Correct Approach Research Articles

Survey expectations and adjustments for multiple testing

Testing hypotheses regarding how individual survey respondents form their expectations is susceptible to the multiple testing problem. The probability of falsely rejecting the null hypothesis for one or more respondents will exceed the nominal single-hypothesis significance level. The Bonferroni correction and related approaches control the family-wise error rate, but are conservative and result in low power when the null hypotheses are false.We compare controlling the family-wise error rate with the effect of controlling the false discovery rate and the false discovery proportion, in terms of the conclusions we draw about forecaster behaviour.The effects of adjustments for multiple testing are investigated for tests of weak efficiency and the over-reaction hypothesis, for beliefs about the persistence of shocks to output growth, and for the accuracy of survey respondents’ perceptions of the uncertainty they face.

Multicriteria optimization techniques for understanding the case mix landscape of a hospital

Various medical and surgical units operate in a typical hospital and to treat their patients these units compete for infrastructure like operating rooms (OR) and ward beds. How that competition is regulated affects the capacity and output of a hospital. This article considers the impact of treating different patient case mix (PCM). As each case mix has an economic consequence and a unique profile of hospital resource usage, this consideration is important. To better understand the case mix landscape and to identify those which are optimal from a capacity utilisation perspective, an improved multicriteria optimization (MCO) approach is proposed. As there are many patient types in a typical hospital, the task of generating an archive of non-dominated (i.e., Pareto optimal) case mix is computationally challenging. To generate a better archive, an improved parallelised epsilon constraint method (ECM) is introduced. Our parallel random corrective approach is significantly faster than prior methods and is not restricted to evaluating points on a structured uniform mesh. As such we can generate more solutions. The application of KD-Trees is another new contribution. We use them to perform proximity testing and to store the high dimensional Pareto frontier (PF). For generating, viewing, navigating, and querying an archive, the development of a suitable decision support tool (DST) is proposed and demonstrated.

Evaluation of the performance characteristics of a new chemical sensor, device, or method

For those of us involved in the design of novel sensors and methods, understanding the analytical requirements based upon their intended use is essential. In the case of a medical sensor, we must know how the results of a test, performed with the novel sensor, will increase the probability of a good diagnostic or disease management decisions by a physician. So, to assess whether the new sensor meets the expectations, one must design and execute experiments and analyze the results by appropriate statistical methods. As a last step of the evaluation of a novel sensor, one can measure the agreement between the results provided by an established method and the new sensor in a method comparison study. However, the correct statistical approach in method comparison studies is not obvious. In this paper a new evaluation method for determining the unbiased parameters of the association between the compared methods is discussed. It is based on the relationship between the slope and intercept of the regression line in the scatter plot and the parameters of the regression line in the Bland and Altman plot of the differences, in which the differences between the values measured by the compared methods in the same samples are plotted as a function of the average of the measured values. Moreover, we suggest a graphical representation of the data for assessing both the association and the agreement between the compared methods and show the limits of the proposed evaluation method theoretically and using computer-generated data and real-world examples.

Basic cell carcinoma of the vulva. Case report and literature review

Background: Vulvar carcinoma is rare, 4% of gynecological cancer worldwide and basal cell carcinoma of these represents 2 to 3%; Its diagnosis is delayed due to carelessness of the patient and doctor. Objective: To present a clinical case of basal cell carcinoma of the vulva and review of the literature. Clinical case: A 58-year-old patient, without comorbidities or risk factors, who presented a nodule in the upper third of the right labia majora; Excisional biopsy was performed with margins free of macroscopic tumor, basal cell carcinoma was reported. Methodology: A narrative review is carried out from 2014 to 2021 in PubMed, scholaris, SciELO Google scholar and books, finding 27 articles and only 20 were included for reliability, impact factor. Results: Vulvar cancer represents 4% of gynecological cancer worldwide. 0.4% of all basal cell carcinomas occur in the genital region, and in the vulva it represents 2 to 4% of all vulvar cancers. Basal cell carcinoma of the vulva most commonly presents as a solitary pink or pigmented papule or plaque on the labia majora; bilateral and multifocal lesions may occur. Basal cell carcinoma of the vulva is an extremely rare tumor that rarely metastasizes or spreads. . Primary treatment should consist of wide local excision and continuous monitoring. Conclusion: Any suspicious lesion of the vulva must be biopsied to reach a timely diagnosis and treatment, the rarity of these lesions and the lack of care on the part of the patient and the negligence of the doctor not to perform an examination of the vulva, the lesions progress until symptoms occur or are discovered during medical examination, vulvar cancer is suspected, radical excisional biopsy is the correct therapeutic approach.

