Background: Clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by applying long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid tendon healing after surgery has been documented, but the aspect regarding long-term tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescents previously treated for clubfoot have been described in the literature. As rupture is a rare event in this age group, a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon in patients treated for clubfoot, between patients treated with casting alone and with patients who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: There were 22 asymptomatic patients (34 feet) with a median age of 12 years, previously treated for clubfoot, that were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: A greater thickness and increased number of structural alterations with the presence of hypoechoic areas of the operated tendons compared with those treated with plaster alone were observed (p-value: 0.0498 and <0.001, respectively). These ultrasound findings were indicative of tendon suffering, as seen in tendinopathies. Conclusions: The presence of ultrasound alterations in asymptomatic patients operated on for clubfoot requires careful control of the extrinsic factors of tendinopathy in order to reduce the risk of subcutaneous rupture. Full article

The effect of microwave treatment on the grinding and flotation performance of a typical copper–nickel sulfide ore was evaluated, based on the determination of its microwave absorption capability, grinding and flotation indexes such as crack percentage, mineral liberation degree, particle size distribution, relative work index (RWI), metal enrichment ratio, and recovery. There were obvious differences between the microwave absorption capabilities of the main minerals in the ore, as demonstrated by their different microwave penetration depths. They also induced temperature differences between sulfide minerals and gangue minerals which could reach 418 °C after microwave treatment for 20 s. It was shown that microwave treatment could effectively improve the grindability of the ore, as proven by the increase in fine particles smaller than 0.074 mm and a decrease in RWI after grinding due to the higher crack percentage and mineral liberation degree. Moreover, microwave treatment affected the ore floatability because of the generation of cuprite, retgersite, and rozenite with poor floatability when the treatment time was extended. By microwave treatment for a proper time, 20 s, an optimal balance between the grindability and flotation performance could be achieved. Compared with the untreated ore, the RWI of the ore decreased by 11.5%. After flotation, the Cu and Ni enrichment ratios of the flotation concentrate increased by 0.3 and 0.2, respectively. Meanwhile, their corresponding recoveries increased by 4.2% and 3.1%. This study provides new insights for the treatment of copper–nickel sulfide ore to enhance the grinding and flotation process. Full article

Goal: This study aimed to examine provincial differences in patient spending for cancer care and reductions in household spending including decisions to forego care in Canada. Methods: Nine-hundred and one patients with cancer, from twenty cancer centers across Canada, completed a self-administered questionnaire (P-SAFE version 7.2.4) (344 breast, 183 colorectal, 158 lung, and 216 prostate) measuring direct and indirect costs and spending changes. Results: Provincial variations showed a high mean out-of-pocket cost (OOPC) of CAD 938 (Alberta) and a low of CAD 280 (Manitoba). Differences were influenced by age and income. Income loss was highest for Alberta (CAD 2399) and lowest for Manitoba (CAD 1126). Travel costs were highest for Alberta (CAD 294) and lowest for British Columbia (CAD 67). Parking costs were highest for Ontario (CAD 103) and lowest for Manitoba (CAD 53). A total of 41% of patients reported reducing spending, but this increased to 52% for families earning <CAD 50,000 per year. The highest national rates of decisions to forego care were in relation to vitamins/supplements, the selection made by 21.3% of those who indicated spending reductions. Reductions for complementary and alternative medicine (CAM) were made by 16.3%, and for drugs, by 12.8%. Most cost categories had higher proportions of individuals who decided to forego care when family income was <CAD 50,000 per year and for patients under 65 years of age. Conclusions: Levels of financial burden for patients with cancer in Canada vary provincially, including for OOPC, travel and parking costs, and lost income. Decisions to forego cancer care are highest in relation to vitamins/supplements, CAM, and drugs. Provincial differences suggest that regional health policies and demographics may impact patients’ overall financial burden. Full article

The HMG-domain containing transcription factor Sox10 plays a crucial role in regulating Schwann cell survival and differentiation and is expressed throughout the entire Schwann cell lineage. While its importance in peripheral myelination is well established, little is known about its role in the early stages of Schwann cell development. In a search for direct target genes of Sox10 in Schwann cell precursors, the transcriptional co-repressor Tle4 was identified. At least two regions upstream of the Tle4 gene appear involved in mediating the Sox10-dependent activation. Once induced, Tle4 works in tandem with the bHLH transcriptional repressor Hes1 and exerts a dual inhibitory effect on Sox10 by preventing the Sox10 protein from transcriptionally activating maturation genes and by suppressing Sox10 expression through known enhancers of the gene. This mechanism establishes a regulatory barrier that prevents premature activation of factors involved in differentiation and myelin formation by Sox10 in immature Schwann cells. The identification of Tle4 as a critical downstream target of Sox10 sheds light on the gene regulatory network in the early phases of Schwann cell development. It unravels an elaborate regulatory circuitry that fine-tunes the timing and extent of Schwann cell differentiation and myelin gene expression. Full article

