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Introduction: Acute confusional migraine (ACM) is a rare variant of migraine that is benign and self-resolving but difficult to diagnose. Without known causative pathophysiology and a lack of recognition in the International Classification of Headache Disorders (ICHD-3), ACM offers a puzzling clinical presentation. There currently is no standardized treatment for ACM, but with a growing anecdotal dataset there is the opportunity to formally recognize and establish protocols to improve patient care and outcomes.Case Report: A 14-year-old female presented to the emergency department (ED) with acute onset of confusion, vision changes, right-sided weakness, and dysarthria one hour prior to arrival. A stroke workup at the initial ED offered no pertinent findings. The patient was transferred to a pediatric specialty ED where all symptoms, aside from numbness and a mild headache, resolved during transfer. After administration of a migraine cocktail at the pediatric specialty ED, all remaining symptoms completely resolved. The patient was discharged home from the ED the same evening with outpatient follow-up.Conclusion: This case presents the difficulty of diagnosing and treating ACM prior to its self-resolution. It highlights the need for formal recognition of the condition by the ICHD-3. In doing so, greater recognition will promote more research, awareness, and establishment of a standardized treatment for ACM.

Biological, clinicobiological and clinical conceptions of Alzheimer's disease and related dementias are being promoted simultaneously to different practical ends. The co‐existence of contemporary conceptions and the ‘scary label’ associated with older diagnostic criteria create the possibility of misunderstanding and harm. In this comment, we argue in favour of socio‐ethical interventions targeted to health workers and the general public so as to lower the uncertainties introduced by contemporary diagnostic criteria and to articulate how they relate to established criteria. [ABSTRACT FROM AUTHOR]

This essay explores Proust's use of Vinteuil as a way to consider the relationship between artistic genius and perceived eccentricity. Vinteuil is presented both a ‘foolish old man’ and a composer of genius, thus staging a tension between the contingent and absolute nature of art. Proust's metaphorical use of music becomes a model for the creative process, where the ‘confused music’ of inspiration must be translated into coherent expression. Yet, Proust's treatment of Vinteuil and his musical analogies point to the mysteries and disturbances inherent in art. [ABSTRACT FROM AUTHOR]

Introduction: At the end of life, the prevalence of delirium and pain is high. Current therapy is not satisfactory. Dexmedetomidine could be useful in the control of delirium and pain but is not approved outside of intensive care setting. Our objectives are to evaluate existing evidence in the literature that assessed the efficacy of dexmedetomidine in pain and delirium control and its safety in palliative care patients outside intensive care units. This systematic review was prospectively registered with PROSPERO and included a risk of bias assessment. Methods: PubMed and SCOPUS were examined for literature published until 2023. Experimental, cohort, cross-sectional, case–control studies, and case series/reports were included if they evaluate the use of dexmedetomidine in delirium and/or pain management in hospitalized palliative care adult patients. Studies were excluded if they were carried out in intensive care units. Results: Of the initial 529 records, 14 were included. Although only two studies were randomized trials, most were small and only one had low risk of bias. In most case reports and in the two retrospective cohort studies, dexmedetomidine appears to be a better option for these symptoms, although differences were not significant in the randomized trials. Discussion: Dexmedetomidine seems to be a promising option for refractory pain and delirium and may contribute to a reduction in opioid administration to control pain. This is the first systematic review of dexmedetomidine in palliative care. Quality evidence is limited, but clinical properties of dexmedetomidine justify the conduction of controlled trials in palliative care. [ABSTRACT FROM AUTHOR]

In information security, data encryption plays a crucial role in preventing unauthorized access. Traditional methods often fall short when faced with sophisticated cyber threats. This research presents a hybrid encryption technique that integrates a recently devised 5D chaotic system, effectively bolstering data security by encoding information in an intricate, puzzle-like structure. This approach thwarts easy access to sensitive data, thus safeguarding them from potential interception and exploitation. The proposed encryption method combines the Linear Encryption Algorithm (LEA) and the Advanced Encryption Standard (AES) to create the Parallel Improved LEA (PILEA), blending key components of both algorithms to enhance data security. By integrating AES's S-box, Shift Rounds, Mix Columns, and Add Round Key operations, the PILEA significantly raises the complexity of the encrypted data, making them more resistant to unauthorized decryption attempts. A key innovation of this system is the use of a chaotic system for key generation, resulting in a strong, nonlinear, and dynamic key stream. Furthermore, by operating the entire system in a parallel mode, the proposed approach aims to decrease the number of rounds in the encryption process and the overall execution time for encryption and decryption. These enhancements further strengthen the encryption system's resilience against infiltration by malicious entities. Experimental results show that the PILEA method can withstand various types of cryptographic attacks, provides reduced computation times, and produces a highly random keystream, as confirmed by the NIST statistical test suite for randomness. [ABSTRACT FROM AUTHOR]