Evaluation of surgery -first orthognathic approach in correction of dentofacial skeletal deformities (A longitudinal observational study)

Evaluation of surgery -first orthognathic approach in correction of dentofacial skeletal deformities (A longitudinal observational study)

Analyzing the impact of opportunistic maintenance optimization on manufacturing industries in Bangladesh: An empirical study

The study investigates the impact of opportunistic maintenance (OM) optimization on manufacturing industries, especially in Bangladesh, to reduce maintenance costs. To that end, OM strategies have been proposed and optimized for multi-unit manufacturing systems, whereas most of the existing research is for single- or two-unit systems. OM strategies in this research cover one of the three policies: preventive replacement, preventive repair, and a two-level maintenance approach. The proposed two-level maintenance approach is a combination of lower-level maintenance, known as preventive repair, and higher-level maintenance, known as preventive replacement. Simulation optimization (SO) techniques using Python were utilized to evaluate the strategies. Historical data from two of Bangladesh's most promising and significant sectors, the footwear and railway industries, was used as the case study. Compared to the currently utilized corrective maintenance approach, the two-level maintenance approach is the most effective for both case studies, demonstrating cost savings of 16.9 % and 22.4 % for the footwear and railway industries, respectively. This study reveals that manufacturing industries can achieve significant cost savings by implementing the proposed OM strategies, a concept that has yet to be explored in developing countries like Bangladesh. However, the study considered the proposed approaches for major components of the system, and more significant benefits can be achieved if it is possible to apply them to all critical components of the system.

A comparison of high frequency force balance mode shape correction approaches for predicting wind effects on a high-rise building

A comparison of high frequency force balance mode shape correction approaches for predicting wind effects on a high-rise building

Exploring the impact of automated correction of misinformation in social media

AbstractCorrecting misinformation is a complex task, influenced by various psychological, social, and technical factors. Most research evaluation methods for identifying effective correction approaches tend to rely on either crowdsourcing, questionnaires, lab‐based simulations, or hypothetical scenarios. However, the translation of these methods and findings into real‐world settings, where individuals willingly and freely disseminate misinformation, remains largely unexplored. Consequently, we lack a comprehensive understanding of how individuals who share misinformation in natural online environments would respond to corrective interventions. In this study, we explore the effectiveness of corrective messaging on 3898 users who shared misinformation on Twitter/X over 2 years. We designed and deployed a bot to automatically identify individuals who share misinformation and subsequently alert them to related fact‐checks in various message formats. Our analysis shows that only a small minority of users react positively to the corrective messages, with most users either ignoring them or reacting negatively. Nevertheless, we also found that more active users were proportionally more likely to react positively to corrections and we observed that different message tones made particular user groups more likely to react to the bot.

Genetic and radiological aspects of pediatric renal cystic disease: A case series

Renal cystic diseases are common conditions whose etiology can be highly heterogeneous. They require a correct approach for adequate diagnosis and management. We aimed to illustrate part of the spectrum of renal cystic diseases through some clinical cases managed in our service. We describe 11 clinical cases including clinical entities such as renal multicystic dysplasia, and autosomal dominant and autosomal recessive polycystic renal disease, among other pathologies. Renal cystic diseases are heterogeneous in their clinical presentation, natural history, radiological findings, and genetic and pathophysiological basis. An integral clinical approach is needed to get a clear etiological diagnosis and offer adequate individualized care and follow-up for patients.

