Influenza pandemics pose a serious risk to the global population, with the potential for high morbidity and mortality. An adjuvanted H5N1 vaccine (aH5N1) has been approved for prophylaxis against the avian influenza virus H5N1, which is a likely cause of future pandemics. In this phase-III, stratified, randomized, controlled, observer-blind, multicenter study, we evaluated the safety and immunogenicity of aH5N1 in four separate groups of adults: adults 18–60 years of age who were healthy or had high-risk medical conditions and older adults ≥61 years of age who were healthy or had high-risk medical conditions. Subjects were randomly assigned to aH5N1 or the comparator, adjuvanted trivalent seasonal influenza vaccine (aTIV). Antibody responses to aH5N1 were increased in all four subgroups and, within each age stratum, largely consistent between healthy subjects and those with medical conditions. Injection-site pain was reported by 66–73% of younger and 36–42% of older–aH5N1 recipients, and fatigue and myalgia were reported by 22–41% of subjects across age and health subgroups. No serious adverse events or deaths were considered related to the study vaccine. In conclusion, aH5N1 increased antibody responses regardless of age or health status and demonstrated a clinically acceptable safety and tolerability profile. Full article

Outcomes for glioblastoma (GBM) remain poor despite standard-of-care treatments including surgical resection, radiation, and chemotherapy. Intratumoral heterogeneity contributes to treatment resistance and poor prognosis, thus demanding novel therapeutic approaches. Drug repositioning studies on antiretroviral therapy (ART) have shown promising potent antineoplastic effects in multiple cancers; however, its efficacy in GBM remains unclear. To better understand the pleiotropic anticancer effects of ART on GBM, we conducted a comprehensive drug repurposing analysis of ART in GBM to highlight its utility in translational neuro-oncology. To uncover the anticancer role of ART in GBM, we conducted a comprehensive bioinformatic and in vitro screen of antiretrovirals against glioblastoma. Using the DepMap repository and reversal of gene expression score, we conducted an unbiased screen of 16 antiretrovirals in 40 glioma cell lines to identify promising candidates for GBM drug repositioning. We utilized patient-derived neurospheres and glioma cell lines to assess neurosphere viability, proliferation, and stemness. Our in silico screen revealed that several ART drugs including reverse transcriptase inhibitors (RTIs) and protease inhibitors (PIs) demonstrated marked anti-glioma activity with the capability of reversing the GBM disease signature. RTIs effectively decreased cell viability, GBM stem cell markers, and proliferation. Our study provides mechanistic and functional insight into the utility of ART repurposing for malignant gliomas, which supports the current literature. Given their safety profile, preclinical efficacy, and neuropenetrance, ARTs may be a promising adjuvant treatment for GBM. Full article

The structural, elastic, piezoelectric, and electronic properties of Li-doped K_0.5Na_0.5NbO₃ (K_0.5−xNa_0.5−yLi_x+yNbO₃, KNN-L) are calculated. The properties of KNN-L are related to the Li-doping content and the replaced K or Na atoms. The bulk modulus, the shear modulus, and Young’s modulus of KNN-L are mostly higher than those of KNN, and the hardness value increases. The Poisson ratio of KNN-L is lower than that of most KNN, and the ductility is reduced. All doped structures are direct band gap semiconductors. K_0.5Na_0.375Li_0.125NbO₃ has the largest piezoelectric charge constant, d₃₃ = 44.72 pC/N, in the respective structures, which is 1.5 fold that of K_0.5Na_0.5NbO₃ (29.15 pC/N). The excellent piezoelectric performance of Li-doping KNN-L was analyzed from the insights of elastic and electronic properties. Full article

