Actual Difference Research Articles

Beam Local Stress Prediction Model for Incremental Launching Construction Based on SSA-SVR Algorithm

In the multi-point incremental launching construction process, without setting temporary piers at the mid-span, it is difficult to ensure the synchronization of the launching equipment at the same pier, which can easily cause the beam to deviate from the design axis, leading to changes in the stress of the beam. Calculating the local maximum stress of the beam when lateral deviation occurs is beneficial for establishing a reasonable and reliable threshold for controlling beam deviations. To address this issue, this paper utilizes a finite element model of the bridge under typical adverse conditions, simulating the lateral deviation and asynchronous jacking of the beam to explore stress variation patterns. The results show that the beam stress increases as the lateral deviation and jacking differences increase, severely affecting the structural safety. To overcome the inefficiency of the finite element modeling method when dealing with multiple working conditions and to establish a reasonable deviation control threshold, this study proposes a beam local stress prediction model under the combined influence of lateral deviation and jacking height differences based on the SSA-SVR algorithm. The model calculates the local maximum stress of the beam for 2500 sets of parameters. An engineering case analysis shows that the prediction model has high calculation accuracy, reliable results, fast computational speed, and high efficiency. Based on the stress prediction results, it is recommended to set the jacking height difference control threshold at 20 mm. When the jacking height difference is less than 20 mm, the local maximum stress value under the combined influence of both parameters should be less than the standard limit. The corresponding lateral deviation control threshold can be dynamically adjusted according to the actual travel difference recorded by the jacking equipment, with the control precision improved to 1 mm.

Changes monitoring in Hongjiannao Lake from 1987 to 2023 using Google Earth Engine and analysis of climatic and anthropogenic forces

The research aimed to quantify the lake area dynamics, evaluate the changes in distance and rate of lake shorelines quantitatively and spatially and investigate the key factors influencing the Hongjiannao Lake (HL) area shrinkage. The study used remote sensing (RS) data from Landsat TM/ETM+ and OLI images and Google Earth Engine (GEE), a cloud platform for obtaining the lake surface area and island information from 1987 to 2023. A modified normalized difference water index (MNDWI) was applied to water area extraction. Digital Shoreline Analysis System (DSAS) was employed to assess net shoreline movement (NSM) and depict the lake shoreline length and rate changes. Furthermore, the water level was derived by ASTER GDEM V2 using the waterline method and lake boundaries. Six climatic features (temperature, precipitation, potential and actual evaporation, aridity index, and actual water difference) were investigated to find the driving factors of lake area shrinkage by correlation and factor analysis. The results reveal that during 1987–2023, the HL area has undergone four separate phases: stable (1987–1997), shrinkage (1998–2015), growth (2016–2019), and reduction (2020–2023). The most substantial negative change (−7.45%) in the HL area was observed in 1998. NSM analysis demonstrates that the lake has experienced both expansion and shrinkage at various times and locations. According to Water Balance Method, the water volume of HL exhibited variations, ranging from −0.1895 to −0.009 km³. The average yearly change in lake volume, water level, and area displayed similar characteristics with high inconstancy. Correlation and factor analysis of lake area and climatic factors demonstrate that higher precipitation, low temperatures, less potential evaporation level, lower actual evaporation rates, and more minor differences in water levels are associated with an increase in lake area. In contrast, the opposite conditions lead to a reduction in lake size.

Weekly touch calls with high-risk cohort of patients with commercial Medicare Advantage to reduce avoidable hospital admissions.

