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Protosticta Selys, 1885 is a speciose genus of damselflies distributed in the tropical and subtropical forests of Asia. During an ongoing study to document the odonate diversity of the Western Ghats, we came across a colony of Protosticta species in Wayanad, Kerala, that appeared different from all other species hitherto described. We describe this population as a new species after detailed morphological comparison with closely similar species occurring in the region.

AbstractThese days, paylater, the most well-known alternative credit option in e-commerce, is widely accessible. This research examines the evolving landscape of paylater preferences among Generation Z in Indonesia and Malaysia. The study employs quantitative methodology using a nonexperimental design that measures the effect of perceived ease of use, perceived usefulness, and perceived trust on the intention to use paylater. The research presents two studies. Study 1 had 500 participants from Indonesia who were paylater and non-paylater users. The results of Study 1 revealed that perceived usefulness and perceived trust positively affect the intention to use paylater; however, perceived ease of use has a negative effect on the intention to use paylater. Study 2 had 165 participants from Malaysia who were also paylater and non-paylater users. The results of Study 2 were similar to those of Study 1. That is, perceived usefulness and perceived trust have a positive effect on the intention to use Paylater, but perceived ease of use has a negative effect on the intention to use paylater. This research contributes to the existing literature on consumer behaviour and financial technology adoption by providing insight into the trust dynamics related to paylater preferences among Generation Z in Indonesia and Malaysia.

Introduction Neonatal jaundice is a common and life-threatening health problem in neonates due to overaccumulation of circulating unconjugated bilirubin. Gut flora has a potential influence on bilirubin metabolism. The infant gut microbiome is commonly copied from the maternal gut. During pregnancy, due to changes in dietary habits, hormones and body weight, maternal gut dysbiosis is common, which can be stabilised by probiotics supplementation. However, whether probiotic supplements can reach the baby through the mother and reduce the incidence of neonatal jaundice has not been studied yet. Therefore, we aim to evaluate the effect of prenatal maternal probiotic supplementation on the incidence of neonatal jaundice.Methods and analysis This is a randomised double-blind placebo-controlled clinical trial among 94 pregnant women (47 in each group) in a tertiary hospital in Hong Kong. Voluntary eligible participants will be recruited between 28 and 35 weeks of gestation. Computer-generated randomisation and allocation to either the intervention or control group will be carried out. Participants will take either one sachet of Vivomixx (450 billion colony-forming units per sachet) or a placebo per day until 1 week post partum. Neither the study participants nor researchers will know the randomisation and allocation. The intervention will be initiated at 36 weeks of gestation. Neonatal bilirubin level will be measured to determine the primary outcome (hyperbilirubinaemia) while the metagenomic microbiome profile of breast milk and maternal and infant stool samples as well as pregnancy outcomes will be secondary outcomes. Binary logistic and linear regressions will be carried out to assess the association of the microbiome data with different clinical outcomes.Ethics and dissemination Ethics approval is obtained from the Joint CUHK-NTEC Clinical Research Ethics Committee, Hong Kong (CREC Ref: 2023.100-T). Findings will be published in peer-reviewed journals and presented at international conferences.Trial registration number NCT06087874.

Climate change is an issue that is of concern to the global public and scientific community. There is a close relationship between climate change and carbon emissions, which are the primary cause of global warming. Reporting on carbon emissions is essential for corporate accountability to stakeholders when evaluating a company's financial and non-financial performance. Good management of carbon emissions will enhance the company's reputation. This study analyses the impact of company profitability and market value on the disclosure of carbon emissions, with environmental performance serving as a moderating variable in the context of Indonesian public companies. This study concludes that: (1) There is no significant impact on profitability, as measured by Return on Assets, on Carbon Emission Disclosure; (2) The study finds that there is a statistically significant positive relationship between market value, measured by Tobin's Q, and the level of carbon emission disclosure. This relationship is significant at a 5% significance level; (3) The moderating effect of environmental performance on the relationship between profitability, as measured by return on assets, and carbon emission disclosure is found to be insignificant; (4) The significance level of 10% indicates that the relationship between environmental performance, as a measure of a company's environmental practices, and market value, as represented by Tobin's Q, is strengthened concerning the disclosure of carbon emissions. This research can contribute to developing accounting knowledge to close gaps in the body of knowledge regarding the disclosure of carbon emissions in developing nations, particularly Indonesia.

OBJECTIVES/GOALS: The CTSA consortium’s Informatics Enterprise Committee has developed a maturity assessment model for Clinical Trial Management Ecosystems (CTME). This poster will show the improvements achieved using this model at the University of Iowa as well as guidance on how to apply it at other CTSA hubs. METHODS/STUDY POPULATION: The CTME maturity model consists of 11 categories including, study management; regulatory; financial; and reporting. Each category has 3 subcategories: standardization; complexity; and monitoring, while each subcategory is comprised of 1 to 5 maturity statements: initial; developing; aspiring; capable; and efficient. The maturity assessment team at Iowa—comprised of key personnel from clinical research and compliance, accounting, and administration—have used the CTME maturity model to assess Iowa’s research performance across the 11 categories. The initial maturity ratings for each category revealed any gaps in research operations, which led to developing strategies to address the gaps. RESULTS/ANTICIPATED RESULTS: The assessment team initiated a CTME maturity planning project—holding regular meetings to review Iowa’s CTME research maturity and plan changes to improve our CTME maturity ratings. This analysis is done at the statement level to minimize the scope of actions needed and keep resource loads for improvements low. Proposed improvements are assigned to a team member who serves as an “accountability leader.” Such leaders develop action plans aimed at increasing maturity at least one level. The leaders are responsible for acquiring the resources to carry out the plan. Each action plan identifies qualifiers reviewed by the team to confirm that the maturity level has been met. DISCUSSION/SIGNIFICANCE: The CTME maturity model has been shown to be effective in identifying gaps in organizational operations at the University of Iowa, where it has led to incremental steps to improve clinical research operations. The utilization of the model at other CTSA hubs will be discussed at this session.