Background: Exercise and the consumption of sugars result in a dysfunction of the intestinal barrier (IB). Here, we determined the effect of sugar in a natural matrix on the intestinal barrier after moderate (A) and intensive endurance exercise (B). Method: The IB function was determined before (pre) and after running (post), and 120 and 180 min after consuming the drink by measuring serum endotoxin concentrations (lipopolysaccharides—LPS), IL-6, CD14, and i-FABP. In study A, nonspecifically trained participants (n = 24, males and females, age 26 ± 4) ran for one hour at 80% of their individual anaerobic threshold (IAT). After finishing, the runners consumed, in a crossover setup, either 500 mL of water, diluted cloudy apple juice (test drink), or an identical drink (placebo) without the fruit juice matrix (FJM). In study B, the participants (n = 30, males and females, age 50 ± 9) completed an ultra-marathon run, were divided into groups, and consumed one of the above-mentioned drinks. Results: Study A: Exercise resulted in a significant increase in serum LPS, i-FABP, and IL-6, which decreased fast after finishing. No impact of the different drinks on LPS i-FABP, or IL-6 could be observed, but there was an impact on CD14. Study B: The ultra-marathon resulted in a strong increase in serum LPS, which decreased fast after finishing in the water and test drink groups, but not in the placebo group. Conclusions: The consumed drinks did not affect the kinetics of IB regeneration after moderate exercise, but impacted CD14 serum concentrations, indicating possible beneficial effects of the FJM on the immune system. After an ultra-marathon, IB function regenerates very fast. The intake of sugar (placebo) seems to have had a negative impact on IB regeneration, which was diminished by the presence of the FJM. Full article

This study investigated how process parameters of laser cladding affect the microstructure and mechanical properties of WC-12Co composite coating for use as a protective layer of continuous caster rolls. WC-Co powders, WC-Ni powders, and Ni-Cr alloy powder with various wear resistance characteristics were evaluated in order to determine their applicability for use as cladding materials for continuous caster roll coating. The cladding process was conducted with various parameters, including laser powers, cladding speeds, and powder feeding rates, then the phases, microstructure, and micro-hardness of the cladding layer were analyzed in each specimen. Results indicate that, to increase the hardness of the cladding layer in WC-Co composite coating, the dilution of the cladding layer by dissolution of Fe from the substrate should be minimized, and the formation of the Fe-Co alloy phase should be prevented. The mechanical properties and wear resistance of each powder with the same process parameters were compared and analyzed. The microstructure and mechanical properties of the laser cladding layer depend not only on the process parameters, but also on the powder characteristics, such as WC particle size and the type of binder material. Additionally, depending on the degree of thermal decomposition of WC particles and evolution of W distribution within the cladding layer, the hardness of each powder can differ significantly, and the wear mechanism can change. Full article

Herein, we investigate the temperature compensation for a dual-mass MEMS gyroscope. After introducing and simulating the dual-mass MEMS gyroscope’s working modes, we propose a hybrid algorithm for temperature compensation relying on improved complete ensemble empirical mode decomposition with adaptive noise (ICEEMDAN), sample entropy, time–frequency peak filtering, non-dominated sorting genetic algorithm-II (NSGA II) and extreme learning machine. Firstly, we use ICEEMDAN to decompose the gyroscope’s output signal, and then we use sample entropy to classify the decomposed signals. For noise segments and mixed segments with different levels of noise, we use time–frequency peak filtering with different window lengths to achieve a trade-off between noise removal and signal retention. For the feature segment with temperature drift, we build a compensation model using extreme learning machine. To improve the compensation accuracy, NSGA II is used to optimize extreme learning machine, with the prediction error and the 2-norm of the output-layer connection weight as the optimization objectives. Enormous simulation experiments prove the excellent performance of our proposed scheme, which can achieve trade-offs in signal decomposition, classification, denoising and compensation. The improvement in the compensated gyroscope’s output signal is analyzed based on Allen variance; its angle random walk is decreased from 0.531076°/h/√Hz to 6.65894 × 10⁻³°/h/√Hz and its bias stability is decreased from 32.7364°/h to 0.259247°/h. Full article

The aim of this study is to purify industrial textile effluents by treating two types of commonly encountered dyes: blue maxilon (BM), of cationic nature, and black eriochrome (NE), of anionic nature. We intend to employ an innovative approach based on the adsorption of these dyes onto a novel vegetal biomaterial derived from Aleppo pine fibers (FPAs). A kinetic and thermodynamic study was conducted. The effect of some physicochemical parameters on both dye adsorption and FPAs was also evaluated. The modeling of the adsorption results was performed using Langmuir, Freundlich, Temkin, and Dubinin Radushkevich (D-R) isotherms. The results indicate that the equilibrium time strongly depends on the initial concentration of the two dyes, being 60 min with pseudo-second-order adsorption kinetics for both dyes. Adsorption isotherms under the optimal conditions of adsorbent mass, temperature, medium pH, and dye concentration were used to determine the maximum adsorption efficiency, which was close to 93% and 98% for BM and NE, respectively. The results also show that the adsorption of both dyes on FPAs fits well with Langmuir’s model. The thermodynamic study indicates that the adsorption of both dyes on FPAs is spontaneous and exothermic in nature for BM and endothermic for NE. Full article

