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Sexual violence and sexual harassment (SVSH) are prevalent among college and university students; however, the experiences of ethnic minority students, especially Asians, are understudied. This study aimed to reduce this gap by exploring Asian students' perceptions of SVSH on three public university campuses in Southern California. We examined their perceptions about the campus environment related to SVSH, attitudes, and behaviors toward help seeking, and utilization of on-campus resources. A total of 23 in-depth interviews were conducted with Asian students enrolled at the three University of California campuses. Thematic coding was conducted to generate main themes and subthemes. Five main themes emerged: (a) SVSH is considered a "taboo" topic in Asian culture and family systems, and Asian student survivors are often reluctant to disclose incidents or seek support services. (b) Students did not feel their campus environments were tailored to understand or meet the sociocultural realities and needs of Asian student survivors. (c) Campus SVSH services and reporting processes were seen as non-transparent. (d) Peers were the major source of support and SVSH information, as opposed to official campus-based resources and training. (e) Survivors often conduct an internal cost-benefit analysis evaluating their decision about whether to report. This study highlights the lack of conversation surrounding SVSH in Asian families, and how the cultural stigma of sex and sexual violence prevented Asian students from receiving knowledge and resources about these topics in their families. Instead of relying on formal campus resources (e.g., Title IX and confidential advocacy services, mental health services), many students turn to their peers for support. Thus, facilitating peer support groups, training university students to support each other through SVSH incidents, and tailoring campus services to the diverse cultural backgrounds of students are key considerations to foster a safe campus environment and prevent SVSH.

Physics preparation for primary school teachers has received attention only in recent decades. Research on science education provides useful guidelines, often disregarded. Several interrelated research questions must be addressed by field research, namely, (a) which physics subjects to teach in primary school and its relationships with other sciences, technology, and mathematics; (b) how to prepare teachers to grasp the complexity of their tasks; and (c) how to bridge pre-service and in-service training. In this study, we describe innovative aspects of a course, based on the research and action research of our research group, that aims to overcome the limitations of a purely academic approach. Future teachers are dynamically involved in activities in informal and formal contexts and in the training of in-service teachers' activities. The idea of cognitive resonance and a phenomenological approach to the modeling process are the basis of the activities that integrate key concepts of physics with transversal ones to develop skills in physics, mathematics, technology, and language. Field research carried out with qualitative methods shows that the course, despite being demanding, is well received by students. Dozens of students are then involved in the activities of the group when they start a teaching career at school.

Background: Adoption of neoadjuvant chemotherapy (NACT) in the “real world” has been poorly investigated. Aim of this study was to examine the rate of NACT in Italy, trends over time and determinants of therapeutic choices. Methods: Senonetwork, the recognized network of Breast Centers in Italy, has developed a voluntary national data warehouse with the aim to monitor and improve treatments quality. A retrospective analysis was conducted among 58,661 breast cancer (BC) patients treated between 2017 and 2022 by 24 high-volume Breast Centers participating in the project. Results: After subset exclusion, 37,215 primary BC patients were analysed, 32,933 underwent primary-breast-surgery and 4,282 underwent NACT. From 2017 to 2022, the overall NACT incidence increased particularly for HR-/HER2+, Triple-Negative, and HR+/HER2+ BC (p

Resumo A linguagem compreende aspectos ligados tanto à essência, quanto ao uso. O uso da palavra está associado ao seu significado e à sua adoção, ou seja, entende-se o significado de uma expressão quando é possível compreender as regras de seu uso. Os jogos de linguagem apresentam regras constituídas a partir de um uso coletivo, ou seja, da sua prática geral determinada por uma comunidade em que as palavras estão inseridas. O objetivo deste estudo é investigar que aspectos dos jogos de linguagem podem auxiliar na identificação de formas de representar o conhecimento na linguagem carcerária. A pesquisa foi desenvolvida na Penitenciária Masculina de Florianópolis, utilizando a técnica da observação in loco, e está caracterizada como descritiva, exploratória e bibliográfica. Os termos foram coletados por meio de entrevistas realizadas com 26 pessoas privadas de liberdade. A partir da análise aqui realizada, é possível afirmar que os jogos de linguagem estão presentes nas prisões e são formas manifestas de representação do conhecimento.

