Cumulative Probability Curves Research Articles

Agricultural Contribution of Chloride to a Saturated Riparian Buffer System: A Case Study in Central Illinois

ABSTRACT Increases in chloride concentrations in surface water and groundwater from anthropogenic sources is a growing concern throughout the world. In the midwestern United States, the agriculture contribution of chloride may elevate concentrations in surface and groundwater systems. A saturated riparian buffer (SRB), installed to reduce nutrient input into an adjacent stream, and the groundwater water upgradient were investigated to identify sources of chloride and to quantify the agricultural contribution. During a 7-year period, over 2,200 water samples collected from 35 wells, a diversion box, and a stream were analyzed for major anions. Additionally, the waters from four quarterly (seasonal) samplings (n = 155) during the seventh year were analyzed for cations. A cumulative probability curve identified three populations of chloride: (1) upgradient shallow groundwater; (2) diversion box (waters drained from an agricultural field), downgradient shallow groundwater (representing the SRB), diamicton groundwater (waters collected deeper from within the unweathered parent material); and (3) stream water. A background chloride concentration was established at 3.9 mg/L. Elevated concentrations above the background level coupled with principal component analysis suggest agricultural contribution from the diverted tile-drainage waters was a source of chloride. In winter and spring, chloride concentrations were highest in the diversion box, while up-gradient wells were the lowest. Waters downgradient of the diversion tiles had chloride concentrations lower than the tile but higher than the upgradient waters due to mixing of the diverted tile water and the upgradient groundwater. For the specific site, agriculture contributes chloride, but at concentrations below the chronic threshold of 230 mg/L.

Bioaccessibility of plastic-related compounds from polymeric particles in marine settings: Are microplastics the principal vector of phthalate ester congeners and bisphenol A towards marine vertebrates?

Marine vertebrates are known to ingest significant amounts of microplastics (MPs). Once ingested, MPs might cause gastrointestinal injuries and serve as a path of harmful plastic components, such as phthalate esters (PAEs) and bisphenol A (BPA) in the food chain. However, there is a lack of standardized in-vitro methods capable of simulating fish uptake of chemicals from MPs in the environment as potential vectors of such contaminants. In this work, leaching and in-vitro oral bioaccessibility testing of PAEs and BPA from MPs were conducted batchwise using artificial seawater and gut fluids mimicking gastric, intestinal, and gastrointestinal compartments of marine vertebrates at physiological temperature. The environmental and physiologically relevant extraction tests were applied to medium-density polyethylene (PE) and polyvinyl chloride (PVC) certified reference materials containing eight PAEs of varying hydrophobicity, namely, dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate, benzylbutyl phthalate, diethylhexyl phthalate, di-n-octyl phthalate, diisononyl phthalate and diisodecyl phthalate, and BPA (only in PE) as MP surrogates with realistic analyte concentrations of additives for primary MPs. The analysis of the leachates/gut fluid extracts was performed via dilute-and-shoot by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Only the most hydrophilic compounds, i.e. DMP, DEP and BPA, were found to get released significantly in saline waters, and exhibited the highest oral bioaccessibility rates (34–83 %). Based on our results, a dual-compartment physiologically relevant gastrointestinal test is recommended for appropriate estimation of fish bioaccessibility. The fish daily intakes of DMP, DEP and BPA from MPs, and seawater ingestion as well were estimated using several contamination scenarios (10th percentile as the low level, 50th percentile as the medium level and 90th percentile as the high level) based on probabilistic distributions and cumulative probability curves of measured environmental concentrations of (i) MPs in seawater throughout the world, (ii) DMP, DEP and BPA in beached MPs and those sampled in the open ocean (including both incurred and adsorbed contaminants), and (iii) DMP, DEP and BPA in seawater as reported in recent literature. Under a medium-level concentration scenario (50th percentile) in marine settings, and taking the gastrointestinal bioaccessibility factor into account, the daily intake of DMP, DEP and BPA from MPs accounted for a mere 0.02 % of the waterborne contribution. Hence, the ingestion of MPs should not be considered the primary route of fish exposure to BPA and the most polar PAEs in marine environments. However, more studies on the local and the global scales for mass concentrations of MPs and additives in marine settings are needed for further confirmation of our findings.

Clinical features and surgical strategy of retroperitoneal liposarcoma involving the kidney capsule: a retrospective comparative cohort study.

