Crossover Rate Research Articles

LS-DN Algorithm Based User Matching and Power Minimization in NOMA Disaster Communication

<p>To address the limited and time delay disaster communication, a joint optimization scheme integrates the advantages of differential evolution algorithm (DE) and naked mole- rat algorithm (NMR), and proposes Lévy and sigmoidal DE-NMR, namely LS-DN. LS-DN applies the Lévy flight parameters of adaptive features and sigmoidal selection factor (λ) to the worker of NMR phase, and optimizes the crossover rate (CR) and variation parameter (F) in the DE algorithm, to obtain a balance the exploration and development capabilities. The proposed LS-DN algorithm is used to optimize the user aggregation scheme, since an effect aggregation of disaster victims can reduce power consumption and improve system performance. An value of power external function (Cfn ) is defined for each disaster victim, which is expressed as the system power consumption value for each disaster victim under different aggregation schemes. To minimize the microcell power without deteriorating the quality of service (QoS), it is demonstrated by analyzing the relevant characteristics of non-orthogonal multiple access（NOMA）disaster communication that the power consumption strongly depends on user aggregation method and power allocation. The significance of joint optimization for improving the performance of NOMA disaster communication systems is also emphasized. Simulation results show that LS-DN is able to significantly reduce the power consumption of the system. With the application of LS-DN, the throughput of NOMA system increases by 65% compared to the conventional orthogonal multiple access (OMA) system.</p> <p> </p>

Understanding Potential Decay during OCV Hold via Dry Recovery Process

Nearly ∼100 mV of open circuit voltage (OCV) decay is observed in the first 24 h of a typical OCV hold test for assessing the chemical durability of a polymer electrolyte. Significant recovery of this OCV loss has been achieved by subjecting the cell to so-called wet recovery process by lowering the cell potential often under over-humidified conditions, thereby confounding the effect of potential reduction and catalyst/ionomer interfacial reorganization due to humidification. In this work by applying a dry recovery protocol (30% RH) comprising 30 min of lower potential hold in the H2/N2 environment followed by the H2/Air environment, OCV recovery of 82%, 73%, 62% and 58 was achieved by holding potentials at 0.13, 0.2, 0.6, and 0.8 V, respectively. Small changes in electrochemically active surface area and hydrogen cross-over rate observed 48 h cannot explain the nearly 100 mV OCV. The wet recovery process (low potential and 100% RH) resulted in 85% recovery of ∼100 mV of lost OCV implying oxide coverage increase as the dominant factor for sharp OCV decay. Further, it is shown that cross-over hydrogen is not fully oxidized at OCV-like conditions (>0.6 V), highlighting the need to quantify potential-dependent crossover current for OCV decay models.

A hybridizing-enhanced differential evolution for optimization.

Differential evolution (DE) belongs to the most usable optimization algorithms, presented in many improved and modern versions in recent years. Generally, the low convergence rate is the main drawback of the DE algorithm. In this article, the gray wolf optimizer (GWO) is used to accelerate the convergence rate and the final optimal results of the DE algorithm. The new resulting algorithm is called Hunting Differential Evolution (HDE). The proposed HDE algorithm deploys the convergence speed of the GWO algorithm as well as the appropriate searching capability of the DE algorithm. Furthermore, by adjusting the crossover rate and mutation probability parameters, this algorithm can be adjusted to pay closer attention to the strengths of each of these two algorithms. The HDE/current-to-rand/1 performed the best on CEC-2019 functions compared to the other eight variants of HDE. HDE/current-to-best/1 is also chosen as having superior performance to other proposed HDE compared to seven improved algorithms on CEC-2014 functions, outperforming them in 15 test functions. Furthermore, jHDE performs well by improving in 17 functions, compared with jDE on these functions. The simulations indicate that the proposed HDE algorithm can provide reliable outcomes in finding the optimal solutions with a rapid convergence rate and avoiding the local minimum compared to the original DE algorithm.