Background Despite improvement in devices, in‐stent restenosis remains a frequent and challenging complication of percutaneous coronary interventions. Methods and Results The RESTO (Morphological Parameters of In‐Stent Restenosis Assessed and Identified by OCT [Optical Coherence Tomography]; study NCT04268875) was a prospective multicenter registry including patients presenting with coronary syndromes related to in‐stent restenosis. All patients underwent preintervention OCT analysis, which led to analysis of in‐stent restenosis phenotype, number of strut layers, and presence of stent underexpansion. The primary end point was the in‐stent restenosis type according to the OCT morphological classification. The 1‐year incidence of target vessel failure (a composite of death from cardiac causes, target‐vessel myocardial infarction, or ischemia‐driven target‐vessel revascularization) was assessed. The study included 297 patients. The culprit stent was a drug‐eluting stent in 74.2% of cases. OCT analysis revealed the presence of neoatherosclerosis in 57% (52% calcified), neointimal hyperplasia in 43% (58% homogeneous), stent underexpansion (minimal stent area

ABSTRACT Flexible intramedullary nailing and external fixation have become the main methods to surgically treat femur fractures in children. This study aimed to search the current literature and evaluate the clinical and radiographic results of surgical treatment by comparing these methods and investigating their associated complications. This systematic review was carried out following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) recommendations. Searches were carried out on the PubMed, Embase, and Web of Science databases. The search for journals in these databases was carried out from January 2023 to August 2023, retrieving 695 studies. This systematic review included 11 articles, which encompassed 718 patients who underwent surgical external fixation and flexible nailing. The most frequently observed complications referred to late or malunion, superficial and deep infections, skin irritation, angular deformity, and length discrepancy between lower limbs. Both methods of stabilization of pediatric femoral fractures can provide good clinical and radiographic results. However, the choice of treatment with flexible nails is certainly more valid and has greater acceptance than external fixation. Level of Evidence III, Systematic Review .

Background Percutaneous left atrial appendage closure (LAAC) has been suggested as an alternative to long‐term oral anticoagulation for nonvalvular atrial fibrillation, but comparative data remain scarce. We aimed to assess ischemic and bleeding outcomes of LAAC compared with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for the prevention of cardioembolic events in patients with atrial fibrillation. Methods and Results Embase and MEDLINE were searched for randomized trials comparing LAAC, VKAs, and DOACs. The primary efficacy end point was any stroke or systemic embolism. Treatment effects were calculated from a network meta‐analysis and ranked according to the surface under the cumulative ranking curve. Seven trials and 73 199 patients were included. The risk of the primary end point was not statistically different between LAAC versus VKAs (odds ratio [OR], 0.92 [95% CI, 0.62–1.50]) and LAAC versus DOACs (OR, 1.11 [95% CI, 0.71–1.73]). LAAC and DOACs resulted in similar risk of major or minor (OR, 0.93 [95% CI, 0.61–1.42]) and major bleeding (OR, 0.92 [95% CI, 0.58–1.46]); however, after exclusion of procedural bleeding, bleeding risk was significantly lower in those undergoing LAAC. Both LAAC and DOACs reduced the risk of all‐cause death compared with VKAs (LAAC versus VKAs: OR, 0.70 [95% CI, 0.53–0.91]; DOACs versus VKAs: OR, 0.90 [95% CI, 0.85–0.95], respectively). DOACs ranked as the best treatment for stroke or systemic embolism prevention (66.9%) and LAAC for reducing major bleeding (63.9%) and death (96.4%). Conclusions As a nonpharmacological alternative to oral anticoagulation for atrial fibrillation, LAAC showed similar efficacy and safety compared with VKAs or DOACs. Prospective confirmation from larger studies is warranted.