Education in the 21st century is beginning to adopt the use of artificial intelligence, which is a type of technology. Through a search of the Scopus and the Web of Science databases, the primary objective of this methodical investigation is to locate publications that have been subjected to the rigors of peer review and are associated with the field of artificial intelligence in education. Additionally, analyze current trends and challenges in applying artificial intelligence in education. A bibliometric survey of the application of artificial intelligence in educational settings is also analyzed in further detail here. For the purpose of gaining access to the relevant literature, the Scopus and Web of Science databases were utilized. Utilizing the more advanced keyword search capabilities of the VOS viewer software along with the PRISMA methodology. The sample for the study consisted of a total of 298 articles and studies were analyzed between the years 2014 and 2020. According to the results of a bibliometric study, there are ten researchers who stand out as the primary scholars contributing to the field of artificial intelligence technology in education. An examination of the relevant literature reveals that there is a requirement for the development of software and applications of artificial intelligence in education, specifically those that are able to generate graphics from the text that has been loaded. Education has the potential to be a significant driver of advancement in natural language processing within artificial intelligence.

Mario Caccese,1 Silvia Imbevaro,2 Alessandra Feltrin,3 Daniela Costardi,4 Nadia Giordano,5 Maristella Maran,1 Rosalba Martino,1 Ketti Ottolitri,6 Malihe Shams,3 Federica Vascon,7 Anna Roma,5 Antonella Galiano,1 Marco Maruzzo,1 Dario Marino,1 Giuseppe Lombardi,1 Sara Lonardi,5 Antonella Brunello,1 Vittorina Zagonel1 1Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 2General Directorate, Accreditation and Acknowledgment Unit, Veneto Institute of Oncolog IOV - IRCCS, Padua, Italy; 3Health Department, Psycho-Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 4Scientific Directorate, Patient Education and Empowerment, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 5Department of Oncology, Oncology 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 6Health Department, Clinical Risk Office, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 7Department of Imaging and Health Physics, Radiotherapy Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, ItalyCorrespondence: Mario Caccese, Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, Padua, 35128, Italy, Email mario.caccese@iov.Veneto.itPurpose: The SARS-CoV-2 spread has impacted Healthcare systems. COVID-19 pandemic has had consequences for patients with cancer, being associated with delays in diagnosis, in treatment And follow-up care, increase in overall infection rates and higher mortality. A survey on COVID-19 and a vaccination-questionnaire were developed at different times of the outbreak, to evaluate cancer patient-reported experience measures (PREMs) on the policies implemented to reduce the infection from SARS-CoV-2 and on the timing and methods of COVID-19 vaccination.Patients and Methods: The survey was distributed to all patients accessing the Institute during the “first-wave” Of the pandemic, evaluating patients’ concerns about the pandemic, the pandemics’ consequences on their cancer care, and their perception Of the measures adopted to limit the infection spread. The vaccination-questionnaire was proposed to 10% of the first 5297 cancer patients vaccinated with two doses of the Pfizer-BioNTechCOVID-19 vaccine. This questionnaire aimed at assessing the degree Of satisfaction with the Institutional vaccination campaign and vaccination-related adverse events.Results: From May 18th 2020 to June 15th 2020 the survey was completed by 3238 patients. Most of the responders expressed concern on the pandemic yet acknowledging their oncological disease as a priority. Measures implemented were appreciated by patients. Telemedicine was positively evaluated and the absence of the caregiver during the visit did not determine discomfort for two thirds of patients. From March 6th 2021 to May 8th 2021 the vaccination-questionnaire was completed by 357 patients. The 98.8% were satisfied with the vaccination campaign. No serious vaccination-correlated adverse events were reported. No patient had to delay/discontinue chemotherapy due to vaccination.Conclusion: PREMs during COVID-19 pandemic and related vaccination can provide important information to help reorganization of the health care systems for cancer care. Patients’ feedback on the organizational changes implemented in the emergency period are essential for healthcare improvement and to help informed choices that are consistent with patients’ needs.Keywords: patients’ perspective, PREMs, COVID-19, survey, SARS-CoV-2, cancer patients

The stock exchange is one of the most powerful sectors, which contribute significantly to the economy's wealth. It plays a crucial role in economic growth and economic development, to which industry, trade and trade as a whole would be benefiting. Therefore, a significant number of research projects have been devoted not surprisingly to understanding the nature of stock market movements and their general performance. A number of studies have shown that macroeconomic variables have a significant impact on stock market performance, while other studies have at best found an inconclusive relationship. It is also worth noting that most of these studies were conducted on developed markets and rarely touched on the combination of emerging and developed markets. Hence this study aims at understanding the impact of selected macroeconomic variables such as Export growth, Import growth, Trade balance, Inflation rate, Broad money growth and exchange rate on the stock market chosen Indices of five Asian countries such as India, Japan, China, Hong Kong and Singapore. The Augmented Dickey-Fuller test (ADF), Granger causality test, Johansen cointegration test the short-run and long-run cointegration between the variables. Variance decomposition analysis is also used to determine how much of the variability in stock returns is lagged by its own variance. The study's findings reveal a substantial long-run cointegration among the macroeconomic variables and stock indices in the case of Japan, China, Hong Kong, and Singapore. All the macroeconomic variables are integrated into I (1) except for the trade balance in the case of Japan, which is integrated into I (2).

