. These values are almost preserved over the tested Reynolds number range. Coherence length value at harmonics is extensively documented. Spanwise coherence length is also discussed as an ingredient of acoustic efficiency.

A retrospective cohort study comparing reconstructive techniques and outcomes in post-mastectomy triple negative breast cancer patients.

Up to 42% of all breast cancer patients undergo post-mastectomy reconstruction, however reconstructive techniques have not been widely studied in patients with triple negative breast cancer (TNBC). Reconstructive complications may delay adjuvant treatments; in TNBC, which inherently carries an increased risk of locoregional recurrence, this can greatly affect oncological outcomes. Therefore, we evaluate factors influencing choice of reconstructive techniques following mastectomy in TNBC patients and assess operative and oncologic safety outcomes. A single institution retrospective chart review identified TNBC patients who underwent post-mastectomy reconstruction between 2010 to 2020. Clinical characteristics collected included demographics, cancer history, reconstructive techniques [autologous-based reconstruction (ABR) vs. implant-based reconstruction (IBR)] and surgical and oncologic outcomes such as complications, recurrence, and mortality. Factors impacting whether patients underwent ABR versus IBR were assessed, as well as differences in outcomes between the two procedures. Statistical significance was defined as P<0.05. During the 10-year period, 52.9% (n=127) of all post-mastectomy TNBC patients (n=240) underwent breast reconstruction, most frequently immediately after mastectomy (97.0%). Most patients underwent IBR compared to ABR (82.4% vs. 14.5%). Patients undergoing ABR were older than IBR patients (54.3 vs. 46.4 years; P=0.040) and had a higher body mass index (BMI; 30.0 vs. 26.1 kg/m2; P=0.007). Patients more often pursued ABR if they had a prior breast cancer history (36.8% vs. 16.7%; P=0.041) or experienced TNBC recurrence (26.3% vs. 9.3%; P=0.034), while primary TNBC patients more often opted for IBR. Reconstructive type did not impact complications (ABR 31.6% vs. IBR 16.8%, P=0.131), recurrence (ABR 15.8% vs. IBR 13.0%, P=0.719), or mortality (ABR 0.0% vs. IBR 6.5%, P=0.593) rates. Factors such as age, BMI, and breast cancer history impacted choice of reconstructive technique among TNBC women. No differences in complications, recurrence, or mortality occur in these high-risk patients regardless of reconstructive technique, highlighting that neither ABR nor IBR is superior in regard to surgical and oncologic safety in post-mastectomy TNBC patients.

Tracking control on homogeneous spaces: the Equivariant Regulator (EqR)

Accurate tracking of planned trajectories in the presence of perturbations is an important problem in control and robotics. Symmetry is a fundamental mathematical feature of many dynamical systems and exploiting this property offers the potential of improved tracking performance. In this paper, we investigate the tracking problem for input-affine systems on homogeneous spaces: manifolds which admit symmetries with transitive group actions. We show that there is natural manner to lift any desired trajectory of such a system to a lifted trajectory on the symmetry group. This construction allows us to define a global tracking error and apply LQR design to obtain an approximately optimal control in a single coordinate chart. The resulting control is then applied to the original plant and shown to yield excellent tracking performance. We term the resulting design methodology the Equivariant Regulator (EqR). We provide an example input-affine system posed on a homogeneous space, derive the trajectory linearisation in error coordinates and demonstrate the effectiveness of EqR compared to standard approaches in simulation.

DIVI: Dynamically Interactive Visualization.

Dynamically Interactive Visualization (DIVI) is a novel approach for orchestrating interactions within and across static visualizations. DIVI deconstructs Scalable Vector Graphics charts at runtime to infer content and coordinate user input, decoupling interaction from specification logic. This decoupling allows interactions to extend and compose freely across different tools, chart types, and analysis goals. DIVI exploits positional relations of marks to detect chart components such as axes and legends, reconstruct scales and view encodings, and infer data fields. DIVI then enumerates candidate transformations across inferred data to perform linking between views. To support dynamic interaction without prior specification, we introduce a taxonomy that formalizes the space of standard interactions by chart element, interaction type, and input event. We demonstrate DIVI's usefulness for rapid data exploration and analysis through a usability study with 13 participants and a diverse gallery of dynamically interactive visualizations, including single chart, multi-view, and cross-tool configurations.

The relationship between 6-thioguanine levels and remission outcomes in children with autoimmune hepatitis. Single center experience.

