Subsequent Decisions Research Articles

Research on tap breakage monitoring method for tapping process based on SSAELSTM fusion network

Aiming at the problems of high tap breakage rate during tapping of small-diameter internal threads and the difficulty of feature extraction and fusion in characterising tap breakage, this paper proposes a tap breakage monitoring method based on stack sparse autoencoder long-short-term memory (SSAELSTM) fusion network. Specifically, based on change rule of torque in the tapping process and the analysis of the processing mechanism, the normal label and the breakage label are defined, and 36 groups of feature in the multi-feature domain of the torque signal are extracted, constituting a labelled set of feature. Additionally, a stacked sparse autoencoder network (SSAE) is employed to fuse the feature that serve as inputs to the long short-term memory network (LSTM) for recognition, and the classification errors of LSTM are back-propagated to SSAE to optimize the weights of the LSTM and SSAE networks. Finally, 31 SSAELSTM fusion network models with different structures are constructed, and the final tap breakage monitoring model is determined by comparing the performance indexes. Compared with the features before fusion, the constructed model fusion effectively reduces the amount of data and improves the correlation with the labels. Compared with other network models, it was found that SSAELSTM fusion network is superior to other models in both accuracy and robustness, providing breakage warning for the tapping process, and laying the foundation for subsequent decision-making to avoid tap breakage.

Use of coronary physiology to guide revascularization in clinical practice: results of the F(FR)2 registry

BackgroundDespite the recommendation of coronary physiology to guide revascularization in angiographically intermediate stenoses without established correlation to ischemia, its uptake in clinical practice is slow.AimsThis study aimed to analyze the use of coronary physiology in clinical practice.MethodsBased on a multicenter registry (Fractional Flow Reserve Fax Registry, F(FR)2, ClinicalTrials.gov identifier NCT03055910), clinical use, consequences, and complications of coronary physiology were systematically analyzed.ResultsF(FR)2 enrolled 2,000 patients with 3,378 intracoronary pressure measurements. Most measurements (96.8%) were performed in angiographically intermediate stenoses. Out of 3,238 lesions in which coronary physiology was used to guide revascularization, revascularization was deferred in 2,643 (78.2%) cases.Fractional flow reserve (FFR) was the most common pressure index used (87.6%), with hyperemia induced by an intracoronary bolus of adenosine in 2,556 lesions (86.4%) and intravenous adenosine used for 384 measurements (13.0%). The route of adenosine administration did not influence FFR results (change-in-estimate -3.1% for regression model predicting FFR from diameter stenosis). Agreement with the subsequent revascularization decision was 93.4% for intravenous and 95.0% for intracoronary adenosine (p = 0.261).Coronary artery occlusion caused by the pressure wire was reported in two cases (0.1%) and dissection in three cases (0.2%), which was fatal once (0.1%).ConclusionsIn clinical practice, intracoronary pressure measurements are mostly used to guide revascularization decisions in angiographically intermediate stenoses. Intracoronary and intravenous administration of adenosine seem equally suited. While the rate of serious complications of wire-based intracoronary pressure measurements in clinical practice seems to be low, it is not negligible.Graphical abstract

Does Volunteering Crowd Out Donations? Evidence from Online Experiments

Problem definition: Conventional wisdom often cautions charities against providing volunteer opportunities to potential donors based on the assumption that volunteering crowds out monetary donations. We challenge this assumption and investigate the causal relationship between an individual’s volunteering activities and their subsequent decisions to donate. Methodology/results: We conducted three consequential experiments where participants engaged in virtual assignments and were subsequently prompted to donate to an existing charity. In the first two experiments, participants were tasked with creating affectionate cards for the homeless, enjoying full autonomy in the design of these cards. In the third experiment, participants colored patterns of varying complexity. Our results indicated that volunteering increased both the propensity and the amount of participants’ donations, pointing to a potential explanation rooted in moral consistency. However, as individuals’ volunteering efforts intensified, their subsequent donations decreased, reflecting a mental budgeting mechanism in these settings. Managerial implications: Our results suggest that (i) volunteer programs not only build up a charity’s labor source but may also increase their donation income; (ii) charities should consider developing virtual volunteering programs that increase their resources by connecting them with more volunteers; and (iii) to maximize donations, charities should carefully design light volunteer tasks.