Valid and generalizable data on the clinical features and surgical strategies for retroperitoneal liposarcoma (LPS) involving the kidney capsule remain scarce. This study aimed to investigate the clinical characteristics, morbidity, mortality, and long-term survival of patients with retroperitoneal LPS involving the kidney capsule. The authors analyzed a prospectively maintained database of patients who underwent surgical resection for retroperitoneal LPS between 2015 and 2020. The patients were categorized into kidney capsule or no kidney capsule groups based on the presence or absence of kidney capsule involvement. A kidney-sparing strategy for retroperitoneal LPS involving the kidney capsule was developed. The primary outcome measure was overall survival (OS). The cumulative event probability curve was estimated using the Kaplan-Meier, and differences between groups using the Log-Rank. The study population consisted of 128 patients-54 with and 74 without kidney capsule involvement. Of these patients, 70 were female (54.7%) and 58 were male (45.3%), with a median age of 55. The median follow-up duration was 35 months. Postoperative morbidity, mortality, length of hospital stay, length of ICU stay, OS, and recurrence-free survival (RFS) did not differ significantly between the groups. Eleven patients developed postoperative acute kidney injury (AKI), and one patient required dialysis during the follow-up period. In multivariable logistic regression analysis, only nephrectomy was independently associated with postoperative AKI. Subgroup analysis of patients with kidney capsule involvement showed that nephrectomy did not improve OS or RFS but significantly decreased postoperative estimated glomerular filtration rate. Nephrectomy was associated with an increased risk of postoperative AKI after retroperitoneal LPS resection. A kidney-sparing strategy for retroperitoneal LPS involving the kidney capsule achieved optimal clinical outcomes.

Remaining Useful Life for Heavy-Duty Railway Cast Steel Knuckles Based on Crack Growth Behavior with Hypothetical Distributions

The current research on the integrity of critical structures of rail vehicles mainly focuses on the design stage, which needs an effective method for assessing the service state. This paper proposes a framework for predicting the remaining useful life (RUL) of in-service structures with and without visible cracks. The hypothetical distribution and delay time models were used to apply the equivalent crack growth life data of heavy-duty railway cast steel knuckles, which revealed the evolution characteristics of the crack length and life scores of the knuckle under different fracture failure modes. The results indicate that the method effectively predicts the RUL of service knuckles in different failure modes based on the cumulative failure probability curves for different locations and surface crack lengths. This study proposes an RUL prediction framework that supports the dynamic overhaul and state maintenance of knuckle fatigue cracks.

High incidence of gallstones after Roux-en-Y reconstruction gastrectomy in gastric cancer: a multicenter, long-term cohort study.

Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. Five hundred thirty-one patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, gallstones occurred in 170 cases after gastrectomy, of which 145 cases accounted for 85.29% of all stones in the first two years after surgery. Then, to reduce the impact of bias, a 1:1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥23kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis showed that open surgery further increased the risk of gallstones after total gastrectomy. The incidence of gallstones increased significantly within 2years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.

Functional outcomes of robot-assisted radical prostatectomy with preservation of pelvic stabilized structure and early elevated retrograde liberation of neurovascular bundle