In the past years, the importance of using chaotic systems in encrypting media has increased, for example, media (text, images, videos, etc.). To protect these media from the increasing hacking risk and modification, it is necessary to use highly secure and efficient encryption methods to repel these attacks over the network, due to the strength that chaotic systems provide in any encryption system in which they are used. In this article, a cipher algorithm for 2D images is proposed. The proposed cryptosystem includes a new 4D chaotic system and a new permutation method for the image using the proposed dithering box [256]. The proposed chaotic system is used for the dynamic permutation of pixels depending on the value from the chaotic system then it applies XOR operations on the input image data (a dynamic stream cipher). The proposed permutation method is used to encrypt each set of 256 pixels in the image data (a dynamic block cipher). The most important feature of the proposed encryption scheme is the speed of performance in encrypting data. The encryption speed of a color image (256×256) reaches 0.9946 milliseconds, and 1 that of a color image (512×512) is 1.561223 milliseconds. In addition, the proposed encryption scheme shows excellent diffusion and confusion properties. The proposed algorithm keyspace length (10195) increases its defense against brute force attacks, the encrypted image analyses show entropy values up to (7.9998) indicating that the values in the image appear almost equal. The proposed scheme shows more resistance to differential attacks through the values of NPCR tests of 99.607% and UACI tests of 33.447, which are ideal values compared to modern encryption schemes. Performance analyses show that the proposed cryptosystem has excellent cipher speed and security performance. [ABSTRACT FROM AUTHOR]

In daily life, millennials have undoubtedly experienced distress, which can be interpreted as feelings of stress and anxiety. This research focuses on understanding distress from the perspective of the Qur'an, which serves as the primary guidance for Muslims. This study aims to explore the Qur'anic view on distress, the definition of distress in both language and the Qur'an, as well as understanding how millennials interpret distress, the terms used in the context of distress, and interpreting distress according to the Qur'an by providing solutions to improve the quality of life. This research adopts a qualitative descriptive approach that relies on literature study research, including Qur'anic verses, research publications, and related articles. In terms of interpretation, this research relies on the thematic interpretation method (tafsir maudhu’i). It also includes studies conducted by experts related to the phenomenon of distress, which encompasses stress and anxiety. In the context of the millennial generation, this research discovers solutions to overcome distress, which are further elaborated by the author through new ideas, especially by referring to relevant Qur'anic verses. The findings revealed in this research are 1) the Qur'anic view on stress as a test from Allah SWT, 2) that calamities are a source of stress, 3) the importance of having strong selfconfidence, and 4) solutions for distress from the perspective of the Qur'an. [ABSTRACT FROM AUTHOR]

I respond to comments from Mark Bowker, Jessica Keiser, and Eliot Michaelson on my book, Talking About. The response clarifies my stance on the nature of reference, conflicting intentions, and the sense in which language may have proper functions. [ABSTRACT FROM AUTHOR]

This paper proposes a model for encrypted images that depend on chaotic maps. This scheme uses eight chaotic maps to perform the encryption process: Logistic, Gauss, Circle, Sine, Singer, Piecewise, Tent, and Chebyshev. The two major processes of the suggested model are chaotic confusion and pixel diffusion. Chaotic maps are used to permute the pixel positions during the confusion process. In the diffusion process, the value of the image pixel is changed. To evaluate the suggested model, some performance metrics were used, such as execution time, peak signal-to-noise ratio, entropy, key sensitivity, noise attack, the number of pixels change rate (NPCR), unified average changing intensity (UACI), histogram analysis, and cross-correlation. According to experimental analysis, images encrypted with the suggested system have correlation coefficient values that are almost zero, NPCR of 99.6%, UACI of 32.9%, the key space of 10^(80), the histogram analysis showed that the encrypted images have almost similar pixels, an execution time of 0.1563 ms, the, and entropy of 7.9973. All prior results have verified the robustness and efficiency of the suggested algorithm. [ABSTRACT FROM AUTHOR]