282 Background: Patients who have been diagnosed with cancer have an increased risk of complications and potential hospitalization instances. Those in more advanced age groups have an additional risk, especially those of the age group of 65 and higher. Avoidable hospitalizations increase the total cost of care and decrease patient quality of life during treatment. Methods: To reduce potentially avoidable hospital admissions, patients enrolled in a commercial insurance contract were reviewed weekly for a high-risk potential. Criteria for high-risk inclusion included: Any patient >75 years of age receiving treatment; Any patient receiving chemotherapy/radiation combination therapy; Any patient with the following diagnosis: Metastatic lung cancer, Metastatic pancreatic cancer, Multiple myeloma, Breast cancer, Prostate cancer with multiple HCC; Any patient receiving: Cisplatin, Adriamycin, Taxanes, Ifosfimide, Doxorubicin, or Carbo with AUC 4 or greater; Any patient that has had one visit to ER/hospital during the program During the recording period, the high-risk list of patients was reviewed weekly. Before the weekend, each patient identified was contacted by phone by a registered nurse for a weekly “touch call” to address side effects, treatment questions, complications, or concerns. Patients were reminded to contact the practice first when a non-life-threatening concern occurs. Results: The program began on April 1, 2020, with a baseline admission rate of 1.8%. At the conclusion of the program on March 31st, 2023, this cohort of patients had a 53.1% reduction in admission rates from their baseline. Additionally, the reimbursement PPPM was under target yearly, concluding at $65.64, $14.46 below the target amount of $80. The cohort consisted of a range of 36-75 patients per quarter, program total of 185 enrolled patients. Conclusions: Identifying potentially high-risk patients and conducting weekly, personalized calls before the weekend reduced the overall avoidable admission rate. Timely identification and support for high-risk patients reduces the total cost of care and potentially increases patient care quality during treatment. Period Practice Inpatient Admits per 1000 Benchmark Target Target Difference Targeted Reimbursement PPPM Actual Reimbursement PPPM Reimbursement Difference 2020 Q1 1.8% 754 378 $80 2020 Q4 -17.9% 680 233 $80 $75.56 -$4.44 2021 Q4 -31.5% 622 3 $80 $66.66 -$13.34 2022 Q4 -51.3% 602 -235 $80 $65.64 -$14.46

AI-HIP system for prosthesis size, global femoral offset and osteotomy in total hip arthroplasty

To explore planning effect of AI-HIP assisted surgical planning system in primary unilateral total hip arthroplasty (THA) and its influence on clinical outcomes. A retrospective analysis was conducted on clinical data of 36 patients who underwent their first unilateral THA from March 2022 to November 2022 and continuously used AI-HIP system (AI-HIP group), including 16 males and 20 females, aged from 43 to 81 years old with an average of (62.2±10.9) years old. According to the matching principle, 36 patients who were planned by the traditional template method at the same period were selected as the control group, including 16 males and 20 females, aged from 40 to 80 years old with an average of (60.9±12.1) years old. The accuracy between two groups of prostheses were compared, as well as the combined eccentricity difference between preoperative planning and postoperative practice, lower limb length difference, osteotomy height from the upper edge of the lesser trochanter and top shoulder distance to evaluate planning effect. Harris score and visual analogue scale (VAS) were used to evaluate clinical efficacy. Both groups were followed up for 12 to 18 months with an average of (14.5±2.1) months. The complete accuracy and approximate accuracy of acetabular cup and femoral stalk prosthesis in AI-HIP group were 72.2%, 100%, 58.3%, 88.9%, respectively, which were better than 44.4%, 83.3%, 33.3%, 66.7% in control group (P<0.05). There was no statistical significance in planning of femoral head prosthesis size (P>0.05). The actual combined eccentricity difference and combined eccentricity difference (practical-planning) in AI-HIP group were 1.0(0.2, 2.4) mm and 1.1(-2.1, 3.2) mm, respectively;which were better than 3.0 (1.4, 4.9) mm and 3.5 (-1.6, 6.5) mm in control group (P<0.05). There was no significant difference between two groups in actual osteotomy height of the upper margin of the lesser trochanter (P>0.05). In AI-HIP group, the actual difference of lower extremity length after surgery, the difference of lower extremity length (practical-planning), osteotomy height from the upper margin of lesser trochanter (practical-planning), actual topshoulder distance after surgery, and topshoulder distance (practical-planning) were 1.5 (0.2, 2.8), 1.1 (-0.3, 2.2), 2.1(-2.3, 4.1), (15.3±4.1), 2.2(-4.8, 0.3) mm, respectively;which were better than control group of 2.6(1.3, 4.1), 2.5 (0.3, 3.8), 5.8(-2.4, 7.7), (13.0±4.3), -5.7(-9.4, -2.2) mm(P<0.05). At final follow-up, there were no significant differences in Harris scores of pain, function, deformity, total scores and VAS between two groups (P>0.05). The range of motion score was 4.8±0.6 in AI-HIP group, which was higher than that in control group (4.4±0.8)(P<0.05). Compared with traditional template planning, AI-HIP assisted surgical planning system has good accuracy in predicting the prosthetic size of the acetabular cup and femoral stalk, restoring joint eccentricity, planning lower limb length, osteotomy height and top shoulder distance on the first unilateral THA, and the clinical follow-up effect is satisfactory.