Differential evolution with an adaptive penalty coefficient mechanism and a search history exploitation mechanism

A critical issue of constrained optimization evolutionary algorithms (COEAs) is how to balance the minimization of the objective function and the reduction of the constraint violation during the optimization process. This paper proposes a differential evolution (DE) algorithm with an adaptive penalty coefficient mechanism and a search history exploitation mechanism (called APCSH) to address this issue. Specifically, APCSH includes a learning stage and an evolving stage. In the learning stage, the correlation between the constraint violation and objective function values is calculated. Then, in the evolving stage, the correlation is used with a sigmoid function to determine the upper and lower bounds of the penalty coefficient, followed by a ranking strategy to assign the penalty coefficient to each solution. Furthermore, an exponentially weighted average method is used to update the search direction of solutions to promote convergence. Additionally, the scaling factor and crossover rate of DE are tuned automatically based on the successful search history. Many numerical experiments are conducted on 18 CEC2010 benchmark problems, 28 CEC2017 benchmark problems, and 4 heat pipe constraint optimization problems to demonstrate the advantages of the proposed algorithm over some state-of-the-art COEAs.

Improved catheter delivery for aspiration thrombectomy using Tenzing 7 ledge reducing catheter and FreeClimb 70.

Previous comparative mechanical thrombectomy device trials reported a substantial crossover rate from first-line aspiration to stent-retriever thrombectomy. A specialized delivery catheter may help track large-bore aspiration catheters to target occlusions. We report our multicenter experience of aspiration thrombectomy of intracranial large vessel occlusions using the FreeClimbTM 70 and Tenzing® 7 delivery catheter (Route 92, San Mateo, CA). After local Institutional Review Board approval, we retrospectively reviewed the clinical, procedural, and imaging data of patients who underwent mechanical thrombectomy with the FreeClimb 70 and Tenzing 7. FreeClimb 70 was successfully delivered using Tenzing 7 to target occlusion in 30/30 (100%) patients (18 M1, 6 M2, 4 ICA-terminus, and 2 basilar artery occlusions), without the use of a stent-retriever for anchoring. In 21/30 (70%) cases, a leading microwire was not needed to advance the Tenzing 7 to the target. Median (interquartile range) time from groin puncture to first pass was 12 (interquartile range 8-15) minutes. Overall first pass effect, or first pass effect (modified thrombolysis in cerebral ischemia 2C-3), was achieved 16/30 (53%). For M1 occlusions, first pass effect was 11/18 (61%). Successful reperfusion (modified thrombolysis in cerebral ischemia ≥ 2B) was achieved in 29/30 (97%) cases after a median of 1 pass (interquartile range 1-3). Median groin puncture to reperfusion time was 16 (interquartile range 12-26) minutes. There were no procedural complications or symptomatic intracranial hemorrhage. Average improvement in National Institutes of Health Stroke Scale at discharge was 6.6 ± 7.1. There were three patient deaths (renal failure, respiratory failure, and comfort care). Initial data support the use of Tenzing 7 with FreeClimb 70 catheter for reliable access to rapid, effective, and safe aspiration thrombectomy of large vessel occlusions.

Use of reduced-voltage EIS to establish a relation between oxygen concentration and EIS responses of large commercial PEM fuel cell modules

This paper employs equivalent circuit analysis of electrochemical impedance spectra (EIS) signatures of commercial proton exchange membrane fuel cell stacks (PEMFC) to establish a relation between oxygen concentration and EIS response within individual cells of the stack. This paper is part of an ongoing effort to use EIS for detecting and quantifying hydrogen crossover to understand and reduce hydrogen cathode exhaust emissions. Selected results from different sets of experiments performed on Ballard water-cooled and air-cooled PEMFC stacks are presented. A novel reduced-voltage EIS system with the ability to perform impedance measurements over different cell counts is employed to record EIS scans of these stacks. In the first set of experiments, hydrogen was injected into the cathode side of a 30 kW 150+-cell water-cooled module at various rates to emulate the phenomenon of hydrogen crossover at different levels. In the second set of experiments, nitrogen was injected into a target single-cell in an air-cooled stack with over 50 cells (50+-cell) to dilute the cathode available oxygen, and the impedance was measured over various numbers of cells spanning around this target cell. A novel equivalent circuit model with resistors, constant phase elements (CPEs), and a linear finite Warburg parameter was used to study the EIS data via an optimization-based fitting approach in python. Results of these experiments have shown there is a proportional relationship between the Warburg parameter (in the equivalent circuit model used) and hydrogen crossover (at nominal idle and low-current air flows), and that this Warburg parameter increases significantly with reduced cathode air flows. Also, it is concluded that this relationship can be further used, along with decomposition of the EIS scan of a stack into different cell-level scans, to estimate the number of large-leaky cells as well as the total hydrogen crossover rate.

