Equivalent Results In Terms Research Articles

Hyperparameter Optimization for 1D-CNN-Based Network Intrusion Detection Using GA and PSO

This study presents a comprehensive exploration of the hyperparameter optimization in one-dimensional (1D) convolutional neural networks (CNNs) for network intrusion detection. The increasing frequency and complexity of cyberattacks have prompted an urgent need for effective intrusion-detection systems (IDSs). Herein, we focus on optimizing nine hyperparameters within a 1D-CNN model, using two well-established evolutionary computation methods—genetic algorithm (GA) and particle swarm optimization (PSO). The performances of these methods are assessed using three major datasets—UNSW-NB15, CIC-IDS2017, and NSL-KDD. The key performance metrics considered in this study include the accuracy, loss, precision, recall, and F1-score. The results demonstrate considerable improvements in all metrics across all datasets, for both GA- and PSO-optimized models, when compared to those of the original nonoptimized 1D-CNN model. For instance, on the UNSW-NB15 dataset, GA and PSO achieve accuracies of 99.31 and 99.28%, respectively. Both algorithms yield equivalent results in terms of the precision, recall, and F1-score. Similarly, the performances of GA and PSO vary on the CIC-IDS2017 and NSL-KDD datasets, indicating that the efficacy of the optimization algorithm is context-specific and dependent on the nature of the dataset. The findings of this study demonstrate the importance and effects of efficient hyperparameter optimization, greatly contributing to the field of network security. This study serves as a crucial step toward developing advanced, robust, and adaptable IDSs capable of addressing the evolving landscape of cyber threats.

Social sphere and gender issues

The article deals with the issues of gender equality based on the consideration of Russian and international norms, statistics of gender equality in the Russian Federation. The measures implemented in the Russian Federation to preserve gender equality, in particular the National Strategy of Action for Women for 2023–2030, the state programs «Development of healthcare», «Social support for citizens», «Employment», national projects «Demography», «Healthcare», «Small and medium–sized entrepreneurship» are considered and support for individual entrepreneurial initiative».The proposals for the preservation of gender equality in the Russian Federation for the long term are formulated. The development of a separate federal project is proposed, for example, as part of the state program economic development and innovative economy with indicators such as the proportion of women who have the same salary as men holding equivalent positions; the proportion of women holding managerial positions; achieving equivalent results in terms of the amount of time for household chores for men and women, including through development and accessibility of technologies that replace women’s labor. The development and adoption of the all–Russian standard of gender equality policy is also proposed. A standard can be a set of principles, rules, processes, an analysis of the current situation, and best practices for observing gender equality. The standard should have practice–oriented recommendations for the implementation of gender policy in the organization.

Performance Assessment and Modeling of Routing Protocol in Vehicular Ad Hoc Networks Using Statistical Design of Experiments Methodology: A Comprehensive Study

The performance assessment of routing protocols in vehicular ad hoc networks (VANETs) plays a critical role in testing the efficiency of the routing algorithms before deployment in real conditions. This research introduces the statistical design of experiments (DOE) methodology as an innovative alternative to the one factor at a time (OFAT) approach for the assessment and the modeling of VANET routing protocol performance. In this paper, three design of experiments methods are applied, namely the two-level full factorial method, the Plackett–Burman method and the Taguchi method, and their outcomes are comprehensively compared. The present work considers a case study involving four factors namely: node density, number of connections, black hole and worm hole attacks. Their effects on four measured outputs called responses are simultaneously evaluated: throughput, packet loss ratio, average end-to-end delay and routing overhead of the AODV routing protocol. Further, regression models using the least squares method are generated. First, we compare the main effects of factors resulted from the three DOE methods. Second, we perform analysis of variance (ANOVA) to explore the statistical significance and compare the percentage contributions of each factor. Third, the goodness of fit of regression models is assessed using the adjusted R-squared measure and the fitting plots of measured versus predicted responses. VANET simulations are implemented using the network simulator (NS-3) and the simulator of urban mobility (SUMO). The findings reveal that the design of experiments methodology offers powerful mathematical, graphical and statistical techniques for analyzing and modeling the performance of VANET routing protocols with high accuracy and low costs. The three methods give equivalent results in terms of the main effect and ANOVA analysis. Nonetheless, the Taguchi models show higher predictive accuracy.