According to strategic management theory, dynamic capability plays a significant role in enhancing organizational performance. Using a cross-sectional research design, the current study quantitatively assesses the mediating effect of dynamic capability on the relationships of total quality management, customer intellectual capital, and human resource management practice with the performance of microfinance institutions. An online survey involving 120 members of Induk Koperasi Kredit, a credit union association in West Kalimantan, Indonesia, is conducted. All the data are subjected to variance-based partial least squares structural equation modeling (PLS-SEM) analysis. The obtained results demonstrate the significant and positive influence of total quality management and human resource management practice on dynamic capability. Furthermore, dynamic capability is found to mediate the relationship between total quality management and human resource management practice on the performance of microfinance institutions. However, this study is unable to conclude that total quality management and human resource management practice have any significant impact on the performance of microfinance institutions. Nonetheless, this study demonstrates the crucial need for microfinance institutions to enhance their management activities via dynamic capability to enhance performance. This is one of the earliest studies conducted during the COVID-19 pandemic to examine the capabilities and performance of microfinance institutions in Indonesia. Notably, the performance of microfinance institutions can be further sustained by improving customers' intellectual and dynamic capabilities.

The clinical research units (CRUs) are one of the main spaces where both translational research and science take place. However, there is a lack of information about both best practices for CRU operations and, ultimately, benchmarks to evaluate CRU performance. The Research Unit Network (RUN) was created with the purpose to enable direct communication and collaboration among CRUs. An online survey was administered to further illustrate the functionality and impact of RUN. Thirty-one individual survey responses (39.2%) were included in the final analysis. The members value RUN monthly meetings (87.1%) as the most useful aspect of this network and CRU budgeting (67.7%) and staffing (61.3%) were the most relevant topics discussed. This is followed by EPIC – Research (58.1%), delegation of authority logs, unit signatures, and policies (51.6%), COVID-19 pandemic response (41.9%), the implementation of clinical trial management system (29.0%), and protocol deviations (19.4%). The intermediate goal of RUN is to identify best practices CRUs are establishing, implementing, and sharing these experiences with the goal to adopt them in different CRUs. The network’s long-term goal is to establish standard benchmarks that can be used for evaluating the performance of CRUs across the nation.

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) is a complex condition with multisystem involvement. We assessed patients’ experience with a PASC clinic established at University of Iowa in June 2020. A survey was electronically mailed in June 2021 asking about (1) symptoms and their impact on functional domains using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures (Global Health and Cognitive Function Abilities) (2) satisfaction with clinic services, referrals, barriers to care, and recommended support resources. Survey completion rate was 35% (97/277). Majority were women (67%), Caucasian (93%), and were not hospitalized (76%) during acute COVID-19. As many as 50% reported wait time between 1 and 3 months, 40% traveled >1 h for an appointment and referred to various subspecialities. Participants reported high symptom burden-fatigue (77%), “brain fog” (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). On PROMIS measures, some patients scored significantly low (≥1.5 SD below mean) in physical (22.7%), mental (15.9%), and cognitive (17.6%) domains. Approximately 61% to 93% of participants were satisfied with clinical services. Qualitative analysis added insight to their experience with healthcare. Participants suggested potential strategies for optimizing recovery, including continuity of care, a co-located multispecialty clinic, and receiving timely information from emerging research. Participants appreciated that physicians validated their symptoms and provided continuity of care and access to specialists.

Abstract MYB proteins are highly conserved DNA-binding domains (DBD) and mutations in MYB oncoproteins have been reported to cause aberrant and augmented cancer progression. Identification of MYB molecular biomarkers predictive of cancer progression can be used for improving cancer management. To address this, a biomarker discovery pipeline was employed in investigating deleterious non-synonymous single nucleotide polymorphisms (nsSNPs) in predicting damaging and potential alterations on the properties of proteins. The nsSNP of the MYB family; MYB, MYBL1, and MYBL2 was extracted from the NCBI database. Five in silico tools (PROVEAN, SIFT, PolyPhen-2, SNPs&GO and PhD-SNP) were utilized to investigate the outcomes of nsSNPs. A total of 45 nsSNPs were predicted as high-risk and damaging, and were subjected to PMut and I-Mutant 2.0 for protein stability analysis. This resulted in 32 nsSNPs with decreased stability with a DDG score lower than − 0.5, indicating damaging effect. G111S, N183S, G122S, and S178C located within the helix-turn-helix (HTH) domain were predicted to be conserved, further posttranslational modifications and 3-D protein analysis indicated these nsSNPs to shift DNA-binding specificity of the protein thus altering the protein function. Findings from this study would help in the field of pharmacogenomic and cancer therapy towards better intervention and management of cancer.

Adrenocortical carcinoma (ACC) is a rare malignancy with an overall unfavorable prognosis. Clinicians treating patients with ACC have noted accelerated growth in metastatic liver lesions that requires rapid intervention compared to other metastatic locations. This study measured and compared the growth rates of metastatic ACC lesions in the lungs, liver, and lymph nodes using volumetric segmentation. A total of 12 patients with metastatic ACC (six male; six female) were selected based on their medical history. Computer tomography (CT) exams were retrospectively reviewed and a sampling of ≤5 metastatic lesions per organ were selected for evaluation. Lesions in the liver, lung, and lymph nodes were measured and evaluated by volumetric segmentation. Statistical analyses were performed to compare the volumetric growth rates of the lesions in each organ system. In this cohort, 5/12 had liver lesions, 7/12 had lung lesions, and 5/12 had lymph node lesions. A total of 92 lesions were evaluated and segmented for lesion volumetry. The volume doubling time per organ system was 27 days in the liver, 90 days in the lungs, and 95 days in the lymph nodes. In this series of 12 patients with metastatic ACC, liver lesions showed a faster growth rate than lung or lymph node lesions.