Long Term Results of a Randomised Trial of Stenting of the Superficial Femoral Artery for Intermittent Claudication

Primary stenting of the superficial femoral artery (SFA) in intermittent claudication (IC) has been shown to increase health related quality of life (HRQoL) after 12 and 24 months. An extended follow up of HRQoL 36 and 60 months after randomisation is presented. A multicentre randomised controlled trial was conducted at seven vascular clinics in Sweden between 2010 and 2020. One hundred patients randomised to either primary stenting and best medical treatment (BMT; n = 48) or BMT alone (n = 52) were followed for 60 months. HRQoL, assessed by the Short Form 36 Health Survey (SF-36) and EuroQoL 5 dimensions (EQ5D) 36 and 60 months after randomisation, was the primary outcome. Walking Impairment Questionnaire (WIQ) score, re-interventions, progression to chronic limb threatening ischaemia (CLTI), amputation, and death were secondary outcomes. At the 36 month follow up, the stent group (n = 32) had statistically significantly better scores in the SF-36 domain “Role Physical” (p = .023) and the Physical Component Summary (p = .032) compared with the control group (n = 30); however, there was no statistically significant difference in EQ5D scores (p = .52). WIQ was statistically significantly better in the stent group compared with the control group (p = .029) at 36 months. At the 60 month follow up, no statistically significant difference in HRQoL was seen between patients in the stent (n = 31) and control groups (n = 32). Crossover from the control group to the stent group was 25% at 60 months. There were no differences in progression to CLTI, amputation (2.1% vs. 1.9%), or mortality (14.6% vs. 15.4%) between groups. In patients with IC caused by isolated SFA lesions, primary stenting conferred benefits to HRQoL until 36 months from treatment vs. BMT alone, but these benefits were no longer detectable at 60 months, where a high crossover rate affected the power of the final analysis.

Stainless Steel Felt as a Combined OER Electrocatalyst/Porous Transport Layer for Investigating Anion-Exchange Membranes in Water Electrolysis

Anion-exchange membrane water electrolysis (AEMWE) is a promising technology for low-cost, high-efficiency, green hydrogen production. The stability of the AEM is a critical issue but difficult to delineate in situ from degradation of the catalyst layer (CL). Moreover, the porous transport layer (PTL) can contribute electrocatalytically. Herein, we demonstrate that stainless steel (SS) felt, in the absence of an anode CL, is highly active toward the oxygen evolution reaction (OER) (1 A cm–2 at 1.74 Vcell) and serves as a combined OER electrocatalyst and PTL, thus simplifying the study of AEMs in water electrolyzers. We further show that Ni felt exhibits much lower OER activity than SS felt, which suggests that in situ studies of OER electrocatalysts and CL compositions should be performed with Ni felt, not SS felt, to reduce OER contributions from the PTL. Lastly, we found that the substrate for depositing the cathode CL, AEM, or PTL strongly influences the rate of H2 crossover.

Differential Evolution and Agglomerative-Clustering-Based Mutation Strategy for Complex Numerical Optimization Problems

Differential evolution is an evolutionary algorithm that is used to solve complex numerical optimization problems. Differential evolution balances exploration and exploitation to find the best genes for the objective function. However, finding this balance is a challenging task. To overcome this challenge, we propose a clustering-based mutation strategy called Agglomerative Best Cluster Differential Evolution (ABCDE). The proposed model converges in an efficient manner without being trapped in local optima. It works by clustering the population to identify similar genes and avoids local optima. The adaptive crossover rate ensures that poor-quality genes are not reintroduced into the population. The proposed ABCDE is capable of generating a population efficiently where the difference between the values of the trial vector and objective vector is even less than 1% for some benchmark functions, and hence it outperforms both classical mutation strategies and the random neighborhood mutation strategy. The optimal and fast convergence of differential evolution has potential applications in the weight optimization of artificial neural networks and in stochastic and time-constrained environments such as cloud computing.

PARP inhibitors and overall survival in ovarian cancer, reevaluation advised in all settings.