A suitable procedure of dose reduction factor measurements of X-ray shields during computed tomography examination - The importance of considering positional changes of an X-ray tube

During computed tomography (CT) examinations, radio-sensitive organs located outside the field of view (FOV) are usually exposed to radiation caused by both direct and scattered X-rays. Traditionally, the use of radiation protection products has been an option for reducing exposure doses. The catalog value of the dose reduction factor (DRF) for a commercial X-ray shield is generally determined by the manufacturer using a plain X-ray irradiation system to measure the difference in dose with and without the shield. In contrast, actual shielding ability measurements during clinical CT examinations are usually evaluated using a similar equation, but it is not guaranteed that the incident directions of X-rays will be the same between the measurement data with and without a shield. The purposes of this study are to introduce a novel method for evaluating DRF by accounting for the influence of the X-ray incident direction in helical scanning and to obtain knowledge about the correctness of previously reported DRF values. Experiments pertaining to chest CT examinations were performed using a human body phantom and small-type dosimeters which consist of an optically stimulated luminescence element using Al2O3:C. A total of 100 examinations were iteratively performed, both with and without a shield. The corresponding DRF was then calculated. The novelty of the proposed analysis procedure lies in a paired analysis method, where the DRF is calculated by reorganizing numerous acquired data sets with and without the shield to pair similar incident angles of X-rays. As a result, the DRF values were estimated to be 48.5 ± 4.3%, 48.7 ± 2.7%, and 48.9 ± 1.5% based on the data results within the 10–40 data sets, 40–70 data sets, and 70–100 data sets, respectively. When the DRF values were obtained by the conventional method without applying our sorting procedure, the results were 48.4 ± 8.1%, even when the 70–100 data sets were used. This result indicates that the proposed method can analyze DRF with higher accuracy. In the example of thyroid X-ray shield, while there was no significant difference in the most probable values of DRF between the conventional and proposed methods coincidentally, we believe it is important to evaluate DRF based on a scientifically correct approach because the mathematical formulas for calculating these two values differ. In conclusion, when calculating the DRF of shielding materials during CT examination, it is imperative that data analysis considers the significant impact of differences in incident X-ray directions on the measured exposure dose data.

Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review.

In recent years, there has been increased interest in the management of medial femorotibial knee osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency. Traditional treatment modalities included conservative therapy, high tibial osteotomy with or without ACL reconstruction, and total knee replacement. Since younger patients with higher physical demands are more likely to suffer from this pathological condition, reduced invasiveness, faster recovery time, and improved knee kinematics are preferred to allow for satisfying clinical and functional outcomes. Thus, a new surgical strategy combining medial unicompartmental knee replacement (UKR) and ACL reconstruction has been proposed to allow bone stock preservation, to reduce surgical morbidity and recovery time, and ultimately to improve joint kinematics and clinical outcomes. Based on the data present in the literature, in the setting of unicompartmental OA in association with ACL deficiency, UKR combined with ACL reconstruction provided encouraging early results. Studies evaluating the outcomes of combined ACL reconstruction and UKR demonstrate promising results in select patient populations. Improved knee stability, pain relief, functional recovery, and patient satisfaction improved after surgery. Moreover, the combined approach offered advantages such as reduced surgical trauma, faster rehabilitation, and preservation of native knee anatomy compared with traditional treatment strategies. However, still, high-level studies on this topic are lacking; therefore, more comparative studies reporting long-term outcomes are needed to support the potential of this combined procedure to become mainstream. In this paper, we discuss the relevant features and rationale behind the indications and technique of this combined surgical procedure, to help surgeons choose the correct therapeutic approach for a patient with concomitant medial OA and ACL insufficiency. Continued advancements in surgical techniques, patient selection criteria, and rehabilitation strategies will further enhance the success of this combined approach, offering hope to individuals with concomitant ACL injuries and unicompartmental knee OA.

Machine learning model with output correction: Towards reliable bradycardia detection in neonates