Objectives: To examine the functional outcomes of robot-assisted radical prostatectomy (RARP) with preservation of pelvic floor stabilized structure and early elevated retrograde liberation of the neurovascular bundle (PEEL). Methods: This study was a retrospective cohort study. Between June 1, 2022, and March 20, 2023, 27 cases of RARP with PEEL and 153 cases of RARP with preservation of pelvic floor stabilized structure (PPSS) were included in this study. All patients were males, aged (62.5±5.2) years (range: 50 to 73 years). There were 18 cases of ≤T2b stage and 9 cases of T2c stage. After 1∶1 propensity score matching, the postoperative functional outcomes of 27 cases of RARP with PEEL and 27 cases of RARP with PPSS were compared. All surgeries were performed by a single surgeon and included patients were clinically staged as cT1-2N0M0 without preoperative urinary incontinence or erectile dysfunction. In RARP with PEEL, the prostate was cut near the midline at the front when dissecting the neurovascular bundle, dissection was performed between the visceral layer of the pelvic fascia and the prostatic fascia, preserving the parietal layer and the visceral layer of the pelvic fascia, and the neurovascular bundle was retrogradely released from the apex. The cumulative probability curve was plotted using the Kaplan-Meier method and the Log-rank test was used to compare the differences in functional outcomes between the two groups. Univariate and multivariate analysis with the Cox proportional hazards model was used to compare postoperative urinary continence and sexual function. Results: The recovery time of continence and potency was significantly longer in the PPSS group than in the PEEL group (all P<0.05). The continence rate of the PEEL group was significantly higher than that of the PPSS group (92.59% vs. 68.10%, P=0.026) at 3 months after surgery. The potency rate of the PEEL group was also significantly higher than that of the PPSS group (40.70% vs. 15.10%, P=0.037) at 3 months after surgery. In the univariate analysis, compared to the PPSS technique, the PEEL technique was associated with a shorter recovery time of continence (HR=1.94, 95%CI: 1.08 to 3.48, P=0.027) and a shorter recovery time of potency (HR=2.06, 95%CI: 1.03 to 4.13, P=0.042). In the multivariate analysis, the PEEL technique was an independent prognosis factor for postoperative recovery of continence (HR=2.05, 95%CI: 1.01 to 4.17, P=0.047) and potency (HR=3.57, 95%CI: 1.43 to 8.92, P=0.007). All the cases of the PPSS group and the PEEL group were performed successfully with negative surgical margins. Conclusion: Compared with PPSS, PEEL may be more conducive to the recovery of urinary continence and sexual function after RARP.

Concise extraction and characterization of the pore-throat network in unconventional hydrocarbon reservoirs: A new perspective

In this study, a new image-based method for the extraction and characterization of pore-throat network for unconventional hydrocarbon storage and exploitation is proposed. “Pore-throat solidity”, which is analogous to particle solidity, and a new method for automatic identification of pores and throats in tight sandstone oil reservoirs are introduced. Additionally, the “pore-throat combination” and “pure pore” are defined and distinguished by drawing the cumulative probability curve of the pore-throat solidity and by selecting an appropriate cutoff point. When the discrete grid set is recognized as a pore-throat combination, Legendre ellipse fitting and minimum Feret diameter are used. When the pore and throat grid sets are identified as pure pores, the pore diameter can be directly calculated. Using the new method, the analytical results for the physical parameters and pore radius agree well with most prior studies. The results comparing the maximum ball and the new model could also prove the accuracy of the latter's in micro and nano scales. The new model provides a more practical theoretical basis and a new calculation method for the rapid and accurate evaluation of the complex processes of oil migration.

Abstract 15373: Guiding Modalities for Non-Culprit Artery Revascularization in Acute Myocardial Infarction With Multivessel Disease: A Pooled Analysis of FLOWER-MI and FRAME-AMI

Background: Currently, it is not yet clear whether angiography or fractional flow reserve (FFR) is better in guiding percutaneous coronary intervention (PCI) for non-culprit artery revascularization in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) after primary PCI. Therefore, a pooled analysis is conducted to summarize the findings from two only available trials, i.e., FRAME-AMI and FLOWER-MI. Aim: To compare major cardiac adverse event (MACE) between angiography-guided and FFR-guided non-culprit artery revascularization in AMI and MVD Method: MACE defined as a primary endpoint of all-cause death, non-fatal myocardial infarction, or unplanned revascularization was the primary outcome while all-cause death was the secondary outcome. Pooled cumulative probability of developing the primary endpoint curves were constructed from extracted Kaplan-Meier curves using Weibull distribution, and a meta-analysis was performed to pool extracted hazard ratio (HR) and 95% confidence intervals (CI). Furthermore, a subgroup analysis of STEMI and NSTEMI groups was performed. Result: Cumulative probability curve is displayed in Figure 1A. A pooled analysis showed no difference between two guiding modalities both in MACE and all-cause death risk reduction. FFR-guided PCI reduced MACE risk by 24% (HR 0.76, 95% CI 0.25-2.27) and risk of all-cause death by 47% (HR 0.53, 95% CI 0.18-1.54) compared to angiography-guided PCI but not statistically significant as shown in Figure 1B. Regarding subgroup analysis concerning MACE, FFR-guided PCI was not superior to angiography-guided PCI in STEMI (HR 1.06, 95% CI 0.60-1.90) despite significantly superior to angiography-guided PCI in FRAME-AMI NSTEMI group. Conclusion: FFR-guided PCI is not superior to angiography-guided PCI in non-culprit artery revascularization in AMI and MVD concerning risk reduction of MACE and all-cause death, but might show superiority in the NSTEMI subgroup.