PARP inhibitors in ovarian cancer have been a breakthrough therapy of the past decade, driven by positive trial results, and supported by an original pharmacological rationale. However, with mature data, detrimental survival results led to the withdrawals, in 2022, of all approved PARP inhibitors in the most advanced settings' indication (as monotherapy in third or subsequent lines) by the US Food and Drug Administration (FDA). Two other indications, as maintenance after relapse, were also restricted. In this work, based on pooled meta-analysis in each setting, we question a unique situation in oncology: a survivalbenefit is seen in front-line settings, with, at the same time, a survivaldecrement in later lines. Either this original feature is explained by the unique biological action of PARP inhibitors-through synthetic lethality-in patients with ovarian cancer and homologous repair deficiency. Another explanation may be trial design: decrement in later lines could partly explain why beneficial results were seen in early settings, simply by avoiding late exposure to PARP inhibitors in the experimental arm in those trials. High crossover rates seen in some trials further support this alternate hypothesis. We contend our analysis and recent survival results of PARP inhibitors warrant a whole reassessment of the place of these compounds in the landscape of ovarian cancer treatments.

PO-03-161 INTRA-PROCEDURAL CROSSOVER OF LEFT ATRIAL APPENDAGE OCCLUSION DEVICES, A SINGLE CENTER EXPERIENCE

Two devices are currently available for percutaneous left atrial appendage occlusion (LAAO), Watchman FLX and Amplatzer Amulet. While in most cases LAAO is achieved by implanting the originally planned device, intra-procedural crossover from one type to the other might be necessary when LAAO is not satisfactory. To evaluate the rate and characteristics of intra-procedural device crossover in LAAO procedure. All successful LAAO procedures performed in our center since October 2021 (Amulet’s FDA approval) are included in the study. Of note, LAAO procedures are performed under fluoroscopic and ultrasound (TEE or ICE) guidance, without formal preprocedural imaging planning. 365 patients (74±9 years; 34% female) underwent LAAO over 12 months. LAAO was successful in all but 1 case, in which the LAA was too large for successful implantation of the originally planned device (Watchman) and crossover was not attempted. In almost all cases (361/364, 99%), the original planned device was implanted successfully achieving complete LAAO (Watchman in 325 patients, Amulet in 34 patients). Intra-procedural device crossover was observed in 4 (1%) patients, all from Watchman to Amulet. In 3 cases, the LAA ostium and proximal LAA were large, leading to deployment of an undercompressed, unstable 35 mm Watchman device: Amulet allowed positioning of the lobe in a more distal, stable location with the disc covering the ostium (Figure, left panel). In 1 case, the LAA was of adequate size, but a proximal ridge (s/p LAA isolation) lead to Watchman deformation (struts’ introversion on one side) once fully deployed, a behavior observed despite multiple recaptures and a device change: with Amulet, the lobe could be placed distally to the ridge with the disc covering the ostium (Figure, right panel). Mean procedural time was 107±3 min, with a mean contrast volume used of 203±70 mL and a mean fluoroscopy time of 15±4 min (yielding to a mean dose of 2070±3107 mGy). There were no procedural-related complications, and all patients were discharged home after overnight observation. Intraprocedural LAAO device crossover is a rare occurrence, usually secondary to unsatisfactory deployment of the originally planned device. To avoid unsuccessful LAAO, operators should be skilled in implantation of both type of devices and be able to switch from one to the other at the time of the index procedure.Tabled 1PatientLAA os max diameterOriginal deviceFinal device131 mm35 mm Watchman FLX31-mm Amplatzer Amulet229 mm35-mm Watchman FLX34-mm Amplatzer Amulet329 mm35-mm Watchman FLX34-mm Amplatzer Amulet421 mm27-mm Watchman FLX22-mm Amplatzer Amulet Open table in a new tab

Comparison of High Flow Nasal Therapy with Non-Invasive Ventilation and Conventional Oxygen Therapy for Acute Hypercapnic Respiratory Failure: A Meta-Analysis of Randomized Controlled Trials.