Human papillomavirus vaccine beliefs and intentions Post-COVID-19 vaccine release among mothers in Alabama

PurposeThe current study sought to determine if the release of COVID-19 vaccines influenced Alabama mothers’ attitudes and behaviors regarding HPV vaccination of their adolescent children. MethodsA social media survey was conducted August − September 2022 among mothers of adolescents ages 9–18, who self-identified as Alabama residents and their child(ren)’s primary medical decision maker. The survey assessed demographics, vaccine knowledge and opinions, vaccination history, influences on vaccination decisions, and how COVID-19 vaccine release affected vaccine opinions. Univariable and multivariable analyses were conducted. ResultsOf 241 responses, most participants were white (82.0 %, n = 196), non-Hispanic (96.6 %, n = 230), and privately insured (64.5 %, n = 151), with annual household incomes ≥$61,000 (45.4 %, n = 103). The majority (60.8 %) reported that their child either had or planned to receive the HPV vaccine. The release of COVID-19 vaccines did not change the majority of parental opinions towards HPV, with 78.5 % (n = 161) reporting no change. Among those who experienced a change, 25 % (n = 5) reported an increased likelihood of having their child vaccinated for HPV and 75 % (n = 15) reported a decrease in likelihood. Moderate and high HPV knowledge scores were associated in multivariable analysis with increased likelihood of having their child vaccinated for HPV (“moderate” knowledge AOR: 12.4, 95 % CI: 1.98–78.1; “high” knowledge AOR: 12.8, 95 % CI: 2.00–82.1). Positive HPV opinion scores in the univariable analysis similarly showed increased odds (AOR = 1.5). ConclusionsThese findings indicate that, in this population, COVID-19 vaccine release did not significantly impact subsequent HPV vaccination decision making. Parental perceptions regarding vaccination are critical to informing future interventions.

Bovine DDX3X Restrains Bovine SP110c-Mediated Activation of Inflammasome in Macrophages.

The inflammasome is a vital part of the host's innate immunity activated by cellular infection or stress. Our previous research identified the bovine SP110c isoform (bSP110c) as a novel activator of the inflammasome that promoted the secretion of proinflammatory cytokines IL-1β and IL-18 in macrophages infected with Listeria monocytogenes or stimulated with lipopolysaccharide (LPS). However, the exact molecular mechanism for inhibiting bSP110c-induced inflammasome activation requires further clarification. Here, the researchers identified bovine DDX3X (bDDX3X) as an NLRP3-associated protein and an inhibitor of the bSP110c-induced inflammasome in the human THP1 macrophage cell line. Immunoprecipitation showed that bDDX3X interacted with the bSP110c CARD domain via its helicase domain. The co-expression of bSP110c and bDDX3X in THP1 macrophages significantly prevented the bSP110c-induced activation of inflammasomes. In addition, both bDDX3X and bSP110c interacted with bovine NLRP3 (bNLRP3), and bDDX3X enhanced the interaction between bSP110c and bNLRP3. The expression of bDDX3X in nigericin-stimulated THP1 macrophages significantly suppressed NLRP3 inflammasome activation, ASC speck formation, and pyroptosis. These findings demonstrate that bDDX3X negatively regulates the bSP110c-mediated inflammatory response by restricting the activation of the NLRP3 inflammasome. This discovery unveils a novel regulatory mechanism involving bDDX3X and bSP110c in coordinating inflammasome activation and subsequent cell-fate decisions in LPS-treated macrophages and, in turn, constitutes a step forward toward the implementation of marker-assisted selection in breeding programs aimed at utilizing cattle's immune defenses.

The Association between the Body Mass Index, Chronic Obstructive Pulmonary Disease and SUV of the Non-Tumorous Lung in the Pretreatment [18F]FDG-PET/CT of Patients with Lung Cancer.