Adrenocortical carcinoma (ACC) is a rare endocrine malignancy of the adrenal gland with an unfavorable prognosis. It is rare in the pediatric population, with an incidence of 0.2-0.3 patients per million in patients under 20 years old. It is primarily associated with Li-Fraumeni and Beckwith-Wiedemann tumor predisposition syndromes in children. The incidence of pediatric ACC is 10-15fold higher in southern Brazil due to a higher prevalence of TP53 mutation associated with Li-Fraumeni syndrome in that population. Current treatment protocols are derived from adult ACC and consist of surgery and/or chemotherapy with etoposide, doxorubicin, and cisplatin (EDP) with mitotane. Limited research has been reported on other treatment modalities for pediatric ACC, including mitotane, pembrolizumab, cabozantinib, and chimeric antigen receptor autologous cell (CAR-T) therapy.

Cryopreservation impairs sperm quality and functions, including motility and DNA integrity. Antioxidant additives in sperm freezing media have previously brought improvements in postthawed sperm quality. Green tea extract (GTE) is widely considered as an excellent antioxidant, and its beneficial role has been proven in other human cells. This study aims to evaluate the GTE as a potential additive in cryopreservation media of human spermatozoa. In part one, the semen of 20 normozoospermic men was used to optimize the concentration of GTE that maintains sperm motility and DNA integrity against oxidative stress, induced by hydrogen peroxide (H2O2). Spermatozoa were treated with GTE at different concentrations before incubation with H2O2. In part two, the semen of 45 patients was cryopreserved with or without 1.0 ng ml−1 GTE. After 2 weeks, the semen was thawed, and the effect on sperm motility and DNA fragmentation was observed. Our data showed that GTE significantly protected sperm motility and DNA integrity against oxidative stress induced by H2O2when added at a final concentration of 1.0 ng ml−1. We found that the addition of 1.0 ng ml−1 GTE to cryopreservation media significantly increased sperm motility and DNA integrity (both P < 0.05). More interestingly, patients with high sperm DNA damage benefited similarly from the GTE supplementation. However, there was no significant change in the reactive oxygen species (ROS) level. In conclusion, supplementing sperm freezing media with GTE has a significant protective effect on human sperm motility and DNA integrity, which may be of clinical interest.

The unlicensed spectrum utilized by Wi-Fi can be regarded as an economic commons in many deployments. Operators of Wi-Fi-enabled devices are usually non-cooperative, vying for spectral resources when in close range to each other, typically adopting a strategy of maximizing their transmission power. With an ever-growing number of wireless devices, this will ultimately lead to depletion of the spectrum, unless players collaborate. Previous studies used cooperative game theory to explore various collaboration strategies, enabled by the presence of some central authority or controller that executes an agreed-upon interference mitigation policy. However, the regulatory nature of unlicensed spectrum dictates that players cannot be forced into such collaboration. Most deployments therefore involve a mix of cooperative and non-cooperative players. In this paper, we propose a new way of modeling use cases involving a central authority or controller by combining non-cooperative and cooperative game theory. Our model uses the non-cooperative concept of Nash equilibriums as well as the cooperative concept of Nash bargaining. To the best of our knowledge, this paper is the first to propose a hybrid non-cooperative and cooperative game theoretic model for communication networks that offers the players the opportunity to strategize between non-cooperative and cooperative natures. It is successfully applied to the case of a densely-populated apartment block. The results show that, if only a subset of players joins the collaboration, most of the remaining non-joining players may obtain an SINR that is worse than what they would have obtained in the fully non-cooperative scenario; they are punished for their uncooperative behavior.

Marie Alexandre,1 Aurélie Maran-Gonzalez,2 Marie Viala,1 Nelly Firmin,1 Véronique D’Hondt,1,3,4 Marian Gutowski,5 Céline Bourgier,3,6 William Jacot,1,3,4 Séverine Guiu1,3,4 1Department of Medical Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 2Department of Pathology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 3INSERM U1194 – Institut de Recherche en Cancérologie de Montpellier (IRCM), Montpellier, France; 4University of Montpellier, Montpellier,France; 5Department of Surgery, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, France; 6Department of Radiation Oncology, Institut Régional du Cancer de Montpellier, Montpellier Cedex 5 34298, FranceCorrespondence: Marie AlexandreMedical Oncology Department, Institut Régional du Cancer Montpellier, 208, Rue des Apothicaires, Montpellier Cedex 5 34298, FranceTel +33-4 67 61 23 93Fax +33-4 67 61 37 64Email marie.alexandre@icm.unicancer.frAbstract: The decision to administer adjuvant chemotherapy in treatment of early invasive breast cancer (EBC) is often complex, particularly for hormone receptor-positive (HR+) diseases, and current guidelines often classify these patients in an intermediate-risk group. Several biomarkers are currently available in this indication, in order to obtain additional and more accurate prognostic information compared to classic clinicopathological characteristics and guide the indication of adjuvant chemotherapy, optimizing the efficacy/toxicity ratio. We conducted a systematic review to evaluate the clinical validity and clinical utility of five biomarkers (uPA/PAI-1, OncotypeDX®, MammaPrint®, PAM50, and EndoPredict®) in HR+/HER2- EBC, whatever the nodal status. A total of 89 studies met the inclusion criteria. Even though data currently available confirm the clinical validity of these biomarkers, there is a lack of data regarding clinical utility for most of them. Prospective studies in well-defined populations are needed to integrate these biomarkers in a decision strategy.Keywords: breast cancer, adjuvant chemotherapy, biomarkers

