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Background End‐stage kidney disease (ESKD) is commonly associated with critical limb‐threatening ischemia (CLTI) and frailty. Yet there are no specific tools to predict outcomes of CLTI in ESKD, particularly those that incorporate frailty. We aimed to assess the utility of the medical record–based Hospital Frailty Risk (HFR) score in predicting outcomes of CLTI in ESKD. Methods and Results We identified patients with ESKD diagnosed with CLTI from the US Renal Data System from 2015 to 2018. These patients were categorized into 3 frailty risk groups on the basis of their HFR scores: low (10), and on the basis of whether they underwent revascularization (endovascular revascularization [ER]/surgical revascularization [SR]) or not (no revascularization). Primary outcomes of interest included in‐hospital composite of death or major amputation and in‐hospital death. We included 49 454 eligible patients, with ER/SR cohort including 19.8% (n=9777). A total of 88.4% (ER/SR) and 90.0% (no revascularization) were frail on the HFR scale. We found a nonlinear association between HFR score and in‐hospital adverse outcomes. In both cohorts, intermediate and high‐risk HFR scores were associated with greater risk of in‐hospital death (high‐risk, ER/SR: odds ratio, 2.7 [95% CI, 1.6–4.8]; P

Objectives To evaluate whether the effectiveness and safety of low (81 mg daily) versus high-dose (325 mg daily) aspirin is consistent across races among patients with established atherosclerotic cardiovascular disease (ASCVD).Design A secondary analysis of the randomised controlled trial ADAPTABLE was performed.Setting The study was conducted in 40 centres and one health plan participating in the National Patient-Centred Clinical Research Network (PCORnet) in the USA.Participants Among 15 076 participants with established ASCVD, 14 096 had self-reported race available and were included in the analysis. Participants were divided according to self-reported race as Black (n=1311, 9.3%), White (n=11 990, 85.1%) or other race (n=795, 5.6%).Interventions Participants were randomised to open-label daily aspirin doses of 81 mg versus 325 mg in a 1:1 ratio for a median of 26.2 months.Primary and secondary outcomes measures The primary effectiveness endpoint was a composite of death from any cause, hospitalisation for myocardial infarction or hospitalisation for stroke. The primary safety endpoint was hospitalisation for bleeding requiring blood product transfusion.Results Estimated cumulative incidence of the primary effectiveness endpoint at median follow-up with the 81 mg and the 325 mg daily doses were 6.70% and 7.12% in White participants (adjusted HR: 1.00 [95% CI: 0.88 to 1.15]); 12.27% and 10.69% in Black participants (adjusted HR: 1.40 [95% CI: 1.02 to 1.93]); and 6.88% and 7.69% in other participants (adjusted HR: 0.86 [95% CI: 0.54 to 1.39]) (p-interaction=0.12), respectively. There was no significant interaction between self-reported race and assigned aspirin dose regarding the secondary effectiveness and the primary safety endpoints.Conclusion Race is not an effect modifier on the impact of aspirin dosing on effectiveness and safety in patients with established ASCVD. In clinical practice, treatment decisions regarding aspirin dose in secondary prevention of ASCVD should not be influenced by race.Trial registration number NCT02697916.

Background In patients with atherosclerotic cardiovascular disease, increasing age is concurrently associated with higher risks of ischemic and bleeding events. The objectives are to determine the impact of aspirin dose on clinical outcomes according to age in atherosclerotic cardiovascular disease. Methods and Results In the ADAPTABLE (Aspirin Dosing: A Patient‐Centric Trial Assessing Benefits and Long‐Term Effectiveness) trial, patients with atherosclerotic cardiovascular disease were randomized to daily aspirin doses of 81 mg or 325 mg. The primary effectiveness end point was death from any cause, hospitalization for myocardial infarction, or hospitalization for stroke. The primary safety end point was hospitalization for bleeding requiring transfusion. A total of 15 076 participants were randomized to aspirin 81 mg (n=7540) or 325 mg (n=7536) daily (median follow‐up: 26.2 months; interquartile range: 19.0–34.9 months). Median age was 67.6 years (interquartile range: 60.7–73.6 years). Among participants aged 0.05 for all). Conclusions Age does not modify the impact of aspirin dosing (81 mg or 325 mg daily) on clinical end points in secondary prevention of atherosclerotic cardiovascular disease.

Copper-based alloys are widely known for their high thermal and electrical conductivity. Although the use of these alloys in powder-based additive manufacturing (AM) shows significant promise, applying this method in wire arc additive manufacturing (WAAM) processes poses various considerable challenges, including porosity, delamination, surface oxidation, etc. The limited research on WAAM of copper alloys, especially Cu1897, highlights the need for a more in-depth investigation. This study addresses the effects of process parameters in pulse cold metal transfer (CMT)-based WAAM of Cu1897, i.e., pulse correction (PC) and arc length correction (ALC), on bead penetration and porosity. The results showed that as PC was increased from −5 to +5, weld bead penetration increased from 2.38 mm to 3.87 mm. To further enhance penetration and reduce the porosity, the ALC was varied from +30% to −30% with a step size of 15%. The results showed that weld bead penetration increased to 4.47 mm by altering the ALC from +30% to −30%. Additionally, as the ALC varied within this range, porosity decreased significantly from 3.98% to 0.28%. Overall, it is concluded that a lower value of ALC is recommended to improve bead penetration and reduce porosity in WAAM of Cu1897.