Bradycardia is a commonly occurring condition in premature infants, often causing serious consequences and cardiovascular complications. Reliable and accurate detection of bradycardia events is pivotal for timely intervention and effective treatment. Excessive false alarms pose a critical problem in bradycardia event detection, eroding trust in machine learning (ML)-based clinical decision support tools designed for such detection. This could result in disregarding the algorithm’s accurate recommendations and disrupting workflows, potentially compromising the quality of patient care. This article introduces an ML-based approach incorporating an output correction element, designed to minimise false alarms. The approach has been applied to bradycardia detection in preterm infants. We applied five ML-based autoencoder techniques, using recurrent neural network (RNN), long-short-term memory (LSTM), gated recurrent unit (GRU), 1D convolutional neural network (1D CNN), and a combination of 1D CNN and LSTM. The analysis is performed on ∼440 hours of real-time preterm infant data. The proposed approach achieved 0.978, 0.73, 0.992, 0.671 and 0.007 in AUC-ROC, AUC-PRC, recall, F1 score, and false positive rate (FPR) respectively and a false alarms reduction of 36% when compared with methods without the correction approach. This study underscores the imperative of cultivating solutions that alleviate alarm fatigue and encourage active engagement among healthcare professionals.

Comparing Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen-Positron Emission Tomography for Prediction of Extraprostatic Extension of Prostate Cancer and Surgical Guidance: A Prospective Nonrandomized Clinical Trial.

Survivors of surgically managed prostate cancer may experience urinary incontinence and erectile dysfunction. Our aim was to determine if 68Ga-prostate-specific membrane antigen-11 positron emission tomography CT (PSMA-PET) in addition to multiparametric (mp) MRI scans improved surgical decision-making for nonnerve-sparing or nerve-sparing approach. We prospectively enrolled 50 patients at risk for extraprostatic extension (EPE) who were scheduled for prostatectomy. After mpMRI and PSMA-PET images were read for EPE prediction, surgeons prospectively answered questionnaires based on mpMRI and PSMA-PET scans on the decision for nerve-sparing or nonnerve-sparing approach. Final whole-mount pathology was the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic curves were calculated and McNemar's test was used to compare imaging modalities. The median age and PSA were 61.5 years and 7.0 ng/dL. The sensitivity for EPE along the posterior neurovascular bundle was higher for PSMA-PET than mpMRI (86% vs 57%, P = .03). For MRI, the specificity, positive predictive value, negative predictive value, and area under the curve for the receiver operating characteristic curves were 77%, 40%, 87%, and 0.67, and for PSMA-PET were 73%, 46%, 95%, and 0.80. PSMA-PET and mpMRI reads differed on 27 nerve bundles, with PSMA-PET being correct in 20 cases and MRI being correct in 7 cases. Surgeons predicted correct nerve-sparing approach 74% of the time with PSMA-PET scan in addition to mpMRI compared to 65% with mpMRI alone (P = .01). PSMA-PET scan was more sensitive than mpMRI for EPE along the neurovascular bundles and improved surgical decisions for nerve-sparing approach. Further study of PSMA-PET for surgical guidance is warranted in the unfavorable intermediate-risk or worse populations. NCT04936334.

Elevation dependent precipitation changes in historical and future times in the Himalayan Upper Ganga Basin, India

This study examines long-term (1991–2092) precipitation trends in the Upper Ganga Basin (UGB) across multiple elevations, using historical data (1991–2022) and future Coupled Model Intercomparison Project Phase 6 (CMIP6) climate model datasets (2022–2092). By identifying the top five best-fit models from 29 climate model datasets, this study assesses historical patterns and project future changes in the Near-Future-Term (NFT) (2023–2056) and Far-Future-Term (FFT) (2061–2092) under moderate and extreme scenarios. Based on the evaluation of 29 CMIP6 climate models precipitation products, five models namely: BCC-CSM2-MR, CMCC-CM2-SR5, INM-CM5–0, KIOST-ESM, and NESM3 were selected as the best models describing precipitation over UGB and future precipitation of these models were bias corrected using linear scaling bias correction approach. Also it was observed that in the UGB region usually the climate models are much more reliable in capturing the precipitation pattern in lower and mid elevation regions as compared to higher-elevation regions. Further analysis of best five climate models' future precipitation indicates a substantial increase in wet spell occurrences in the south-western part of UGB, while the north-western and central regions are expected to see a rise in dry spell counts, although dry spell increase is insignificant. The mid-elevation range from 2200 to 4050 m which historically receives the most precipitation and is expected to continue experiencing the highest volume of precipitation in the future. The lower elevation range (287–1500 m) has anticipated the most substantial increase in future precipitation. Analysis suggests a future rise in low precipitation events (2.5 mm/day to 10 mm/day) at high elevations (4050 m to 7399 m) and an increase in events exceeding 10 mm/day in mid to low elevations (287 m to 4050 m). Although an increase in low precipitation events is expected across the entire UGB, it is particularly noteworthy that the region between 287 m to 4050 m is likely to experience a greater prevalence of these events. Historically, high elevations witnessed most of the years with over 20 days of annual snowfall. However, future scenarios indicate a prominent shift, predominantly anticipating <20 days per year of snowfall, signifying a significant change in snowfall patterns within the UGB. An analysis of snowfall patterns within the UGB indicates that historically, in the elevation range of 1500 m to 2200 m, some years have experienced 3–7 days of snowfall per year, however, under the SSP245 (NFT) scenario, this is projected to decrease to 2–5 days per year. Conversely, in scenarios SSP245 (FFT), SSP585 (NFT), and SSP585 (FFT), it is anticipated that there will be no snowfall in this elevation range in the future.