Background: A debate persists on the prognostic value of the pre-therapeutic standardized uptake value (SUV) of non-tumorous lung tissue for the risk assessment of therapy-related pneumonitis, with most studies lacking significant correlation. However, the influence of patient comorbidities on the pre-therapeutic lung SUV has not yet been systematically evaluated. Thus, we aimed to elucidate the association between comorbidities, biological variables and lung SUVs in pre-therapeutic [18F]FDG-PET/CT. Methods: In this retrospective study, the pre-therapeutic SUV in [18F]FDG-PET/CT was measured in non-tumorous areas of both lobes of the lung. SUVMEAN, SUVMAX and SUV95 were compared to a multitude of patient characteristics and comorbidities with Spearman's correlation analysis, followed by a Bonferroni correction and multilinear regression. Results: In total, 240 patients with lung cancer were analyzed. An elevated BMI was significantly associated with increased SUVMAX (β = 0.037, p < 0.001), SUVMEAN (β = 0.017, p < 0.001) and SUV95 (β = 0.028, p < 0.001). Patients with chronic obstructive pulmonary disease (COPD) showed a significantly decreased SUVMAX (β = -0.156, p = 0.001), SUVMEAN (β = -0.107, p < 0.001) and SUV95 (β = -0.134, p < 0.001). Multiple other comorbidities did not show a significant correlation with the SUV of the non-tumorous lung. Conclusions: Failure to consider the influence of BMI and COPD on the pre-therapeutic SUV measurements may lead to an erroneous interpretation of the pre-therapeutic SUV and subsequent treatment decisions in patients with lung cancer.

A survey of medication and raw food use among canine blood donors.

Blood donors are screened for medication use to determine their health status and to ensure that the collection will be safe and efficacious for transfusion. Although stringent medication deferral guidelines exist for human blood donors, no consensus exists as to which medications should be permitted among canine donors. A brief survey regarding canine donor screening methods was distributed to an online hematology and transfusion medicine group and included questions pertaining to commonly prescribed medications and consumption of a raw food diet. The survey results demonstrate that more than half of the respondents accept canine donors given thyroid supplements, whereas respondents were split as to whether they accept canine donors given antihistamines chronically. Most survey respondents exclude canine donors taking anti-inflammatory or anti-itch medications unless in acute circumstances and only after a washout period. More than half of the survey respondents exclude dogs fed a raw food diet. The survey results demonstrate that there is no obvious agreement regarding which medications to permit in canine donors. Evidence-based guidelines are needed to inform best practices and the subsequent decisions made by donor programs.

Data-driven online prediction of remaining fatigue life of a steel plate based on nonlinear ultrasonic monitoring

Online monitoring fatigue damage and remaining fatigue life (RFL) prediction of engineering structures are essential to ensure safety and reliability. A data-driven online prediction method based on nonlinear ultrasonic monitoring was developed to predict the RFL of the structures in real-time. Nonlinear ultrasonic parameters were obtained to monitoring the fatigue degradation. A Bayesian framework was employed to continuously compute and update the RFL distributions of the structures. Nonlinear ultrasonic experiments were performed on the fatigue damaged Q460 steel to validate the developed prediction methodology. The result indicates that the developed method has high prediction accuracy and can provide effective information for subsequent decision-making.

The effect of false cognitive feedback on subsequent cognitive task performance

ABSTRACT Introduction Previous research has found beliefs about oneself and one’s own abilities may have the potential to affect subsequent performance on a particular task. Additionally, providing false feedback about a particular characteristic or even about overall cognitive abilities may also affect performance on later tasks. However, it is unclear to what extent false positive or negative feedback about cognition will affect subsequent executive function task performance. In the present series of studies, we examined whether receiving negative false feedback about cognition would affect subsequent decision making and other executive function task performance. Method In Study 1, the participants (n = 115) received false feedback that they were either high or low in creative intelligence before completing a series of decision making tasks. In Study 2, the participants (n = 146) completed a similar false feedback paradigm before completing assessments of a range of executive functions. Results Across studies, we found limited evidence of a consistent pattern of how false feedback affects subsequent cognitive task performance, although receiving positive and negative feedback affected specific tasks. Conclusions Our results indicate that the influence of false feedback on task performance is variable and may depend on factors such as the specific task or executive function assessed. In clinical work, it is important to consider how patients may internalize feedback about their cognitive abilities, as the feedback, coupled with other factors such as level of insight, apathy, disinhibition, or prior perceptions regarding a diagnosis, may influence interpretations.

Moral decision-making in context: Behavioral and neural processes underlying allocations based on need, merit, and equality