Accuracy of the surgical execution of virtually planned deep circumflex iliac artery flaps and their appropriateness for masticatory rehabilitation

BackgroundTumorous diseases of the jaw demand effective treatments, often involving continuity resection of the jaw. Reconstruction via microvascular bone flaps, like deep circumflex iliac artery flaps (DCIA), is standard. Computer aided planning (CAD) enhances accuracy in reconstruction using patient-specific CT images to create three-dimensional (3D) models. Data on the accuracy of CAD-planned DCIA flaps is scarce. Moreover, the data on accuracy should be combined with data on the exact positioning of the implants for well-fitting dental prosthetics. This study focuses on CAD-planned DCIA flaps accuracy and proper positioning for prosthetic rehabilitation.MethodsPatients post-mandible resection with CAD-planned DCIA flap reconstruction were evaluated. Postoperative radiograph-derived 3D models were aligned with 3D models from the CAD plans for osteotomy position, angle, and flap volume comparison. To evaluate the DCIA flap’s suitability for prosthetic dental rehabilitation, a plane was created in the support zone and crestal in the middle of the DCIA flap. The lower jaw was rotated to close the mouth and the distance between the two planes was measured.Results20 patients (12 males, 8 females) were included. Mean defect size was 73.28 ± 4.87 mm; 11 L defects, 9 LC defects. Planned vs. actual DCIA transplant volume difference was 3.814 ± 3.856 cm³ (p = 0.2223). The deviation from the planned angle was significantly larger at the dorsal osteotomy than at the ventral (p = 0.035). Linear differences between the planned DCIA transplant and the actual DCIA transplant were 1.294 ± 1.197 mm for the ventral osteotomy and 2.680 ± 3.449 mm for the dorsal (p = 0.1078). The difference between the dental axis and the middle of the DCIA transplant ranged from 0.2 mm to 14.8 mm. The mean lateral difference was 2.695 ± 3.667 mm in the region of the first premolar.ConclusionThe CAD-planned DCIA flap is a solution for reconstructing the mandible. CAD planning results in an accurate reconstruction enabling dental implant placement and dental prosthetics.

A Precise Temperature Control Method for Lithium-ion Battery Pack based on the Nonlinear Model Predictive Control Algorithm

Abstract To utilize the maximum performance of the battery while ensuring its thermal safety, a battery thermal management system is used to control the battery maximum temperature within a safe range. This paper centres on the establishment of a temperature prediction model and the development of the nonlinear-based model predictive control (MPC) strategy. First, to address the need of predicting battery temperature, this paper develops a distributed parameter thermal resistance model to predict battery temperature quickly and accurately. Secondly, the open-loop formulation of the nonlinear-based MPC is derived based on the established state space equations. Then the soft and hard constraints of the model are established based on the actual current conditions, pump conditions, temperature difference and temperature rise indexes, so as to establish the objective function of the MPC algorithm. Finally, the established temperature nonlinear MPC algorithm is embedded on the board and the hardware platform of battery liquid cooling system is established. The experiment test result shows that the maximum error of temperature control is less than 0.1°C, and the effectiveness of the temperature control strategy of lithium-ion battery is verified through experiments.

A study of the temperature distribution in the OTEC cold water pipe using a heat and mass transfer approach

Abstract The difference between sea water temperature at a depth of around 1000 m and sea water temperature at sea level is generally used as a parameter in the design of Ocean Thermal Energy Conversion (OTEC). In practice, electricity generation is determined by the difference between the temperature of the cold seawater coming out of the Cold Water Pipe (CWP) and the temperature of the seawater at the surface. The temperature of cold sea water increases due to heat transfer experienced by cold sea water flowing through the CWP, which comes into contact with surrounding sea water which has a higher temperature. This in turn provides a lower actual temperature difference, and therefore reduces the design power capacity. However, many previous studies did not consider these lower temperature differences. This may be acceptable for cases with practically small heat transfer such as CWP with low thermal conductivity combined with good insulation used in 1000 m CWP vertical floating systems. Unfortunately, this may not be the case for many of OTEC’s proposed alternative sites, which are located on land systems that require CWP lengths of five km or more. This raises the need for careful investigation to determine the temperature of the sea water coming out of the CWP, where it is necessary to calculate the temperature distribution of the cold sea water flowing through the CWP. This paper aims to estimate the temperature distribution of cold sea water flowing through the CWP and the increase in temperature of cold sea water leaving the CWP. Analysis based on the principles of mass and heat transfer was carried out in this research, where modelling was carried out numerically using a finite volume approach. For the case considered, the change in sea water temperature at CWP from depth to the surface occurs 1-3°C, which is the accumulation of each change in sea water depth. The results of this research illustrate that designing an OTEC system with a long CWP must consider the temperature distribution of cold sea water flowing through the CWP to produce a more realistic design.