Abstract 15493: Coronary Artery Revascularization Strategies for Angiographically Inconclusive Lesions: A Network Meta-Analysis of Randomized Controlled Trials

Background: There has been no head-to-head comparison among coronary artery revascularization strategies including different guiding modalities for percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). Aim: To compare the cardiovascular outcome of all available coronary artery revascularization strategies Method: Systematic search of randomized controlled trials and study selection were performed in accordance with PRISMA guidelines. Coronary artery disease with angiographically inconclusive lesions was the domain of interest. Trials were excluded if they involved patients with left main disease, chronic total occlusion, or primary PCI for acute myocardial infarction (MI). The outcome of interest was a primary endpoint of all-cause death, non-fatal MI, or unplanned revascularization. Patient-level data was constructed from Kaplan-Meier (KM)-extracted data and combined across studies. A mixed-effect Weibull regression with accelerated failure time was used, and hazard ratios (HR) with 95% confidence intervals (CI) were then estimated. Result: A network map of 7 interventions including 15 trials of 17286 patients and cumulative probability curves are shown in Figure 1A and 1B respectively. CABG is the most effective strategy with 42% risk reduction in primary endpoint compared to angiography-guided PCI (HR 0.58, 95% CI 0.50-0.67), followed by quantitative flow ratio (QFR)-guided PCI (HR 0.64, 95% CI 0.50-0.82), intravascular ultrasound (IVUS)-guided PCI (HR 0.70, 95% CI 0.53-0.93) and fractional flow reserve (FFR)-guided PCI (HR 0.79, 95% CI 0.66-0.96). PCI guided by instantaneous flow ratio (iFR) and optical coherence tomography (OCT) is also superior to angiography but not statistically significant as shown in Figure 1C. Conclusion: CABG remains the most effective strategy in reducing the primary endpoint while QFR is superior to OCT, IVUS, FFR, iFR, and angiography in guiding PCI accordingly.

Ignition Delay Time Modeling in Wire-EDM

This study presents a comprehensive investigation and modeling of the ignition delay time (td) in wire-EDM (WEDM). The research focuses on the influence of gap distance, discharge energy, and piece height on the stochastic distributions of td, providing important insights into the complex properties of these distributions. Observations indicate that these parameters exert significant yet intricate influences on td, with a particular emphasis on the gap distance. A critical value was identified, around 8μm to 10μm, that divides the stochastic behavior. To capture the binomial nature of td, a mixture probability model consisting of two Weibull distribution curves was developed and validated through extensive experimentation and a data analysis. The model demonstrated strong agreement with observed cumulative probability curves, indicating its accuracy and reliability in predicting td. Further, a sensitivity analysis revealed regions of fast change, emphasizing the challenges and importance of careful parameter selection in control of WEDM processes. The findings of this study contribute to a deeper understanding of WEDM processes and provide a modeling approach for predicting td. Future research directions include refining the model by incorporating additional input parameters, investigating the influence of other process variables on td.

Comparative effectiveness of different exercise interventions for elderly patients with hip fracture: A systematic review and Bayesian network meta-analysis protocol of randomized controlled trials.

Exercise intervention (EI) is a promising and economical way for elderly patients with hip fracture, but the evidence regarding effective EIs remains fragmented and controversial, and it is unclear which type of exercise is optimal. The purpose of this Bayesian network meta-analysis (NMA) is to compare and rank the efficacy of various EIs in elderly patients with hip fracture. A comprehensive literature search was performed using a systematic approach across various databases including Medline (via PubMed), CINAHL, CNKI, Web of Science, Wan Fang, Embase, VIP, Cochrane Central Register of Controlled Trials and CBM databases. The search encompasses all available records from the inception of each database until December 2022. The Inclusion literature comprises randomized controlled trials that incorporate at least one EI for elderly patients with hip fracture. We will assess the risk of bias of the studies in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, and assess each evidence of outcome quality in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework. The NMA will be performed by STATA 15.0 software and OpenBUGS version 3.2.3. The identification of publication bias will be accomplished through the utilization of a funnel plot. We will rank the EIs effects according to the cumulative ranking probability curve (surface under the cumulative ranking area, SUCRA). The primary outcomes will be hip function in elderly patients, and the secondary outcomes will be activities of daily living, walking capacity and balance ability of elderly patients. PROSPERO registration number: CRD4202022340737.