How to fairly allocate goods is a key issue of social decision-making. Extensive research demonstrates that people do not selfishly maximize their own benefits, but instead also consider how others are affected. However, most accounts of the psychological processes underlying fairness-related behavior implicitly assume that assessments of fairness are somewhat stable. In this paper, we present results of a novel task, the Re-Allocation Game, in which two players receive an allocation determined by the computer and, on half of the trials, one player has the subsequent possibility to change this allocation. Importantly, prior to the receipt of the allocation, players were shown either their respective financial situations, their respective performance on a previous simple task, or random information, while being scanned using functional neuroimaging. As expected, our results demonstrate when given the opportunity, participants allocated on average almost half the money to anonymous others. However, our findings further show that participants used the provided information in a dynamic manner, revealing the underlying principle based on which people re-allocate money – namely based on merit, need, or equality – switches dynamically. On the neural level, we identified activity in the right and left dorsolateral prefrontal cortices related to context-independent inequity and context-dependent fairness information respectively when viewing the computer-generated allocations. At the same time, activity in the temporoparietal and precuneus represented these different types of fairness-related information in adjacent and partially overlapping clusters. Finally, we observed that the activity pattern in the precuneus and putamen was most clearly related to participants’ subsequent re-allocation decisions. Together, our findings suggest that participants judge an allocation as fair or unfair using a network associated with cognitive control and theory-of-mind, while dynamically switching between what might constitute a fair allocation in a particular context.

LNQ Challenge 2023: Learning Mediastinal Lymph Node Segmentation with a Probabilistic Lymph Node Atlas

The evaluation of lymph node metastases plays a crucial role in achieving precise cancer staging, which in turn influences subsequent decisions regarding treatment options. The detection of lymph nodes poses challenges due to the presence of unclear boundaries and the diverse range of sizes and morphological characteristics, making it a resource-intensive process. As part of the LNQ 2023 MICCAI challenge, we propose the use of anatomical priors as a tool to address the challenges that persist in automatic mediastinal lymph node segmentation in combination with the partial annotation of the challenge training data. The model ensemble using all suggested modifications yields a Dice score of 0.6033 and segments 57% of the ground truth lymph nodes, compared to 27% when training on CT only. Segmentation accuracy is improved significantly by incorporating a probabilistic lymph node atlas in loss weighting and post-processing. The largest performance gains are achieved by oversampling fully annotated data to account for the partial annotation of the challenge training data, as well as adding additional data augmentation to address the high heterogeneity of the CT images and lymph node appearance. Our code is available at &lt;a href='https://github.com/MICAI-IMI-UzL/LNQ2023'&gt;https://github.com/MICAI-IMI-UzL/LNQ2023&lt;/a&gt;.

Temporal and Spatial Influences on Fawn Summer Survival in Pronghorn Populations: Management Implications from Noninvasive Monitoring.

Monitoring vital rates allows managers to estimate trends in growth rates of ungulate populations. However, connecting the influence of nutrition on ungulate demography is challenging. Noninvasive sampling offers a low-cost, low-effort alternative for measuring nutritional indices, allowing for an increased understanding of the mechanistic relationships between environmental factors, nutrition, and specific population vital rates. We examined the temporal influence of intrinsic and extrinsic factors on pronghorn (Antilocapra americana) fawn recruitment. We collected fresh fecal samples from adult female pronghorn in five subpopulations spanning three sampling periods associated with critical maternal life-history stages (late gestation, early lactation, breeding season) for 2 years to investigate both intra- and interannual influences. Intrinsic factors were fecal glucocorticoid metabolites (FGMs), nutritional indices (fecal nitrogen (FN) and 2,6-diaminopimelic acid (DAPA)), and dietary composition (protein intake of forbs, graminoids, legumes, other, shrubs), while the extrinsic factor was vegetative greenness (normalized difference vegetation index (NDVI)). We found variations in DAPA, protein intake of forbs, variation in forb protein intake, and protein intake of legumes during late gestation positively influenced fawn recruitment. Fecal nitrogen during early lactation showed the strongest positive influence on the recruitment of any measured parameter. Finally, breeding season NDVI and the variation in DAPA values positively influenced the subsequent year's fawn recruitment. Our longitudinal study enabled us to investigate which parameter was most important to specific periods of fawn development and recruitment. We combined the results across five subpopulations, but interpretation and subsequent management decisions should be made at the subpopulation level such that pronghorn subpopulations with low recruitment can be positively influenced by increasing nitrogen on the landscape available to adult females during the early lactation period. As the use of noninvasive monitoring methods continues to expand, we believe our methodologies and results can be broadly applied to other ungulate monitoring programs.

