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[Display omitted] • New thiosemicarbazide and 1,2,4-triazole derivatives, not described in the literature, were synthesized. • The anthelmintic activity was tested in vitro and in vivo on four pathogenic nematode species. • The in vivo studies showed no systemic toxicity of the tested compound (II-1). • The degree of inhibition of selected CYP450 enzymes depending on the concentration of the tested compound II-1 was assessed. • The in silico studies indicated tubulin and the SDH enzyme as potential molecular targets of the tested compound (II-1) Intestinal parasitic infections are neglected diseases and, due to the increasing resistance of parasites to available drugs, they pose an increasing therapeutic challenge. Therefore, there is a great need for finding new compounds with antiparasitic activity. Objectives: In this work, new thiosemicarbazide and 1,2,4-triazole derivatives were synthesized and tested for their anthelmintic activity. The synthesis was carried out by classical methods of organic chemistry. Anthelmintic activity tests were carried out in vitro (Rhabditis sp., Haemonchus contortus , Strongylidae sp.) in vivo (Heligmosomoides polygyrus/bakeri), and in silico analysis was performed. Quinoline-6-carboxylic acid derivative compounds were designed and synthesized. The highest activity in the screening tests in the Rhabditis model was demonstrated by compound II-1 with a methoxyphenyl substituent LC 50 = 0.3 mg/mL. In the next stage of the research, compound II-1 was analyzed in the H. contortus model. The results showed that compound II-1 was active and had ovicidal (percentage of dead eggs > 45 %) and larvicidal (percentage of dead larvae > 75 %) properties. Studies in the Strongylidae sp. model confirmed the ovicidal activity of compound II-1 (percentage of dead eggs ≥ 55 %). In vivo studies conducted in the H. polygyrus / bakeri nematode model showed that the number of nematodes decreased by an average of 30 % under the influence of compound II-1. In silico studies have shown two possible modes of action of compound II-1, i.e. inhibition of tubulin polymerization and SDH. The test compound did not show any systemic toxic effects. Its influence on drug metabolism related to the activity of cytochrome CYP450 enzymes was also investigated. The results obtained in the in vitro, in vivo , and in silico studies indicate that the test compound can be described as a HIT, which in the future may be used in the treatment of parasitic diseases in humans and animals. [ABSTRACT FROM AUTHOR]

Bipolar radiofrequency ablation (B-RFA) is a method used to treat the arrhythmia substrate resistant to unipolar ablation. Few studies have addressed endo-epicardial B-RFA. The aim of the study was to evaluate chronic lesions resulting from endo-epicardial B-RFA and to determine optimal settings for such procedures in an animal model. In 7 pigs, up to 5 radiofrequency applications per animal were performed with 2 electrodes placed on both sides of the left ventricular free wall. Current was delivered for 60 seconds by a generator dedicated for B-RFA with power settings of 25, 30, 35, 40, and 50 W. At 12 weeks after ablation, 31 lesions were assessed. Their maximal cross-sectional area ranged from 7.2 to 68 mm2 and correlated with total power delivered (r = 0.53), with temperature increment at the endocardial catheter (r = 0.65), and inversely with temperature decrement at the epicardial catheter (r = 0.54). For power values between 30 and 40 W, the lesion area did not differ significantly (P =.92). Lesion depth ranged from 1.9 to 11 mm and correlated with impedance decrement (r = 0.5). Lesions were transmural in 8 cases. Lesion depth/wall thickness ratio was on average 0.6 ± 0.3, with the smallest value for 25 W (0.5 ± 0.3) and the largest for 50 W (0.8 ± 0.3). Steam pops occurred at a power range of 30–50 W, with an incidence of 1 in 5 applications, with 1 case of fatal tamponade at 40 W. Impedance decrement, endocardial catheter temperature increment, and endocardial electrogram amplitude decrement were greater during applications with steam pops. Chronic lesions resulting from endo-epicardial B-RFA appear smaller and less often transmural compared with acute lesions described in the literature. The incidence of steam pops during endo-epicardial B-RFA is relatively high even at low powers. [ABSTRACT FROM AUTHOR]

Scalp involvement in plaque psoriasis is challenging to treat. To evaluate the efficacy and safety of deucravacitinib (DEUC) in scalp psoriasis. POETYK PSO-1 and PSO-2 were global phase 3, 52-week, double-blinded trials in adults with moderate to severe psoriasis. Patients were randomized 1:2:1 to oral placebo, DEUC 6 mg once daily, or apremilast 30 mg twice daily. This pooled secondary analysis evaluated scalp-specific Physician Global Assessment score of 0 or 1 (0/1), ≥90% improvement from baseline in Psoriasis Scalp Severity Index, and change from baseline in Psoriasis Scalp Severity Index. Adverse events were evaluated through week 16. Overall, 1084 patients with moderate to severe scalp psoriasis at baseline were included. At week 16, response rates were greater with DEUC versus placebo or apremilast for scalp-specific Physician Global Assessment 0/1 (64.0% vs 17.3% vs 37.7%; P <.0001), ≥90% improvement from baseline in Psoriasis Scalp Severity Index (50.6% vs 10.5% vs 26.1%; P <.0001), and change from baseline in Psoriasis Scalp Severity Index. Responses were maintained through 52 weeks with continuous DEUC. Safety was consistent with the entire study population. Lack of data in milder scalp psoriasis. DEUC was significantly more efficacious than placebo or apremilast in improving moderate to severe scalp psoriasis and was well tolerated. [ABSTRACT FROM AUTHOR]

Remote patient monitoring (RPM) of patients treated with automated peritoneal dialysis (APD) at home allows clinicians to supervise and adjust the dialysis process remotely. This study aimed to review recent scientific studies on the use of RPM in patients treated with APD and based on extracted relevant data assess possible clinical implications and potential economic value of introducing such a system into practice in Poland. A systematic literature review was performed in the MEDLINE, EMBASE, and Cochrane databases. The model of clinical effects and costs associated with APD was built as a cost-effectiveness analysis with a 10-year time horizon from the Polish National Health Fund perspective. Cost-effectiveness analysis compared 2 strategies: APD with RPM versus APD without RPM. Thirteen publications assessing the clinical value of RPM among patients with APD were found. The statistical significance of APD with RPM compared with APD without RPM was identified for the main clinical outcomes: frequency and length of hospitalizations, APD technique failure, and death. An incremental cost-effectiveness ratio was equal to €27 387 per quality-adjusted life-year. The obtained incremental cost-effectiveness ratio is below the willingness-to-pay threshold for the use of medical technologies in Poland (€36 510 per quality-adjusted life-year), which means that APD with RPM was a cost-effective technology. RPM in patients starting APD is a clinical option that is worth considering in Polish practice because it has the potential to decrease the frequency of APD technique failure and shorten the length of hospitalization. • To the best of our knowledge, our work is the first cost-effectiveness analysis of using the newest remote patient monitoring (RPM) in automated peritoneal dialysis in Poland. • It presents an assessment of the clinical effects of the latest research for RPM and an estimate of the costs and resource utilization of the currently used technologies and the new RPM in dialysis from the perspective of the Polish National Health Fund. • Our results show cost-effectiveness of the new RPM, and policymakers take this aspect into account. • Poland is one of the leaders in introducing new policies into practice in healthcare in Central and Eastern Europe; therefore, our research can give valuable information to any other local policymakers, in Europe and other countries. [ABSTRACT FROM AUTHOR]