We aimed to evaluate whether high flow nasal cannula (HFNC) is an effective and safe method for adult patients with acute hypercapnic respiratory failure (AHRF). We searched the Cochrane Library, Embase, and PubMed databases from inception to August 2022 to obtain randomized controlled trials (RCTs) that compared HFNC with conventional oxygen treatment (COT) or non-invasive ventilation (NIV) in patients with AHRF, and then performed a meta-analysis. A total of ten parallel RCTs with 1265 individuals were identified. Of them, two studies compared HFNC with COT and eight studies compared HFNC with NIV. In terms of intubation rate, mortality, and arterial blood gas (ABG) improvement, HFNC showed comparable effects to NIV and COT. However, HFNC was more comfortable (mean difference [MD] -1.87, 95% confidence interval [CI] =-2.59, -1.15, P <0.00001, I2 =0%) and resulted in fewer adverse events (odds ratio [OR] 0.12, 95% CI=0.06, 0.28, P<0.00001, I2 = 0%), compared with NIV. In comparison to NIV, HFNC could significantly lower heart rate (HR) (MD -4.66, 95% CI=-6.82, -2.50, P <0.0001, I2 =0%), respiratory rate (RR) (MD -1.17, 95% CI=-2.03, -0.31, P =0.008, I2 =0%), and hospital stay length (MD -0.80, 95% CI=-1.44, -0.16, P =0.01, I2 =0%). NIV showed a decreased frequency in the treatment crossover rate, compared with HFNC in patients with pH<7.30 (OR 5.78, 95% CI=1.50, 22.31, P = 0.01, I2: not applicable). Contrary to COT, HFNC could considerably reduce the need for NIV (OR 0.57, 95% CI=0.35, 0.91, P=0.02, I2=0%). HFNC was effective and safe in patients with AHRF. However, in patients with pH <7.30, HFNC may result in a higher incidence of treatment crossover, compared with NIV. Compared to COT, HFNC may decrease the need for NIV in patients with compensated hypercapnia.

Efficacy and Safety of Coronary Intervention Via Distal Trans-Radial Access (DTRA) in Patients with Low Body Mass Index

Background: The distal transradial approach (dTRA) is anticipated to improve the benefits of transradial availability, hemorrhagic incidents and the occurrence of radial artery occlusion (RAO) with the dTRA is uncertain. The aim of this study to investigate the puncture time rate, homeostasis and radial artery occlusion related to low BMI in distal artery access (dTRA) vs conventional radial artery access (cTRA). Study design: This cross-sectional study was carried out at NICVD, Nawabshah, for the duration of six months from July 2022 to December 2022. Materials and Methods: The total participants were 160 who diagnosed coronary artery disorder and include 75 participants in dTRA and 85 participants in cTRA. The age group were included &gt;21 years. The demographic data, surgical methods, catheterization, procedure-related data, procedures of puncture, ultrasound follow up and BMI were recorded. All data was analyzed by SPSS 22 version. Results: The mean age of participants in dTRA group was 72.0±10.1 years and cTRA group was 73.0±18.0 years. In gender, age and BMI were non-significant in both groups. The crossover rate, puncture time, one needle puncture rate and radial artery occlusion were shown significantly change in dTRA and cTRA group, p=0.005. Conclusion: Distal radial access is a new facility for cardiovascular interventions that provides several benefits over prior links. The key benefits would be less arterial blockage and faster hemostasis. When compared to traditional radial artery access, the dTRA may be a viable and reliable connectivity site for both diagnostic and interventional coronary methods, with a decreased prevalence of RAO, high crossover rate and time needed for hemostasis. Keywords: Distal transradial artery (dTRA); conventional transradial artery (cTRA); Radial artery occlusion (RAO)

Transradial access with Simmons guiding catheter for carotid artery stenting: Feasibility and procedural complications in a single-center experience.

There is an increasing number of transradial approach (TRA) for carotid artery stenting (CAS), however, similar techniques and materials as for femoral access are used. We report the results of TRA lower profile technique for CAS using a 7 F Simmons guiding catheter, especially in terms of feasibility and procedural safety in a single center. We retrospectively analyzed 68 consecutive patients with symptomatic extracranial carotid stenoses who underwent 75 CAS between January 2018 and December 2021. The success and crossover rate, procedural time, fluoroscopy, clinical outcomes, technical considerations, and procedural complications were analyzed. TRA CAS with Simmons guiding catheter was successful in 67/75 (89.3%) cases, with a 7 (9.3%) crossover rate. Fluoroscopy mean time was 15.8 minutes. Two forearm hematomas were described. No ischemic or surgical site complications were reported. In our experience frontline TRA with a 7 F Simmons guiding catheter is feasible with high procedural success and a low rate of access site complications.