Investigation and optimization into flow dynamics for an axial flow pump as turbine (PAT) with ultra-low water head

When the water downstream is abundant, axial flow pumps are often used as turbines (PAT) for reverse power generation to obtain additional benefits. However, due to the actual water level difference, PAT usually operates at off-design conditions. The CFD technology and entropy production theory were used to study the working performance, flow characteristics, and energy loss mechanism of the blade adjustable axial-flow PAT under a low water head. The results indicate that the strength of the tubular vortex at the pressure surface and the separation position of the tip-leakage-vortex at the suction surface depend on the inlet angle of the blade. The energy loss in the draft tube is influenced by the velocity circulation at the runner’s outlet, which depends on the blade’s outlet angle. Subsequently, the blade inlet and outlet angles in the runner were optimized. In turbine mode, the overall efficiency of the optimized runner increased by an average of 0.99 %. The blade pressure load distribution of the optimized runner has improved, and the pressure fluctuation in the draft tube is also under control. In pump mode, due to the increasing of the inlet angle within the same demand pump head range, the optimized runner’s pumping flow increases by an average of 2 m3/s.

Comparison of Outcome of Concurrent Chemoradiotherapy and Sequential Chemoradiotherapy in Locally Advanced, Inoperable Squamous Cell Carcinoma of Head and Neck Region

Background: Head and neck cancer is prevalent in Bangladesh, with a majority of patients presenting with locally advanced, inoperable disease. This study aimed to compare the effectiveness and accessibility of concurrent and sequential (CCRT with RT) chemoradiotherapy in treating this condition, addressing a debate among oncologists. Materials and Methods: A quasi-experimental study at Rajshahi Medical College Hospital (June 2019 - May 2020) involved 60 inoperable head and neck cancer patients, comparing concurrent chemoradiotherapy with Cisplatin and sequential chemoradiotherapy with Paclitaxel and Cisplatin, monitoring treatment response and toxicities. Results: The mean age was 56.1 (±9.5) years in Arm-A and 56.9 (±9.4) years in Arm-B. The primary endpoint was loco-regional control and early toxicities. In the final response, 14 weeks after the completion of treatment, the overall loco-regional control rate was 86.67% and 76.67% in Arm-A and Arm-B, respectively. Severe toxicities include grade 3 reaction only and happened 18(58%) vs 13(42%) in Arm-A and Arm-B, respectively. Among severe toxicities, mucositis and skin reaction were higher in the concurrent Arm and anemia and neutropenia were higher in the sequential Arm. However, there was no actual difference in the two treatment modalities (p=&gt;0.05). The overall treatment time was short in concurrent chemoradiotherapy (49 vs 133 days) and lower treatment cost as well, which was statistically significant (p=&lt;0.0001). Conclusion: concurrent chemoradiotherapy proves cost-effective and accessible, demonstrating outcomes similar to sequential chemoradiotherapy. It stands as a viable treatment choice for locally advanced, inoperable head and neck squamous cell carcinoma.

(025) Compliance with GMC Guidelines for the Use of a Chaperone in Urology Outpatient Clinic

Abstract Introduction Intimate physical examination is an integral part of our urological practice. There is a paucity of literature regarding the use of chaperones among urologists. As per GMC guidelines: The offer, and use, of a chaperone, including their full name and designation, should be clearly documented in patients’ notes. Objective Given the importance of this ethical topic for both patient safety as well as in providing support for the urologist, we decided to assess our performance as per the GMC guidelines for good medical practice. Methods We completed an audit loop to evaluate the performance of 12 members in our urology team as regards compliance with GMC guidance for the documentation of chaperone use in urology clinic. Based on our scoring system, we objectively assessed both overall team performance as well as individual scores for documenting chaperone use. • For each urologist, We checked records for 10 patients who attended urology clinic AND had a physical examination as evidenced in the notes and/or clinic letter •N= 120 patient records checked • Each urologist was given a score; NO mention of a chaperone= 0 point A chaperone JUST mentioned= 1 point The chaperone specified (name/signature)= 2 points Results Initial audit revealed overall chaperone documentation in clinical notes was 75.25% which may be acceptable while in the clinic letters, it was only 14.6%. At individual level, results were quiet variable reflecting the actual difference in practice between individuals in real life. Following the discussion of the 1st audit results in the urology clinical governance meeting, posters were made to raise awareness of the audit outcome as well as direct discussions with the urology team members to encourage them to improve their score. Six months later, re-audit showed significant improvement was achieved for individual as well as overall documentation to 85% of clinical notes and more than 50% of clinic letters. Conclusions Documenting chaperone presence during patient examination in urology clinics, is mandatory given the intimate nature of urological examination. We present the first report using a scoring system for objective assessment of a pertinent topic such as the use of chaperone and its documentation. This managed to achieve a significant improvement in our practice in accordance with GMC guidance for Good Medical Practice. Disclosure No.