Turbulent vortex pair at equilibrium and its interaction with the ground at

A turbulent two-vortex system (T-2VS) is obtained by inserting analytical model wake vortices into very weak homogeneous isotropic turbulence (HIT) and by evolving them in time using large-eddy simulation until a turbulent state at statistical equilibrium is reached. The T-2VS is characterised as follows: circulation distribution of the vortices; energy of the mean and fluctuating fields; energy dissipation rate. It is also verified that essentially the same T-2VS is obtained when varying the initial model or initial HIT perturbation. A wall-resolved simulation of the T-2VS further interacting with a smooth ground is then performed at $Re_\varGamma = 2 \times 10^5$ ; this is $10 \times$ higher than in previous works, which allows us to better capture the high Reynolds number behaviour. The high release height of the T-2VS also ensures a physically correct approach to the ground. The results are compared with the literature and also to what is obtained for the case of non-turbulent vortices interacting with the same ground at the same Reynolds number. The flow topologies are discussed, and significant differences are highlighted regarding the separation of the boundary layer generated at the ground, and the way this secondary vorticity interacts with the primary vortices and makes them decay. The vortex trajectories are also measured, together with their circulation distribution and global circulation evolution, and the differences are discussed.

Absorption Correction for 3D Elemental Distributions of Dental Composite Materials Using Laboratory Confocal Micro-X-ray Fluorescence Spectroscopy.

Confocal micro-X-ray fluorescence (micro-XRF) spectroscopy facilitates three-dimensional (3D) elemental imaging of heterogeneous samples in the micrometer range. Laboratory setups using X-ray tube excitation render the method accessible for diverse research fields but interpretation of results and quantification remain challenging. The attenuation of X-rays in composites depends on the photon energy as well as on the composition and density of the material. For confocal micro-XRF, attenuation severely impacts elemental distribution information, as the signal from deeper layers is distorted by superficial layers. Absorption correction and quantification of fluorescence measurements in heterogeneous composite samples have so far not been reported. Here, an absorption correction approach for confocal micro-XRF combining density information from microcomputed tomography (micro-CT) data with laboratory X-ray absorption spectroscopy (XAS) and synchrotron transmission measurements is presented. The energy dependency of the probing volume is considered during the correction. The methodology is demonstrated on a model composite sample consisting of a bovine tooth with a clinically used restoration material.

Semiparametric and multiplicative bias correction techniques for second-order discrete kernels

In this article, we propose to estimate the probability mass function (pmf) of a discrete supported random variable by a semiparametric bias corrected method using discrete associated kernels. This method consists in applying a two-stage multiplicative bias correction (MBC) approach for the initial parametric model in order to improve the accuracy of the estimator measured in terms of the vanishing bias. Various properties of the resulting semiparametric MBC discrete associated kernel estimator are provided (bias, variance, and mean integrated squared error). The common cross-validation technique and the Kullback–Leibler divergence are adapted for bandwidth selection. Monte Carlo simulations and a real-data application for count data illustrate the performance of the semiparametric-MBC estimator.