Coronary artery disease is the leading cause of morbidity and mortality worldwide. Despite remarkable advances in the management of coronary artery disease, the prediction of adverse coronary events remains challenging. Over the preceding decades, considerable effort has been made to improve risk stratification using noninvasive imaging. Recently, these efforts have increasingly focused on the direct imaging of coronary atherosclerotic plaque. Modern imaging now allows imaging of coronary plaque burden, plaque type, atherosclerotic plaque activity, and plaque thrombosis, which have major potential to refine patient risk stratification, aid decision making, and advance future clinical practice. [Display omitted] • The prediction of adverse coronary events remains challenging. • Noninvasive imaging in coronary artery disease is increasingly being focused on the atherosclerotic plaque. • The assessment of plaque burden, plaque type, disease activity, and plaque thrombosis hold promise in improving patient risk stratification. [ABSTRACT FROM AUTHOR]

In patients with some cardiovascular disease conditions the result of Nutritional Risk Screening 2002 (NRS-2002) and body mass index (BMI) is related to the in-hospital mortality. The aim of this study was to assess the prognostic impact of BMI and NRS 2002 on in-hospital mortality among patients with acute myocardial infarction (AMI) in relation to sex. The study was based on a retrospective analysis of 945 medical records of AMI patients admitted to the Cardiology Department between 2017 and 2019. Patients with a score NRS2002 ≥ 3 are considered to be nutritionally at risk. The WHO BMI criteria were used. The endpoint was in-hospital mortality. Logistic regression was used to analyse the impact of quantitative variables on dichotomous outcome. Odds ratios (OR) with 95% confidence intervals were reported. Female patients were significantly older than male patients (73.24 ± 11.81 vs 67 ± 11.81). In an unadjusted model, the risk of malnutrition was a significant predictor of the odds of in-hospital mortality only in female patients (OR = 7.51, p = 0.001). In a multivariate model adjusted by all variables, heart failure (HF) (OR = 8.408, p = 0.003) and the risk of malnutrition (OR = 6.555, p = 0.007) were independent predictors of the odds of in-hospital mortality in female patients. The only significant independent predictor of the odds of in-hospital mortality in male patients was HF (OR = 3.789 p = 0.006). Only in the case of female patients with AMI, the risk of malnutrition was independently associated with the odds of in-hospital mortality. There was no effect of BMI on in-hospital mortality in both sexes. • Sex-related nutritional status assessment could be a potential factor optimizing the individual acute coronary syndrome patient treatment. • The female sex and risk of malnutrition (according to NRS-2002) is associated with in-hospital mortality in acute coronary syndrome. • To provide primary and secondary prevention, it is necessary to provide sex specific nutritional recommendations to patients with a risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

[Display omitted] [ABSTRACT FROM AUTHOR]

In this paper, a new perfect control law dedicated to nonminimum-phase unstable LTI MIMO systems governed in the continuous-time state–space domain is proposed. Two algorithms are investigated, one of which has turned out to be definitely accurate. Henceforth, the inverse model control-based formula can be applied to any right-invertible plants having more input than output variables. Last, not least, through the application of some generalized inverses, the perfect control procedure guarantees the structural stability behavior even for unstable systems. Thus, the notion of the nonminimum-phase property should be understood in terms of a possible achieveability covering the entire class of LTI MIMO continuous-time plants. Theoretical and practical simulation examples performed in the Matlab/Simulink environment confirm the feasibility of the newly introduced approach. • A new perfect control law devoted to nonminimum-phase unstable systems is offered. • The IMC-originated approach is derived from the application of generalized inverses. • A new method certifies a stability for unstable and nonminimum-phase systems. • A new procedure is associated with the continuous-time state–space MIMO framework. • Theoretical and practical scenarios confirm the correctness of the new solution. [ABSTRACT FROM AUTHOR]

Background: Recurrent ST-segment elevation myocardial infarction (rSTEMI) can be attributed to the same (target-vessel, TV-rSTEMI) or different culprit vessel (non-target, nonTV-rSTEMI) compared with the first infarction. We hypothesized that long-term mortality after rSTEMI depends on the infarct-related artery (the same or different compared with the first STEMI).Methods: Using the Polish Registry of Acute Coronary Syndromes (PL-ACS) we retrospectively identified survivors of first STEMI treated with PCI who experienced rSTEMI. We divided rSTEMI into TV-rSTEMI and nonTV-rSTEMI. We compared clinical, angiographic, and procedural characteristics and utilized propensity score matching to adjust for baseline differences. Primary outcome was 1-, 3- and 5-year all-cause mortality.Results: Between 2003 and 2019 a total of 3,411 patients (mean age 63.7 years, 76% male) had rSTEMI, of whom 1,916 (56%) had TV-rSTEMI and 1,495 (44%) had nonTV-rSTEMI. Median time since first infarction was 716 days (100, 1,807). Patients with nonTV-rSTEMI had higher body mass index (27.2 vs 26.7 kg/m2, P = .041), more arterial hypertension (77.4 vs 73.7%, P = .015) and atrial fibrillation (4.8 vs 3.3%, P = .02), and lower left ventricular ejection fraction (43 [35, 50] vs 45 [38, 50]%, P <.001) compared with TV-rSTEMI. On coronary angiography nonTV-rSTEMI more frequently presented with Thrombolysis In Myocardial Infarction >1 flow (25.8 vs 15.7%, P < .001), multivessel disease (51.9 vs 40.8%, P =.002), culprit lesion located in circumflex artery (22.6 vs 5.6%, P < .001), and more frequently underwent stenting (88.8 vs 76.1%, P < .001) compared with TV-rSTEMI. There was no difference in unadjusted 1-, 3- and 5-year mortality between nonTV-rSTEMI and TV-rSTEMI. After propensity score analysis, 807 well-matched pairs of patients were selected. Adjusted 1-, 3- and 5-year mortality remained similar between nonTV-rSTEMI and TV-rSTEMI (14.7 vs 14.4%, P = .88; 23.6 vs 23.1%, P = .81; 30.0 vs 32.0%, P = .50 respectively).Conclusions: Our study shows overall low frequency of rSTEMI. Patients with nonTV-rSTEMI have different clinical and angiographic characteristics compared with TV-rSTEMI. No long-term mortality difference was observed between both groups. [ABSTRACT FROM AUTHOR]