Caught in the liberal pragmatic trap? How political parties viewed energy dependence on Russia in three European countries 2012–2022

After Russia’s full-scale invasion of Ukraine in February 2022, and its subsequent decision to stop its gas export to Europe, Europe’s energy dependence on Russia was put on full display. In this paper, we map energy relations with Russia in three European countries that in the period of analysis between 2012 and 2022 were among the most important energy customers of Russia: Poland, Germany and the Netherlands. Moreover, we examine how this issue has been addressed – if at all – in party programs in elections in the same period. Examining party programs, we argue, brings new insights and a better understanding of how energy policies and relations with Russia were viewed in the three countries – and in the EU in general in that period. The paper identifies two ideal types – the ‘liberal pragmatists’, who treated strong energy interdependence as a possible conflict-mitigating measure, and the ‘hard core realists’, who viewed strong energy dependence on Russia as a possible source of strategic threat.

Does Sentinel Lymph Node Biopsy Influence Subsequent Management Decisions in Women With Breast Cancer ≥ 70 Years Old?

BackgroundThere have been ongoing attempts to de-escalate surgical intervention in older breast cancer patients in recent years. However, there remains ongoing hesitancy amongst surgeons to de-implement axillary staging in this cohort. The supporting argument for performing a sentinel lymph node biopsy (SLNB) is that it may guide subsequent management. MethodsA retrospective review was performed of 356 SLNBs, in 342 women ≥ 70 years of age with invasive breast cancer, between 2014 and 2022 in a single institution. Data were collected on patient and tumor characteristics and subsequent management for all patients and for patients with ER+/HER2-, early-stage disease. ResultsPositive SLNB significantly increased likelihood of receiving adjuvant chemotherapy (CTh) in patients aged 70-75 in all clinical subtypes (OR 4.0, 95% CI, 1.6-10; P = .0035). Positive SLNB did not significantly increase likelihood of receiving adjuvant CTh in patients aged 75-80, however, an Oncotype Dx score of ≥ 26 did (OR 34.50, 95% CI, 3.00-455.2; P = .0103). Positive SLNB was significantly associated with receiving adjuvant radiotherapy (RTh) in all patients aged 70-75 (OR 4.5, 95% CI, 2.0-11; P = .0004) and 75-80 (OR 9.7, 95% CI, 2.7-46; P = .0015). In patients aged ≥ 80 years, positive SLNB did not have a significant influence on subsequent treatments. ConclusionIn this study, SLNB did not significantly influence subsequent management decisions in patients over 80 and should rarely be performed in this cohort. However, SLNB still had a role in patients aged 70-80 and should be used selectively in this cohort.

The impact of facial attractiveness and alleged personality traits on fairness decisions in the ultimatum game: Evidence from ERPs.

In the mind of the beholder the personality and facial attractiveness of others are interrelated. However, how these specific properties are processed in the neurocognitive system and interact with each other while economic decisions are made is not well understood. Here, we combined the ultimatum game with EEG technology, to investigate how alleged personality traits and the perceived facial attractiveness of proposers of fair and unfair offers influence their acceptance by the responders. As expected, acceptance rate was higher for fair than unfair allocations. Overall, responders were more likely to accept proposals from individuals with higher facial attractiveness and with more positive personality traits. In ERPs, words denoting negative personality traits elicited larger P2 components than positive trait words, and more attractive faces elicited larger LPC amplitudes. Replicating previous findings, FRN amplitudes were larger to unfair than to fair allocations. This effect was diminished if the proposer’s faces were attractive or associated with positive personality traits. Hence, facial attractiveness and the valence of personality traits seem to be evaluated independently and at different time points. Subsequent decision making about unfair offers is similarly influenced by high attractiveness and positive personality of the proposer, diminishing the negative response normally elicited by “unfair” proposals, possibly due a “reward” effect. In the ERPs to the proposals the effect of positive personality and attractiveness were seen in the FRN and P300 components but for positive personality traits the effect even preceded the FRN effect. Altogether, the present results indicate that both high facial attractiveness and alleged positive personality mitigate the effects of unfair proposals, with temporally overlapping but independent neurocognitive correlates.

Interim performance feedback and quitting in tournaments: evidence from the civil service exam in China

ABSTRACT This study investigates the impact of interim performance feedback on candidates’ subsequent decisions on whether to quit during the tournament-like civil service exam in China, consisting of two stages: the written exam and the interview. We empirically find that, following the disclosure of written exam scores, candidates’ own scores significantly decrease their probability of quitting the later interview, whereas the scores of their rivals for the same government position significantly increase their probability of quitting. This indicates that candidates compare their own scores to those of their rivals to assess their chances and strategically decide whether to quit midway. However, this impact is only significant for laggards, requiring further explanation in future studies.