A prospective study on the relationship between polycystic ovary syndrome and age at natural menopause.

This study aimed to determine whether polycystic ovary syndrome (PCOS) was associated with age at menopause, compared with women without PCOS, after adjusting for potential confounders. A total of 1,696 reproductive-aged participants from the Tehran Lipid and Glucose Study were included in this population-based prospective study with a follow-up of approximately 20 years. Of these, 348 women with PCOS based on the Rotterdam criteria and 1,348 non-PCOS controls were followed to assess the age at which they reached menopause. An accelerated failure time survival regression model was used to identify the association between PCOS and the age at natural menopause (ANM), with and without adjustment for potential confounders. The unadjusted accelerated failure time survival model revealed a significant positive association between PCOS and ANM; PCOS women experienced time to menopause by a factor of 1.05 than non-PCOS controls (95% confidence interval, 1.02-1.06; P < 0.001). After adjusting for age at baseline, menarche age, history of hypertension, history of type 2 diabetes mellitus, parity, oral contraceptive use, body mass index, education level, physical activity, and smoking, the results remained significant (time ratio: 1.03; 95% confidence interval, 1.01-1.06; P = 0.002). This study indicates that ANM is significantly associated with PCOS in women. Our study findings may have implications for the fertility and reproductive health of women with PCOS. However, further large longitudinal studies on diverse populations accounting for other relevant confounders are still needed to provide data on the actual difference in age at menopause and to elucidate the underlying mechanisms of this association.

FCVM(i): Integrated FCNP-VWA-MCDM(i) Methods for On-Demand Charging Scheduling in WRSNs

On-demand charging schemes have been recently proposed to make efficient charging schedules of mobile chargers by introducing MCDM methods in wireless rechargeable sensor networks (WRSNs). However, most of the existing schemes use analytic hierarchy process (AHP) or fuzzy AHP (FAHP) of paired ratio scale (PRS) to exaggerate the actual paired difference between multi-criteria, thereby very likely producing misapplications such as inappropriately ranking the charging locations or inaccurately drawing the partial charging time in charging scheduling (CS) of WRSNs. In addition, in case of using FCNP of paired interval scale (PIS) for weight assignment of multi-criteria, weight compensation has not been considered. In particular, it is still unknown which is the best method for integrating FCNP with several MCDM approaches. This paper proposed novel CS methods by integrated FCNP-VWA-MCDM(i) called FCVM(i) which solves all of these problems. The proposed methods first assign the weights to multiple criteria discriminating charging request nodes (cRNs) using FCNP and make compensation of them to be relatively exact weights with VWA. Then, on the basis of these weights, MCDM(i) is used to elect the best proper next charging position. In this way, drawing up the recharging schedule, at the selected charging locations, we decide the reasonable partial charging time using the assigned weights with FCNP-VWA. Extended experiment results prove that the FCVM(1) using TOPSIS gives the best performance among FCVM(i) methods.

Simulation and Experimental Study of Nanosecond Pulse Laser Removal of Epoxy Paint on 6061 Aluminum Alloy Surface

Laser paint removal is a new cleaning technology that mainly removes paint through thermal ablation and mechanical stripping mechanisms. This paper established a thermal-mechanical coupling laser removal model of paint based on the heat conduction equation, Newton’s second law, and Fabbro’s theory. The removal process of epoxy resin paint film on an aluminum alloy surface via a nanosecond pulsed laser was studied using finite element simulations and experimental measurements. The simulation and experimental results show that the nanosecond pulse laser’s primary paint removal mechanism is the mechanical stripping caused by thermal stress and plasma shock. The laser paint removal threshold is 1.4 J/cm2. In addition, due to the different generation times of plasma shock and thermal stress, the mutual superposition of stress waves occurs in the material. This results in a discrepancy between the actual and thermal stress differences. Moreover, the thermal stress difference causes the maximum actual stress difference to fluctuate. The simulation model established in this paper can provide a reference for studying the thermal-mechanical coupling process of laser paint removal.