Hip arthroscopic treatment for femoroacetabular impingement syndrome and labral tears is the gold standard in the adult and adolescent population, as we all know the most common surgical approach to the hip is entering the central compartment with fluoroscopy and with continuous distraction. A periportal capsulotomy in traction must be done to have visibility and instrument maneuverability. These maneuvers avoid scuffing the femoral head cartilage. In adolescents, extreme care must be taken in hip distraction, as the force used can cause iatrogenic neurovascular lesions, avascular necrosis, and lacerations of the genitals and foot/ankle. Experienced surgeons around the world have developed an extracapsular approach to the hip with smaller capsulotomies with a low complication rate. This approach to the hip has brought attention in the adolescent population because it is more secure and simple. Less force of distraction is needed because the capsulotomy is done first. This surgical technique allows observation of the cam morphology while entering to the hip without distraction. We describe an extracapsular approach as an option to treat femoral acetabular impingement syndrome and labral tears in the pediatric and adolescent population. [Display omitted] [ABSTRACT FROM AUTHOR]

The COMMENCE trial was conducted to evaluate the safety and effectiveness of aortic valve replacement using a bioprosthesis with novel RESILIA tissue (Edwards Lifesciences). RESILIA tissue is incorporated in the INSPIRIS RESILIA aortic valve (Edwards Lifesciences). Patients underwent clinically indicated surgical aortic valve replacement with a bovine pericardial bioprosthesis (model 11000A; Edwards Lifesciences) in a prospective, multinational, multicenter (n = 27), US Food and Drug Administration Investigational Device Exemption trial. Events were adjudicated by an independent clinical events committee, and echocardiograms were analyzed by an independent core laboratory. Outcomes through an observational period of 5 years are reported. Between January 2013 and March 2016, 689 patients received the study valve. Mean patient age was 66.9 ± 11.6 years; Society of Thoracic Surgeons Predicted Risk of Mortality was 2.0% ± 1.8%; and 23.8%, 49.9%, and 24.4% of patients were New York Heart Association functional class I, II, and III at baseline, respectively. Through December 11, 2020 the follow-up duration was 4.3 ± 1.4 years, and the completeness of follow-up over the observational period was 95.5%. Early (<30 days) all-cause mortality was 1.2%, stroke 1.6%, and major paravalvular leak 0.1%. Five-year actuarial freedom from all-cause mortality, structural valve deterioration, and all-cause reintervention were 89.2%, 100%, and 98.7%, respectively. At 5 years the effective orifice area was 1.6 ± 0.5 cm2, mean gradient was 11.5 ± 6.0 mm Hg, 97.8% of patients were class I/II, and 97.8% and 96.3% of patients had none/trace paravalvular and transvalvular regurgitation, respectively. The safety and hemodynamic performance of this aortic bioprosthesis with RESILIA tissue through 5 years are encouraging, with clinically stable hemodynamics, minimal regurgitation, and no evidence of structural valve deterioration. [ABSTRACT FROM AUTHOR]

Authors have described selected problems related to valuation and value creation of Internet related companies. In case of intangible assets related to the new economy and Internet companies, valuation is usually much more complicated due to rapid volatility, limited historical information and constantly emerging new technologies that change the image of the market. The same situation is in case of young companies, which current, tangible assets are of little value, while the value of the company is concentrated in intangible assets and development options The paper presents general valuation indicators for Internet companies, which are a root point for a client division allowing a further model improvement. Based on the Internet companies evaluation indicators review, authors decided that for this proposal, the division between one-time (non-loyal) and repetitive (loyal) customers is of the greatest use. Following, the method of valuing companies based on valuation of Customer Lifetime Value was described. Considering different kinds of the Internet clients, a valuation model for one time and continuous relation was proposed. Authors suggest modifying traditional model by dividing the customers into two segments. The consumer's loyalty measured by behavioral outcome - the frequency of purchase is the criteria of segmentation. Such segmentation allows better extrapolation of company's value. [ABSTRACT FROM AUTHOR]

This article presents an e-learning system that supports the adaptation of course content to the student's way of learning. The adaptability of an e-learning course is a challenging task that requires appropriate tools and a well-thought-out architecture. The solution presented in this article is based on the concept of information imprecision and fuzzy control. The proposed fuzzy controller, based on an expert rule base calculates the student's activity in the course in order to determine the questions in tests at the end of successive parts of the course. The solution proposed was implemented in an e-learning Applications of Fuzzy Sets course, which was part of an Artificial Intelligence class. The proposed system successfully adapts the course content to the student's learning style. The article highlights the potential of fuzzy controllers in adaptive e-learning systems. The use of fuzzy controllers makes it possible to take into account the imprecision of information, enabling better handling of uncertainty and variability in the student's learning style. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate six methods of gaze control of pieces in board games without time pressure designed for disabled users who cannot use a keyboard or mouse. Checkers was used as an example game in the experiment, however, the pieces could only be moved one square (i.e. there were no flying kings), but the same control methods with only minor modifications can be used in most board games. By experimenting, we determined that the control method with dwell-time equal to about 600-700ms was the more practical and worked better for users, while the gesture control worked poorly, and the control method involving directly the board was rated higher than the one based on using the buttons around the board. [ABSTRACT FROM AUTHOR]

The research aimed to test the influence on text entry efficiency of supporting features in gaze text entry systems (aka gaze keyboards), leading to dynamic changes in key layout and size. We examined three gaze-controlled on-screen keyboards, that differ in the degree of support, which translates into the amount of change that occurs in the arrangement of the keys and their size - three degrees of dynamism of keyboards' graphical user interface. We also attempted to examine the importance of user attention while using dynamic interface and its impact on text input performance. [ABSTRACT FROM AUTHOR]