In-host models have been essential for understanding the dynamics of virus infection inside an infected individual. When used together with biological data, they provide insight into viral life cycle, intracellular and cellular virus–host interactions, and the role, efficacy, and mode of action of therapeutics. In this review, we present the standard model of virus dynamics and highlight situations where added model complexity accounting for intracellular processes is needed. We present several examples from acute and chronic viral infections where such inclusion in explicit and implicit manner has led to improvement in parameter estimates, unification of conclusions, guidance for targeted therapeutics, and crossover among model systems. We also discuss trade-offs between model realism and predictive power and highlight the need of increased data collection at finer scale of resolution to better validate complex models. Full article

Inferior frontal sulcal hyperintensities (IFSHs) on fluid-attenuated inversion recovery (FLAIR) sequences have been proposed to be indicative of glymphatic dysfunction. Replication studies in large and diverse samples are nonetheless needed to confirm them as an imaging biomarker. We investigated whether IFSHs were tied to Alzheimer’s disease (AD) pathology and cognitive performance. We used data from 361 participants along the AD continuum, who were enrolled in the multicentre DELCODE study. The IFSHs were rated visually based on FLAIR magnetic resonance imaging. We performed ordinal regression to examine the relationship between the IFSHs and cerebrospinal fluid-derived amyloid positivity and tau positivity (Aβ42/40 ratio ≤ 0.08; pTau181 ≥ 73.65 pg/mL) and linear regression to examine the relationship between cognitive performance (i.e., Mini-Mental State Examination and global cognitive and domain-specific performance) and the IFSHs. We controlled the models for age, sex, years of education, and history of hypertension. The IFSH scores were higher in those participants with amyloid positivity (OR: 1.95, 95% CI: 1.05–3.59) but not tau positivity (OR: 1.12, 95% CI: 0.57–2.18). The IFSH scores were higher in older participants (OR: 1.05, 95% CI: 1.00–1.10) and lower in males compared to females (OR: 0.44, 95% CI: 0.26–0.76). We did not find sufficient evidence linking the IFSH scores with cognitive performance after correcting for demographics and AD biomarker positivity. IFSHs may reflect the aberrant accumulation of amyloid β beyond age. Full article

Vibration in hot tandem rolling mills has been a problem in the iron and steel industry mainly due to its unpredictability. In this work, vibration data of the second finishing mill (F2) stand of a hot tandem rolling mill are collected and analyzed, and a mathematical model based on the coupling of a non-uniform deformation process, mill structure and hydraulic control system is constructed. The influence of different inlet thickness fluctuation forms, structural parameters and control parameters on the vibration behavior is analyzed. It is concluded that the low-frequency thickness fluctuation with additional skewness can cause the resonance of each subsystem of the rolling mill. The deviation angle of the roll system influences the vibration harmonic output of the rolling mill under a single low-frequency thickness fluctuation excitation. The compensation parameter in the thickness control system affects the natural frequency of the vertical system. Full article

Background: Significant pericardial effusion requires percutaneous drainage. Some patients experience recurrent pericardial effusion following index drainage, but its risk factors remain unknown. Such knowledge should further improve the clinical management of individuals presenting with pericardial effusion for risk stratification and the construction of therapeutic and management strategies beforehand. Methods: Patients who underwent percutaneous drainage for pericardial effusion between 2018 and 2023 were retrospectively included and were followed for 2 years or until November 2023. Baseline factors associated with recurrent pericardial effusion that required percutaneous drainage again were investigated to identify the high-risk cohort. Results: A total of 39 patients (83 years on median, 28 males) were included. During the 2-year observation period, 11 patients had the primary outcome. The left ventricular end-diastolic diameter at baseline was independently associated with the primary outcome with an adjusted hazard ratio of 0.88 (95% confidence interval 0.80–0.97, p = 0.013) with a cutoff of 42 mm, which significantly stratified the cumulative incidence of the primary outcome (53% versus 10%, p = 0.011). Conclusions: Recurrent pericardial effusion after percutaneous drainage is not a rare phenomenon. A smaller left ventricular endo-diastolic diameter was an independent risk factor for recurrent pericardial effusion. The clinical implications of our findings in daily clinical practice should be validated in future prospective studies. Further studies are warranted to clarify the underlying causality between them. Full article