Background Hypertrophic cardiomyopathy (HCM) and aortic stenosis can cause obstruction to the flow of blood out of the left ventricular outflow tract into the aorta, with obstructive HCM resulting in dynamic left ventricular outflow tract obstruction and moderate or severe aortic stenosis causing fixed obstruction caused by calcific degeneration. We sought to report the characteristics and longer‐term outcomes of patients with severe obstructive HCM who also had concomitant moderate or severe aortic stenosis requiring surgical myectomy and aortic valve replacement. Methods and Results We studied 191 consecutive patients (age 67±6 years, 52% men) who underwent myectomy and aortic valve (AV) replacement (90% bioprosthesis) at our center between June 2002 and June 2018. Clinical and echo data including left ventricular outflow tract gradient and indexed AV area were recorded. The primary outcome was death. Prevalence of hypertension (63%) and hyperlipidemia (75%) were high, with a Society of Thoracic Surgeons score of 5±4, and 70% of participants had no HCM‐related sudden death risk factors. Basal septal thickness and indexed AV area were 1.9±0.4 cm and 0.72±0.2 cm2/m2, respectively, while 100% of patients had dynamic left ventricular outflow tract gradient >50 mm Hg. At 6.5±4 years, 52 (27%) patients died (1.5% in‐hospital deaths). One‐, 2‐, and 5‐year survival in the current study sample was 94%, 91%, and 83%, respectively, similar to an age‐sex–matched general US population. On multivariate Cox survival analysis, age (hazard ratio [HR], 1.65; 95% CI, 1.24–2.18), chronic kidney disease (HR, 1.58; 95% CI, 1.21–2.32), and right ventricular systolic pressure on preoperative echocardiography (HR, 1.28; 95% CI, 1.05–1.57) were associated with longer‐term mortality, but traditional HCM risk factors did not. Conclusions In symptomatic patients with severely obstructive HCM and moderate or severe aortic stenosis undergoing a combined surgical myectomy and AV replacement at our center, the observed postoperative mortality was significantly lower than the expected mortality, and the longer‐term survival was similar to a normal age‐sex–matched US population.

For the last three decades, ASEAN has been facing a persistent fiscal deficit. However, the impact of fiscal deficit on the current account deficit in the sub-groups of ASEAN is still unknown. This study aims to investigate the impact of fiscal deficit on current account deficit and their relationship among the three sub-groups of ASEAN which are based on gross national income (GNI), i.e., lower-middle-, upper-middle-, and higher-income countries. The analysis covers the panel data collected over the span of the last three decades (1990–2020) for ten Southeast Asian nations (ASEAN). The analyses incorporate the panel methodology for data analysis such as panel unit root for checking data stationarity, cointegration testing, panel autoregressive distributed lag (PARDL) for short- and long-run analysis, cointegration regression (fully modified and dynamic ordinary least squares) for significance, the panel Dumitrescu and Hurlin Granger causality test for examining causal relationships in tested variables, and stability diagnostics and CUMSUM and CUSUMSQ techniques for structural breaks and coefficient stability in the model. In lower-middle-income economies (LMIE), results indicate the existence of a unidirectional causal relationship from the current account deficit (CAD) to the fiscal deficit (FD), suggesting a reverse causal relationship from CAD to FD. In the long run, FD does not significantly induce CAD, while real interest rate (RIR) and exchange rate (EXC) influence CAD. In upper-middle-income economies (UMIE), results specify that there is no causality between FD and CAD. The RIR, EXC, and FD are significant to CAD in the long run. In higher-income economies (HIE), RIR and FD have an influence on CAD in the long run period. Moreover, from CAD to FD, a unidirectional causal association exists, and likewise for LMIE. This is a reverse causal relationship from CAD to the FD, supporting the current account targeting hypothesis (CATH) in both the LMIE and HIE groups. This study recommends that the LMIE and HIE groups can use the fiscal deficit as a tool to eliminate the unfavorable current account position. Policymakers can target EXC and RIR to stabilize CAD in long run. In UMIE and HIE, policymakers must consider FD alarming, as it can induce CAD in the long run. The RIR can be the targeted factor in the sub-groups of ASEAN.

Dysregulation of fibroblast growth factors is linked to the pathogenesis of bladder cancer. The role of FGF1 and FGF3 is evident in bladder cancer; however, the role of FGF4 is vague. Despite being reported that FGF4 interacts with FGF1 and FGF3 in MAPK pathways, its pathogenesis and mechanism of action are yet to be elucidated. Therefore, this study aimed to elucidate pathogenic nsSNPs and their role in the prognosis of bladder cancer by employing in-silico analysis. The nsSNPs of FGF4 were retrieved from the NCBI database. Different in silico tools, PROVEAN, SIFT, PolyPhen-2, SNPs&GO, and PhD-SNP, were used for predicting the pathogenicity of the nsSNPs. Twenty-seven nsSNPs were identified as “damaging”, and further stability analysis using I-Mutant 2.0 and MUPro indicated 22 nsSNPs to cause decreased stability (DDG scores < −0.5). Conservation analysis predicted that Q97K, G106V, N164S, and N167S were highly conserved and exposed. Biophysical characterisation indicated these nsSNPs were not tolerated, and protein-protein interaction analysis showed their involvement in the GFR-MAPK signalling pathway. Furthermore, Kaplan Meier bioinformatics analyses indicated that the FGF4 gene deregulation affected the overall survival rate of patients with bladder cancer, leading to prognostic significance. Thus, based on these analyses, our study suggests that the reported nsSNPs of FGF4 may serve as potential targets for diagnoses and therapeutic interventions focusing on bladder cancer.