The surge of disinformation in the digital sphere following the COVID-19 pandemic presents a considerable threat to democratic principles in contemporary societies. In response, multiple fact-checking platforms and citizen media literacy initiatives have been promoted. The fact checker has indeed become a new professional profile demanded by the sector. In this context, this research delves into the study of digital skills applied to information verification by journalism students. Adopting a comprehensive understanding of digital skills that extends beyond technical proficiency to encompass a shift in mindset, journalism students’ perceptions of their verification abilities are examined using a quantitative survey technique. This examination is based on an original list of competencies prepared specifically for this study. The results indicate that journalism students demonstrate awareness of the implications of disinformation, exhibiting scepticism towards content from unfamiliar sources or displaying clear signs of deceptive intent. Furthermore, they emphasise the importance of verification and fact-checking practices and express confidence in their proficiency in analysis, critical thinking, and social skills. However, their confidence in handling computer applications for verification and specialisation in data journalism is comparatively lower. Notably, significant gender disparities were observed in these areas, with women exhibiting greater confidence in social skills, collaborative work, and innovation, while men displayed a heightened proficiency in computer applications. Consequently, there is a need for improvements in teaching practices, which could potentially create new job opportunities for journalism students. Full article

Breast cancer includes tumor subgroups with morphological, molecular, and clinical differences. Intrinsic heterogeneity especially characterizes breast tumors with a triple negative phenotype, often leading to the failure of even the most advanced therapeutic strategies. To improve breast cancer treatment, the use of natural agents to integrate conventional therapies is the subject of ever-increasing attention. In this context, garlic (Allium sativum) shows anti-cancerous potential, interfering with the proliferation, motility, and malignant progression of both non-invasive and invasive breast tumor cells. As heterogeneity could be at the basis of variable effects, the main objective of our study was to evaluate the anti-tumoral activity of a garlic extract in breast cancer cells with a triple negative phenotype. Established triple negative breast cancer (TNBC) cell lines from patient-derived xenografts (PDXs) were used, revealing subtype-dependent effects on morphology, cell cycle, and invasive potential, correlated with the peculiar down-modulation of Akt signaling, a crucial regulator in solid tumors. Our results first demonstrate that the effects of garlic on TNBC breast cancer are not unique and suggest that only more precise knowledge of the mechanisms activated by this natural compound in each tumor will allow for the inclusion of garlic in personalized therapeutic approaches to breast cancer. Full article

OpenAI’s ChatGPT (San Francisco, CA, USA) and Google’s Gemini (Mountain View, CA, USA) are two large language models that show promise in improving and expediting medical decision making in hand surgery. Evaluating the applications of these models within the field of hand surgery is warranted. This study aims to evaluate ChatGPT-4 and Gemini in classifying hand injuries and recommending treatment. Methods: Gemini and ChatGPT were given 68 fictionalized clinical vignettes of hand injuries twice. The models were asked to use a specific classification system and recommend surgical or nonsurgical treatment. Classifications were scored based on correctness. Results were analyzed using descriptive statistics, a paired two-tailed t-test, and sensitivity testing. Results: Gemini, correctly classifying 70.6% hand injuries, demonstrated superior classification ability over ChatGPT (mean score 1.46 vs. 0.87, p-value < 0.001). For management, ChatGPT demonstrated higher sensitivity in recommending surgical intervention compared to Gemini (98.0% vs. 88.8%), but lower specificity (68.4% vs. 94.7%). When compared to ChatGPT, Gemini demonstrated greater response replicability. Conclusions: Large language models like ChatGPT and Gemini show promise in assisting medical decision making, particularly in hand surgery, with Gemini generally outperforming ChatGPT. These findings emphasize the importance of considering the strengths and limitations of different models when integrating them into clinical practice. Full article