In recent duration, exponential internet growth usage has necessitated robust methods for securing data during transmission. Image encryption has emerged as a crucial technique to prevent unauthorized access and manipulation of digital content. This study introduces a novel encryption method that enhances image security through a two-stage process. The first stage involves substituting and shuffling plain image pixels using a set of random numbers generated by the ISING model, where these numbers are described as a sequence of movements. In the second stage, pixel values are permuted using the Gyrator transformation, resulting in a ciphered image. Extensive numerical simulations have been conducted to calculate the effectiveness of the suggested method. The results confirm the method's efficacy, demonstrating significant improvements in security and robustness compared to existing encryption techniques. Statistical analyses further prove the advantages of using the confusion and diffusion properties for improving the proposed method. The proposed method represents a substantial improvement in the field of image encryption, presenting a secure and reliable solution for protecting digital images. [ABSTRACT FROM AUTHOR]

Due to the rapid growth in the field of information transmission techniques, billions of data are transmitted through variant authentication applications between clients. Providing protection to store and transmit these details has the priority in most services. Cancelable biometric techniques have the ability to store and employ these biometric signatures safe away any intruders. These template protection techniques are derived into transformation and cipher based cancelable biometric methodologies. The cipher approaches that are dependent on chaotic schemes quite achieve the two requirements of successful cancelable systems known by confusion and diffusion. This is prompted us to propose a novel cancelable research combines between Hyperchaotic technique and Fibonacci Q-matrix. The hyperchaotic system employs six initial conditions, equations, to construct the initial deformed patterns. Afterwards, the stage of diffusion is accomplished by employing Fibonacci Q-matrix for the resultant dislocated patterns to obtain the final protected template. The proposed cancelable authentication technique is validated by the two evaluation perspectives of authentication and security measurements, respectively. Furthermore, the proposed cancelable system is compared with the most recent studies in the same state-of-art which are utilized by GA and RNA-GA. Five tested biometrics are exploited to prove the validation of our work through any gray or colored biometric patterns with different sizes under different capturing environments even in the presence of noise level. The proposed work achieves high authentication performance by large values of AROC (Area under Receiver Operating Characteristic) Curve leads to 0.999, and similarity coefficients of licensed clients. As well as, the least values of FAR, and FRR (False Acceptance, and False Rejection Ratios) in addition the more uniform resultant histogram shapes due to the cancelable patterns. From the security perspective, the proposed cancelable methodology achieves high entropy of 7.99, NPCR (Number of Pixels Change Rate), and UACI (Unified Average Changing Intensity) values lead to almost optimum results of 99.0271%, and 31.2058%, respectively. This validates its immunity against probable differential attacks. [ABSTRACT FROM AUTHOR]

Local statistical analysis has long been of interest to social and environmental scientists who analyze geographic data. Research into local spatial statistics experienced a step-change in the mid-1990s, which provided a large class of local statistical methods and models. The local Moran statistic is one commonly used local indicator of spatial association, able to detect both areas of similarity and observations that are very dissimilar from their surroundings. From this, many further local statistics have been developed to characterize spatial clusters and outliers. These statistics have seen limited adoption because they do not sufficiently model the relationships involved in confounded spatial data, where the analyst seeks to understand the local spatial structure of a given outcome variable that is influenced by one or more additional factors. Recent innovations used to do joint multivariate local analysis also do not model this kind of conditional local structure in data. This article provides tools to rigorously characterize confounded local inference and a new and different class of multivariate conditional local Moran statistics that can account for confounding. To do this, we return to the Moran scatterplot as the critical tool for local Moran-style covariance statistics. Extending this concept, a new method is available directly from a "Moran-form" multiple regression. We show the empirical and theoretical properties of this statistic, show how some existing heuristic approaches arise naturally from this framework, and show how the use of conditional inference can change interpretations in an empirical analysis of rent and housing stock in a rapidly changing neighborhood. [ABSTRACT FROM AUTHOR]

In Talking about, Unnsteinsson defends an intentionalist theory of reference by arguing that confused referential intentions degrade reference. Central to this project is a "belief model" of both identity confusion and unconfused thought. By appealing to a well‐known argument from Campbell, I argue that this belief model falls short, because it fails to explain the inferential behavior it promises to explain. Campbell's argument has been central in the contemporary literature on Frege's puzzle, but Unnsteinsson's account of confusion provides an opportunity for more clarity about how the argument is best interpreted, and what it shows. [ABSTRACT FROM AUTHOR]