Cardiovascular disease (CVD) remains the leading cause of death globally, with unhealthy lifestyles today greatly increasing the risk. Over the decades, scientific investigation has been carried out on reactive oxygen species (ROS) and their resultant oxidative stress based on their changes made on biological targets such as lipids, proteins, and DNA. Since the existing clinical studies with antioxidants failed to provide relevant findings on CVD prediction, the focus has shifted towards recognition of oxidised targets as biomarkers to predict prognosis and response to accurate treatment. The identification of redox markers could help clinicians in providing risk stratification for CVD events beyond the traditional prognostic and diagnostic targets. This review will focus on how oxidant-related parameters can be applied as biomarkers for CVD based on recent clinical evidence.

Background We report characteristics and outcomes of elderly patients with hypertrophic cardiomyopathy (HCM) with basal septal hypertrophy and dynamic left ventricular outflow tract obstruction. Methods and Results We studied 1110 consecutive elderly patients with HCM (excluding moderate or greater aortic stenosis or subaortic membrane, age 80±5 years [range, 75–92 years], 66% women), evaluated at our center between June 2002 and December 2018. Clinical and echocardiographic data, including maximal left ventricular outflow tract gradient, were recorded. The primary outcome was death and appropriate internal defibrillator discharge. Hypertension was observed in 72%, with a Society of Thoracic Surgeons (STS) score (8.6±6); while 80% had no HCM‐related sudden cardiac death risk factors. Left ventricular mass index, basal septal thickness, and maximal left ventricular outflow tract gradient were 127±43 g/m2, 1.7±0.4 cm, and 49±31 mm Hg, respectively. A total of 597 (54%) had a left ventricular outflow tract gradient >30 mm Hg, of which 195 (33%) underwent septal reduction therapy (SRT; 79% myectomy and 21% alcohol ablation). At 5.1±4 years, 556 (50%) had composite events (273 [53%] in nonobstructive, 220 [55%] in obstructive without SRT, and 63 [32%] in obstructive subgroup with SRT). One‐ and 5‐year survival, respectively were 93% and 63% in nonobstructive, 90% and 63% in obstructive subgroup without SRT, and 94% and 84% in the obstructive subgroup with SRT. Following SRT, there were 5 (2.5%) in‐hospital deaths (versus an expected Society of Thoracic Surgeons mortality of 9.2%). Conclusions Elderly patients with HCM have a high prevalence of traditional cardiovascular rather than HCM risk factors. Longer‐term outcomes of the obstructive SRT subgroup were similar to a normal age‐sex matched US population.

Few studies have explored the challenges that the COVID-19 pandemic has presented for Clinical Research Units (CRUs), the solutions that have been implemented, and the changes that have been made in the operational guidelines for these entities. This study sought to identify and document common practices implemented by CRUs around the United States of America (USA) when addressing the unique challenges posed by the COVID-19 pandemic. This descriptive study utilized a non-experimental mixed-methods approach and gathered data from representatives of 43 CRUs across the USA. An online survey was followed by in-depth interviews. The findings show that challenges faced from the COVID-19 pandemic, changes made to daily operations, and lessons learned are very similar across CRUs. Although most CRUs never stopped performing essential clinical research, many adapted to the pandemic by engaging in virtual visits, and many played key roles in administering and supporting both COVID-19 therapeutic and vaccine trials. Follow-up interviews showed that processes for formal approval and reopening were similar across CRUs. In addition to highlighting the significance of the role played by CRUs during the COVID-19 pandemic, this study addresses the relevance of CRUs and lays the groundwork for future conversations on the importance of these units.

Background In patients with obstructive hypertrophic cardiomyopathy, surgical myectomy (SM) is indicated for severe symptoms. We sought to compare long‐term outcomes of patients with obstructive hypertrophic cardiomyopathy where SM was based on guideline‐recommended Class I indication (Functional Class or FC ≥3 or angina/exertional syncope despite maximal medical therapy) versus earlier (FC 2 and/or impaired exercise capacity on exercise echocardiography with severe obstruction). Methods and Results We studied 2268 consecutive patients (excluding

OBJECTIVES/GOALS: CTRUs support clinical research. RUN is a Learning Research System that is created to enhance CTSA and non-CTSA research units capacity through implementing, assessing, and disseminating discoveries in methods, approaches, education, and training in clinical and translational science. METHODS/STUDY POPULATION: The RUN association began in July 2018 with eight universities. The association has grown to 44 hospitals, research, and academic institutions (including 36 CTSA institutions). A RUN Discussion Forum has been approved by the National Center for Advancing Science (NCATS) and utilized by RUN. The Discussion Forums are created with the goal of advancing CTSA Program objectives in high priority areas of clinical and translational science. RUN actively engages members through in depth scheduled monthly meeting discussions with various relevant topics regarding the development and evaluation of clinical trials metrics, benchmarks, and scholarly publication and presentation activities. RESULTS/ANTICIPATED RESULTS: Topics covered in RUN monthly meetings include research units general budget guidelines, staff recruitment and retainment strategies, EPIC use in scheduling CRU research visits, and PPE for investigational drugs in context of USP800 requirements. RUN members vary in geographic location, type of clinical research (outpatient vs inpatient), resources, and research subject volume. They are engaged in online discussion and learning opportunities to improve translational science practices. A recent article titled “Impact of COVID-19 on Clinical Research Units (CRUs)” in JCTS is an example of best practices learned by RUN members and shared with the broader research community. DISCUSSION/SIGNIFICANCE: RUN as a Learning Research System enhances clinical and translational research unit capacity and efficiency, encouraging collaboration to contribute with improving public health. This network is aligned with the CTSAs mission of developing innovative solutions to improve translational science.