Comparison analysis of local angular interpolation methods in diffusion MRI

ABSTRACT The tradeoff between recovering fibre populations crossing in the cerebral white matter and resolving it with a reduced number of Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) images presents an interesting problem. In this work, we combine the Delaunay triangulation and an interpolation method to estimate the DW images in non-measured Diffusion Gradients (DG) directions. The overarching aim of this work is to perform a comparison among interpolation methods. The experimentation is performed on simulated data in order to compare the methods as a function of the number of directions and crossing angle. Moreover, we investigate the robustness under various noise levels. Finally, we compare the methods using the data of five healthy volunteers from Human Connectome Project (HCP). Experimental results on synthetic and in-vivo data show that the linear interpolation methods and distance-based interpolation methods give equivalent results in terms of both the number and orientation of fibre compartments in each voxel, for all noise levels. Statistical results obtained from a one-way analysis of variance (ANOVA) confirm the simulations results. As a conclusion, Planar Linear Interpolation (PLI) method provides a way to avoid the complicated interpolation procedure while preserving the accuracy with a relatively small number of DW images.

Comparison of ‘Posterior (SMA-First)-Approach’ to ‘Standard-Approach’ in Terms of Circumferential Resection Margin, Lymph Node Retrieval and Long-Term Survival after Pancreaticoduodenectomy for Periampullary and Pancreatic Carcinoma: A Randomized Controlled Trial

Introduction: SMA-first-approach to pancreatoduodenectomy (PD) was found to be associated with better oncological outcomes as compared to the standard-approach in our pilot study. Hence, we performed a randomized controlled trial to compare these two-approaches in terms of resection margins, lymphnode-retrieval and long-term survival. Methods: Between January2014 to December2018, all consecutive patients undergoing PD for periampullary cancer at the Department of Gastrointestinal Surgery, AIIMS, New Delhi were assessed for randomization. Primary outcomes were R0 resection-rate and number of lymphnodes retrieved. The secondary outcomes were operating-time, blood-loss, postoperative-complications, recurrence-free and overall-survival. Results: Of 299 patients assessed, 203 were randomized and 183 analyzed(20:excluded after randomization, 90:patients-SMA, 93:patients-classical). The median age of the study population was 56(14-78) years, with predominantly male(138, 68%) and with periampullary tumours(89%). The demographic-profile, preoperative clinical and laboratory parameters were comparable. The blood-loss was significantly higher in SMA-first group (675vs600 ml, p=0.02) however the operating time and the need for blood transfusion were comparable in both the groups. ISGPS Grade B/C pancreatojejunostomy leak(20vs24.7%, p=0.68), post-pancreatectomy haemorrhage(8.8vs14%, p=0.38), delayed gastric emptying(37.8vs40.9%, p=0.67) and Clavien–Dindo grade ≥III complications(27.7vs31.2, p=0.85) were similar in both the groups. The R0 resection-rates(82.2vs78.5%, p=0.53) and total lymphnodes retrieved(18vs17, p=0.63) were similar between the two groups. Both groups were comparable in terms of median recurrence-free(48vs44 months, p=0.85) and overall-survival(53vs51 months, p=0.69). Conclusions: ‘Posterior-(SMA-first)-approach’ and ‘Standard-approach’ for pancreatoduodenectomy for periampullary cancer yielded equivalent results in terms of R0 resection-rate, number of lymphnodes retrieved, recurrence-free and overall-survival.

Is 6 Months of Antitubercular Chemotherapy as Effective as More Than 6 Months Regimen in Spinal Tuberculosis? A Systematic Review and Meta-analysis.