This article presents the design, analysis, and prototype testing of a four-degrees-of-freedom (4-DoFs) spatial pose adjustment system (SPAS) that achieves high-precision positioning with 4-DoFs (Z/Tip/Tilt/$\Theta$). The system employs a piezoelectric-driven amplification mechanism that combines a bridge lever hybrid amplification mechanism, a double four-bar guide mechanism, and a multi-level lever symmetric rotation mechanism. By integrating these mechanisms, the system achieves low coupling, high stiffness, and wide stroke range. Analytical modeling and finite element analysis are employed to optimize geometric parameters. A prototype is fabricated, and its performance is verified through testing. The results indicate that the Z-direction feed microstroke is 327.37 $\mathsf{\mu }$m, the yaw motion angle around the X and Y axes is 3.462 mrad, and the rotation motion angle around the Z axis is 12.684 mrad. The x-axis and y-axis motion magnification ratio can reach 7.43. Closed-loop decoupling control experiments for multiple-input-multiple-outputs (MIMO) systems using inverse kinematics and proportional-integral-derivative feedback controllers were conducted. The results show that the Z-direction positioning accuracy is ±100 nm, the X and Y axis yaw motion accuracy is ±2 $\mathsf{\mu }$rad, and the Z-axis rotation accuracy is ±25 $\mathsf{\mu }$rad. Due to the ZTT$\Theta$ mechanism, the design proved to be feasible and advantageous, demonstrating its potential for precision machining and micro-nano manipulation. Full article

This study aims to illustrate the complex relationships between reading motivation and reading comprehension for Black girl readers. There is an urgent need for research that explicitly centers on the reading motivations of Black girls through a humanizing, asset-oriented lens. Through a Situative Black Girlhood Reading Motivations lens, which integrates a situative perspective on motivation and the tenets of Black Girlhood Studies, this multi-year study focuses on a group of Black girl readers participating in a summer reading program. Qualitative data, including video observations, student work artifacts, and small-group artifact-elicited interviews, were analyzed through a generic inductive approach to answer the research question, “How are relationships between Black girls’ reading motivations and their reading comprehension evident in their reading engagement and enactments?” The findings demonstrate that the participants’ most salient reading motivations in this instructional context (meaning-oriented, collaborative, and liberatory reading motivations) (1) were a precursor to their comprehension, (2) worked in tandem with their comprehension, and (3) stemmed from their comprehension. These findings contribute to models of reading by illustrating the need for additional complexity when describing the relationship between reading motivation and comprehension. Full article

In engineering measurements, metal foil strain gauges suffer from a limited range and low sensitivity, necessitating the development of flexible sensors to fill the gap. This paper presents a flexible, high-performance piezoresistive sensor using a composite consisting of graphene nanoplatelets (GNPs) and polydimethylsiloxane (PDMS). The proposed sensor demonstrated a significantly wider range (97%) and higher gauge factor (GF) (6.3), effectively addressing the shortcomings of traditional strain gauges. The microstructure of the GNPs/PDMS composite was observed using a scanning electron microscope, and the distribution of the conductive network was analyzed. The mechanical behavior of the sensor encapsulation was analyzed, leading to the determination of the mechanisms influencing encapsulation. Experiments based on a standard equal-strength beam were conducted to investigate the influence of the base and coating dimensions of the sensor. The results indicated that reducing the base thickness and increasing the coating length both contributed to the enhancement of the sensor’s performance. These findings provide valuable guidance for future development and design of flexible sensors. Full article

Wildfires and their long-term impacts on the environment have become a major concern in the last few decades, in which climate change and enhanced anthropogenic activities have gradually led to increasingly frequent events of such hazards or disasters. Geological materials appear to become more vulnerable to hazards including erosion, floods, landslides and debris flows. In the present study, the well-known 2017 wildfire and subsequent 2018 debris flows in the Montecito area of California are examined. It is found that the post-wildfire debris flows were initiated from erosion and entrainment processes and triggered by intense rainfall. The significant debris deposition in four major creeks in this area is investigated. Numerical modeling of the post-wildfire debris flows is performed by employing a multi-phase mass flow model to simulate the growth in the debris flows and eventual debris deposition. The debris-flow-affected areas estimated from the numerical simulations fairly represent those observed in the field. Overall, the simulated debris deposits are within 7% error of those estimated based on field observations. A similar simulation of the pre-wildfire scenario indicates that the debris would be much less significant. The present study shows that proper numerical simulations can be a promising tool for estimating post-wildfire erosion and the debris-affected areas for hazard assessment and mitigation. Full article