The objective of this study was to identify the genetic, phenotypic and environmental parameters related to chemical compounds associated with beverage quality in a conilon coffee collection, grown in an irrigated system, in the Cerrado. The experiment was carried out at Embrapa Cerrados using green grains harvested in two years from 84 genotypes of the cultivar Robusta Tropical. Caffeine content, protein, ether extract, total soluble solids, pH and titratable acidity were evaluated. The data were subjected to analysis of variance. Significant differences were observed at 1% probability among accessions for all evaluated chemical characteristics in both harvest years. The high heritability, genetic coefficients of variation and selective accuracy reveal the potential for achieving genetic gains via the selection of genotypes adapted to the irrigated system in the Cerrado combined with high beverage quality.

Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) is a biodegradable polymer with excellent thermal and mechanical properties comparable to fossil-based plastics. Scaling up the production of this polymer could provide a viable solution for reducing the use of fossil-based materials. However, its current production capacities are limited, with only a few facilities implementing the process at pilot or semi-industrial scales. The primary challenge lies in the high production costs, with 40% of the expenses attributed to the feedstock used for fermentation. Additionally, the energy required for sterilization in processes using pure methanotrophic cultures further reduces its economic viability. In this study, the economic aspects of the PHBV production process were assessed at an industrial level (100,000 t/y PHBV), using cheap and renewable substrates such as valeric acid and methane. A mixed methanotrophic consortium was used to reduce the need for sterility. The techno-economic analysis was based on estimating both fixed investment and operating costs. Then, a sensitivity analysis was performed to analyse the effect that the polymer content has on the final selling price: the initial biomass concentration was set to 30 g L-1, and the PHBV content was considered to be 20, 30, 40, 50 and 70% wt on a dry weight basis. The results revealed that increasing the polymer content beyond 40% wt led to a more competitive PHBV selling price, thus opening significant market opportunities.

BackgroundAdipose tissue (AT) wasting in cancer is an early catabolic event with negative impact on outcomes. Circulating miRNAs may promote body weight loss and cachexia. We measured circulating miRNAs linked to AT alterations and compared their levels between i) gastrointestinal (GI) cancer patients and controls, ii) cachectic and non-cachectic cancer patients, and iii) according to adiposity level and its distribution.MethodsPatients with GI cancer and subjects with benign diseases as controls were considered. Cachexia was assessed and adiposity evaluated by CT-scan for subcutaneous AT area (SAT), visceral AT area and the total AT area (TAT). MiRNAs involved were measured in plasma by RT-qPCR.Results37 naïve GI cancer patients and 14 controls were enrolled. Patients with cachexia presented with lower SAT compared to non-cachectic (p < 0.05). In cancer patients, we found higher levels of miR-26a, miR-128, miR-155 and miR-181a vs. controls (p < 0.05). Cancer patients with BMI < 25 kg/m2 showed higher levels of miR-26a vs. those with BMI ≥ 25 (p = 0.035). MiR-26a and miR-181a were higher in cachectic and non-cachectic vs. controls (p < 0.05). Differences between cachectic and controls were confirmed for miR-155 (p < 0.001) but not between non-cachectic vs. control (p = 0.072). MiR-155 was higher in cachectic patients with low TAT vs. those without cachexia and high TAT (p = 0.036).ConclusionOur data confirm a modulation of specific and different miRNAs involved in AT metabolism in cancer and cachexia. MiR-155 levels were higher in patients presenting with cachexia and low adiposity with implications in the pathogenic mechanisms and clinical consequences of GI cancer patients.

Campus-based sexual violence and sexual harassment (SVSH) are prevalent issues that impact students detrimentally. Guided by community-based participatory research, this qualitative study assessed undergraduate students' perceptions of available campus SVSH resources, gaps in services, and recommendations for solutions for SVSH at three universities in California via interviews and focus groups. Approximately half of participants were unaware of available SVSH services, while others had varying knowledge of service availability and experiences with services. Students want better-funded, trauma-informed, and survivor-centered services and providers who share their identities and lived experiences. We provide multi-level student-centered solutions to improve current campus-based SVSH prevention efforts.