Differences in Effort, Reward, Grit, Burnout, and Continuous Exercise Intention: Assessing the Effort-Reward Imbalance among Korean Athletes.

Although studies have shown that an imbalance between effort and reward in the workplace negatively affects an individual's physiological and mental health, few have looked at how this imbalance may affect the mental state of athletes. Therefore, this study aimed to evaluate the importance of the effort-reward imbalance (ERI) in athletes by examining whether psychological variables would differ depending on the ERI. To accomplish this, 795 registered collegiate athletes were recruited. Of them, 227 and 230 responses with the ERI in the bottom and in the top 30% of the ERI scale were selected to compare groups with a high and a low ERI. Athletes completed a self-reported 64-item questionnaire (general characteristics: 5; effort: 14; rewards: 14; grit: 12; burnout: 15; and continuous exercise intention: 4 items). Data analysis included reliability and validity using the Jamovi and SPSS/AMOS software. The results showed no significant differences in effort, reward, grit, burnout, and intention to continue to exercise based on gender, weekly training frequency, and hours of training per day. There were differences in effort, reward, grit, burnout, and intention to continue exercising based on the presence of a professional league. Additionally, differences were found in effort, reward, grit, burnout, and intention to continue exercising between the low and high ERI groups. There was a clear difference between the mental state of those who were satisfied with their effort and reward, and those who were not. However, given that the two groups spent approximately the same amount of time exercising each week, the difference may have been more a function of the psychology of athletes than an actual difference in effort and reward. As our findings confirmed that the level of the ERI in athletes is related to their mental state, further research is necessary to identify and control factors that affect the ERI in athletes.

On the Actual Difference between the Nosé and the Nosé–Hoover Thermostats: A Critical Review of Canonical Temperature Control by Molecular Dynamics

This article has to be intended both as a review and as an historical tribute to the ideas developed almost 40 years ago by S. Nosé, establishing the theoretical foundations of the implementation and use of thermostats in molecular dynamics (MDs). The original motivation of this work is enriched by an observation related to the connection between the Nosé seminal expression of temperature control and the extension proposed in 1985 by W. G. Hoover, known as the Nosé–Hoover thermostat. By carefully rederiving the equations of motion in both formalisms, it appears that all features of Nosé–Hoover framework (replacement of the Nosé variables by a single friction coefficient in the equations of motion) are already built in the Nosé approach. Therefore, one is able to work directly within the Nosé formalism with the addition of a single variable only, by greatly extending its general impact and simplicity and somewhat making redundant the Nosé–Hoover extension. Having been implicitly (and somewhat inadvertently) put to good use by a multitude of users over the past 40 years (in the context of classical and first‐principles MDs), this finding does not need any specific application to be assessed.

The risk of DDH between breech and cephalic-delivered neonates using Graf ultrasonography.

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal disorder in infants. The most significant risk factors include female gender, breech presentation, left hip and family history. In this study, we utilized the Graf method at different time intervals to evaluate both breech-delivered and cephalic-born newborns. The objectives were to compare the incidence of DDH in cephalic and breech-delivered neonates and investigate whether the hip joints of neonates delivered in the breech position exhibit a distinct maturation pattern. We studied prospectively 618 hip joints (309 newborns). Each hip joint was examined with the Graf method in four time periods as follows: Phase #1 (0-1weeks), Phase #2 (1-4weeks), Phase #3 (4-7weeks), and Phase #4 (7-10weeks). The α and β angles for each hip joint were measured, and the hips were classified according to Graf classification. With our statistical analysis within the different phases, we were able to investigate potential variations in the maturation patterns between newborns delivered in the breech and cephalic delivery positions. A significant difference (at the 5% level) was observed in Phase 1 between breech and cephalic-delivered neonates (35.6-8.6%). This difference tended to decrease in next phases (13.6-1% in Phase 2, 2.5-0% in Phase 3 and 1.7-0% in Phase 4). A significant difference (at the 5% level) for cephalic-delivered neonates was also observed between Phase 1 and Phase 4 (8.5-0%), but the percentages were low. Additionally, the breech-delivered had extreme difference in incidence of DDH from Phase 1 to Phase 4 (35.6-11.9%, 2.5%, and 1.7%, respectively). It appears that there is an actual difference in the incidence of DDH between breech-delivered and cephalic-delivered neonates, although the difference may be less significant than previously considered. The majority of the breech-delivered neonates that were initially considered as pathological (Phase 1) are, in fact, healthy. This is ascertained in subsequent ultrasound examinations conducted in later phases (Phases 2-4), when the incidence of pathological cases decreases. This could be attributed to potential different maturation pattern between these groups.