Historically, osteoarticular tuberculosis (TB), including spinal TB, was treated with prolonged course of antitubercular therapy (ATT). Due to various challenges, there has been reluctance to explore the use of short-course ATT in spinal TB. However, with the success of short-course ATT being demonstrated in other forms of extrapulmonary TB, the subject is open for debate again. Therefore, we systematically reviewed various published literature to determine whether short-course treatment regimen (6 months) of ATT provides equivalent results in terms of disease healing as long-course treatment regimen (≥9 months) in the management of spinal TB. Five electronic databases (PubMed, MEDLINE, EMBASE, CENTRAL, and Web of Science) and their reference lists were searched to identify relevant randomized controlled trials with at least 1 year of follow-up that compared short-course with standard-course ATT for treatment of spinal TB. The methodological quality of included studies was assessed, and their data were extracted. A meta-analysis was used to calculate pooled effect sizes and 95% confidence interval (CI). The outcome measure was healed status of the disease at the final follow-up. Of 331 publications identified through literature search, eight publications describing six randomized studies were included. Moreover, 375 of 414 patients (90.58%) who received 6 months of ATT had healed status at their final follow-up compared to 404 of 463 patients (87.26%) who received ≥9 months of ATT. Overall, the healed status of spinal TB was equivalent in patients in both groups (pooled relative risk, 0.98; 95% CI, 0.92-1.04; p =0.439). However, there was considerable heterogeneity among the trials (I2=40.8%, p =0.149). The results suggest that the use of short-course (6 months) chemotherapy may be considered for the treatment of spinal TB in view of the similarity in the healing response achieved compared to treatment regimens of longer duration.

Laparoscopic Toupet fundoplication for gastroesophageal reflux disease and hiatus hernia: proposal for standardization using the "critical view" concept.

Laparoscopic Toupet fundoplication has gained progressive consideration in the management of patients with gastroesophageal reflux disease and hiatus hernia. Previous studies showed equivalent results in terms of reflux control with lower rate of side effects compared to the Nissen fundoplication. However, multiple technical variations may account for the long-lasting reputation of decreased durability and poor long-term reflux control. Inspired by the "critical view" concept, a step-by-step laparoscopic Toupet fundoplication is described and illustrated. During the study period, 2012-2017, 348 consecutive patients underwent laparoscopic Toupet fundoplication according to a standardized procedure. A large hiatus hernia was present in 39% of patients, and 14% had volvulus of the intrathoracic stomach. Sixty-four (18.4%) patients had one or more previously failed antireflux procedures. The median follow-up was 37months (range 12-61). The Gastroesophageal Reflux Disease Health-Related Quality of Life score significantly improved compared to baseline (p < 0.001), and 77% of patients were off proton-pump inhibitors. The proposed standardization of the Toupet fundoplication based on a "critical-view" concept may help to improve reproducibility, clinical outcomes, and teachingof this procedure.

Histological and immunohistochemical comparison of two different allogeneic bone grafting materials for alveolar ridge reconstruction: A prospective randomized trial in humans.

ABSTRACTBackgroundPreclinical studies have hypothesized a possible immunological reponse to allogeneic materials due to detection of remnants of potential immunogenic molecules. However, their impact on integration, bone remodeling and immunological reaction after the augmentation procedure is largely unknown and a direct correlation of analytical data and evaluation of human biopsies is missing.PurposeThe present study aimed to compare two commercially available allogeneic materials regarding their content of cellular remnants as well as the bone remodeling, and integration and potential immunologic reactions on a histological and immunohistochemical level, integrating also in vitro analytical evaluation of the specific batches that were used clinically.Materials and MethodsTwenty patients were randomly assigned to treatment with Maxgraft or Puros for lateral ridge augmentation in a two‐stage surgery. After a mean healing period of 5 months, implants were placed and biopsies were taken for histological, immunhistochemical, and histomorphometrical evaluation regarding bone remodeling and inflammation, protein concentrations in vitro and the presence of MHC molecules of the same batches used clinically.ResultsNo differences in clinical outcome, histological, immunohistochemical, and in vitro protein analysis between the two bone grafting materials were observed. Active bone remodeling, amount of newly formed bone, and residual grafting material was independent of the materials used, but varied between subjects. MHC1 residues were not detected in any sample.ConclusionsWithin the limitations of this study, both tested materials yielded equivalent results in terms of clinical outcome, new bone formation, and lack of immunological potential on a histological and immunohistochemical level.