Unlocking the potential of blockchain technology in enhancing the fisheries supply chain: an exploration of critical adoption barriers in China

The application of blockchain technology holds significant potential for improving efficiency, resilience, and transparency within the Fisheries Supply Chain (FSC). This study addresses the critical barriers hindering the adoption of blockchain technology (BT) in the Chinese FSC, recognizing the unique challenges posed by its intricacies. Through a comprehensive literature review, fourteen Critical Barrier Factors (CBFs) were identified, and a grey Delphi method was employed to distill this set. Five pivotal CBFs emerged, including "Regulatory Compliance," "Cost of Implementation," and "Complex Supply Chain Network". A subsequent grey Decision-Making Trial and Evaluation Laboratory (DEMATEL) analysis revealed the causal relationships among these factors, categorizing them into effect and cause groups. "Regulatory Compliance," "Cost of Implementation," and "Complex Supply Chain Network" were identified as primary influencing factors demanding attention for effective BT integration in the FSC. The findings serve as a valuable resource for FSC stakeholders, assisting in prioritizing efforts to address these barriers. The discerned causal relationships provide guidance for managers in optimizing resource allocation. Ultimately, this research advocates for the adoption of blockchain technology in the fisheries supply chain to enhance overall performance and operational efficiency.

Abstract PO5-26-12: Optimizing Treatment Decisions in Microinvasive Ductal Carcinoma in Situ: Evaluating the Need for Surgical Axillary Staging

Abstract Background: Surgical axillary staging is often debated in patients with microinvasive ductal carcinoma in situ (T1mi) due to the low occurrence of nodal metastasis. Axillary surgery (ASx) is associated with risks like seroma, wound complications, lymphedema, and sensory deficits. This study aims to assess the utility of surgical axillary staging in clinically node-negative (cN0) T1mi breast cancer patients and provide insights for optimizing high value surgical treatment and subsequent decision-making. Methods: This retrospective cohort study analyzed data from the National Cancer Database (NCDB) to investigate axillary status of patients with cT1mi breast cancer between 2012 and 2019. Patient demographics, clinical characteristics, treatment methods and pathologic findings were collected. Comparisons were made between those who did and did not undergo ASx, and of those who did, between patients who were pathologically node-positive (pN+) vs. node-negative (pN-). Results: Of 10,843 patients analyzed, 9,220 (85.0%) underwent ASx while 1,623 (15.0%) did not. Mean age of patients undergoing ASx and those who did not was 59.2±11.2 and 66.3±12.8 years, respectively (p&amp;lt; 0.001). On univariate analysis, other factors associated with undergoing ASx were having private insurance, fewer medical comorbidities, having a HER2+ or triple negative phenotype, higher grade, presence of lymphovascular invasion and undergoing mastectomy (all p&amp;lt; 0.05). Sentinel lymphadenectomy was performed in 83% of patients while axillary lymph node dissection (ALND) was performed in 17% of patients. Final pathology demonstrated an upgrade to a true invasive cancer (T1 or greater) in 29.3% of cases. Of 9,069 patients who underwent ASx with known pathologic nodal status, 8,512 (93.9%) were pN- and 557 (6.1%) were pN+. Factors independently associated with increased odds of having positive nodes were younger age (OR 1.02, 95% CI 1.01-1.03, p&amp;lt; 0.001), Black race (OR 1.51, 95% CI 1.12-2.10, p=0.007), lymphovascular invasion (OR 13.72, 95% CI 10.25-18.36, p&amp;lt; 0.001), and undergoing mastectomy (OR 1.98, 95% CI 1.57-2.51, p&amp;lt; 0.001). Among the pN+ patients, only 64 (0.7%) had ≥3 total positive nodes and would require ALND. On subset analysis of the 4,190 patients undergoing mastectomy, 244 (5.8%) did not undergo ASx, while 3,946 (94.2%) did, of whom 373 (9%) were pN+. Regarding adjuvant treatments in this group, more patients who underwent ASx received chemotherapy (12% v. 8%, p&amp;lt; 0.001), and among those who did undergo surgery those who were pN+ were much more likely to receive chemotherapy (58% v. 12%, p&amp;lt; 0.001). However, similar proportions of patients who did and did not undergo ASx received adjuvant radiation (5% v. 4%, p=0.65), while, as expected, among those undergoing ASx, a higher proportion who were pN+ underwent radiation (32% v. 5%, p&amp;lt; 0.001). Conclusion: Surgical axillary staging for T1mi breast cancer is common, but many patients are node-negative. More patients are undergoing ALND than necessary based on pathology. Nodal status influences adjuvant therapy decisions. Identifying factors linked to upgrade and higher pN+ probabilities can enable personalized surgical treatments, reducing morbidity for most patients. Citation Format: Christian Lava, Karen Li, Lauren Berger, Daisy Spoer, Lindy Rosal, Austin Williams, Monika Masanam, Ian Greenwalt, Jennifer Son, Lucy De La Cruz. Optimizing Treatment Decisions in Microinvasive Ductal Carcinoma in Situ: Evaluating the Need for Surgical Axillary Staging [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-26-12.