Age of first deciduous tooth eruption in a Portuguese children population: a cross-sectional study

Objectives: To define the timing of the first deciduous tooth eruption in a sample of Portuguese children. Methods: Observational study including a convenience sample of 2115 healthy Portuguese children aged between 1-24 months. A single clinician performed the oral observation under an artificial light source, identifying the first erupted deciduous tooth and registering age (in months). Data were analyzed with IBM® SPSS® v24, R v3.3.2, and Python v3.7.1 (α=0.05). The percentiles of the age of first tooth eruption were determined, along with the cumulative probability curve for both genders and the proportion of first erupted tooth type per gender with its confidence interval. Results: The age of first tooth eruption was slightly inferior in males (mean=7.01 (± 2.24); median=6.0 months; 95% CI [5.8, 6.2]) than in females (mean=7.55 (± 2.41); median=6.5 months; 95% CI [6.3, 6.7]), with a statistically significant difference. The first deciduous tooth erupting was the mandibular central incisor, on average, at 6.94 (± 2.10) months in males and 7.49 (± 2.17) months in females. Conclusions: The present study indicates that, unequivocally, the mandibular central incisor was most often the first deciduous tooth to erupt, and, on average, that happened at 6.94 months for males and at 7.49 months for females.

Grain Size Curve Characteristics of 2nd Member of Sangonghe Formation in Qianshao Area and Its Indicative Significance of Hydrodynamic Environment

There are mainly two sedimentary types of the 2nd member of Jurassic Sangonghe Formation (J1s2) in the Qianshao area: shallow-water delta and sandy debris flow. In order to accurately understand the characteristics and further identify the difference of sedimentary microfacies, the characteristics of the grain size curve are analyzed. The results show that the cumulative probability curve of sandstone particle size in the research area mainly includes two basic types: tractive current type and sandy debris flow type. The tractive current type is mainly developed in the shallow-water delta front. Among them, the inner front subaqueous distributary channel microfacies develop two patterns: tri-segment pattern and one bouncing segment-one suspension segment-one complex transitional zone pattern. The transitional section is widely developed. There are two patterns in the subaqueous distributary channel microfacies of the outer front (bi-segment pattern and one bouncing segment-one suspension segment-one transitional zone pattern) and two patterns in the estuary bar microfacies (bi-bouncing segment-one suspension segment-one transitional zone pattern and one bouncing segment-one suspension segment-one transitional zone pattern). The main tractive current characteristics are higher bouncing component content and slope and lower suspended component content. The sand debris flow type mainly develops two patterns: one bouncing segment-one suspension segment-one transitional zone pattern and one bouncing segment-one suspension segment-one complex transitional zone pattern with lower jump component content and slope and higher suspended component content.

Sedimentary characteristics of deep-lacustrine fans: a case study on the lower Jurassic Sangonghe formation of the Turpan Basin, NW China

Ancient deep-lacustrine fans serve as prolific hydrocarbon reservoirs and provide records of climatic and tectonic activity. The deep-lacustrine fans of the Lower Jurassic Sangonghe Formation in Turpan Basin have become the most important exploration targets as stratigraphic traps. An integrated analysis of field profile investigation, core examination, well logging and seismic reflection profile interpretation, and grain size distribution patterns has enabled the identification of a series of deep-lacustrine fans. The deep-lacustrine fans of the Lower Jurassic Sangonghe Formation, deposited in the Turpan Basin consist of sandy debris flow, bottom current reworking and turbidite lithofacies. The deep-lacustrine fans are depicted by the following geological and geophysical features: (1) abundant soft-sediment deformation structures, and dish structures, normal graded beddings and inverse graded bedding structures developed in the strata, (2) the grain size distribution on the C–M diagram is parallel to the C = M baseline and cumulative probability curves display a bi-segment pattern with the suspension components to be the dominant parts, (3) gamma-ray logging curve are inverse-cycle features and seismic reflection profiles are characterized of poor continuity, high amplitudes, scattered and lenticular shapes. The deep-lacustrine fans are favorable target reservoirs, and have become the most important exploration targets in the Turpan Basin.

Microfluidic Platform with Serpentine Geometry Providing Chaotic Mixing in Induction Time Experiments.