Assessment of coronary artery calcium (CAC) by computed tomographic (CT) imaging provides an accurate measure of atherosclerotic burden. CAC is also visible in computed tomographic attenuation correction (CTAC) scans, always acquired with cardiac positron emission tomographic (PET) imaging. The aim of this study was to develop a deep-learning (DL) model capable of fully automated CAC definition from PET CTAC scans. The novel DL model, originally developed for video applications, was adapted to rapidly quantify CAC. The model was trained using 9,543 expert-annotated CT scans and was tested in 4,331 patients from an external cohort undergoing PET/CT imaging with major adverse cardiac events (MACEs) (follow-up 4.3 years), including same-day paired electrocardiographically gated CAC scans available in 2,737 patients. MACE risk stratification in 4 CAC score categories (0, 1-100, 101-400, and >400) was analyzed and CAC scores derived from electrocardiographically gated CT scans (standard scores) by expert observers were compared with automatic DL scores from CTAC scans. Automatic DL scoring required <6 seconds per scan. DL CTAC scores provided stepwise increase in the risk for MACE across the CAC score categories (HR up to 3.2; P < 0.001). Net reclassification improvement of standard CAC scores over DL CTAC scores was nonsignificant (−0.02; 95% CI: −0.11 to 0.07). The negative predictive values for MACE of zero CAC with standard (85%) and DL CTAC (83%) CAC scores were similar (P = 0.19). DL CTAC scores predict cardiovascular risk similarly to standard CAC scores quantified manually by experienced operators from dedicated electrocardiographically gated CAC scans and can be obtained almost instantly, with no changes to PET/CT scanning protocol. [Display omitted] [ABSTRACT FROM AUTHOR]

Ruxolitinib cream demonstrated safety and efficacy over 8 weeks in 2 double-blind phase 3 atopic dermatitis studies (NCT03745638 / NCT03745651). To evaluate long-term safety (LTS) and disease control with ruxolitinib cream. Patients initially randomized to twice-daily 0.75%/1.5% ruxolitinib cream maintained their regimen during the 44-week LTS period (as-needed treatment). Patients on vehicle were rerandomized (1:1) at week 8 to either ruxolitinib cream strength. Safety and disease control (Investigator's Global Assessment score 0/1 and affected body surface area) were assessed. Over 52 weeks, adverse events were reported in 67.4%/62.6%/53.5%/57.6% of patients in 0.75%/1.5% ruxolitinib cream/vehicle to 0.75% ruxolitinib cream/vehicle to 1.5% ruxolitinib cream groups (n = 426/446/101/99). Most common adverse events were upper respiratory tract infection (10.3%/11.4%/5.9%/7.1%) and nasopharyngitis (8.9%/9.9%/7.9%/14.1%). Most adverse events were considered unrelated to treatment. Application site reactions were infrequent (3.8%/1.8%/1.0%/1.0%). Disease control was achieved throughout the LTS; 74.1% to 77.8% of patients had Investigator's Global Assessment 0/1 at week 52, and mean affected body surface area was low (1.4%-1.8%). LTS had no control treatment. During 44 weeks of as-needed treatment, ruxolitinib cream demonstrated effective disease control and tolerability; low ruxolitinib plasma concentrations alongside safety findings reflecting known risk factors suggest physiologically meaningful systemic Janus kinase inhibition is highly unlikely. [ABSTRACT FROM AUTHOR]

• Sleep-disordered breathing (SDB), predominately central sleep apnea, is found in approximately 50% of patients with congestive heart failure (CHF). • The presence of severe SDB reflects poor cardiac function with low cardiac output and pulmonary congestion. • SDB worsens the prognosis of patients with ischemic CHF and may affect the response to cardiac resynchronization therapy (CRT). The response to cardiac resynchronization therapy (CRT) is suboptimal in one-third of patients. The study aimed to evaluate the impact of sleep-disordered breathing (SDB) on the CRT-induced left ventricular (LV) reverse remodeling and response for CRT in patients with ischemic congestive heart failure (CHF). A total of 37 patients aged 65.43 years (SD 6.05), seven of whom were females, were treated with CRT according to class I European Society of Cardiology recommendations. Clinical evaluation, polysomnography, and contrast echocardiography were performed twice during the six-month follow-up (6M-FU) to assess the effect of CRT. In 33 patients (89.1%), sleep-disordered breathing (SDB), predominantly central sleep apnea (70.3%) was observed. This include nine patients (24.3%) with an apnea-hypopnea index (AHI) of >30 events/hour. During the 6M-FU, 16 patients (47.1%) responded to CRT by reducing LV end-systolic volume index (LVESVi) by ≥15%. We stated a directly proportional linear relationship between AHI value and LV volume: LVESVi p = 0.004, and LV end-diastolic volume index p = 0.006. Pre-existing severe SDB can impair the LV volumetric response to CRT even in an optimally selected group with class I indications for resynchronization, which may have an impact on long-term prognosis. [ABSTRACT FROM AUTHOR]

In this paper, as a new application of machine learning, a K- Nearest Neighbor (KNN) classification model is proposed to recognize artifacts in Electrocardiography (ECG) signal using 3-axis accelerometer signals. A fine KNN model using wavelet scattering coefficients as features of 3-axis accelerometer sensor captured training dataset have been proposed as alternative to other machine learning methods to classify artifacts. In wearable health-monitoring devices, artifact noise results signal deformations and it is not possible to employ filtering methods all the time due to data loss. As a result, wearable ECG monitoring devices are not reliable for critical medical usages. Our proposed model classifies accelerometer sensor samples with high probability of having artifact noises in ECG signal with positive predictive value of 94.7%. High accuracy rate of the proposed model in this work gives it an opportunity to be employed in ECG monitoring wearable devices to capture patients ECG history and labeling artifact samples for noise filtration or signal reconstruction systems to cancel the noise without having signal deformations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the safety and feasibility of sequential hypothermic oxygenated perfusion and normothermic machine perfusion and the potential benefits of graft viability preservation and assessment before liver transplantation. With the Food and Drug Administration and institutional review board approval, 17 expanded criteria donor livers underwent sequential hypothermic oxygenated perfusion and normothermic machine perfusion using our institutionally developed perfusion device. Expanded criteria donor livers were from older donors, donors after cardiac death, with steatosis, hypertransaminasemia, or calcified arteries. Perfusion duration ranged between 1 and 2 hours for the hypothermic oxygenated perfusion phase and between 4 and 9 hours for the normothermic machine perfusion phase. Three livers were judged to be untransplantable during normothermic machine perfusion based on perfusate lactate, bile production, and macro-appearance. One liver was not transplanted because of recipient issue after anesthesia induction and failed reallocation. Thirteen livers were transplanted, including 9 donors after cardiac death livers (donor warm ischemia time 16–25 minutes) and 4 from donors after brain death. All livers had the standardized lactate clearance >60% (perfusate lactate cleared to <4.0 mmol/L) within 3 hours of normothermic machine perfusion. Bile production rate was 0.2 to 10.7 mL/h for donors after brain death livers and 0.3 to 6.1 mL/h for donors after cardiac death livers. After transplantation, 5 cases had early allograft dysfunction (3 donors after cardiac death and 2 donors after brain death livers). No graft failure or patient death has occurred during follow-up time of 6 to 13 months. Two livers developed ischemic cholangiopathy. Compared with our previous normothermic machine perfusion study, the bile duct had fewer inflammatory cells in histology, but the post-transplant outcomes had no difference. Sequential hypothermic oxygenated perfusion and normothermic machine perfusion preservation is safe and feasible and has the potential benefits of preserving and evaluating expanded criteria donor livers. [ABSTRACT FROM AUTHOR]