Effects of the fidelity level of numerical simulations on the wake meandering phenomenon

The aim of this paper is to verify that a modeling approach affordable at wind farm scale, in this case a fourth-order finite differences code combined with a rotating actuator disk, provides equivalent results in terms of wake meandering compared to a method with a higher fidelity level, i.e. a Vortex Particle-Mesh Method combined with immersed lifting lines. The analysis is performed on the wake centerlines obtained from Large Eddy Simulations of an isolated NREL 5-MW wind turbine subject to several synthetic turbulent inflows: 6%, 10%, and 15% turbulence intensity. A direct comparison of the wake centerlines reveals a good match between the two approaches up to five rotor diameters. Concerning the amplitude and wavelength of the wake meandering, the lower fidelity code leads to larger amplitudes and shorter wavelengths. Assuming that Taylor’s frozen turbulence hypothesis is applicable, the Strouhal number St is computed as the ratio between the rotor diameter and the wavelength. Obtained values are such that 0.22 ⩽ St ⩽ 0.4.

Comparative Analysis of Generalized Sidelobe Cancellation and Multi-Channel Linear Prediction for Speech Dereverberation and Noise Reduction

For blind speech dereverberation, two frameworks are commonly used: on the one hand, the multi-channel linear prediction (MCLP) framework, and on the other hand, data-dependent beamforming, e.g., the generalized sidelobe canceler (GSC) framework. The MCLP framework is designed to perform deconvolution and hence has gained increased prominence in blind speech dereverberation. The GSC framework is commonly used for noise reduction, but may be applied for dereverberation as well. In previous work, we have shown that for the noiseless case, MCLP and the GSC yield in theory mathematically equivalent results in terms of dereverberation. In this paper, we assume additional coherent as well as incoherent-noise components and formally analyze and compare both frameworks in terms of dereverberation and noise reduction performance. Both the theoretical analysis and time domain simulation results demonstrate that unlike the GSC, MCLP expectably shows limited performance in terms of noise reduction, while both perform equally well in terms of dereverberation, provided that the GSC blocking matrix achieves complete blocking of the early reverberant-speech component and sufficiently many microphones are available. In case of incomplete blocking, however, the GSC performs inferior to MCLP in terms of dereverberation, as shown in short-time Fourier transform domain simulations.

Comparison of the Diatheva STEC FLUO with BAX System Kits for Detection of O157:H7 and Non-O157 Shiga Toxin-Producing Escherichia coli (STEC) in Ground Beef and Bean Sprout Samples Using Different Enrichment Protocols

The aim of this study was to assess the performance of the Diatheva STEC FLUO and BAX System real-time PCR assays for detection of Shiga toxin-producing Escherichia coli (STEC) (stx1/stx2 and eae target genes) and O-group identification in ground beef and bean sprout samples. Ground beef (325 g or 25 g) and mung bean sprout (25 g) samples were inoculated with ~ 10 CFU of the “top five” STEC (O157:H7, O26, O103, O111, and O145 as specified in EU regulation ISO13136:2012), enriched using different broths and incubation temperatures, and tested using the Diatheva and BAX real-time PCR assays. In ground beef, both molecular methods were able to detect the “top five” STEC, and lower Ct values were observed for the Diatheva kits compared to BAX System. The O111-contaminated samples gave negative results with both methods using mTSB + novobiocin for enrichment. In bean sprouts, both methods provided positive results, although detection was not possible using mTSB + acriflavin/cefsulodin/vancomycin for enrichment. In conclusion, the Diatheva and BAX methods detected the “top five” STEC in ground beef and bean sprouts when inoculated at low levels. Both assays provided equivalent results in terms of performance and reliability. Thus, the Diatheva kits are comparable to reference STEC-detection methods and could be used by the food industry to reliably detect the “top five” STEC.

Robotic Versus Conventional Coronary Artery Bypass Grafting: Direct Comparison of Long-Term Clinical Outcome.