Methaemoglobinaemia is a rare but potentially life-threatening condition in which there is diminution of the oxygen-carrying capacity of the circulating haemoglobin. It can result from either congenital or acquired processes. Acquired methaemoglobinaemia is more prevalent than congenital methaemoglobinaemia, and notably it has a higher prevalence in infants and neonates than in adults; it results from exposure to oxidising agents. Methaemoglobin forms when haemoglobin is oxidised to contain iron in the ferric (Fe3+) state rather than the normal ferrous (Fe2+) state. Methaemoglobinaemia is a clinical diagnosis and is suspected in the presence of hypoxaemia refractory to supplemental oxygen and in the presence of chocolate-coloured blood. Symptoms are usually dependent on the methaemoglobin levels; at levels higher than 35%, systemic symptoms from tissue hypoxia may be fatal. We present a case of severe life-threatening methaemoglobinaemia following intra-abdominal use of cetrimide during hydatid cyst removal in a 60-year-old female.

Confusion emotion in a learning environment can motivate the learner, but prolonged confusion hinders the learning process. Recognizing confused learners is possible; nevertheless, finding them requires a lot of time and effort. Due to certain restrictions imposed by the settings of an online learning environment, the recognition of confused students is a big challenge for educators. Therefore, novel technologies are necessary to handle such crucial difficulties. Lately, Electroencephalography (EEG)-based emotion recognition systems have been rising in popularity in the domain of Education Technology. Such systems have been utilized to recognize the confusion emotion of learners. Numerous studies have been conducted to recognize confusion emotion through this system since 2013, and because of this, a systematic review of the methodologies, feature sets, and utilized classifiers is a timely necessity. This article presents the findings of the review conducted to achieve this requirement. We summarized the published literature in terms of the utilized datasets, feature preprocessing, feature types for model training, and deployed classifiers in terms of shallow machine learning and deep learning-based algorithms. Moreover, the article presents a comparison of the prediction accuracies of the classifiers and illustrates the existing research gaps in confusion emotion recognition systems. Future study directions for potential research are also suggested to overcome existing gaps.

One of the leading causes of concern with the advancement of cyber technologies is the increasing number of data and security breaches, especially given the amount of tools and information available at the disposal of anyone, let alone someone with malicious intent. This article presents a highly secure, secret, and robust data communication network mechanism. Confusion, diffusion mechanisms, and a key generation method are all components of a sound encryption scheme. All three of these factors are chosen carefully to maximise entropy, key space, execution speed, and resistance to differential and statistical attacks, as well as cryptographic analysis. The encryption approach used in the proposed work is a unique key generated using a high randomness and non-periodic quantum chaotic map in conjunction with hash function to ensure the key is unique. As a result, the mechanism is prone to resist differential attacks. Confusion is accomplished through the use of the Substitution process, permutation of bit values, and random bit plane scrambling. The substitution and bit permutation operations, both of which are matching, are chosen for their rapid speed of execution. Depending on the conditions, the folding technique is applied in two ways during the diffusion process, ensuring a high-security mechanism. The proposed mechanism is compared to state-of-the-art mechanisms, and it is argued that some outcomes are much improved over others, while others are comparable to other procedures. [ABSTRACT FROM AUTHOR]

The present study aimed to test the assumption that cognitive conflict constitutes part of the mechanism underlying the arousal of epistemic emotions. Specifically, the study investigated potential activation of epistemic emotions (surprise, confusion, curiosity, and wonder) due to cognitive conflict. One hundred fifty-two undergraduate students participated in the study. The tasks were 12 decision-making scenarios depicting dilemmas faced by autonomous (self-driving) cars, such as crossing over or avoiding an obstacle, that may have implications for pedestrians crossing a road. The tasks differed in the implications of the conflicting alternatives. Participants were asked to choose 1 of 2 response options in each scenario and then report, on a 4-point Likert-type scale, their feelings of difficulty and confidence regarding their response and their epistemic emotions. Scenarios posing high cognitive conflict resulted in increased levels of epistemic emotions compared with easily resolved conflicting scenarios. However, the various epistemic emotions followed different patterns of arousal, with confusion being the most affected emotion and surprise being the least affected one. [ABSTRACT FROM AUTHOR]