Operando benchtop NMR reveals reaction intermediates and crossover in redox flow batteries

Redox flow batteries (RFBs) provide a promising battery technology for grid-scale energy storage. High-field operando NMR analyses of RFBs have yielded useful insight into their working mechanisms and helped improve battery performance. Nevertheless, the high cost and large footprint of a high-field NMR system limit its implementation by a wider electrochemistry community. Here, we demonstrate an operando NMR study of an anthraquinone/ferrocyanide-based RFB on a low-cost and compact 43 MHz benchtop system. The chemical shifts induced by bulk magnetic susceptibility effects differ remarkably from those obtained in high-field NMR experiments, due to the different orientations of the sample relative to the external magnetic field. We apply Evans method to estimate the concentrations of paramagnetic anthraquinone radical and ferricyanide anions. The degradation of 2,6-dihydroxy-anthraquinone (DHAQ) to 2,6-dihydroxy-anthrone and 2,6-dihydroxy-anthranol has been quantified. We further identified the impurities commonly present in the DHAQ solution to be acetone, methanol and formamide. The crossover of DHAQ and impurity molecules through the sseparation Nafion® membrane was captured and quantified, and a negative correlation between the molecular size and crossover rate was established. We show that a benchtop NMR system has sufficient spectral and temporal resolution and sensitivity for the operando study of RFBs, and anticipate a broad application of operando benchtop NMR methods for studying flow electrochemistry targeted for different applications.

A Self-Adaptive Trajectory Optimization Algorithm Using Fuzzy Logic for Mobile Edge Computing System Assisted by Unmanned Aerial Vehicle

The advancement of the Internet of Things (IoT) and the availability of wide cloud services have led to the horizon of edge computing paradigm which demands for processing the data at the edge of the network. The development of 5G technology has led to the increased usage of IoT-based devices and the generation of a large volume of data followed by increased data traffic, which is difficult to process by the mobile edge computing (MEC) platform. The latest inventions related to unmanned aerial vehicles (UAVs) helps to assist and replace the edge servers used for MEC. In the present work, the objective is to develop self-adaptive trajectory optimization algorithm (STO) which is a multi-objective optimization algorithm used to solve the vital objectives associated with the above scenario of a UAV-assisted MEC system. The objectives identified are minimizing the energy consumed by the MEC and minimizing the process emergency indicator, where the process emergency indicator implies the urgency level of a particular process. Finding the optimal values for these conflicting objectives will help to further efficiently apply UAV for MEC systems. A self-adaptive multi-objective differential evolution-based trajectory optimization algorithm (STO) is proposed, where a pool of trial vector generation strategies is extended. The strategies and the crossover rate associated with a differential evolution (DE) algorithm are self-adapted using fuzzy systems to improve the population diversity. The experimentation is planned to be conducted on hundreds of IoT device instances considered to be fixed on the ground level and to evaluate the performance of the proposed algorithm for a single unmanned aerial vehicle-assisted mobile edge computing system.

The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope: A multicenter retrospective international study

BackgroundDuodenoscope-related multidrug-resistant organism (MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography (ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. MethodsThis is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score (1 to 10) on performance rating of the single-use duodenoscope, and adverse event (AE) rate. ResultsA total of 66 patients (26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47 (71.2%) grade 3 and 19 (28.8%) grade 4. The technical success rate was 98.5% (65/66). Procedural duration was 64 (interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66 (1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients (6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis (PEP), 1 cholangitis and 1 bleeding. ConclusionsSingle-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

Traditional versus distal radial access for coronary angiography: a meta-analysis of randomized controlled trials.

Radial artery occlusion (RAO) is a well known complication that occurs after traditional radial artery (TRA) intervention and limits the radial artery as a future access site, as well as an arterial conduit. Distal radial artery (DRA) access has emerged recently as an alternative approach with a potential lower incidence of RAO. Database search of Pubmed/MEDLINE, Cochrane Library, and EMBASE was conducted by two authors from inception through 1 October 2022. Randomized trials that compared TRA with the DRA approach to perform coronary angiography were included. Two authors extracted pertinent data into predefined data collection tables. The risk ratios and 95% confidence intervals (CIs) were reported. Eleven trials were included (5700 patients) in the study. The mean age was 62.0 ± 10.9 years. Compared with DRA, vascular access through the TRA was associated with a higher incidence of RAO (risk ratio 3.05, 95% CI, 1.74-5.35, P < 0.01); however, arterial access by using the TRA was associated with a lower incidence of access failure leading to a crossover compared with the DRA approach (risk ratio 0.35; 95% CI, 0.21-0.57, P < 0.01). The incidence of radial artery spasm and access site-associated hematoma was not significant in the group treated with TRA compared with the DRA approach (P > 0.05). The DRA approach was associated with a lower incidence of RAO compared with the TRA approach but this was at the expense of a higher crossover rate.