Cybersecurity is one of the important considerations when adopting IoT devices in smart applications. Even though a huge volume of data is available, data related to attacks are generally in a significantly smaller proportion. Although machine learning models have been successfully applied for detecting security attacks on smart applications, their performance is affected by the problem of such data imbalance. In this case, the prediction model is preferable to the majority class, while the performance for predicting the minority class is poor. To address such problems, we apply two oversampling techniques and two undersampling techniques to balance the data in different categories. To verify their performance, five machine learning models, namely the decision tree, multi-layer perception, random forest, XGBoost, and CatBoost, are used in the experiments based on the grid search with 10-fold cross-validation for parameter tuning. The results show that both the oversampling and undersampling techniques can improve the performance of the prediction models used. Based on the results, the XGBoost model based on the SMOTE has the best performance in terms of accuracy at 75%, weighted average precision at 82%, weighted average recall at 75%, weighted average F1 score at 78%, and Matthews correlation coefficient at 72%. This indicates that this oversampling technique is effective for multi-attack prediction under a data imbalance scenario. Full article

Governments worldwide have invested considerable money and time into creating pedestrian-oriented urban environments. However, generalizing arbitrary standards for walking environments is challenging. Therefore, this study presents a method for predicting walkability scores of evaluations using five regression models, including Multiple linear, Ridge, LASSO regression, SVR, and XGBoost. The models were trained using semantic segmentation, walkability evaluations based on crowdsourcing, and image scores obtained using the TrueSkill algorithm, and their performances were compared. Feature selection was employed to improve the accuracies of the models, which were retrained using the importance of extracted features. Among the five regression models, XGBoost, a tree-based regression model, exhibited the lowest error rate, high accuracy, and greatest performance improvement after retraining. This study is expected to generalize the walking environments preferred by various people and demonstrate that objective walkability evaluations are possible through a computer system rather than through subjective human judgment. Full article

Background: Surveys conducted in different regions of the world show that the prevalence rates of health risk behaviors (HRBs) in university students are sometimes higher than those found in non-university populations. This study aims to identify the prevalence rates and demographic and academic environment correlates associated with HRBs among Brazilian university students. Methods: In a cross-sectional epidemiological study, a random sample of 5310 university students answered an online questionnaire, with demographic (sex, age, skin color, marital status, and paid work) and academic setting information (housing type, size of campus, year, and shift of study), as well as items clustered in four HRB domains: personal safety and violence, sexual behavior and contraception, addictive substance use, eating habits, physical activity, and sleep. The data were analyzed statistically using bivariate analysis and hierarchical multiple regression. Results: The highest prevalence rates occurred in HRBs clustered in the domain of eating habits, physical activity, and sleep (>60%), while HRBs for personal security and violence were less prevalent (<15%). From 15% to 35% of university students assumed HRBs regarding addictive substance use, and approximately 50% reported risky sexual behavior. The university students most susceptible to HRBs were men, aged ≥ 22 years, living far from their family, studying on larger campuses, attending night classes, and with two or more years of study at the university. Conclusion: The findings suggest that policies and interventions in the university context aimed at students’ readiness to engage in a healthy lifestyle should target specific correlates associated with HRBs. Full article

Chronic migraine (CM) significantly affects underage individuals. The study objectives are (1) to analyze the effectiveness and safety of onabotulinumtoxinA (BTX-A) in adolescents with CM; (2) to review the literature on BTX-A use in the pediatric population. This prospective observational study included patients under 18 years old with CM treated with BTX-A (PREEMPT protocol) as compassionate use. Demographic, efficacy (monthly headache days—MHD; monthly migraine days—MMD; acute medication days/month—AMDM) and side effect data were collected. A ≥ 50% reduction in MHD was considered as a response. Effectiveness and safety were analyzed at 6 and 12 months. A systematic review of the use of BTX-A in children/adolescents was conducted in July 2023. In total, 20 patients were included (median age 15 years [14.75–17], 70% (14/20) females). The median basal frequencies were 28.8 [20–28] MHD, 18 [10–28] MMD and 10 [7.5–21.2] AMDM. Compared with baseline, at 6 months (n = 20), 11 patients (55%) were responders, with a median reduction in MHD of −20 days/month (p = 0.001). At 12 months (n = 14), eight patients (57.1%) were responders, with a median reduction in MHD of −17.5 days/month (p = 0.002). No adverse effects were reported. The literature search showed similar results. Our data supports the concept that BTX-A is effective, well tolerated, and safe in adolescents with CM resistant to oral preventatives. Full article