This work presents a private consortium blockchain-based automotive data monetization architecture implementation using the Substrate blockchain framework. Architecture is decentralized where crowd-sourced data from vehicles are collectively auctioned ensuring data privacy and security. Smart Contracts and OffChain worker interactions built along with the blockchain make it interoperable with external systems to send or receive data. The work is deployed in a Kubernetes cloud platform and evaluated on different parameters like throughput, hybrid consensus algorithms AuRa and BABE, along with GRANDPA performance in terms of forks and scalability for increasing node participants. The hybrid consensus algorithms are studied in depth to understand the difference and performance in the separation of block creation by AuRa and BABE followed by chain finalization through the GRANDPA protocol. Full article

Sacral historical monuments are primarily places of prayer, but also objects performing numerous other functions. These are public goods, including cultural goods that build national identity. Their preservation in the right condition is important not only for the owner, but also for the public authorities, whose duty is to preserve them for future generations. The study concerns the financing of sacral monuments in Poland. Its aim is to indicate the legitimacy of financing the revalorization of sacral monuments from public funds, the solutions applied in this area in Poland, and the sources and amount of support provided to the owners of these objects in the years 2017–2022. In it, the authors: (1) refer to such concepts as: public good, cultural good and cultural heritage, (2) define—based on Polish regulations—the concept of a sacral monument and indicate the multiplicity of functions that these objects perform, (3) present the number and types of sacral monuments in Poland, taking into account their location, (4) identify available sources of public funds for the revalorization of sacral monuments in Poland. The analyses carried out show that in Poland, every year, public funds play an important role in the revalorization of sacral historical monuments. In real terms, its volume remained at a similar level over the period considered. The methods used in the development are as follows: critical analysis of the literature and legal acts and selected methods of descriptive statistics. Full article

The pre-tender cost estimation serves as the foundation for determining the project cost in the early stages and is crucial for all parties involved in the tendering process. It is expected to be highly accurate. However, industry surveys have advocated that in the Iranian construction industry, the pre-tender estimated costs of construction projects are not sufficiently accurate during the bidding stage. Building information modelling (BIM) technology is a modern digital tool deployed in the construction industry that has seen substantial growth of application. It employs useful tools in different sectors and has extended its involvement in various stages of the project lifecycle, including feasibility studies, planning, design, construction, and operation and maintenance. This study examines and assesses the status of BIM development in Iran for its applicability in the pre-tender cost estimating process in construction projects. The findings of this study indicate that while there is a limited number of Iranian building projects’ BIM models that possess the required quality and capabilities for BIM-based cost estimation, the results obtained are more precise when compared to existing manual methods. Additionally, utilising BIM-based cost estimation significantly reduces the time required for this process by enhancing the speed of cost estimation operations. An innovative evaluation framework for assessing the quality and functionalities of BIM models is presented, which improves the accuracy of cost estimation before the bidding process in Iran’s construction industry. The research findings demonstrate the enhanced accuracy and effectiveness of BIM as compared to conventional approaches. It also suggests the incorporation of AI technology for model evaluation, which has the potential to become an established global industry standard. Full article

It is difficult to learn meaningful representations of time-series data since they are sparsely labeled and unpredictable. Hence, we propose bootstrap inter–intra modality at once (BIMO), an unsupervised representation learning method based on time series. Unlike previous works, the proposed BIMO method learns both inter-sample and intra-temporal modality representations simultaneously without negative pairs. BIMO comprises a main network and two auxiliary networks, namely inter-auxiliary and intra-auxiliary networks. The main network is trained to learn inter–intra modality representations sequentially by regulating the use of each auxiliary network dynamically. Thus, BIMO thoroughly learns inter–intra modality representations simultaneously. The experimental results demonstrate that the proposed BIMO method outperforms the state-of-the-art unsupervised methods and achieves comparable performance to existing supervised methods. Full article