Robotic coronary artery bypass grafting (CABG) was shown to be a safe and feasible method for the treatment of coronary artery disease in highly selected patients. However, long-term outcome data comparing robotic CABG with conventional CABG are still missing. Therefore, we aimed to compare robotic with conventional CABG in terms of perioperative and long-term outcomes. Of 2947 consecutive elective patients with coronary artery disease operated at a single center between 2001 and 2013, 280 underwent robotic CABG. After propensity score matching, 134 pairs of robotic versus conventional CABG (age = 62 ± 10 years, log EuroScore = 2.4 ± 2.4% vs. mean ± SD age = 63 ± 10 years, log EuroScore 2.5 ± 1.7%, respectively; all P > 0.05) were formed. The mean ± SD follow-up was 6.6 ± 3.2 years. There was no difference in perioperative mortality (robotic = 0% vs. conventional = 1.5%, P = 0.154), myocardial infarction (robotic = 0% vs. conventional = 2.2%, P = 0.08), and stroke rate (robotic = 0% vs. conventional = 0.7%, P = 0.318) between the groups. Longer cardiopulmonary bypass (robotic = 112 ± 100 minutes vs. conventional = 67 ± 48 minutes, P < 0.0001) and cross-clamp times (robotic = 68 ± 54 minutes vs. conventional = 38 ± 27 minutes, P < 0.0001) were observed in robotic patients. Long-term follow-up yielded equivalent results in terms of survival (1, 5, and 10 years: robotic = 99.3%, 96.9%, and 81.3% vs. conventional = 96.3%, 92.2%, and 82.6%, respectively; log-rank P = 0.187) and freedom from major adverse cardiac and cerebral events at 1, 5, and 10 years after procedure (robotic = 90.6%, 77.7%, 70.1% vs. conventional = 94.1%, 82.2%, 66.6%; log-rank P = 0.790). Long-term outcomes of robotic CABG are comparable with conventional CABG for selected patients. Longer operative times of robotic CABG do not influence the excellent long-term outcomes.

Bonding to silicate ceramics: Conventional technique compared with a simplified technique.

BackgroundSilicate ceramic bonding is carried out by acid-etching with hydrofluoric acid (HF) followed by an application of silane. By replacing HF with ammonium polyfluoride, contained in the same flask as the silane, the number of steps in this clinical procedure, can be reduced, while maintaining bond strength values, and reducing toxicity. A shear bond test was performed to compare the conventional and the simplified surface treatment techniques.Material and Methods Twenty ceramic samples were fabricated from IPS emax CAD® ceramic (Ivoclar Vivadent) and divided into two groups (G1 and G2) (n=10). The conventional technique was applied to G1 samples, and the simplified technique to G2 samples. A resin cement cylinder was bonded to each sample. Afterwards, samples underwent shear bond strength testing in a universal test machine.Results G1 obtained 26.53±6.33 MPa and G2 23.52±8.41 MPa, without statistically significant differences between the two groups.Conclusions Monobond Etch&Prime appears to obtain equivalent results in terms of bond strength while simplifying the technique. Further investigation is required to corroborate these preliminary findings. Key words:Shear bond strength, surface treatment, bonding to ceramic, hydrofluoric acid, ammonium polyfluoride.

A Review of the Acute Effects and Long-Term Adaptations of Single- and Multi-Joint Exercises during Resistance Training.

Resistance exercises can be considered to be multi-joint (MJ) or single-joint (SJ) in nature. Many strength coaches, trainers, and trainees believe that adding SJ exercises to a resistance training (RT) program may be required to optimize muscular size and strength. However, given that lack of time is a frequently cited barrier to exercise adoption, the time commitment resulting from these recommendations may not be convenient for many people. Therefore, it is important to find strategies that reduce the time commitment without negatively affecting results. The aim of this review was to analyze and discuss the present body of literature considering the acute responses to and long-term adaptations resulting from SJ and MJ exercise selection. Studies were deemed eligible for inclusion if they were experimental studies comparing the effects of MJ, SJ, or MJ+SJ on dependent variables; studies were excluded if they were reviews or abstracts only, if they involved clinical populations or persons with articular or musculoskeletal problems, or if the RT intervention was confounded by other factors. Taking these factors into account, a total of 23 studies were included. For the upper and lower limbs, analysis of surface electromyographic (sEMG) activation suggests that there are no differences between SJ and MJ exercises when comparing the prime movers. However, evidence is contrasting when considering the trunk extensor musculature. Only one study directly compared the effects of MJ and SJ on muscle recovery and the results suggest that SJ exercises resulted in increased muscle fatigue and soreness. Long-term studies comparing increases in muscle size and strength in the upper limbs reported no difference between SJ and MJ exercises and no additional effects when SJ exercises were included in an MJ exercise program. For the lumbar extensors, the studies reviewed tend to support the view that this muscle group may benefit from SJ exercise. People performing RT may not need to include SJ exercises in their program to obtain equivalent results in terms of muscle activation and long-term adaptations such as hypertrophy and strength. SJ exercises may only be necessary to strengthen lumbar extensors and to correct muscular imbalances.