Electrical discharge machining (EDM) is a non-traditional machining technique that is frequently employed on hard materials. In today's industrial practice, it has been the most prevalent non-traditional material removal procedure. It allows you to process challenging materials and construct complicated forms with excellent accuracy. In the context of image pre-processing approaches to discover defective or non-defective machining pieces through EDM, the Centre of attention of this article is utilizing convolutional neural networks (CNN) to create a machinery piece defective detection approach. A total of 180 datasets of varying sizes produced from public datasets, the proposed CNN model is assessed and compared to pre-trained networks, namely the VGG-16, VGG-19, ResNet-50, and ResNet-101 models. The assessment took into crack detection outcomes, and classification parameters such as accuracy, precision, recall, and F1-score. Also, we have given the receiver operating characteristic (ROC) curve, precision–recall curve, and confusion matrices for each model for the required classification to predict the defective cracks, and also, we included the histograms to find the probabilities of defective and non-defective cracks. The suggested model can discriminate between pictures that are cracked and those that are not. According to the findings, VGG-16 has the best accuracy out of all of these models. In comparison to prior conventional procedures, the proposed EDM crack defective detecting methodology gives great accuracy.VGG-16 attains 93% accuracy, 93% of F1-score, 94% of precision, 93% of recall, 93% of specificity, as well as 97% of AUC, testing findings suggest that our strategy is capable of incredible performances. [ABSTRACT FROM AUTHOR]

Some scholars find that behavioral variation in the public goods game is explained by variations in participants' understanding of how to maximize payoff and that confusion leads to cooperation. Their findings lead them to question the common assumption in behavioral economics experiments that choices reflect motivations. We conduct two experiments, in which we minimize confusion by providing participants with increased training. We also introduce a question that specifically assesses participants' understanding of payoff maximization choices. Our experimental results show that the distribution of behavior types is significantly different when participants play with computers versus humans. A significant increase in contributions is also observed when participants play with humans compared to when they play with computers. Moreover, social norms may be the main motive for contributions when playing with computers. Our findings suggest that social preferences, rather than confusion, play a crucial role in determining contributions in public goods games when playing with humans. We therefore argue that the assumption in behavioral economics experiments that choices reveal motivations is indeed valid. [ABSTRACT FROM AUTHOR]

Post-injury confusional state is a common phenomenon following acquired brain injury. A multi-faceted approach for decreasing confusion is recommended, but there is a paucity of research related to non-pharmacological management. The main objective was to present a conceptual model of multi-faceted approaches for confusion, and secondly to investigate the rehabilitation outcome following these approaches. The setting is a specialized ward for rehabilitation of patients with severe cognitive difficulties following acquired brain injury. The conceptual model encompasses neurobehavioral strategies, pharmacological treatment, engagement in meaningful occupations, next of kin involvement, organizational demands, the physical environment, along with differential diagnostics. Patient cases are provided to illustrate the impact of each approach. A total of 141 of 281 patients were in a confusional state at admission. At discharge, 62% had emerged from the confusional state. Patients in a confusional state due to traumatic brain injury and subarachnoid hemorrhage had clinically important differences of >22 points in the functional independence measure from admission to discharge, following rehabilitation efforts based on the conceptual model. No clinically important difference was seen in patients with non-SAH stroke and patients with other types of brain injuries. The proposed conceptual model should be further evaluated in complex intervention studies. [ABSTRACT FROM AUTHOR]

In this paper, we present a new test for stream ciphers named the 'Bit Inclusion Test (BIT)'. This test provides an enhancement to the conventional avalanche test for stream ciphers. This test is efficient and includes the conventional avalanche test. Additionally, it can capture the shortcomings which escape the conventional avalanche test. We also demonstrate, with examples, how BIT is capable of going deeper into the structure of crypto-algorithms and detecting internal biases which make an algorithm susceptible to cryptanalytic attacks. [ABSTRACT FROM AUTHOR]