Abstract Background Adipose tissue metabolism may be impaired in patients with cancer. In particular, increased lipolysis was described in cancer-promoting adipose tissue atrophy. For this reason, we assessed the expression of the lipolysis-associated genes and proteins in subcutaneous adipose tissue (SAT) of gastrointestinal (GI) cancer patients compared to controls to verify their involvement in cancer, among different types of GI cancers, and in cachexia. Methods We considered patients with GI cancer (gastric, pancreatic, and colorectal) at their first diagnosis, with/without cachexia, and controls with benign diseases. We collected SAT and total RNA was extracted and ATGL, HSL, PPARα, and MCP1 were analyzed by qRT-PCR. Western blot was performed to evaluate CGI-58, PLIN1 and PLIN5. Results We found higher expression of ATGL and HSL in GI cancer patients with respect to controls (p ≤ 0.008) and a trend of increase for PPARα (p = 0.055). We found an upregulation of ATGL in GI cancer patients with cachexia (p = 0.033) and without cachexia (p = 0.017) vs controls. HSL was higher in patients with cachexia (p = 0.020) and without cachexia (p = 0.021), compared to controls. ATGL was upregulated in gastric cancer vs controls (p = 0.014) and higher HSL was found in gastric (p = 0.008) and in pancreatic cancer (p = 0.033) vs controls. At the protein level, we found higher CGI-58 in cancer vs controls (p = 0.019) and in cachectic vs controls (p = 0.029), as well as in gastric cancer vs controls (p = 0.027). Conclusion In our cohort of GI cancer patients, we found a modulation in the expression of genes and proteins involved in lipolysis, and differences were interestingly detected according to cancer type.

Barley (Hordeum vulgare L.) is a significant cereal globally, widely used in human and animal food. Furthermore, it has a strong influence on genotype-by-environment interactions, being considered a highly adaptable crop. This study aimed to estimate the parameters of adaptability and stability for 17 barley genotypes, compared with two controls (BRS 180 and BRS 195) grown under irrigation in the Cerrado. The experiments were conducted from 2017 to 2020, from May to September, in two different experimental areas of Embrapa in the Federal District, Brazil. Five traits were evaluated: 1. Esti mated grain yield (kg ha−1); 2. CL1—commercial classification of first grains (>2.5 mm) (%); 3. TGW—1000-grain weight (g); 4. plant height (cm); 5. cycle—days after emergence to earing (days). The data obtained were analyzed for normality and homogeneity of variance, subjected to individual and joint analysis of variance, with means compared by Tukey’s test at 5% significance and the adaptability and stability parameters estimated for the genotypes. The coefficients of environmental variation (CV%) were generally low, indicating good experimental precision. The PFC 2006053 and PFC 2006054 genotypes have broad adaptability and high stability for most traits and outperformed the controls and the overall experiment average.

Research has found associations between intercollegiate athletics and risk for sexual violence, and that sexual violence is more pervasive at colleges and universities with National Collegiate Athletic Association (NCAA) Division I athletic programs, relative to NCAA Division II, NCAA Division III and no athletic programs. Simultaneously, sports involvement is linked with prosocial values and there are documented developmental benefits of sports participation. College athletic programs hold promise for fostering sexual violence prevention but there is limited knowledge about how student-athletes conceptualize sexual violence and how athletes, coaches, and administrators perceive available prevention and response programs. We conducted seven Focus Group Discussions (FGDs) and 21 In-Depth Interviews (IDIs) with student-athletes, athletic directors, and coaches from public university Division I (n = 2) and Division II (n = 1) campuses. We assessed perceptions of sexual violence, knowledge and opinions of available prevention and response programs, and sought input on how to bridge gaps in campus sexual violence policies. Student-athletes associated sexual violence with alcohol in their relationships with peers and asymmetrical power dynamics in relationships with coaches and faculty. Athletes felt strong connections with teammates and sports programs but isolated from the larger campus. This created barriers to students' use of services and the likelihood of reporting sexual violence. Athletes felt the mandatory sexual violence prevention training, including additional NCAA components, were ineffective and offered to protect the university and its athletic programs from legal complications or cultural ridicule. Athletic staff were aware of policies and programs for reporting and referring sexual violence cases but their knowledge on how these served students was limited. Student-athletes were uncomfortable disclosing information regarding relationships and sexual violence to coaches and preferred peer-led prevention approaches.