We present a droplet microfluidic platform mixing the contents of the droplet chaotically in microfluidic induction time measurements, a promising method for quantifying nucleation kinetics with minute amounts of solute. The nucleation kinetics of aqueous potassium chloride droplets dispersed in mineral oil without surfactants is quantified in the presence and absence of chaotic mixing. We demonstrate the ability of the proposed platform to dictate droplet size, to provide a homogeneous temperature distribution, and to chaotically mix the droplet contents. Chaotic mixing in induction time measurements is facilitated by the motion of droplets through serpentine micromixer bends, while the extent of mixing is controlled by how much droplets move. Different nucleation kinetics are observed in experiments where the droplets are static, mixed, and in motion. We hypothesize that the droplet motion induces formation of a thin-liquid Bretherton film surrounding the droplets. The thin film shields droplets from solid boundaries that are more efficient heteronucleant surfaces compared to liquid–liquid interfaces. We observed that repeated microfluidic induction time measurements, particularly with moving droplets, produce significantly distinct cumulative nucleation probability curves, indicating that the measured nucleation kinetics depend strongly on the details of the experimental procedure, which we discuss in detail. Finally, we compare the microfluidic experiments to well-mixed, milliliter volume, turbidity-based measurements in the context of classic nucleation theory.

Microstructure-based fatigue life modeling methodology for ferritic-pearlitic hypo-eutectoid steels

A microstructure-based fatigue life prediction methodology was proposed and verified for 44MnSiVS6 hypo-eutectoid steel. As a first step, a statistically equivalent synthetic microstructure generation algorithm was developed by applying the cellular automata under the multi-level microstructure generation approach, and verified by comparing to the real microstructure. Crystal plasticity-based elasto-viscoplastic constitutive models were developed for the primary ferrite and pearlite, and their constitutive parameters were calibrated. Synthetic microstructure-based crystal plasticity finite element method (CP-FEM) simulations were performed for stress-controlled axial fatigue tests. The Fatemi-Socie (FS) parameter was chosen to calculate a fatigue indicator parameter increment (ΔFIP) per cycle, and its cumulative distribution probability (CDP) curve was obtained from CP-FEM simulations. Three different criteria extracting a representative ΔFIP from the CDP curve were proposed after thoroughly examining the nature of the CDP curves, which showed the dual transition in the upper CDP range. Extracted representative ΔFIP values coupled with the power law-based model gave reasonable fatigue life prediction. In particular, the best prediction was made when the representative ΔFIP values were taken beyond the second transition of the CDP curve, in which the ΔFIP hot spots were concentrated in the primary ferrite.

An approach to exploring patterns of imbalance and potential missingness in reports of the randomized baseline values for primary outcomes measurable at baseline in randomized controlled trials for meta-analyses

BackgroundThis study evaluated the adequacy of randomization in randomized controlled trials by investigating baseline differences in the primary outcome when a meta-analysis employed an outcome whose baseline level was measurable.MethodsWe retrieved Cochrane reviews published during one year. We calculated the proportion of studies that reported randomized baseline values for the primary outcome. The standardized mean difference (SMD) was used to assess baseline imbalance and heterogeneity. We explored ranking-ordered forest plots using a normal cumulative probability curve as a guideline representing well-performed randomized trials. When skewness was suggested, a funnel plot was drawn to assess whether there was a significant linear trend.ResultsIn 10 of 18 meta-analyses, more than 25% of trials did not report randomized baseline values of the primary outcomes. Three meta-analyses indicated baseline imbalance (P < 0.1) and three showed substantial heterogeneity (I2 > 60%). Four meta-analyses with forest plots suggesting a skewed SMD distribution also showed a linear trend on their standard errors on the funnel plot.ConclusionsIf the primary outcome is measured at baseline, it is essential to explore the full scope of baseline imbalance among the trials. This could help understand patterns of bias, including missingness, for designing adjustment.

Socioeconomic, Clinical, and Molecular Features of Breast Cancer Influence Overall Survival of Latin American Women.