Introduction: In developed countries, heart disease is the primary cause of maternal mortality during pregnancy. Arterial stiffness, an independent risk factor for atherosclerosis and a predictor of cardiovascular complications, can be assessed using the augmentation index (AIx) and pulse wave velocity (PWV). In this prospective study, we aimed to evaluate diverse hemodynamic parameters and arterial stiffness in pregnant women before and after participating in a structured, personalized exercise training program. Materials and methods: Forty healthy pregnant women, non-smokers, who agreed to participate daily for 12 weeks in a physical exercise training program under the supervision of a team made up of an obstetrician, a cardiologist, and a physiotherapist were included. Anthropometric characteristics, arterial function, and physical activity data were collected from the participants at two different time points: at the beginning of the exercise training program (T0) and at the end, after 12 weeks (T1). Results: Upon conducting a statistical analysis, it was discovered that there were noteworthy disparities (p = 0.05) in body mass index, brachial AIx, systolic blood pressure, and pulse pressure values between the two time points. The regression analysis for the AIx brachial values and the PWVao values from Trim II (T0) and Trim III (T1) showed major differences between these two time points; the association between the AIx brachial values in the second and third trimesters of pregnancy revealed a strong direct significant correlation (p < 0.001), and the correlation between the PWVao values in the second (T0) and third trimester (T1) of pregnancy was weak and insignificant (p = 0.12). Conclusions: The findings of our study indicate that a personalized exercise training program positively impacts the physical and psychological well-being of pregnant women, leading to a reduction in PWV. Full article

Although several studies have found disparities in health outcomes between heterosexual and lesbian, gay, and bisexual (LGB)-identifying individuals, few studies have focused on subjective well-being and protective factors for health and well-being. The purpose of this work is twofold: (1) to examine the relevance of sexual orientation to health and well-being in women and men; (2) to identify protective and risk factors for psychological distress, self-rated health, and well-being for gay men, lesbian women, bisexual women and men, and heterosexual women and men. The sample consisted of 908 women and 586 men from the general Spanish population aged 16–64, half of whom identified themselves as LGB and half as heterosexual. All were assessed using eight questionnaires and inventories. The results showed that differences varied depending on the health indicator considered. In general, bisexuals had the poorest health, with lower self-rated health and lower self-esteem. In all groups, self-esteem was a protective factor against psychological distress and was associated with better health and well-being. To a lesser extent, social support served as a protective factor against psychological distress and was associated with greater well-being in all groups. It is concluded that although sexual orientation is relevant to the health and well-being of individuals, there are differences among sexual minorities, with bisexuals having lower self-esteem than homosexuals. Full article

Introduction: Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) mortality remains high despite revascularization and the use of the intra-aortic balloon pump (IABP). Advanced mechanical circulatory support (MCS) devices, such as catheter-based ventricular assist devices (cVAD), may impact mortality. We aim to identify predictors of mortality in AMI-CS implanted with IABP and the proportion eligible for advanced MCS in an Asian population. Methods: We retrospectively analyzed a cohort of Society for Cardiovascular Angiography and Intervention (SCAI) stage C and above AMI-CS patients with IABP implanted from 2017–2019. We excluded patients who had IABP implanted for indications other than AMI-CS. Primary outcome was 30-day mortality. Binary logistic regression was used to calculate adjusted odds ratios (aOR) for patient characteristics. Results: Over the 3-year period, 242 patients (mean age 64.1 ± 12.4 years, 88% males) with AMI-CS had IABP implanted. 30-day mortality was 55%. On univariate analysis, cardiac arrest (p < 0.001), inotrope/vasopressor use prior to IABP (p = 0.004) was more common in non-survivors. Non-survivors were less likely to be smokers (p = 0.001), had lower ejection fraction, higher creatinine/ lactate and lower pH (all p < 0.001). On multi-variate analysis, predictors of mortality were cardiac arrest prior to IABP (aOR 4.00, CI 2.28–7.03), inotrope/vasopressor prior to IABP (aOR 2.41, CI 1.18–4.96), lower arterial pH (aOR 0.02, CI 0.00–0.31), higher lactate (aOR 2.42, CI 1.00–1.19), and lower hemoglobin (aOR 0.83, CI 0.71–0.98). Using institutional MCS criteria, 106 patients (44%) would have qualified for advanced MCS. Conclusions: Early mortality in AMI-CS remains high despite IABP. Many patients would have qualified for higher degrees of MCS. Full article