The application of ICESAT-2 altimetry data in river hydrology critically depends on the accuracy of the mean water surface elevation (WSE) at a virtual station (VS) where satellite observations intersect solely with water. It is acknowledged that the ATL13 product has noise elevations of the adjacent land, resulting in biased high mean WSEs at VSs. Earlier studies have relied on human intervention or water masks to resolve this. Both approaches are unsatisfactory solutions for large river basins where the issue becomes pronounced due to many tributaries and meanders. There is no automated procedure to partition the truly representative water height from the totality of the along-track ICESAT-2 photon segments (portions of photon points along a beam) for increasing precision of the mean WSE at VSs. We have developed an automated approach called “auto-segmentation”. The accuracy of our method was assessed by comparing the ATL13-derived WSEs with direct water level observations at 10 different gauging stations on 37 different dates along the Lower Murray River, Australia. The concordance between the two datasets is significantly high and without detectable bias. In addition, we evaluated the effects of four methods for calculating the mean WSEs at VSs after auto-segmentation processing. Our results reveal that all methods perform almost equally well, with the same R² value (0.998) and only subtle variations in RMSE (0.181–0.189 m) and MAE (0.130–0.142 m). We also found that the R², RMSE and MAE are better under the high flow condition (0.999, 0.124 and 0.111 m) than those under the normal-low flow condition (0.997, 0.208 and 0.160 m). Overall, our auto-segmentation method is an effective and efficient approach for deriving accurate mean WSEs at river VSs. It will contribute to the improvement of ICESAT-2 ATL13 altimetry data utility on rivers. Full article

Greenways are networks of green corridors of various widths that have attracted increasing scholarly and policy interest due to their economic influence on proximate property values. However, most existing studies have focused on community-scale greenway projects. On the urban scale, in particular, there is a lack of understanding of the heterogeneity of greenway economic influences on property values. In Chengdu, China, the recently developed Jincheng Greenway is a special case, characterized by large-scale green spaces and value capture policies. Through hedonic pricing analysis, we examined the influence of the Jincheng Greenway on proximate properties based on 106,328 transaction records of preowned apartments between January 2017 and December 2020. Empirical results show that apartments along greenways have higher prices compared with apartments 500 m away. However, proximity to a greenway does not necessarily lead to higher prices because apartments located 500 m–1 km from a greenway will benefit more from greenways than those located within 500 m. Moreover, compared with the assumed increment in the value capture policies, the actual increases were smaller than the policy expectations. As a result, both the increase in property value and the areas influenced by the greenway deviated from what was anticipated in the original land value capture policy. From this perspective, this study contributes to examining the economic benefits of citywide greenway projects in the Chinese context and provides essential evidence for future land value capture policies related to greenway development. Full article

A jointed rock mass (JRM) is the usual case in practical engineering, which has significant effects on its mechanical performance. To clarify the difference in the seismic responses of underground structures in JRM sites or homogeneous rock mass (HRM) sites, two models were prepared to take shaking table tests in a structural laboratory. The HRM site was prepared following the similitude relations of material; meanwhile, underground structures of a metro station were embedded during the casting of the models. The JRM site and structure were made with the same material but produced random joints after the natural drying process. Different frequencies of harmonics were used to excite along the two models in the transverse or the longitudinal direction, respectively. The dynamic effect was evaluated by time-frequency and frequency-domain analyses. The test results compared with the HRM model indicated that the JRM model had a 22% reduction in the transverse fundamental frequency, but the dynamic response of the ground surface was enhanced due to the effect of the joints. Under harmonic excitations of the same intensity, the JRM model produced a greater energy response to the station structure and reduced the acceleration response of the platform in the high-frequency region. Meanwhile, the JRM model produced a peak tensile strain at the connections of the main and subsidiary structures that was 31% larger than that of the HRM model, and the range of tensile strains observed at the platform connecting the horizontal passage was 1.5 times larger than that of the HRM model. Full article