Molecular profile of breast cancer in Latin-American women was studied in five countries: Argentina, Brazil, Chile, Mexico, and Uruguay. Data about socioeconomic characteristics, risk factors, prognostic factors, and molecular subtypes were described, and the 60-month overall cumulative survival probabilities (OS) were estimated. From 2011 to 2013, 1,300 eligible Latin-American women 18 years or older, with a diagnosis of breast cancer in clinical stage II or III, and performance status ≦̸1 were invited to participate in a prospective cohort study. Face-to-face interviews were conducted, and clinical and outcome data, including death, were extracted from medical records. Unadjusted associations were evaluated by Chi-squared and Fisher’s exact tests and the OS by Kaplan–Meier method. Log-rank test was used to determine differences between cumulative probability curves. Multivariable adjustment was carried out by entering potential confounders in the Cox regression model. The OS at 60 months was 83.9%. Multivariable-adjusted death hazard differences were found for women living in Argentina (2.27), Chile (1.95), and Uruguay (2.42) compared with Mexican women, for older (≥60 years) (1.84) compared with younger (≤40 years) women, for basal-like subtype (5.8), luminal B (2.43), and HER2-enriched (2.52) compared with luminal A subtype, and for tumor clinical stages IIB (1.91), IIIA (3.54), and IIIB (3.94) compared with stage IIA women. OS was associated with country of residence, PAM50 intrinsic subtype, age, and tumor stage at diagnosis. While the latter is known to be influenced by access to care, including cancer screening, timely diagnosis and treatment, including access to more effective treatment protocols, it may also influence epigenetic changes that, potentially, impact molecular subtypes. Data derived from heretofore understudied populations with unique geographic ancestry and sociocultural experiences are critical to furthering our understanding of this complexity.

Geomorphology of a bended submarine canyon in Wanhu Seamount region, northern South China Sea: Insights from manned submersible observation and measurement

Submarine canyons can transport large volumes of terrigenous material from the continent to the deep-sea environment and are the primary conduits of source-to-sink systems. The large-scale morphologic features of canyons have been well studied using seismic reflection and the bathymetry data. However, detailed analyses of the small-scale elements of canyon morphology are relatively few because of the limited resolution of traditional field investigations. In this paper, the multi-scaled geomorphology of a bended submarine canyon (canyon C4) located in Wanhu Seamount region (northern South China Sea) is described and discussed based on the in-situ high-definition video data, high-precision near-bottom acoustic data, and push-cores obtained using the manned submersible vehicle. The NNW-trending submarine canyon diverted to 122.5° at the foot of Wanhu Seamount, and the fresh erosional surfaces were recorded using the video data at the canyon axis bend. A total of eight sediment waves were generated at the overbank of the bending region. These waves contain wavelengths and wave heights decreasing in an upslope direction from the canyon axis towards the Wanhu Seamount. The C-M pattern (coarsest one percentile grain size versus median grain size values), grain cumulative probability curves, and grain size gradations derived from the sediment cores suggested that these sediment waves were induced by a turbidity current. The bending of the canyon resulted from the deflection and reflection of the turbidity currents, which were constrained by Wanhu Seamount. The abnormal geomorphologies of some sediment waves were related to the back-squeezed underflow of the turbidity currents. The turbidity current behavior was compared and found to be in agreement with the experimental and modeling simulation results mentioned in the literature. However, the morphologic setting in the natural case was more complex than that observed from the experiments, with the flow behaviors being more complicated. Future studies are required for more detailed comparison between the natural case and simulations to better understand the turbidity current behavior in a bended submarine canyon.

Predictors of Hyperviscosity Syndrome (HVS) in Waldenström Macroglobulinemia (WM)

