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Background: Gastric adenocarcinoma in Indian patients’ is on the rise. A high level of plasma von Willebrand factor (vWF) is associated not only with the development of cancerassociated thrombosis but also with the degree of malignancy, the rate of metastasis, and cancer prognosis. Aims and Objectives: The aim of this study was to study the association of vWF with tumor location, TNM staging, and grades of tumor differentiation in gastric adenocarcinoma and to assess the usefulness of circulating vWF levels as a potential biomarker for gastric adenocarcinoma. Materials and Methods: This study is a prospective observational study done in the Department of Surgical Gastroenterology, Madurai Medical College, Madurai, over a period of 2 years between September 2020 and August 2022. Fifty cases of gastric cancer and 50 controls were recruited and vWF levels were analyzed. Results: Among the 50 gastric cancer patients, 8% belonged to Stage II, 62% belonged to Stage III, and 30% belonged to Stage IV. vWF was elevated in Gastric Cancer patients compared to control group. Mean value of vWF in Cases and Control population was 3.68 ng/ml and 0.58 ng/ml respectively (p value 0.0005). Pertaining to Stage, the vWF value was, Stage II – 4.7, Stage III – 3.3, and Stage IV – 4.1 ng/mL. With respect to tumor differentiation, the vWF values were, poorly differentiated – 4.7, moderately differentiated – 3.0, and well differentiated – 3.9 ng/mL. Conclusion: vWF values were significantly elevated in gastric cancer patients. Based on the results, vWF can be used as a surrogate marker to predict the tumor differentiation in patients, thereby prognosticating the disease. Stage-wise, there was no significant difference in the vWF values.

Anna Taylor,1 Andrew Cushing,2 Morgan Dow,2 Jacqueline Anderson,1 Grace McDowell,1 Stephanie Lua,1 Maureen Manthe,1 Sandosh Padmanabhan,3 Shane Burns,2 Paul McGinness,2 David J Lowe,1,4 Christopher Carlin1 1Departments of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, Scotland; 2Lenus Health Ltd, Edinburgh, Scotland; 3Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland; 4Institute of Health and Wellbeing, University of Glasgow, Glasgow, ScotlandCorrespondence: Christopher Carlin, Department of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, Scotland, Tel + 44 141 451 6088, Email christopher.carlin@ggc.scot.nhs.ukPurpose: Digital tools may improve chronic obstructive pulmonary disease (COPD) management, but further evidence of significant, persisting benefits are required. The RECEIVER trial was devised to evaluate the Lenus COPD support service by determining if people with severe COPD would continue to utilize the co-designed patient web application throughout study follow-up and to explore the impact of this digital service on clinical outcomes with its adoption alongside routine care.Patients and Methods: The prospective observational cohort hybrid implementation-effectiveness study began in September 2019 and included 83 participants. Recruitment stopped in March 2020 due to COVID-19, but follow-up continued as planned. A contemporary matched control cohort was identified to compare participant clinical outcomes with and minimize biases associated with wider COVID-19 impacts. Utilization was determined by daily COPD assessment test (CAT) completion through the application. Survival metrics and post-index date changes in annual hospitalizations were compared between the RECEIVER and control cohorts. Longitudinal quality of life and symptom burden data and community-managed exacerbation events were also captured through the application.Results: High and sustained application utilization was noted across the RECEIVER cohort with a mean follow-up of 78 weeks (64/83 participants completed at least one CAT entry on ≥ 50% of possible follow-up weeks). Subgroup analysis of participants resident in more socioeconomically deprived postcode areas revealed equivalent utilization. Median time to death or a COPD or respiratory-related admission was higher in the RECEIVER cohort compared to control (335 days vs 155 days). Mean reduction in annual occupied bed days was 8.12 days vs 3.38 days in the control cohort. Quality of life and symptom burden remained stable despite the progressive nature of COPD.Conclusion: The sustained utilization of the co-designed patient application and improvements in participant outcomes observed in the RECEIVER trial support scale-up implementation with continued evaluation of this digital service.Keywords: COPD, self-management, remote monitoring, patient-reported outcomes

Polycyclic heterocycles are the most common and critical structural motifs found in a variety of natural products, medicines, fertilizers, and advanced materials. Because of their widespread use in biologically active compounds and material chemistry, functionalised dibenzo heterocyclic compounds, especially dibenzofuran, dibenzothiophene, and carbazole derivatives, garnered much attention over time. Scientists are especially interested in elucidating more efficient techniques for developing these industrially essential compounds. Dibenzo‐fused heterocycles can rapidly be synthesised using highly efficient transition metal‐catalysed strategies as well as by economic metal‐free reaction conditions. This review includes a detailed overview of the most recent significant synthetic techniques, both metal‐catalysed and metal‐free, to produce these industrially significant and medicinally important dibenzo‐fused heterocycles. [ABSTRACT FROM AUTHOR]

The present study is aimed at upgrading the passenger car's front inner bumper. The dynamic explicit time-stepping method IMPACT was used to conduct the impact analysis. The programme was first evaluated against experimental findings for beams subjected to impacts at low loads. The deviation between the simulated and experimental findings of the deflected beam ranged from 1.6% to 9.5%. The genuine bumper was subjected to two different kinds of impact simulations. The data were used as a standard against which to compare future bumper improvements. Internal energy absorption is much higher in all the conditions. All three designs are able to absorb more energy without changing their overall performance. [ABSTRACT FROM AUTHOR]