MP73-15 COMPARISON OF POSTOPERATIVE COMPLICATIONS BETWEEN FOCAL ABLATION AND RADICAL PROSTATECTOMY FOR INTERMEDIATE-RISK PROSTATE CANCER: THE FARP RANDOMIZED CONTROL TRIAL

You have accessJournal of UrologyCME1 Apr 2023MP73-15 COMPARISON OF POSTOPERATIVE COMPLICATIONS BETWEEN FOCAL ABLATION AND RADICAL PROSTATECTOMY FOR INTERMEDIATE-RISK PROSTATE CANCER: THE FARP RANDOMIZED CONTROL TRIAL Eduard Baco, Tigist Alemu, and Erik Rud Eduard BacoEduard Baco More articles by this author , Tigist AlemuTigist Alemu More articles by this author , and Erik RudErik Rud More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of this study is to report and compare postoperative complications at 1 year, in Clavien-Dindo classification (CD) and Comprehensive Complication Index (CCI), for patients who were treated by Focal Ablation (FA), using high-intensity focused ultrasound (HIFU) or transurethral ultrasound ablation (TULSA), vs. Robot-Assisted Laparoscopic Prostatectomy (RALP) in the FARP Randomized Control Trial. METHODS: 213 men with biopsy-proven unilateral intermediate-risk prostate cancer visible on MRI were randomized 1:1 to FA or RALP with a cross-over rate of 27 % from RALP to FA. 131 patients were treated with FA (108 HIFU, 23 TULSA), and 75 with RALP using a unilateral nerve-sparing technique. Seven patients who were randomized to RALP declined to undergo prostatectomy and remained untreated. All patients were followed for at least 1 year with no drop-out. Complications were prospectively registered in a digital patient journal, entered in the FARP database, and graded according to CD. CCI was calculated as the sum of all complications and weighted for severity. Differences in binary outcomes were assessed with a Chi-square test, while continuous variables were evaluated using an independent sample T-test. RESULTS: Mean age, PSA, index tumor diameter, and prostate volume on MRI for FA vs. RALP were: 64 vs. 66 years, p=0.3; 8.6 vs. 8.5 ng/ml, p=0.9; 14.5 vs. 15.5 mm, p=0.2; and 41.3 vs. 41.7 ml, p=0.9. Grade CD 1 and 2 complications in FA vs. RALP were 17% vs. 25 %, p=0.18. The incidence of serious complications defined as CD≥3 was 2 % vs. 13 %, p<0.001 (Table 1). The mean CCI was 3.9 and 6.9 in FA and RALP, respectively; p=0.08. CONCLUSIONS: FA of prostate was associated with significantly better safety outcomes as compared to RALP considering the frequency and severity of CD grade≥3 complications and across the entire CCI scale. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1041 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eduard Baco More articles by this author Tigist Alemu More articles by this author Erik Rud More articles by this author Expand All Advertisement PDF downloadLoading ...

Size and Charge Effects on Crossover of Flow Battery Reactants Evaluated by Quinone Permeabilities Through Nafion

Organic reactants are promising candidates for long-lifetime redox flow batteries, and synthetic chemistry unlocks a wide design space for new molecules. Minimizing crossover of these molecules through ion exchange membranes is one important design consideration, but the ways in which the crossover rate depends on the structure of the crossing species remain unclear. Here, we contribute a systematic evaluation of size- and charge-based effects on dilute-solution small molecule permeability through the Nafion NR212 cation exchange membrane. We found that increasing the magnitude of charge number z with the same sign as membrane fixed charges, achieved here by successive sulfonation of quinone redox cores, results in more than an order of magnitude permeability reduction per sulfonate. Size-based effects, understood by comparing the Stokes radii of the quinones studied, also reduces permeability with increasing effective molecule size, but doubling the effective size of the redox reactants resulted in a permeability decrease of less than a factor of three.