The treatment of autoimmune hepatitis (AIH) is based on steroids and azathioprine (AZA). AZA is a pro-drug which is converted among others into 6-thioguanine (6-TG) and 6-methylmercaptopurine (6-MMP). The aim of the study was to determine the relationship between the AZA active metabolite 6-TG and both the biochemical and histological remission outcomes. The authors conducted a retrospective analysis of a single chart review. The sample size consisted of 44 pediatric patients with AIH. Biochemical remission was defined as an alanine aminotransferase (ALT) level below 40 U/l and histological remission was defined as a situation when the control biopsy revealed inflammation grade G1 (or lower) in the Batts-Ludwig score. Statistical analysis was applied to assess the difference in remission outcomes in patients with different levels of 6-TG. In the benchmark variant of our statistical analysis, we found that the correlation between 6-TG and ALT in the sample was not statistically significant. Moreover, the difference between the mean levels of ALT in the populations in and without remission was not statistically significant (the p-value of the t-test was 0.16). Our results tend to support the claim that there is no statistically significant relationship between 6-TG concentration and remission (both biochemical and histological) in pediatric patients with AIH.

Dean Martin: King of Cool“Sammy and Dino,” You Must Remember This

Dean Martin: King of Cool“Sammy and Dino,” <i>You Must Remember This</i>

Semiotics on music charts: The signification of late-blooming hits in contemporary popular music

Eliseo Verón’s approach to circulation focuses on the gap between production and recognition and the consideration of texts in relation to their contexts of production and consumption. In this paper, we employ Veron’s concepts of grammar of production and grammar of recognition to examine popular songs that reached their peak of success several years after their release. Drawing our case studies from the Hot 100 American singles chart, we combine social semiotics and semiotics of popular music to examine the contexts of the initial songs’ release and their eventual commercial peak while considering changes in the media ecology and how these songs re-entered popular culture. The corpus of songs examined is split into three major categories: Songs that re-entered popular culture after their performer’s passing, recurring Christmas- themed songs, and hits featuring in audiovisual productions like films and television series.

340: FIXED-DOSE FOUR-FACTOR PCC FOR THE REVERSAL OF FACTOR XA INHIBITOR-ASSOCIATED BLEEDING

Introduction: Four-Factor PCC (4F-PCC) is labeled for the reversal of vitamin K antagonists and may be considered off label for the reversal of factor Xa inhibitors. A fixed-dose strategy of 4F-PCC for the reversal of factor Xa inhibitors has the potential to minimize delay to reversal, avoid confusion during the ordering process, and lead to cost savings. The purpose of this study is to evaluate the safety and efficacy of fixed-dose 4F-PCC for the management of life-threatening bleeds associated with factor Xa inhibitors. Methods: This was a single center retrospective chart review conducted from May 2019 to January 2022. Patients were included if they were 18 years or older, experienced a life-threatening bleed while on a factor Xa inhibitor, and received 4F-PCC at a fixed dose of 2000 units. Exclusion criteria included: reversal for non-emergent surgery, receipt of 4F-PCC at an outside hospital, and/or receipt of an additional reversal agent. The primary outcome was achievement of hemostasis using a hemostatic effectiveness scale described by Sarode et al. Secondary outcomes included incidence of thrombosis within seven days of 4F-PCC administration and mortality. Results: A total of 39 patients received 4F-PCC for the reversal of a factor Xa inhibitor; 26 patients had central nervous system (CNS) bleeding and 13 had a non-CNS bleed. Overall 49% achieved excellent hemostatic effectiveness, 3% achieved good hemostatic effectiveness, 28% achieved poor, and in 20% we were unable to assess hemostatic effectiveness. In the subset of patients with CNS bleeding, 61% had either excellent or good effectiveness, 8% had poor, and 31% were unable to assess. There was one patient who experienced thromboembolism within seven days of reversal. In-hospital mortality was 18%. Conclusions: The results of this study demonstrate that a fixed-dose 4F-PCC dosing strategy for the reversal of factor Xa inhibitors produces reasonable hemostatic effectiveness and is safe. The rates of effectiveness seen in the subset of patients with CNS bleeding are similar to what has previously been reported for a weight-based dosing strategy. Randomized prospective studies are needed comparing 4F-PCC to andexanet alfa, the FDA labeled reversal agent for factor Xa inhibitors.