Many organizations are trying to assess how they progress on their digital transformation journey. One of the methods to assess this progress is to apply the concept of digital maturity. In this article authors describe how they discovered the need to develop a digital maturity model tailored to research and development organizations and share their experience from testing the first version of this model. Digital maturity can be assessed to determine the current state of the organization and to develop roadmaps helping organizations evolve and respond to market dynamics. The authors firmly believe that there is no responsible digitalization without considering the dimension of sustainability and therefore they included it in their maturity model. A digitally transformed company becomes more efficient, generates less waste, and uses fewer resources, which makes it more sustainable. [ABSTRACT FROM AUTHOR]

Myocardial perfusion imaging (MPI) is frequently used to provide risk stratification, but methods to improve the accuracy of these predictions are needed. The authors developed an explainable deep learning (DL) model (HARD MACE [major adverse cardiac events]-DL) for the prediction of death or nonfatal myocardial infarction (MI) and validated its performance in large internal and external testing groups. Patients undergoing single-photon emission computed tomography MPI were included, with 20,401 patients in the training and internal testing group (5 sites) and 9,019 in the external testing group (2 different sites). HARD MACE-DL uses myocardial perfusion, motion, thickening, and phase polar maps combined with age, sex, and cardiac volumes. The primary outcome was all-cause mortality or nonfatal MI. Prognostic accuracy was evaluated using area under the receiver-operating characteristic curve (AUC). During internal testing, patients with normal perfusion and elevated HARD MACE-DL risk were at higher risk than patients with abnormal perfusion and low HARD MACE-DL risk (annualized event rate, 2.9% vs 1.2%; P < 0.001). Patients in the highest quartile of HARD MACE-DL score had an annual rate of death or MI (4.8%) 10-fold higher than patients in the lowest quartile (0.48% per year). In external testing, the AUC for HARD MACE-DL (0.73; 95% CI: 0.71-0.75) was higher than a logistic regression model (AUC: 0.70), stress total perfusion deficit (TPD) (AUC: 0.65), and ischemic TPD (AUC: 0.63; all P < 0.01). Calibration, a measure of how well predicted risk matches actual risk, was excellent in both groups (Brier score, 0.079 for internal and 0.070 for external). The DL model predicts death or MI directly from MPI, by estimating patient-level risk with good calibration and improved accuracy compared with traditional quantitative approaches. The model incorporates mechanisms to explain to the physician which image regions contribute to the adverse event prediction. [Display omitted] [ABSTRACT FROM AUTHOR]

Effective, well-tolerated oral psoriasis treatments are needed. To compare the efficacy and safety of deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, versus placebo and apremilast in adults with moderate to severe plaque psoriasis. Participants were randomized 2:1:1 to deucravacitinib 6 mg every day (n = 332), placebo (n = 166), or apremilast 30 mg twice a day (n = 168) in the 52-week, double-blinded, phase 3 POETYK PSO-1 trial (NCT03624127). Coprimary end points included response rates for ≥75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment score of 0 or 1 (sPGA 0/1) with deucravacitinib versus placebo at week 16. At week 16, response rates were significantly higher with deucravacitinib versus placebo or apremilast for PASI 75 (194 [58.4%] vs 21 [12.7%] vs 59 [35.1%]; P <.0001) and sPGA 0/1 (178 [53.6%] vs 12 [7.2%] vs 54 [32.1%]; P <.0001). Efficacy improved beyond week 16 and was maintained through week 52. Adverse event rates with deucravacitinib were similar to those with placebo and apremilast. One-year duration, limited racial diversity. Deucravacitinib was superior to placebo and apremilast across multiple efficacy end points and was well tolerated in moderate to severe plaque psoriasis. [ABSTRACT FROM AUTHOR]

Due to the negative results of randomized aspiration thrombectomy studies, its role in myocardial infarction has been limited to high thrombus burden and/or failed vessel recanalization, with little technological advancement over the last years. In contrast, there has been rapid progress in mechanical thrombectomy in stroke, which is understandable as most ischemic cerebrovascular accidents have an embolic etiology. We present three transradial procedures wherein neurointerventional catheters were used as a first-line device for en bloc removal of large clots lodged distally in tortuous coronary anatomy. First-pass reperfusion was achieved in all the cases, without dissection, distal embolization, or the no reflow phenomenon. In the case of large clots, where coronary aspiration devices fail, neurointerventional catheters may be considered as a rescue strategy. They provide large aspiration lumen and excellent trackability with atraumatic design. Many other neurointerventional techniques can be easily adopted into the coronary armamentarium, possibly increasing the safety and efficacy of thrombus aspiration. [ABSTRACT FROM AUTHOR]

The authors aimed to identify predictors of new-onset postoperative atrial fibrillation (POAF) during the initial 90 days following liver transplantation, and to assess the association between POAF in-hospital and 1-year mortality. A retrospective cohort study. At a university hospital between 2005 and 2017. Adults without a history of preoperative atrial fibrillation who underwent orthotopicliver transplantation. The authors assessed the univariate association between new-onset of POAF in the postoperative period and each potential factor through a logistic regression model. Moreover, they explored predictors for POAF through stepwise selection. Finally, the authors assessed the relationship between POAF and in-hospital and 1-year mortality using logistic regression models, and whether the duration of atrial fibrillation was associated with in-hospital and 1-year mortality. Among 857 patients, 89 (10.4%) developed POAF. Using only preoperative variables, pulmonary hypertension, age, Model for End-Stage Liver Disease (MELD) score, and White race were identified as the most important predictors. Model discrimination was 0.75 (95% CI: 0.69-0.80), and incorporating intraoperative variables was 0.77 (95% CI: 0.72-0.82). In-hospital mortality was observed in 7.2% (6/83) of patients with new-onset of POAF, and in 2.8% (22/768) without, with confounder-adjusted odds ratio (OR) 1.00 (97.5% CI: 0.29,3.45; p = 0.996). One-year mortality was 22.4% (20/89) in patients who developed POAF and 8.3% (64/768) in patients who did not, confounder-adjusted OR 2.64 (97.5% CI: 1.35-5.16; p = 0.001). The duration of POAF did not affect long-term postoperative mortality. Preoperative, mostly unmodifiable comorbidities are important risk factors for new-onset POAF after liver transplantation. The POAF was not associated with in-hospital mortality, but with increased 1-year mortality. Once developed, the duration of POAF did not affect long-term mortality after a liver transplant. [ABSTRACT FROM AUTHOR]