Abstract PO1-05-05: Overall survival (OS) and subsequent therapy patterns in Japanese patients with HR+/HER2− advanced breast cancer (ABC) treated with palbociclib (PAL) plus letrozole (LET) in first-line setting (1L)

Abstract Background: PAL is a first-in-class cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) for the treatment of HR+/HER2− ABC. In PALOMA-2 study, PAL plus LET demonstrated a numerically, not statistically significant, prolonged OS versus placebo plus LET (53.9 vs 51.2 months; HR, 0.956; 95% CI, 0.777–1.177) in patients with HR+/HER2− ABC in 1L. Subgroup analyses showed a similar trend in Asia/Pacific region (73.4 vs 55.1 months; HR, 0.744), however, data specific to Japanese subgroup have not been reported. An open-label, single-arm, multicenter Japanese phase 2 study (J-Ph2) investigated the efficacy and safety of PAL plus LET in postmenopausal Japanese women with HR+/HER2− ABC in 1L and showed a median progression-free survival (PFS) of 35.7 months (95% CI, 21.7–46.7) in the final analysis of PFS. However, OS data were immature at the data cutoff. Here, we report the findings from a follow-up study of J-Ph2 (NCT04735367) evaluating OS and subsequent therapy in these Japanese patients. Methods: Patients (N=42) who participated in J-Ph2 were enrolled in this follow-up study. The primary endpoint was OS, defined as the time from the first dose of PAL plus LET in J-Ph2 to date of death due to any cause. Secondary endpoints included chemotherapy-free survival (CFS) and type and duration of subsequent therapy. Median OS, CFS, duration of subsequent therapy and associated 95% CIs were estimated using the Kaplan–Meier method. Outcomes were also assessed for baseline demographic and disease characteristic subgroups including visceral or nonvisceral metastatic disease, disease-free interval (DFI; ≤12 months, &amp;gt;12 months, de novo metastatic), and duration of 1L PAL use (≤24 months or &amp;gt;24 months). Results: Patients had a median age of 62.5 years; 48% had visceral metastases; 33% had de novo disease; 48% had a TFI &amp;gt;12 months; 93% had an ECOG performance status (PS) of 0. At a median follow up of 89.7 months, the median OS was 85.4 months (95% CI, 64.3–not estimable [NE]). Median OS was longer in patients with nonvisceral versus visceral metastases (not reached [NR] vs 67.3 months), with TFI &amp;gt;12 months versus ≤12 months (85.4 vs 45.4 months), or with duration of 1L PAL use &amp;gt;24 months versus ≤24 months (NR vs 47.5 months). Median CFS was 69.1 months (95% CI, 24.2–85.4), and that was longer in patients with nonvisceral versus visceral metastases (77.5 vs 37.5 months). At the data cutoff, 3 patients (7.1%) were still receiving PAL plus LET (90.9–93.2 months). Subsequent therapy after disease progression was administered to 34 of 42 patients (81%). Of these patients, 28 (82%) received endocrine-based therapy, while 3 (9%) patients each received chemotherapy and other therapy, respectively. The median duration of the first subsequent therapy was 8.3 months (95% CI, 3.9–12.2), and that was similar among patients with nonvisceral versus visceral metastases (7.8 vs 8.3 months). Conclusion: This interim analysis showed a median OS of &amp;gt;7 years with 1L PAL plus LET. Patient demographics (geographic, racial factors), disease characteristics (ECOG PS, visceral metastases), and subsequent therapy decisions may have contributed to the extended median OS observed in this study. Further, this report provides insight into real-world subsequent treatment patterns following PAL plus ET. Table Citation Format: Masato Takahashi, Tomofumi Osako, Hiroyuki Yasojima, Kenichi Inoue, Masahiro Kawashima, Hideki Maeda, Mitsuya Ito, Yasuaki Sagara, Kan Yonemori, Masaya Hattori, Naohito Yamamoto, Eriko Tokunaga, Shozo Ohsumi, Yutaka Yamamoto, Akemi Ichikawa, Yasuaki Muramatsu, Norikazu Masuda. Overall survival (OS) and subsequent therapy patterns in Japanese patients with HR+/HER2− advanced breast cancer (ABC) treated with palbociclib (PAL) plus letrozole (LET) in first-line setting (1L) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-05-05.