Abstract Background Up to 30% of patients (pts) with WM can develop HVS, although serum viscosity (sV) level associated with hyperviscosity-related symptoms in individual pts with WM varies (symptomatic threshold). Also, monoclonal IgMs exhibit a wide range of intrinsic viscosity values with differing individual properties. A recent study proposed that serum IgM level (sIgM) level >6000 mg/dL at diagnosis be considered a new criterion for initiating therapy in otherwise asymptomatic (smoldering) WM to pre-empt the development of HVS.(Gustine et al., BJH 2017) However, the study did not consider patients' sV as information on this parameter was unavailable. We therefore 1) evaluated the predictors of HVS including sV in WM, and 2) assessed the potential value of incorporating the sIgM level at diagnosis into the Consensus criteria for initiating therapy in WM. (Kyle et al., Semin Oncol. 2003) Methods All pts seen at Mayo Clinic, Rochester, between January 1, 01/01/1996 and 06/30/ 2017, in whom a definitive diagnosis of WM was made, were included. HVS was identified by the presence of ≥1 symptoms characteristic of HVS (Stone et al., Blood 2012) that could not otherwise be attributed to another cause. Receiver Operating Characteristic (ROC) curve analysis was used to identify cut-off for continuous variables. Multivariate analysis (MVA) using Cox proportional hazard method was performed to identify independent predictive factors for HVS. Based on this, sV and sIgM at diagnosis of WM were used to formulate a score to predict the cumulative probability of developing HVS in pts who did not present with HVS at diagnosis of WM. sV of 2.2-4.0 cp and sIgM >4,600 mg/dl at diagnosis of WM were given 1 point each and sV >4cp at diagnosis was given 2 points based on hazard ratios (HR) on MVA, allowing for a minimum additive score of 0 and maximum of 3. Kaplan -Meier method was utilized for all time-to-event analyses. Results Of 687 pts, HVS was observed in 93 (13.5%) pts, either at the time of diagnosis of WM (n=48) or subsequently during the disease course. The baseline characteristics, presenting symptoms and laboratory parameters of pts with and without HVS, are outlined in Table 1. Optimal cut-offs from ROC curve analysis for sV and sIgM were 2.2 cp and 4600 mg/dL, respectively for predicting the development of HVS. After excluding the pts who developed HVS at diagnosis, a MVA showed that sIgM >4600mg/dL [HR 3.1 (1.3-8.9); p 2.2 cp [HR 7.6 (3.2-20.5 p 4 cp and sIgM >4600 mg/dL (score 3), with 36% cumulative probability of developing HVS at 6 months (Figure 1). Of 520 pts in whom sIgM levels at diagnosis were available, 107 (21%) had a sIgM level >6000 mg/dL. Of these, 83 (78%) pts had one or more indications at diagnosis or instituting systemic therapy per the 2003 Consensus criteria [Hb 6000 mg/dl at diagnosis were otherwise asymptomatic (smoldering WM), not requiring therapy at diagnosis. The median sV for this cohort was 1.6 cp (1.0-4.0 cp) and no pts had sV >4 cp. Of these 24 pts, none developed HVS subsequently, and median time to frontline treatment was 9 years (95% CI 3.6-12.3 years). The median follow-up for the entire cohort was 9.6 years (95% CI: 8.9-10.6) with no difference in the OS in pts with HVS [median OS 9.6 years (95% CI: 6.2-12.3)] versus pts without HVS [median OS 9.7 years (95% CI: 8.8-10.7), p=0.67]. Conclusion A vast majority of patients with baseline sIgM >6000 mg/dL already have an indication for commencement of therapy based on the 2003 Consensus guidelines. The probability of developing HVS in otherwise asymptomatic patients with sIgM level >6000 mg/dl alone at diagnosis remains low if sV is not taken into account, and high sIgM levels alone at diagnosis may not merit preemptive therapy. A simple scoring system based on sVand sIgM level can reliably predict for the development of HVS in pts who do not present with HVS at diagnosis. Regardless, the overall outcome of pts with WM is unaffected by the development of HVS. Download : Download high-res image (224KB) Download : Download full-size image Disclosures Kumar: Celgene, Millennium/Takeda, Onyx, AbbVie, Janssen, Sanofi, Novartis, Amgen, Genentech, Merck, Oncopeptides, Roche, Skyline Diagnostics: Research Funding; Celgene, Millennium, BMS, Onyx, Janssen, Noxxon, AbbVie, Amgen, Merck, Oncopeptides, Skyline Diagnostics, Takeda: Consultancy; Skyline: Honoraria. Gertz: Celgene, Novartis, Smith-Kline, Prothena, Ionis, Amgen: Honoraria; Millennium: Consultancy, Honoraria. Witzig: Novartis: Research Funding; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Acerta: Research Funding; Kura: Research Funding. Dingli: Karyopharm Therapeutics: Research Funding; Millenium: Consultancy; Takeda: Consultancy; Janssen: Consultancy; Alexion Pharmaceuticals: Consultancy. Dispenzieri: Celgene, Millenium, Pfizer, Janssen: Research Funding. Ansell: Affimed: Research Funding; Bristol-Myers Squibb: Research Funding; Merck: Research Funding; Seattle Genetics: Research Funding; Celldex: Research Funding. Kapoor: Takeda, Celgene and Amgen: Research Funding.