Druga część wykładu monograficznego ks. prof. dr. hab. Mariana Borzyszkowskiego, prof. UWM (1936–2001) na temat pielgrzymowania błogosławionej Doroty z Mątów do Einsiedeln w kontekście wpływów ówczesnych ideałów duchowości religijnej

To compare the whole genomic microRNA (miRNA) between the selective fetal growth restriction (sFGR) twin and the normally growing (control) co-twin in monochorionic (MC) twin pregnancies. MC twin pregnancies with or without sFGR were recruited, and their placental miRNAs were profiled by microarray. The ratio of the placental miRNA of the sFGR twin to that of the normally larger co-twin were calculated and compared to that of the control twin pairs. The miRNA microarray intensity amongst normal and sFGR large and small twins are shown. The expression data presented here will facilitate other researchers who are working on placental regulation and mechanism in pregnancy complicated by fetal growth restriction.The dataset supports the research article entitle “Whole genome miRNA profiling revealed miR-199a as potential placental pathogenesis of selective fetal growth restriction in monochorionic twin pregnancies” [1].

OBJECTIVES/GOALS: The RPPR Tool was created to accurately and systematically track our CTSA’s overall program goals and core’s progress in real time. It establishes and centralizes the continuous collection of key performance indicators and fosters accountability and transparency among cores and leadership. METHODS/STUDY POPULATION: Using the University of Chicago’s Annual Progress Report REDCap data dictionary, UI Institute for Clinical and Translational Science (ICTS) core managers convened to explore the adaptability of the reporting format for the CTSA. The team developed the more user friendly and easily accessible RPPR Reporting Tool using REDCap to better fit our CTSA. The RPPR in REDCap provides a central location to monitor the activities for each core, gather status updates, generate performance reports, and identify key performance indicators and challenges to prevent failures in the future. All data are transparent and accessible on-demand to individual core managers, evaluators, and ICTS leadership. RESULTS/ANTICIPATED RESULTS: UI’s RPPR Tool has improved the compliance with ongoing monitoring and reporting of CTSA program’s performance. Documenting all relevant information in a centralized space has eased the administrative and evaluation burden of preparing the RPPR. Furthermore, REDCap as a commonly used tool allows the core managers to complete this reporting with minimal guidance. This tool encourages each core to be accountable for documenting their respective progress. The transparency of the reporting allows the Co-PIs along with the leadership team to access the data at any given time to stay updated on the ICTS’ overall progress and to make the appropriate improvements as needed. DISCUSSION/SIGNIFICANCE OF IMPACT: The RPPR is a required component of all CTSA grants. UI’s RPPR Tool has been instrumental in comprehensively tracking progress of the ICTS and its contributions to translational research. UI is collaborating with CTSA peers to improve the RPPR Tool, so it can become an asset for any CTSA to adapt.

This study aims to explore the causal relationship between fiscal deficit (FD) and current account deficit (CAD) along with policy recommendations based on long-run and short-run dynamics and sensitivities. A panel data span from 1990 to 2019 is analyzed based on panel unit root tests, panel co-integration with auto-regressive distributed lag (ARDL), panel co-integration regression with fully modified ordinary least squares (FMOLS) and dynamic ordinary least squares (DOLS), and causal analysis with the Dumitrescu and Hurlin (DH) technique. The results disclosed that all tested variables are stationary at the first difference I(1) except the real interest rate (IR), which is stationary at level I(0). The ARDL estimates suggested that there is a long-run relationship between tested variables and 92% annual convergence is possible for long-run equilibrium. The FMOLS and DOLS estimates indicated that the CAD is sensitive towards the FD and the exchange rate. The DH causality test showed that the CAD is significantly affecting the FD, supporting the current account targeting hypothesis. Furthermore, it is observed that the interest rate is acting as a moderating factor between the FD and the CAD because it causes both the deficits. Thus, reverse causality is concluded from the CAD to the FD. These results have macroeconomic implications for fiscal policy in the Association of South-East Asian Nations (ASEAN-10).

After the (2007-2008) subprime financial crisis considering bankruptcy evaluation for the banking industry becomes a paramount. In line of that, this study aims to analyze the bankruptcy profile of foreign vs. domestic Islamic banks in Malaysia. This study predicted 40 percent and 75 percent bankruptcy in the subjected samples of foreign and domestic Islamic banks of Malaysia respectively. However, the specific reason behind this variation in their bankruptcy rates is tagged with the significant difference in liquidity ratio i.e. (1.59) by foreign and (0.41) by the domestic Islamic banks sample. The ANOVA results revealed that, the sample of foreign and domestic Islamic banks of Malaysia do differ significantly on bankruptcy rates as well as on the top bankruptcy’s predictors namely liquidity, profitability, and insolvency. However, the sample does not vary on productivity with regards to bankruptcy exposure. Furthermore, the regression results revealed that, liquidity, profitability, and insolvency ratios in the sample of domestic Islamic banks, while only insolvency ratio in the sample of foreign Islamic banks have a significant positive relationship with bankruptcy in Islamic banking industry of Malaysia. Moreover, in the context of identified bankruptcy rates, the analysis here is viable to witness the sustainability ratings possessed by the sample of foreign and domestic Islamic banks of Malaysia.