Spatial statistics is an important methodology for geospatial data analysis. It has evolved to handle spatially autocorrelated data and spatially (locally) heterogeneous data, which aim to capture the first and second laws of geography, respectively. Examples of spatially stratified heterogeneity (SSH) include climatic zones and land-use types. Methods for such data are relatively underdeveloped compared to the first two properties. The presence of SSH is evidence that nature is lawful and structured rather than purely random. This induces another "layer" of causality underlying variations observed in geographical data. In this article, we go beyond traditional cluster-based approaches and propose a unified approach for SSH in which we provide an equation for SSH, display how SSH is a source of bias in spatial sampling and confounding in spatial modeling, detect nonlinear stochastic causality inherited in SSH distribution, quantify general interaction identified by overlaying two SSH distributions, perform spatial prediction based on SSH, develop a new measure for spatial goodness of fit, and enhance global modeling by integrating them with an SSH q statistic. The research advances statistical theory and methods for dealing with SSH data, thereby offering a new toolbox for spatial data analysis. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether an assessment of delirium severity at diagnosis using the Delirium Observation Screening Scale (DOS scale) predicts adverse outcomes in hospital and on discharge. Methods: A prospective cohort study was conducted on a convenience sample of patients admitted to an acute geriatric ward with delirium over an eight‐month period. DOS scale was administered to the patients within 48 h of delirium diagnosis to measure delirium severity. Univariate logistic regression analysis was performed to evaluate the correlation between DOS scale and adverse outcomes. Results: Fifty‐nine patients were included in the study. There was a moderate correlation between increasing DOS scores and duration of delirium (r = 0.46, p < 0.001), as well as increasing DOS scores and decline in mobility on discharge (r = 0.35, p = 0.007). There was a weak correlation between increasing DOS scores and functional decline as measured by change in Katz Index from admission to discharge (r = −0.27, p = 0.04). No statistically significant correlations were found between DOS scores and in‐hospital mortality, inpatient complication rates or discharge to higher level of care. Conclusion: Delirium severity as measured by DOS scale may be useful in predicting delirium duration and decline in mobility and function on discharge. Further research with larger sample sizes is needed to establish if this finding can be replicated and whether delirium severity predicts additional adverse outcomes. Measuring delirium severity at diagnosis may be useful for communicating prognostic information to family members and setting expectations and treatment goals. [ABSTRACT FROM AUTHOR]

Market relations assume the coordinated operation of three basic mechanisms: competition, supply and demand, and prices that set the entire economic system in motion. Economic agents are forced to enter into competitive relations with each other, but economic entities are not always conscientious and honest, respecting the rights and interests of both bona fide competitors and operating according to honest customs, as well as the clientele/consumers. Protection against unfair competition stands out as an independent legal institution that deserves a detailed study due to its importance for the development of competition and business relations. The Moldovan legislator adopted a series of normative acts aimed at regulating the legal relations that arise between the subjects of economic activity in the process of carrying out this activity, including, to ensure their normal realization, the protection of fair competition, the rights and interests of competitors and citizens. For the violation of the "rules of the game", state reaction measures are provided by establishing legal liability, including criminal. A good understanding of the essence and legal nature of the crime of unfair competition provides us with the legal-criminal analysis of the composition of the crime provided for in art. 2461 of the Criminal Code. The article is dedicated to the analysis of the objective side of the crime of unfair competition, the authors focusing on the theoretical and practical aspects of this constitutive element of the crime. Based on the provisions of art. 2461 of the Criminal Code, the authors undertook a study of the five normative methods under which the crime of unfair competition is presented, relating them to the methods provided for in Law no. 183/2012 on competition, but also to the provisions of the Paris Convention for the protection of intellectual property, thus trying to highlight the factual manifestations of the analyzed crime, including elucidating the nature and legal essence of these modalities. The study undertaken allowed the authors to draw certain conclusions which, in turn, suggested certain ideas of legislative proposals that would improve the quality of the legal-penal norm contained in art. 2461 of the Criminal Code of the Republic of Moldova. [ABSTRACT FROM AUTHOR]

Background: Increased age is a strong and unfavorable prognostic factor for patients with glioblastoma (GBM). However, the relationships between stratified patient age, comorbidities, and medications have yet to be explored in GBM patient survival analyses. Objective: To evaluate co-morbid conditions, tumor-related symptoms, medication prescriptions, and subject age for patients with GBM and to establish potential targets for prospective studies. Methods: Electronic health records for 565 patients with IDHwt GBM were evaluated at a single center between January 1, 2000 and August 9, 2021 were retrospectively assessed. Data were stratified by MGMT promoter methylation status when available and were used to construct multivariable time-dependent cox models and intra-cohort hazards. Results: Younger (