Abstract PO4-23-06: Outcomes and experiences of women denied immediate breast REconstruction after maSTectOmy for bREast cancer during the COVID-19 pandemic - The RESTORE C19 Study

Abstract Introduction 40% of women diagnosed with breast cancer in the UK each year undergo mastectomy and immediate breast reconstruction (IBR) is routinely offered to improve quality of life. During COVID19, this offer was withdrawn to prioritise frontline and emergency services. The RESTORE C19 study aimed to use mixed methods to explore the outcomes, lived experiences and views of women denied IBR during the pandemic. Methods Women not offered IBR between March &amp; October 2020, were identified via B-Map-C, a UK prospective multicentre cohort study documenting changes in breast cancer treatment decisions during the pandemic. All patients were followed up between December 2021 &amp; July 2022 (21-28 months following mastectomy) to explore their ongoing management including whether they had undergone, were awaiting, or had decided against delayed breast reconstruction (DBR) and the procedures performed. Descriptive statistics were used to summarise results. Semi-structured qualitative interviews were undertaken to explore the experiences of this group in more depth. Women were purposively sampled based on treatment centre, age, decision regarding DBR, and procedure performed. A topic guide was developed to explore experiences of breast cancer care; feelings about not having been offered IBR and factors influencing subsequent surgical decision-making. Interviews were transcribed in full and analysed thematically, with data collection and analysis undertaken concurrently and iteratively until saturation was achieved. Full ethical approval was obtained: IRAS 302580, Wales REC 4 21/WA/0347. Results Some 366 women were identified as not having been offered IBR in the B-MaP-C study for whom follow up data was available for 311 (85.0%) from 55 centres. The median age was 50 (range 27-83 years). Most women presented with symptomatic breast cancer (n=239, 76.8%), were fit with no significant comorbidities, had T1 or 2 tumours (n=215, 69.1%) and were node negative (n=186, 59.6%). Almost a fifth (n=58, 18.6%) of women had decided against breast reconstruction completely. Of the remainder, just under 60% (n=149/253), had attended a surgical consultation to discuss DBR and only a third (n=91/253, 36%) had been referred to plastic surgical services to discuss autologous procedures. Only 21 women (6.8%) had received DBR; (16 free flaps, 4 implants, 1 pedicled flap+/-implant). Interviews were performed with 18 women from 5 centres with a median age of 49 years (range 34-67): n=5 women had either received/were awaiting DBR; n=4 had undergone/were awaiting contralateral symmetrising mastectomy and n=9 had decided against/were undecided about further surgery. Whilst all women reported feeling ‘grateful’ for their breast cancer treatment, some felt ‘abandoned’ by healthcare professionals, others that they needed to chase breast surgical teams for care, advice, and support. Partners were also impacted by their experiences with some women describing lasting effects on their relationships. Many women described how their desire for symmetry, either by breast reconstruction or symmetrising mastectomy, had “paled into insignificance” in the months and years following treatment. Conclusions The impact of COVID19 continues to be felt by women treated for breast cancer in the UK. Most women not offered IBR are either still awaiting DBR almost three years after their initial mastectomy or have decided against further surgery. The interviews highlight the trauma many women experienced receiving breast cancer treatment during the pandemic and ongoing issues that, for some, are yet to be fully addressed. There is a need for individualised support to provide women with equitable and timely access to DBR and/or symmetrising mastectomy depending on patient preference to help them move on with their lives. Citation Format: Katherine Fairhurst, Rajiv Dave, Baek Kim, Rachel O'Connell, Raghavan Vidya, P.G. Roy, Stuart McIntosh, Patricia Fairbrother, Jo Skillman, Leila Rooshenas, Shelley Potter. Outcomes and experiences of women denied immediate breast REconstruction after maSTectOmy for bREast cancer during the COVID-19 pandemic - The RESTORE C19 Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-23-06.