With the increased emphasis on charting ocean sustainability narratives, marine spatial planning (MSP) is envisioned as a key tenet. MSPs emphasize the systematic and collaborative planning and management of ocean space (resources and activities) for the benefit of all users. Regions that have implemented MSP based on collaborative stakeholder engagement are progressively realizing better ocean sustainability outcomes. Unfortunately, in developing coastal states, progress toward MSP is largely pedestrian and has attracted less interest. This is partly due to archaic coastal/marine resource models that are dominated by few powerful stakeholders. This is worsened by increasing human-environmental shocks, which are creating bleak futures. Our study systematically sourced 12,316 documents from Scopus that were analyzed using bibliometrics to (i) conduct a performance analysis, (ii) conduct a scientific mapping analysis and (iii) identify game-changing developments that can drive ocean sustainability. A performance analysis revealed that even though scholarship and publications on MSP have increased globally, scholarship among or led by researchers from the global south are limited. Scientific mapping analysis revealed emerging positive trends in multi-country collaborations as well as the recognition of threats to the marine environment. Reversing this requires increased stakeholder engagement. However, how to achieve this goal in most developing coastal states has been less studied. Building on this, we developed a novel Collaborative Stakeholder Engagement Pathway (CoSEP) involving eight (8) interrelated steps that can help build collaborative engagements for MSP development and ocean sustainability. A notable takeaway from the CoSEP is that; since research on MSP development is limited or in its infancy, knowledge of how and when to engage which stakeholders is key in creating collaborative mechanisms for positive ocean sustainability, including ocean justice. This can help localize sustainable ocean development pillars and build avenues for integrated coastal resource management. Using participatory approaches that bring forward microlevel stakeholder perspectives could be a future driver in designing effective interventions and cultures to create MSPs that meet ocean sustainability targets.

Marine fishing is paramount to the provision of sustainable coastal livelihood welfare; especially in the global South. To coastal women, marine fishing avails multiplier social-economic benefits; notably employment, food, and income. Sustaining the innumerable benefits of marine fishing is a conduit towards progressive fisherwomen empowerment and the attainment of transformative ocean sustainability targets. However, in most coastal regions, increasing evidence of human-environmental challenges is blanketing the ability of fisherwomen to benefit from marine fishing and, this is worsened by the perpetuation of social barriers to fisherwomen's inclusion in sustainable coastal fisheries value chains. In addition, there is limited research on how to co-design transformative actions to reduce these challenges partly due to the use of top-down approaches and frameworks that are largely complex and less inclusive. Our study aims to co-design transformative ocean sustainability narratives to address the complex human-environmental challenges by using local perspectives of coastal fisherwomen. We systematically reviewed 38 documents mainly focusing on marine fisherwomen in Kerala and used a micro-level community participatory approach; involving Focus Group Discussions with 43 fisherwomen in Alappad in Kerala, India. Review findings revealed that a combination of human-environmental challenges is still prevalent. However, in Alappad, three human-induced systemic barriers predominate: lack of support from people in their own Panchayat, seasonal jobs, and road problem. Through co-designing, fisherwomen in Alappad proposed a novel pathway involving ten steps. This revealed that coastal fisherwomen can identify key systemic challenges that hinder their empowerment and promotion of sustainable ocean practices. Using perspectives and narratives of local fisherwomen could be key in breaking systemic barriers to fisherwomen inclusion in not only fishing but also, in other coastal areas and/or sectors and thus could help in developing collaborative ocean sustainability and governance interventions.

Keratitis-ichthyosis-deafness syndrome (KID) is a rare genetic disorder characterized by the triad of hyperkeratosis, ichthyosis, and congenital prelingual sensorineural deafness, with less than 100 cases described in the literature. In addition to many other extra-cutaneous manifestations, these patients are burdened by two principal increased risk factors involving the skin: the risk of developing infections and the risk of developing malignant skin tumors, especially Squamous Cell Carcinoma and Trichilemmal tumors. We present the case of a 7-year-old girl with a unique genetic variant described to date, who developed 4 dyskeratotic neoformation. Since the dermatoscopic examination was not sufficient to exclude malignancy, excisional and punch biopsies were used. Nonetheless, healing was challenging, with wound dehiscence and infection onset. Ad hoc wound care management resorting to negative pressure therapy and advanced medical honey-based dressings was necessary to achieve complete wound healing.