Anoctamin pharmacology

TMEM16 proteins, also known as anoctamins, are a family of ten membrane proteins with various tissue expression and subcellular localization. TMEM16A (anoctamin 1) is a plasma membrane protein that acts as a calcium-activated chloride channel. It is expressed in many types of epithelial cells, smooth muscle cells and some neurons. In airway epithelial cells, TMEM16A expression is particularly enhanced by inflammatory stimuli that also promote goblet cell metaplasia and mucus hypersecretion. Therefore, pharmacological modulation of TMEM16A could be beneficial to improve mucociliary clearance in chronic obstructive respiratory diseases. However, the correct approach to modulate TMEM16A activity (activation or inhibition) is still debated. Pharmacological inhibitors of TMEM16A could also be useful as anti-hypertensive agents given the TMEM16A role in smooth muscle contraction.In contrast to TMEM16A, TMEM16F (anoctamin 6) behaves as a calcium-activated phospholipid scramblase, responsible for the externalization of phosphatidylserine on cell surface. Inhibitors of TMEM16F could be useful as anti-coagulants and anti-viral agents. The role of other anoctamins as therapeutic targets is still unclear since their physiological role is still to be defined.

Arthroscopic Measurements Predict Knee Chondral Lesion Size More Accurately Than Magnetic Resonance Imaging, and Mechanism of Injury Influences Ability of Either Technique to Predict Graft Size

PurposeTo compare osteochondral defect size measurements and characteristics across magnetic resonance imaging (MRI), arthroscopy, and at the time of implantation with osteochondral allograft (OCA) transplantation or autologous chondrocyte implantation (ACI). MethodsPatients who underwent ACI and OCA transplantation at a single institution between 2015 and 2019 were retrospectively identified. Patients were excluded if they had severe osteoarthritis, if MRIs were not available for review, if surgical records did not include defect sizing necessary for analysis, and if operative reports were not available. Osteochondral lesion characteristics including size were collected preoperatively from MRI and arthroscopy and at the time of definitive open surgical intervention. Subgroup analysis was performed comparing measurement techniques depending on the corrective surgical approach used as well as depending on the mechanism of chondral injury to determine if these had any effect on the ability of arthroscopy or MRI to predict graft size. ResultsOverall, 136 chondral lesions were addressed with restoration procedures in 117 patients (mean age 32.5 years). Average difference between final graft size and lesion area measured with index arthroscopy was 116 mm2, while average difference between final graft size and lesion size measured with preoperative MRI was 182 mm2 (P < .001). Depending on surgical technique, measurements with MRI were more similar to final graft size when a patient underwent OCA transplantation versus ACI (P = .007). Depending on mechanism of injury, MRI measurements of lesions were closer to graft area when lesions resulted from trauma (P = .047). ConclusionChondral lesion size determined by preoperative MRI imaging is less accurate than arthroscopic measurements. The mechanism injury leading to chondral damage and degree of damage may influence the ability of MRI and arthroscopy to accurately measure chondral lesions and predict the final graft size used in surgical correction. Level of EvidenceRetrospective Cohort Study (Level III)

An adjoint-based approach for the surgical correction of nasal septal deviations

Deviations of the septal wall are widespread anatomic anomalies of the human nose; they vary significantly in shape and location, and often cause the obstruction of the nasal airways. When severe, septal deviations need to be surgically corrected by ear–nose–throat (ENT) specialists. Septoplasty, however, has a low success rate, owing to the lack of suitable standardized clinical tools for assessing type and severity of obstructions, and for surgery planning. Moreover, the restoration of a perfectly straight septal wall is often impossible and possibly unnecessary. This paper introduces a procedure, based on advanced patient-specific Computational Fluid Dynamics (CFD) simulations, to support ENT surgeons in septoplasty planning. The method hinges upon the theory of adjoint-based optimization, and minimizes a cost function that indirectly accounts for viscous losses. A sensitivity map is computed on the mucosal wall to provide the surgeon with a simple quantification of how much tissue removal at each location would contribute to easing the obstruction. The optimization procedure is applied to three representative nasal anatomies, reconstructed from CT scans of patients affected by complex septal deviations. The computed sensitivity consistently identifies all the anomalies correctly. Virtual surgery, i.e. morphing of the anatomies according to the computed sensitivity, confirms that the characteristics of the nasal airflow improve significantly after small anatomy changes derived from adjoint-based optimization.