Type 2 diabetes mellitus (T2DM) patients suffer premature development of cardiovascular disease and commonly require cardiac revascularization using the autologous saphenous vein (SV). Smooth muscle cells (SMCs) are the principal cell type within the vascular wall and are dysfunctional in T2DM SV-SMCs, yet the mechanisms underpinning this are incompletely understood. The purpose of this study was to interrogate differential microRNA (miRNA) expression in SV-SMCs to enhance our understanding of T2DM SV-SMC phenotypic change. miRNA expression in primary human SV-SMCs from T2DM and non-diabetic (ND) donors was determined using an array (n = 6 each of ND and T2DM SV-SMCs). Differentially expressed miRNAs were ranked, and functional annotation of the 30 most differentially expressed miRNAs using DAVID and KEGG analysis revealed pathways related to SMC phenotype, including proliferation, migration, cytokine production and cell signaling. After selecting miRNAs known to be involved in SMC phenotypic regulation, miR-17, miR-29b-2, miR-31, miR-130b and miR-491 were further validated using qRT-PCR (n = 5 each of ND and T2DM SV-SMC), with miR-29b-2 subsequently being removed from further investigation. Potential mRNA targets were identified using mirDIP. Predicted target analysis highlighted likely dysregulation in transcription, epigenetic regulation, cell survival, intracellular signaling and cytoskeletal regulation, all of which are known to be dysfunctional in T2DM SV-SMCs. In conclusion, this paper identified four miRNAs that are dysregulated in T2DM SV-SMCs and are implicated in functional changes in the behavior of these cells. This provides a step forward in our understanding of the molecular and epigenetic regulation of vascular dysfunction in T2DM. Full article

Digital platforms are becoming more important in transforming the energy industry and altering the way we produce, distribute, and use energy. This paper explores the role of energy platforms in the transition towards renewable energy. We highlight, through real-life examples, that these platforms foster a participatory approach, convert consumers into proactive participants, democratize energy production, and encourage innovation in areas such as storage, electric mobility, and renewable project investments. Through a comprehensive review of the current literature, technological advancements, and emerging business models, we identify the possible key contributions of digital platforms to the energy sector. These platforms offer personalized user experiences, mutual benefits for users and companies, adaptability to market changes, support for peer-to-peer trade, and a reduction in bureaucracy. We then present a pioneering conceptual model by Liu et al. (2022), which integrates the energy cloud, digital platform, and transaction platform and we explore the business model of energy platforms. This business model is characterized by connectivity, innovative pricing, and revenue strategies independent of physical asset ownership. Advanced technologies like artificial intelligence and blockchain facilitate peer-to-peer energy trading, dynamic pricing, and a focus on transaction and access fees over traditional cost structures. Drawing on the business model and previous analysis we update the conceptual model for energy platforms to present a practical vision through a holistic approach. Full article

Shafts with a stepped shoulder are particularly well known in the field of drive technology. In combination with a form-fit shaft–hub connection, the shaft shoulder fixes the hub on the shaft as well as being responsible for the absorption of the axial forces. With profiled shafts, there is a notch overlay in the shaft shoulder, involving the shaft shoulder and profile. If the hub is also connected with the profiled shaft, the hub edge acts as an additional notch in the shaft shoulder area. The multiple resulting notches have not previously been part of research activities in the field of innovative trochoidal profile connections. Compared to conventional positive-locking connections, such as the keyway connection or the involute splined shaft profile, the favourable features of trochoidal profiles have only been based on connections with stepless shafts without a shoulder in previous studies. Accordingly, this article addresses numerical and experimental investigations of trochoidal profile connections with offset shafts for pure torsional loading. Focusing on a hybrid trochoid with four eccentricities and six drivers, a well-founded numerical and experimental investigation was carried out with numerous fatigue tests. In addition, the influence of a shaft shoulder was also demonstrated on simple epitrochoidal and hypotrochoidal profiles. Full article

This review addresses the modeling approaches for heat transfer processes in oil-immersed transformer. Electromagnetic, thermal, and hydrodynamic thermal fields are identified as the most critical aspects in describing the state of the transformer. The paper compares the implementation complexity, calculation time, and details of the results for different approaches to creating a mathematical model, such as circuit-based models and finite element and finite volume methods. Examples of successful model implementation are provided, along with the features of oil-immersed transformer modeling. In addition, the review considers the strengths and limitations of the considered models in relation to creating a digital twin of a transformer. The review concludes that it is not feasible to create a universal model that accounts for all the features of physical processes in an oil-immersed transformer, operates in real time for a digital twin, and provides the required accuracy at the same time. The conducted research shows that joint modeling of electromagnetic and thermal processes, reducing the dimensionality of models, provides the most comprehensive solution to the problem. Full article