IntroductionThe seeds of jackfruit are often overlooked and discarded globally, leading to the underutilization of this valuable resource. This study explored the potential of utilizing underutilized jackfruit seeds as an alternative source of human subsistence by investigating the availability of jackfruit, the utilization and underutilization of seeds at the household level, and the types of subsistence activities in the community.MethodsWe used a case study of Byse village in Karnataka, India, to understand this topic. A mixed research approach was used. First, a descriptive research design was employed to collect and describe the data, while a correlation design was used to examine the relationships among variables related to jackfruit seed utilization. Second, a bibliometric analysis was conducted to explore global trends in jackfruit seed utilization.Results and DiscussionThe findings indicated that agriculture, particularly arecanut farming followed by paddy rice cultivation, was the primary means of subsistence in the community. While human consumption of jackfruit seeds is statistically significant, it has a detrimental effect on seed utilization in the community (r = −0.295, p = 0.008). The study also revealed that consuming jackfruit seeds in a semidry form had a positive and significant influence (r = 0.345, p = 0.002) compared to eating them in a fresh form. Consequently, more focus could be placed on encouraging the consumption of semidry jackfruit seeds as a preferred option among residents. Despite the abundance of jackfruits, their seeds are rarely used, with a mean utilization score of 1.77. Since jackfruit seeds are limited in their application and are readily available, they could be utilized as an alternative source for sustainable human subsistence. sustainable human subsistence.

Abstract Background Small non‐coding (snc)RNAs, including microRNAs and P‐element induced wimpy testis (PIWI)‐interacting‐RNAs (piRNAs), crucially regulate gene expression in both physiological and pathological conditions. In particular, some muscle‐specific microRNAs (myomiRs) have been involved in the pathogenesis of cancer‐induced muscle wasting. The aims of the present study were (i) to profile sncRNAs in both skeletal muscle and plasma of gastrointestinal cancer patients and (ii) to investigate the association among differentially expressed sncRNAs and the level of muscularity at body composition analysis. Methods Surgical patients with gastrointestinal cancer or benign disease were recruited. Blood samples and muscle biopsies (rectus abdominis) were collected during surgery. Low muscularity patients were those at the lowest tertile of skeletal muscle index (SMI; CT‐scan), whereas moderate/high muscularity patients were in the middle and highest SMI tertiles. SncRNAs in the muscle were assessed by RNAseq, circulating microRNAs were evaluated by qPCR. Results Cancer patients (n = 25; 13 females, 52%) showed a mean age of 71.6 ± 11.2 years, a median body weight loss of 4.2% and a mean BMI of 27.0 ± 3.2 kg/m2. Control group (n = 15; 9 females, 60%) showed a mean age 58.1 ± 13.9 years and a mean BMI of 28.0 ± 4.3 kg/m2. In cancer patients, the median L3‐SMI (cm2/m2) was 42.52 (34.42; 49.07). Males showed a median L3‐SMI of 46.08 (41.17–51.79) and females a median L3‐SMI of 40.77 (33.73–42.87). Moderate‐high and low muscularity groups included 17 and 8 patients, respectively. As for circulating microRNAs, miR‐21‐5p and miR‐133a‐3p were up‐regulated in patients compared with controls, whereas miR‐15b‐5p resulted down‐regulated in the same comparison (about 30% of control values). Sample clustering by muscularity and sex revealed increased miR‐133a‐3p and miR‐206 only in moderate‐high muscularity males. SncRNA profiling in the muscle identified 373 microRNAs and 190 piRNAs (72.5% and 18.7% of raw reads, respectively). As for microRNAs, 10 were up‐regulated, and 56 were down‐regulated in cancer patients versus controls. Among the 24 dysregulated piRNAs, the majority were down‐regulated, including the top two most expressed piRNAs in the muscle (piR‐12790 and piR‐2106). Network analysis on validated mRNA targets of down‐regulated microRNAs revealed miR‐15b‐5p, miR‐106a‐5p and miR‐106b‐5p as main interactors of genes related to ubiquitin ligase/transferase activities. Conclusions These results show dysregulation of both muscle microRNAs and piRNAs in cancer patients compared with controls, the former following a sex‐specific pattern. Changes in circulating microRNAs are associated with the degree of muscularity rather than body weight loss.