Introduction. Osteochondroma is the most common type of benign bone tumor which appears in two forms, sessile and pedunculated. It accounts for 50% of all benign tumors of bone tissue with a double tendency towards male population. It is covered by cartilage cap of different thickness. The thickness of the cap over 30 mm can indicate a malign transformation into the secondary chondrosarcoma. Aim of the study. Determine if there is a correlation between epidemic characteristics of the patients, pathohistologic characteristics, thickness of the cartilage cap and biological behavior of the tumor. Patients and methods. Cross-sectional study included 37 patients which were diagnosed with osteochondroma in the period of 12 months, during the year 2014, at the Institute for pathology of Medical Faculty in Belgrade. The patients’ age, sex, localization, clinical manifestation and length of the case history were descriptively determined. The thickness of the cartilage cap was morphometrically determined on pathohistologic devices of re-sectioned tumors. Out of 37 patients with diagnosed osteochondroma, 3 of them (8%) had malign alteration of the cartilage cap. The thickness of the cartilage cap in all the 3 of them was over 30 mm, ranging from 68-120 mm. Relapse was found in 3 patients (8%). Discussion. The highest importance of this lesion comes from the fact that it is the most common bone tumor with high incidence and possibility for malign transformation of the cartilage cap into secondary chondrosarcoma which makes this tumor interesting for medical staff at the clinic and pathologists. Conclusion. The width of a cartilage cap, in correlation with clinical and radiology parameters, is a significant predictive parameter of biological behavior of osteochondroma.

Various forms of formal and informal violence can be found in secondary schools. Situations in which only one form of violence is present are rare; informal violence often preceds various forms of formal violence and the other way round. Investigations concerning informal violence in relation to formal violence, at least in terms of pedagogical research, is somewhat lacking. Analysing the sample of 440 secondary school students, the authors identified the presence of: rumours, provocation, segregation, marginalization, media abuse and media insulting. Varying content of manifested violence was identified at the core of these forms of informal violence. The results of empirical investigation can serve future authors and practitioners to create programmes of preventative action to suppres various forms of violence in school and outside it. In addition, the findings can be used for the development of various quantitative and qualitative pedagogic-methodological approaches to the investigation of informal violence in educational institutions.

Various minerals, rocks, soil types, ore and fossiliferous deposits, structural and tectonic elements, surface and subterranean landforms, all those natural phenomena representing geodiversity in a small scale contribute to our understanding the significant events and episodes of the geological history of the Earth. Intended methodology for qualitative and quantitative assessment is presented, including valuing criteria and their numerical indicators, which serve as analytical instruments to identify and select potential geoheritage objects in Serbia. Objective assessing and categorizing the geoheritage objects are the starting points for their rational utilization, adequate conservation, proper interpretation and promotion.

BackgroundIn obstructive hypertrophic cardiomyopathy patients with preserved left ventricular (LV) ejection fraction, we sought to determine whether LV global longitudinal strain (LV‐GLS) provided incremental prognostic utility. Methods and ResultsWe studied 1019 patients with documented hypertrophic cardiomyopathy (mean age, 50±12 years; 63% men) evaluated at our center between 2001 and 2011. We excluded age

In this present study, the removal of turbidity, biological oxygen demand (BOD) and chemical oxygen demand (COD) were investigated under different operating conditions such as agitation time (X1: 15-25 min), initial pH (X2:4-8), chitosan dose (X3:1.2-2 g L-1) and settling time (X4:40-80 min) to treat bagasse based paper and pulp industry wastewater via response surface methodology (RSM). The experimental data obtained were fitted to a second-order polynomial equation using multiple regression analysis and ANOVA (analysis of variance) was used to examine the significance of the developed mathematical models. The 3-D response surface plots were derived from the mathematical models in order to study the interactive effects process variables on the treatment efficiency. Derringer’s desired function methodology were applied to determine the optimal conditions and it was found to be: agitation time of 20 min, initial pH of 6, chitosan dose of 1.8 gL-1 and settling time of 60 min. Under these conditions, the removal of turbidity, BOD and COD were found to be 84 %, 90 % and 93 % respectively.

Introduction. Thoracolumbar spinal injuries indicated for surgical intervention specify the necessity of intervention within 24 hours. The traumatologists working in a structure without a Spinal Unit must be able to evaluate such injury and set indications for surgical treatment, that is, nonoperative treatment. The purpose of this study is to evaluate if Thoracolumbar Injury Severity Score (TLISS) is still a good base for the classification of thoracolumbar spinal injuries and to give a correct indication for nonoperative, that is, surgical treatment. Patients and Methods. Six Orthopaedics and Traumatology residents from Siena (Italy), five Orthopaedics and Traumatology residents from the Clinical Centre of Banja Luka (Bosnia and Herzegovina) and five Orthopaedics and Traumatology residents from the Alta Val d'Elsa Hospital, Siena (Italy) were presented 24 clinical cases from professional literature where the following data were indicated: patient's age, neurological conditions, description of the injury, mechanism of the injury and radiological findings (RTG, MR). The abovementioned 24 patients were chosen from the literature based on the injuries mostly seen by an orthopaedist with a lack of experience in the problems of spinal column trauma (low energy trauma, with partial or without neurological impairments, with the TLISS score of 4). The residents from the three groups had to classify all patients according to the TLISS score and to define the most appropriate method of treatment-conservative or surgical, and after that, all classifications, as well as the therapeutic decisions, were compared. The statistical methods used in this study include: statistical significance, reliability (P