Abstract 17654: Sarpogrelate versus Clopidogrel for Arterial Interventions Systematic Review and Meta Analysis

Background: Sarpogrelate has been used to alleviate ischemic changes by preventing thrombosis, vasoconstriction, and vascular smoothmuscle proliferation. The worldwide use of Sarpogrelate is arguable due to the lack of reliable data regarding its efficacy and safety.Accordingly, our meta-analysis aims to compare the complications after receiving Sarpogrelate with Aspirin (S&amp;A) vs. Clopidogrel withAspirin (C&amp;A) as part of dual anti-platelet therapy in patients with endovascular intervention. Methods: Multiple electronic databases weresearched to identify relevant articles, including MEDLINE, Cochrane CENTRAL, Scopus, Google Scholar, Web of Science, and EMBASE. Allclinical studies that investigated the complication after performing Sarpogrelate versus clopidogrel with Aspirin for arterial interventionswere included in the meta-analysis. Reviews, case reports, conference abstracts, editorials, and animal studies were all excluded. Data wereanalyzed by using comprehensive meta-analysis studies. A complete quality assessment was performed using the Cochrane Risk of Bias toolversion 2 for randomized clinical trials (RCTs). Results: A total of 2588 studies were screened, with three studies included. Two multicenterRCTs and one retrospective cohort study including 527 patients (251 S&amp;A and 276 C&amp;A) were included. The overall quality was high in 2studies and fair in one. No statistically significant difference in restenosis, mortality, and bleeding risk as follows, respectively: (RR:0.81, 95%CI:0.52-1.2, P-value:0.36), (RR:0.37, 95% CI:0.06-2, P-value:0.25) and (RR:0.4, 95% CI:0.13-1.19, P-value:0.1). Conclusion: The antithromboticeffects of Aspirin with Sarpogrelate after vascular intervention are comparable to those of Aspirin plus Clopidogrel. Further large clinicalstudies are required to identify the actual difference in early and late complications after using Sarpogrelate versus clopidogrel.

Drift Error Compensation Algorithm for Heterodyne Optical Seawater Refractive Index Monitoring of Unstable Signals.

The refractive index measurement of seawater has proven significance in oceanography, while an optical heterodyne interferometer is an important, highly accurate, tool used for seawater refractive index measurement. However, for practical seawater refractive index measurement, the refractive index of seawater needs to be monitored for long periods of time, and the influence of drift error on the measurement results for these cases cannot be ignored. This paper proposes a drift error compensation algorithm based on wavelet decomposition, which can adaptively separate the background from the signal, and then calculate the frequency difference to compensate for the drift error. It is suitable for unstable signals, especially signals with large differences between the beginning and the end, which is common in actual seawater refractive index monitoring. The authors identify that the primary cause of drift error is the frequency instability of the acousto-optic frequency shifter (AOFS), and the actual frequency difference was measured through experimentation. The frequency difference was around 0.1 Hz. Simulation experiments were designed to verify the effectiveness of the algorithm, and the standard deviation of the optical length of the results was on the scale of 10-8 m. Liquid refractive index measurement experiments were carried out in a laboratory, and the measurement error was reduced from 36.942% to 0.592% after algorithm processing. Field experiments were carried out regarding seawater refractive index monitoring, and the algorithm-processing results are able to match the motion of the target vehicle. The experimental data were processed with different algorithms, and, according to the comparison of the results, the proposed algorithm performs better than other existing drift error elimination algorithms.

Effect of skeletonisation and pedicled bilateral internal mammary artery grafting in coronary artery bypass surgery on post-operative wound infection: A meta-analysis.