Objective: Liver disease (LD) is considered a risk factor for inferior outcomes in general and cardiac surgery, yet current cardiac surgery risk estimators exclude LD, and literature on the topic remains scant. We sought to evaluate whether the presence of advanced LD is associated with inferior outcomes following cardiac surgery. Methods: This single-center, retrospective, observational study included 285 patients diagnosed with LD who underwent cardiac surgery in 2010 to 2020. The cohort contained 3 groups, Child-Turcotte-Pugh (CTP) class A (n = 219), CTP early-class B (n = 34), and CTP advanced-class B (n = 32). A model for end-stage liver disease score of 12.7 points (determined using a receiver-operating characteristic curve analysis on 30-day mortality) dichotomized class B into early- and advanced-groups. Univariate and multivariate logistic regression analyses were performed to identify predictors of 30-day mortality. Results: Patients in CTP advanced-class B had the longest length of stay (14 days), highest incidence of prolonged ventilation (46.9%), renal failure (21.9%), 30-day mortality (18.8%), and in-hospital mortality (18.8%). Incidence of ≥1 postoperative complication was higher in CTP advanced-class B (59.4%), compared with CTP class A (37.9%) and CTP early-class B (38.2%). Multivariate logistic regression analysis demonstrated that female sex (odds ratio, 3.01; 95% CI, 1.07-8.77; P = .037) and peripheral vascular disease (odds ratio, 4.01; 95% CI, 1.33-12.2; P = .013) were independent predictors of 30-day mortality in patients with advanced LD. Conclusions: Severity of LD influences perioperative outcomes following cardiac surgery. Our data suggest that patients in CTP class A and selected patients in CTP class B (model for end-stage liver disease score

Objective: Tricuspid annuloplasty is associated with increased risk of atrioventricular block and subsequent implantation of a permanent pacemaker. However, the exact incidence of permanent pacemaker, associated risk factors, and outcomes in this frame remain debated. The aim of the study was to report permanent pacemaker incidence, risk factors, and outcomes after tricuspid annuloplasty from nationwide databases. Methods: By using data from multiple Swedish mandatory national registries, all patients (n = 1502) who underwent tricuspid annuloplasty in Sweden from 2006 to 2020 were identified. Patients who needed permanent pacemaker within 30 days from surgery were compared with those who did not. The cumulative incidence of permanent pacemaker implantation was estimated. A multivariable logistic regression model was fit to identify risk factors of 30-day permanent pacemaker implantation. The association between permanent pacemaker implantation and long-term survival was evaluated with multivariable Cox regression. Results: The 30-day permanent pacemaker rate was 14.2% (214/1502). Patients with permanent pacemakers were older (69.8 ± 10.3 years vs 67.5 ± 12.4 years, P = .012). Independent risk factors of permanent pacemaker implantation were concomitant mitral valve surgery (odds ratio, 2.07; 95% CI, 1.34-3.27), ablation surgery (odds ratio, 1.59; 95% CI, 1.12-2.23), and surgery performed in a low-volume center (odds ratio, 1.85; 95% CI, 1.17-2.83). Permanent pacemaker implantation was not associated with increased long-term mortality risk (adjusted hazard ratio, 0.74; 95% CI, 0.53-1.03). Conclusions: This nationwide study demonstrated a high risk of permanent pacemaker implantation within 30 days of tricuspid annuloplasty. However, patients who needed a permanent pacemaker did not have worse long-term survival, and the cumulative incidence of heart failure and major adverse cardiovascular events was similar to patients who did not receive a permanent pacemaker.