Three-dimensional numerical modeling of free convection in sloping porous enclosures

Three-dimensional (3D) numerical simulations are carried out to study steady state free convection in a sloping porous enclosure heated from below. The model is based on Darcy’s law and the Boussinesq approximation. Two different approaches to solve this problem are compared: primitive variables and vector potential. Although both numerical models lead to equivalent results in terms of the Nusselt number and convective modes, the vector potential model proved to be less mesh-dependent and also a faster algorithm. A parametric study of the problem considering Rayleigh number, slope angle and aspect ratio showed that convective modes with irregular 3D geometries can develop in a wide variety of situations, including horizontal porous enclosure at relatively low Rayleigh numbers. The convective modes that have been described in previous 2D studies (multicellular and single cell) are also present in the 3D case. Nonetheless the results presented here show that the transition between these convective modes follows an irregular 3D geometry characterized by the interaction of transverse and longitudinal coils.

The effect of gatifloxacin 0.3% or moxifloxacin 0.5% on corneal healing, ocular tolerability and toxicity following pterygium surgery

Purpose: To compare the rate of corneal epithelial healing and ocular tolerability following pterygium surgery between gatifloxacin and moxifloxacin.Methods: In this double masked, prospective, controlled study 40 patients were randomized to receive prophylactic topical gatifloxacin 0.3% or moxifloxacin 0.5% following pterygium surgery. Patients were examined on days 1, 3, 7 and 21 post-operatively or until complete corneal epithelial healing. The primary outcome measure was the area of corneal epithelial defect during the post-operative period. Patients graded post-operative ocular pain, foreign body sensation, tearing, general burning sensation and burning sensation post-antibiotic drops instillation on a scale of 1–5. Conjunctival hyperemia and superficial punctate keratopathy (SPK) were measured on a scale of 0–3.Results: No significant differences between groups were found in terms of corneal epithelial defect percentage over time (p = 0.989) and there was no significant difference between groups on each of the post-operative days. No significant differences were noted in terms of post-operative ocular pain, foreign body sensation, tearing, general burning sensation, burning sensation post-antibiotic drops instillation, conjunctival hyperemia and SPK.Conclusions: Gatifloxacin and moxifloxacin showed equivalent results in terms of corneal epithelial healing and ocular tolerability following pterygium surgery. This study suggests that there was no apparent added epithelial toxicity due to the presence of benzalkonium chloride in the gatifloxacin preparation when compared to moxifloxacin.

Minimally Invasive Surgery: A New Approach for Uterine Cervical Cancer

Initially used for diagnostic, laparoscopy has become a method of treatment in the field of gynecological surgery, but also in many other fields. The results of laparoscopic surgery are now comparable with those obtained by laparotomy in benign and malignant pathologies. Laparoscopy provides improved results in the short term and at least equivalent results in terms of long-term recurrence when compared with open surgery. Robotic-assisted laparoscopy was performed to prevent the disadvantages of conventional laparoscopy. It emerged as a revolutionary technology and has spread in less than a decade in many surgical fields, including urology, cardiothoracic surgery, pediatric surgery and general surgery. Minimally invasive techniques provide a lower rate of complications during surgery as compared to open surgery, which is appropriate tissue due to handling and better anatomical views. Laparoscopic treatment of cervical cancer provides benefits on increasing comfort with decreased convalescence time, but these cases should be reserved for surgeons with extensive experience in laparoscopic procedures. One of the most important advantages of minimally invasive surgical techniques is the short duration of hospitalization.

New possibilities for volumetric-modulated arc therapy using the Agility™ 160-leaf multileaf collimator.