The results showed that different internal thoracic artery (ITA) was associated with the rate of postoperative wound infection and the severity of pain following coronary artery bypass grafting (CABG). In order to ascertain if there was any genuine difference in the rate of postoperative infection and severity of the pain, we conducted a meta-analysis to evaluate if there was any actual difference in the wound complication that had been identified with the ITA method. Through EMBASE, Cochrane Library and Pubmed, and so forth, we systematically reviewed the results by August 2023, which compared the impact of skeletonised versus pedicled internal mammary artery (IMA) on wound complications following CABG. The trial data have been pooled and analysed in order to determine if a randomisation or fixed-effect model should be applied. The meta-analysis of data was performed with Revman 5.3 software. The results of this meta-study included 252 related articles from four main databases, and nine articles were chosen to be extracted and analysed. A total of 3320 patients were treated with coronary artery transplantation. Based on current data analysis, we have shown that the rate of postoperative wound infections is reduced by the use of the skeletonised internal mammary artery (SIMA) (OR, 1.84; 95% CI, 1.13, 3.01; p = 0.01). But the results showed that there were no statistically significant differences in the post-operation pain score of the patients (MD, 0.09; 95% CI, -0.58, 0.76; p = 0.79). Furthermore, the duration of the operation was not significantly different between the SIMA and pedicled internal mammary artery (PIMA) (MD, 3.30; 95% CI, -3.13, 9.73; p = 0.31). Overall, the SIMA decreased the rate of postoperative wound infection in CABG patients than the PIMA.

A Cross sectional descriptive study to investigate the different effects of using approved therapeutic regimens options on the quality of life for chronic heart disease patients with reduced ejection fraction

Abstract Aim Investigate the different effects on the quality of life (QOL) between the approved regimens used for Heart failure patients with reduced ejection fraction (HFrEF) treatment in clinical practice. Methods Cross Sectional descriptive study on (HFrEF) patients was conducted from December 2021 to Mars 2023 at governmental and private hospitals in Egypt and Saudi Arabia, the 118 patients were receiving different treatment regimens divided into 4 groups, all groups have B-blockers and mineralocorticoid receptor antagonist (MRA); 1.Conventional therapy group of 33 patients: angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARBs), 2. Group of 22 patients: Sacubitril/Valsartan as an angiotensin receptor-neprilysin inhibitor (ARNI), 3. Group of 33 patients (ACEi/ARBs) + Sodium−glucose co-transporter 2 inhibitors (SGLT2i), 4. Group of 30 patients (ARNI) with SGLT2i. Their quality of life assessment was done using validated questionnaire MLHFQ (Minnesota Living with Heart Failure Questionnaire) as face to face interviews and data were collected from hospital records. Statistical software IBM SPSS package version 27.0, a one-way ANOVA test was conducted to compare the difference between 4 groups normally distributed quantitative variables. Post hoc pairwise multiple comparisons were executed using the Tukey HSD test. A multiple linear regression analysis was conducted to assess the ability of the independent variables (Platelets count, Ejection Fraction EF%, Hemoglobin, S.Cr, Gender, WBCs and Urea) to predict the value of MLHFQ score. Significance was judged at the 5% level. Results There was a statistically significant difference In MLHFQ Score for the four groups: F (3, 114) = 8.135, P = 0.000. The actual difference in mean scores was relatively high and this was approved by a large effect size, calculated using eta squared (0.176). Post hoc comparisons indicated that the mean score for Conventional regimen group (M = 68.06, SD = 19.77, CI95% 11.92–38.67, P &amp;lt; 0.05) and SGLT2i containing regimen group (M = 56.88, SD = 22.21, CI95% 0.74–27.48, P = 0.034) both were significantly different from that of ARNI + SGLT2i combination containing regimen group (M = 42.77, SD = 19.04). By comparing the EF% between the 4 groups, There was a statistically significant difference: F (3, 114) = 2.725, P = 0.047. Post hoc comparisons indicated that the mean score for Conventional containing regimen (M = 33, SD = 8.746, CI95% 0.1–10.43, P = 0.044) was significantly different from that of ARNI + SGLT2i combination regimen (M = 27.73, SD = 7.497). The linear regression analysis for variables showed statistical significance (F Change (7,110) = 5.234, P = .000).The statistically significant affected predicted variables are (S.Cr, P = 0.01), (B.urea, P = 0.003), (Hb, P = 0.011), while R2 = 0.25 explained only 25% of the variance in the dependent variable (MLHFQ score). Conclusions The early beginning of ARNI + SGLT2i with B-blocker + MRA may improve the QOL beside the approved reduction in heart failure hospitalizations. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.