This article presents a new broadband three-way series Doherty power amplifier (DPA) topology, which enables a broadband output power back-off (OBO) efficiency enhancement of up to 10 dB or higher. The proposed DPA topology achieves Doherty load modulation and three-way power combining through a transformer, which requires only a low coupling factor, thus facilitating its implementation in double-sided PCBs or monolithic microwave integrated circuit (MMIC) processes. The design equations for the proposed DPA topology are proposed and analyzed in detail. A proof-of-concept PA at the 2.1–2.8 GHz band using commercial GaN transistors was designed and fabricated to validate the proposed concept. Within the operating frequency band, it achieves a saturated output power ($P_{\mathrm{sat}}$) of 44.5–46.5 dBm with a peak drain efficiency (DE) of 60–72%, and 43–52% DE at 10 dB OBO. Moreover, under a 20 MHz long-term evolution (LTE)-modulated signal, the PA demonstrates a 36.8–37.5 dBm average output power ($P_{avg}$) and 47–53% average drain efficiency (${DE}_{avg}$). Notably, the adjacent channel leakage ratio (ACLR) is as low as −35–−28.2 dBc without any digital predistortion (DPD). Full article

In early mathematics education, the beliefs of the teacher are essential for facilitating the integration of technology into teaching mathematics. This study explores the influence of physical and digital interactive learning environments on the development of early childhood teachers’ beliefs about integrating technology into early mathematics classrooms. To understand the development of teachers’ beliefs, a half-year, content-based professional development program that incorporates interactive digital and physical environments was designed for this research on early childhood mathematics teachers (N = 58). We administered a questionnaire to measure teachers’ beliefs regarding employing an interactive technological environment in mathematics classrooms before and after engaging in an intervention program. In addition, a reflective writing strategy was implemented with the participants (N = 10) to understand the development of their beliefs about technology via an evaluation of their levels of reflection. In general, the research findings indicate that an interactive learning environment supports an improvement in teachers’ beliefs about technology. Furthermore, positive qualitative findings were drawn from the reflective writing essays of early childhood teachers. The qualitative findings indicate that an interactive environment enables teachers to be conscious of selecting effective math-specific technologies that facilitate children’s exploration and discovery of mathematics concepts. Full article

The economy of South Asia is experiencing growth, yet it faces constraints due to heavy reliance on fossil fuels and frequent power outages. Access to diverse energy sources, particularly electricity, is crucial for sustaining this growth. One feasible solution involves neighbouring countries engaging in the trade of renewable electrical energy. Hydropower stands as one of the many energy sources available in South Asia. However, sectorial constraints pose significant challenges to energy trade initiatives. This study utilises the Analytic Hierarchy Process (AHP) to evaluate Nepal’s readiness and identify obstacles to its cross-border energy trade with India and Bangladesh. A comprehensive analysis of these obstacles is imperative for formulating effective strategies and policies. Additionally, this study offers recommendations for enhancing preparedness and resolving issues related to energy trading, which may apply to similar cross-border situations. This study ranks energy trading obstacles with neighbouring nations using the AHP, offering key insights for stakeholders and policymakers. Using a non-probabilistic purposeful sampling technique, 25 expert respondents from the energy sector and prominent academicians were selected as part of the data collection procedure. At every level of the interview process, their perspectives were invaluable in guaranteeing a thorough and rigorous investigation. Full article

BRCA mutation and homologous recombination deficiency (HRD) are the criteria for the administration of PARP inhibitor (PARPi) maintenance therapy. It is known that PARPi efficacy is related to platinum sensitivity and that the latter can be demonstrated from the CA-125 elimination rate constant (KELIM). This study aims to investigate if KELIM can be another tool in the identification of patients that could be benefit from PARPi therapy. Retrospective analysis of patients with high-grade serous advanced ovarian cancer that underwent cytoreduction and was further tested for HRD status. The HRD status was tested either by myChoice HRD CDx assay or by RediScore assay. KELIM score was measured in both neoadjuvant and adjuvant settings with the online tool biomarker-kinetics.org. A total of 39 patients had available data for estimating both HRD status and KELIM score. When assuming KELIM as a binary index test with the value 1 as the cut-off point, the sensitivity was 0.86, 95% CI (0.64–0.97) and the specificity was 0.83, 95% CI (0.59–0.96). On the other hand, when assuming KELIM as a continuous index test, the area under the curve (AUC) was 81% and the optimal threshold, using the Youden index, was identified as 1.03 with a sensitivity of 85.7% and a specificity of 83.3%. KELIM score seems to be a new, cheaper, and faster tool to identify patients that can benefit from PARPi maintenance therapy. Full article