Since 2012, the European Union has actively promoted the growth of its maritime economy, driven by factors such as climate change and energy shortages. Despite this, research on the blue economy's impact on subnational development remains limited, often focusing solely on coastal regions. This paper aims to explore the broader spatial effects of the maritime economy in Poland, a country with a diverse and rapidly growing blue economy. Our study employs an estimated interregional version of Leontief's input-output (I-O) model, focusing on Poland's 16 regions, including three coastal regions. We address two key methodological challenges: compiling maritime sectors within the I-O table and extending the national I-O table to an interregional dimension using a spatial econometric approach. Our research demonstrates the extensive reach of the blue economy across Poland, offering a comprehensive view of its direct and indirect impacts. The results reveal significant intersectoral and interregional linkages driven by maritime economic activities. These linkages extend beyond coastal regions, highlighting the blue economy's wider influence on regional development. By examining the demand for intermediate goods and services by maritime sectors across regions, we identify the spill-over effects that transcend regional boundaries. This knowledge is crucial for crafting policies that support both maritime industries and the regions supplying these industries, ensuring balanced and inclusive economic growth. Our findings provide specific insights for policymaking, suggesting targeted spatial policy interventions to enhance the effectiveness of maritime policy and its integration with regional development strategies. [ABSTRACT FROM AUTHOR]

Runways are a crucial element of the aircraft operations system at an airport. The concept of practical capacity, which relates the number of takeoff and landing operations to the average delay per operation, is used to evaluate the effectiveness of their use. The study aims to identify factors influencing runway performance and then quantify the scale of this impact. An original simulation model in a colored Petri net was developed to achieve this goal. It enables studying the influence of various disturbances in the takeoff and landing process on the average delay per operation. As a result of the simulation experiments, it was found that the most significant impact on runway performance has (i) the delay between the issue of the takeoff clearance and the beginning of the takeoff run, (ii) air traffic congestion, and (iii) adverse weather conditions. These factors often overlap, which significantly increases the average delay per operation. We can only affect the take-off clearance response time of these three factors. Adequate procedures and training programs should be implemented to make aircrews and air traffic controllers aware of the importance of this issue. • Factors influencing airport runway system performance were identified. • The impact of disturbances in the takeoff process on runway capacity was quantitatively analyzed. • Average delay per operation was used as an evaluation metric during simulations. • A micro-scale takeoff and landing model using dynamic, stochastic, colored Petri nets was built. • The delay between the takeoff clearance and the start of the takeoff run is a crucial disturbance. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic dealt a significantly heavy blow to the already competitive air travel industry. As air travel demand is recovering post-pandemic, both airports and airlines are seeking to establish a steady stream of non-aeronautical/ancillary revenues, especially retail, to aid financial recovery. However, a rigorous analysis of passengers' purchasing behaviour during the whole air travel process has been lacking to date. To investigate this matter, we analyse data from a cross-national survey administered in four multi-airport cities (London in the UK, New York City in the US, Shanghai in China, and Sao Paulo in Brazil) in 2020, asking about the respondent's most recent air trip before the pandemic. A Multiple Discrete-Continuous Extreme Value (MDCEV) model was estimated to jointly analyse the discrete decision (to purchase or not) and continuous aspect (of how much is spent) during three stages of travel: at the departure airport, in flight, and at the transfer airport (if applicable). Six hypotheses, about the stage of travel, product and service type, passenger attributes, context of travel, and presence of companions are postulated and examined empirically. The results demonstrate how such factors shape shopping decisions during different stages of travel. The modelling results point towards the need for better pre-flight product information and more tailored offers. Airport retail requires more flexibility in terms of locations, operating hours and channels (in-store, deliveries) to improve shopping convenience. Use of digital tools and passenger data can aid in realising retail revenue improvement. Proposed future research directions include a focus on the transfer airport (where most spending is observed), post-pandemic behaviour changes, the role of product and service attributes, use of non-survey data and environmental impacts of the evolution in air travel retail. • Air travellers from London, New York, Shanghai and Sao Paulo airports are analysed. • When to shop and how much to spend can be modelled using the MDCEV approach. • Shopping patterns at departure airport, during flight and at transfer airports differ. • On-board retail requires better pre-flight product information and tailored offers. • Airport retail requires flexibility (locations) to improve shopping convenience. [ABSTRACT FROM AUTHOR]

Forest trees facing climate change may persist in a short term through acclimation within the limits of their phenotypic plasticity. In the longer term, however, evolutionary adaptation would be needed for populations to thrive in the changed climate, or species may migrate to new areas as climate becomes favorable there. European beech is one of the most important tree species in western and central Europe, and projections indicate that it may contract its southern range and migrate towards northern and north-eastern Europe in the future climates. It is therefore important to recognize the level of variation in climatic adaptation and climatic responsiveness of populations which are likely the source of genetic material for expanding the species range. In this study we examined variation in growth and productivity among 39 European beech populations, which represent the north-eastern margin of the species distribution range. We employed the transfer function and the Universal Response Function approaches to analyze populations' performance in response to the climatic transfer across five provenance test sites and in relationship to climate at the populations' origin and planting sites. We found significant but low variation among tested populations in tree diameter (DBH; cm) and Volume index (m3 ha−1) and significant population × site interaction at age 30 years. That variation, however, was only weakly related to gradients of climatic variables represented by the set of sampled populations. The variable performance of populations across planting sites, and the importance of planting sites' climate in explaining traits' variation in this experiment confirm the plastic response of examined populations to climate change. Our findings indicate that beech populations from the analyzed region have a high acclimation potential to the projected changes in climate, although for high-altitude populations (from > 600 m a.s.l) the negative effect of transfers to warmer and drier conditions was observed. Detailed knowledge of the plasticity of response and adaptive potential of marginal beech populations in the longer term would be needed to guide management decisions to help future forests to cope with climate change. • Beech populations at species north-east margin would contribute to range expansion. • Those populations vary in diameter growth and productivity across planting sites. • Variation was related more to the climate of planting site than population origin. • The pattern on variation reflects plastic response to climate change. • Beech populations from analyzed region have overall a high acclimation potential. [ABSTRACT FROM AUTHOR]