This study compares the quality of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans optimized for an Elekta Agility(TM) (Elekta, Stockholm, Sweden) multileaf collimator (MLC; leaf width 5 mm) and an Elekta MLCi2 (leaf width 10 mm) for complex target volumes (anal, AC; head and neck, H&N and prostate cancer, PC). For plan comparisons, 15 patients who had been treated with IMRT or VMAT using the MLCi2 were selected. For each patient, a retrospective treatment plan using the MLCi2 for the technique not applied was created, as were treatment plans for both techniques using the Agility(TM) MLC. Dose-volume histograms (DHVs) for planning target volumes (PTVs) and organs at risk (OARs) were compared. Further parameters relating to dose conformity, dose homogeneity and mean dose (Dmean) to the PTV, compliance with the intended OAR dose criteria and overall dose to normal tissue were analyzed. Verification measurements were performed and optimization and treatment times were compared. Compared to the MLCi2 plans, the Agility(TM) IMRT and VMAT plans show better or equivalent results in terms of PTV dose conformity and homogeneity. Compliance with the intended OAR dose criteria does not differ according to technique or MLC type. Slight differences are shown for dose distributions in OARs and normal tissue. Verification measurements show that all plans fulfill the acceptance criteria of a minimum of 95 % matched dose points for the 3 %/3 mm γ criterion. Optimization times for the VMAT plans increase compared to the IMRT plans, whereas treatment times decrease. With the MLCi2, treatment of complex target volumes with VMAT was only possible with compromises in terms of target coverage. Using the Agility(TM) MLC, even complex target volumes can be treated with VMAT without compromising target coverage or resulting in higher exposure of OARs or normal tissue.

The basic facts of korean breast cancer in 2011: results of a nationwide survey and breast cancer registry database.

Breast cancer is the second most frequent malignancy in Korean women, with a continuously increasing incidence. The Korean Breast Cancer Society has constructed a nationwide breast cancer database through an online registration program. The aim of the present study was to report the fundamental facts on Korean breast cancer in 2011, and to analyze the changing patterns in clinical characteristics and breast cancer management in Korea over the last 10 years. Data on newly diagnosed breast cancer patients, including the total number of cases, age, stage, and type of surgery, for the year 2011 were collected from 84 hospitals and clinics nationwide using a questionnaire survey. Additional data relating to the changing patterns of breast cancer in Korea were collected from the online breast cancer registry database and analyzed. According to nationwide survey data, a total of 16,967 patients were newly diagnosed with breast cancer in 2011. The crude incidence of female breast cancer, including invasive cancer and in situ cancer, was 67 cases per 100,000 women. Analysis of the survey and registry data gave equivalent results in terms of age distribution, stage, and type of surgery. The median age at diagnosis was 50 years, and the proportion of postmenopausal women (51.3%) was higher than that of premenopausal women (48.7%) with breast cancer. The incidence of stage 0 and stage I breast cancer increased continuously over the last 10 years (56.3% in 2011), and breast conserving surgery (65.7%) was performed more frequently than total mastectomy (33.8%). The total number of breast reconstruction surgeries increased approximately 8-fold. We conclude that the clinical characteristics of breast cancer have changed over the past 10 years in Korea, and surgical management has changed accordingly. Analysis of nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.

A paradigm shift in the surgical reconstruction of extra-articular distal humeral fractures: Single-column plating

ObjectivesThe study aimed (1) to examine if there are equivalent results in terms of union, alignment and elbow functionally comparing single- to dual-column plating of AO/OTA 13A2 and A3 distal humeral fractures and (2) if there are more implant-related complications in patients managed with bicolumnar plating compared to single-column plate fixation. DesignThis was a multi-centred retrospective comparative study. SettingThe study was conducted at two academic level 1 trauma centres. Patients/participantsA total of 105 patients were identified to have surgical management of extra-articular distal humeral fractures Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 13A2 and AO/OTA 13A3). InterventionPatients were treated with traditional dual-column plating or a single-column posterolateral small-fragment pre-contoured locking plate used as a neutralisation device with at least five screws in the short distal segment. Main outcome measurementsThe patients’ elbow functionality was assessed in terms of range of motion, union and alignment. In addition, the rate of complications between the groups including radial nerve palsy, implant-related complications (painful prominence and/or ulnar nerve neuritis) and elbow stiffness were compared. ResultsPatients treated with single-column plating had similar union rates and alignment. However, single-column plating resulted in a significantly better range of motion with less complications. ConclusionsThe current study suggests that exposure/instrumentation of only the lateral column is a reliable and preferred technique. This technique allows for comparable union rates and alignment with increased elbow functionality and decreased number of complications.