Debates persist regarding the optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in coronary artery disease (CAD). Recent trials have introduced a novel approach involving P2Y12 inhibitor monotherapy with ticagrelor or clopidogrel, after a short DAPT. However, the effectiveness and safety of this strategy remains to be established. We aimed to perform a meta-analysis comparing monotherapy with P2Y12 inhibitors versus standard DAPT in patients undergoing PCI at 12 months. Multiple databases were searched. Six RCTs with a total of 24877 patients were included. The primary endpoint was all-cause mortality at 12 months of follow-up. The secondary endpoints were cardiovascular mortality, myocardial infarction, probable or definite stent thrombosis, stroke events, and major bleeding. The study is registered with PROSPERO (CRD42024499529). Monotherapy with P2Y12 inhibitor ticagrelor significantly reduced both allcause mortality (HR 0.71, 95 CI [0.55-0.91], P = 0.007) and cardiovascular mortality (HR 0.66, 95% CI [0.49-0.89], P = 0.006) compared to standard DAPT. In contrast, clopidogrel monotherapy did not demonstrate a similar reduction. The decrease in mortality associated with ticagrelor was primarily due to a lower risk of major bleeding (HR 0.56, 95% CI [0.43-0.72], P < 0.001), while the risk of myocardial infarction (MI) remained unchanged (HR 0.90, 95% CI [0.73-1.11], P = 0.32). The risk of stroke was found to be similar across treatments. In comparison to standard DAPT, P2Y12 inhibitor monotherapy with ticagrelor may lead to a reduced mortality. The clinical benefits are driven by a reduction of bleeding risk without ischemic risk trade-off. What Is New? • The current meta-analysis showed that mortality is lower in patients treated with P2Y 12 monotherapy compared to standard dual antiplatelet therapy (DAPT), primarily driven by reduced bleeding risks. • Among different P2Y 12 inhibitors, ticagrelor shows greater effectiveness in reducing mortality compared to clopidogrel when used as monotherapy following a short course of DAPT. • The study demonstrates consistency in the effectiveness of P2Y 12 inhibitor monotherapy, indicated by a 0 % I2 value for mortality differences when comparing ticagrelor and clopidogrel monotherapy to standard DAPT, suggesting no observed heterogeneity across the included trials. Bayesian meta-analysis confirmed the findings for mortality from the frequentist meta-analysis. What Are the Clinical Implications? • This meta-analysis supports a paradigm shift in antithrombotic therapy, emphasizing a balance between ischemic prevention and bleeding risk. P2Y12 inhibitor monotherapy, especially with ticagrelor, appears to optimize this balance. • The findings suggest that a shorter duration of DAPT (up to 3 months), followed by P2Y12 inhibitor monotherapy with ticagrelor, may significantly reduce mortality, offering a safer and effective alternative to prolonged standard DAPT. • The reduced mortality associated with P2Y12 monotherapy, especially due to the lower risk of bleeding, highlights the need for personalized antithrombotic strategies. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolemia (FH) is a highly undiagnosed disease. Among FH patients, the onset of premature coronary artery disease is 13 times higher than in the general population. Early diagnosis and treatment is essential to prevent cardiovascular diseases and their complications, and to prolong life. One of the clinical criteria of FH is the occurrence of a corneal arcus (CA) among patients, especially those under 45 years old. Therefore, by detecting a CA, it might be possible to reduce the number of undiagnosed FH cases. In this paper, we propose using convolutional neural networks (CNN) for automatic recognition of the presence of a corneal arcus. To achieve this goal, we created a dataset of images of irises containing different stages of CA as well as irises without a CA. The core of the dataset consists of images acquired from patients with a corneal arcus, enroled in the National Centre of Familial Hypercholesterolemia in Gdansk. To increase the number of images, the dataset was complemented with images downloaded from the Internet. This dataset created for training and testing the model consisted of nearly 4000 images. To detect a CA in photographic images, we tested neural network models based on the VGG16, ResNet and Inception architectures. Finally, the performance of the models was evaluated on a set of images acquired from volunteers with a custom mobile application. The accuracy of CA detection in a real life scenario was 88% and the F1 score was 86% [ABSTRACT FROM AUTHOR]

Safe and economic operation of an open-cathode proton exchange membrane fuel cell (PEMFC) requires an efficient thermal management strategy. The stack temperature regulation in PEMFC is, however, challenging due to often stringent set-point tracking tasks, frequent load fluctuations, constrained manipulated variables, and various modeling uncertainties and nonlinearities. To this end, a feed-forward offset-free model predictive control (MPC) approach, aiming at uncertainties resolving and disturbance mitigation, is developed to simultaneously address the above difficulties. In the proposed framework, the information about the measured power load fluctuations is used in the optimization algorithm as feed-forward information to eventually mitigate the influence of load fluctuations on the controlled output and increases the overall control quality. Additionally, the unmodeled dynamics and the other unmeasurable disturbances/uncertainties are collectively considered as an extended state of the system (to achieve zero static errors) and the on-line reconstructed aggregated disturbances is continuously sent to the MPC algorithm to increase its optimization performance and to achieve offset-free control objectives. The obtained results are quantitatively compared with conventional control strategies for PEMFCs, including a model-based PI controller, its modification utilizing disturbance feed-forward, and a standard offset-free MPC (i.e. without feed-forward). Both the simulations, realized in MATLAB/Simulink, and hardware experiments, conducted on a 500 W PEMFC testbed, show excellence of the proposed feed-forward offset-free MPC consisting in faster temperature tracking and higher robustness. The obtained satisfactory results show the introduced control solution to be a promising prospect and help accelerating further applications of PEMFCs. [Display omitted] • The nonlinearity of the fuel cell stack temperature is exhibited. • The on-line reconstructed aggregated disturbances are feed-forward addressed. • The uncertainties are accommodated by the offset-free approach. • Both simulation and experiments validate the efficaciousness of the proposed method. [ABSTRACT FROM AUTHOR]

Farmers are being continuously encouraged to adopt entrepreneurial practices with the hope that they will increase their competitiveness. One such practice involves defining clear goals for farm development, which is meant to improve farms' capacity to respond to multi-faceted changes in their environment. However, the question remains whether the assumed plans will actually be achieved and whether they should be seen as a prerequisite for improving farm performance. In this paper, we analyse these issues using unique micro data from the dairy sector in Poland. Our focus is on one specific objective – production expansion – which is often included in farmers' future plans. We investigate whether declaring production expansion as a goal for the future has any impact on actual output growth. Our findings suggest a very weak relationship between the two, which is contradictory to strong arguments showing how setting clear goals may lead to improved farm performance. We discuss several potential reasons for this result, namely the specific nature of our data, complex regulatory framework, the fact that new profit opportunities in dairy sector might stem not only from increasing the scale of output, or the fact that business planning may be perceived by farmers just as a technical requirement to receive public support. • There is scarce evidence that planning production expansion supports farm growth in reality. • Using data from the dairy sector in Poland, we show that the two are weakly related. • Simplicity and transparency of the regulatory environment can strengthen the relationship. • Farmers' preference to remain with the traditional way of farming may have the opposite effect. • Relying on private actions to achieve policy objectives may not bring the expected outcomes. [ABSTRACT FROM AUTHOR]

High-porosity, open-cell AZ91 magnesium alloy foams of two pore sizes were fabricated by means of investment casting technology, using PUR foam patterns. Foam casting variables such as pressure, mould temperature and metal pouring temperature were thoroughly investigated to define the most optimal casting conditions. The mechanical properties of the fabricated foams were measured in compression tests. A potential application for the foams considered is temporary bioresorbable bone implants, therefore the mechanical properties of the foams were compared with those of cancellous bone tissue. Foams with smaller pore size and lower porosity (20 PPI and 80%–87%) exhibited mechanical properties in the lower regions of the cancellous bone property range (Young's modulus 36.5–77.5 MPa), while foams with higher pore size and porosity (10 PPI and ∼90%) were found to have insufficient compression strength (Young's modulus 11.65–23.8), but thickening their walls and lowering their porosity below 90% yielded foams with Young's modulus between 36.5 and 77.5 MPa. Foam fractures were also investigated to determine their collapse mechanism. A series of corrosion tests in stimulated body fluid was carried out to determine their applicability as a biomaterial. The Plasma Electrolytic Oxidation (PEO) process was used in a feasibility study to examine the microstructure and chemical composition of foams with protective coating. [ABSTRACT FROM AUTHOR]

A simulation approach was used to improve the results of the laser hardening process of a thin-walled medium manganese steel specimen using oscillating beam technology. During the analysis of the material hardness results, it was found that the hardened zone had an irregular shape, which was the result of different thermal cycles varying with the process progress and heating of the sample. A simulation model of the laser hardening process was built to determine the proper power values to compensate for the effect of thermal inertia of the cool part. The simulation approach, in addition to the development of the master model, included the definition of the proper beam power distribution and the virtual determination of the necessary oscillation frequency that allows the equivalent linear beam distribution to be used in the calculations. The main model considered the dependence of the material properties on the phase composition of the material and was calibrated based on the results of experimental thermocouple measurements. This enabled the determination of the required power course. Using the simulation-calculated beam power, a hardening process was carried out, the results of which confirmed the successful modification of the shape of the hardened zone. [ABSTRACT FROM AUTHOR]

The fundamental problem for designing a gaze-based human-computer interaction is related to development of an effective method for activating graphical user interface elements by means of gaze only. Such a method should be easy for the user to apply, however at the same time, it requires eye movements that are clearly different from the natural behavior of the eye. We examined three methods of button activation by gaze, looking for the most effective way of gaze "clicking". These were: 1) the most standard method based on the use of dwell-time, 2) its modification based on detection of fixation located inside the buttons area and 3) and the most novel method based on gaze gestures consisting of movement into the button area and outward movement in the approximately opposite direction. We compared these gaze control methods under homogeneous conditions, which allows for a more reliable assessment of their relative usefulness. Two layouts of buttons were used: arranged on a grid, like on a telephone pad, and on a circle with an empty center. The experimental task was to enter a set of four-digit PINs using a set of gaze buttons corresponding to ten digits. A group of novices were instructed to use all the three methods and both button layouts (six experimental conditions). The activation methods were compared in terms of system usability, objectively measured by the PIN entry speed and the number of errors, as well as using a subjective SUS questionnaire. The system based on gaze gestures was worse in both measures; however, it had its followers. The method based on fixation detection instead of dwell-time did not significantly increase the entry speed due to the greater number of errors caused by non-intentional buttons activation. The circle layout turned out to be generally more convenient than the telephone pad layout. [ABSTRACT FROM AUTHOR]

Pericoronary adipose tissue (PCAT) attenuation and low-attenuation noncalcified plaque (LAP) burden can both predict outcomes. This study sought to assess the relative and additive values of PCAT attenuation and LAP to predict future risk of myocardial infarction. In a post hoc analysis of the multicenter SCOT-HEART (Scottish Computed Tomography of the Heart) trial, the authors investigated the relationships between the future risk of fatal or nonfatal myocardial infarction and PCAT attenuation measured from coronary computed tomography angiography (CTA) using multivariable Cox regression models including plaque burden, obstructive coronary disease, and cardiac risk score (incorporating age, sex, diabetes, smoking, hypertension, hyperlipidemia, and family history). In 1,697 evaluable participants (age: 58 ± 10 years), there were 37 myocardial infarctions after a median follow-up of 4.7 years. Mean PCAT was −76 ± 8 HU and median LAP burden was 4.20% (IQR: 0%-6.86%). PCAT attenuation of the right coronary artery (RCA) was predictive of myocardial infarction (HR: 1.55; P = 0.017, per 1 SD increment) with an optimum threshold of −70.5 HU (HR: 2.45; P = 0.01). In multivariable analysis, adding PCAT-RCA of ≥−70.5 HU to an LAP burden of >4% (the optimum threshold for future myocardial infarction; HR: 4.87; P < 0.0001) led to improved prediction of future myocardial infarction (HR: 11.7; P < 0.0001). LAP burden showed higher area under the curve compared to PCAT attenuation for the prediction of myocardial infarction (AUC = 0.71 [95% CI: 0.62-0.80] vs AUC = 0.64 [95% CI: 0.54-0.74]; P < 0.001), with increased area under the curve when the 2 metrics are combined (AUC = 0.75 [95% CI: 0.65-0.85]; P = 0.037). Coronary CTA–defined LAP burden and PCAT attenuation have marked and complementary predictive value for the risk of fatal or nonfatal myocardial infarction. [Display omitted] [ABSTRACT FROM AUTHOR]

The paper presents a stability analysis of a closed-loop system with an active disturbance rejection control (ADRC) algorithm and a reduced-order extended state observer (RESO). The controller is designed for first-order plus delay time processes, and one of the input signals to the RESO is delayed to compensate for the effect of the system delay. If the process delay is known, perfect synchronization between the observer input signals can be achieved. In a more realistic case, the process delay is not precisely known, and the resulting imperfect synchronization may lead to instability of the closed-loop system. The perfect synchronization case shows that the closed-loop system can be stabilized for any delay. For the imperfect synchronization case, delay-dependent stability conditions are derived for a simple tuning method. • Stability of delayed systems with active disturbance rejection control is studied. • Stability conditions for the closed-loop system with two delays are derived. • The effect of imperfect delay time compensation on the system's stability is analyzed. • Sufficient delay-dependent stability conditions for a simple tuning method are given. [ABSTRACT FROM AUTHOR]

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