Frequent Patterns Research Articles

MBA: Market Basket Analysis Using Frequent Pattern Mining Techniques

This Market Basket Analysis (MBA) is a data mining technique that uses frequent pattern mining algorithms to discover patterns of co-occurrence among items that are frequently purchased together. It is commonly used in retail and e-commerce businesses to generate association rules that describe the relationships between different items, and to make recommendations to customers based on their previous purchases. MBA is a powerful tool for identifying patterns of co-occurrence and generating insights that can improve sales and marketing strategies. Although a numerous works has been carried out to handle the computational cost for discovering the frequent itemsets, but it still needs more exploration and developments. In this paper, we introduce an efficient Bitwise-Based data structure technique for mining frequent pattern in large-scale databases. The algorithm scans the original database once, using the Bitwise-Based data representations as well as vertical database layout, compared to the well-known Apriori and FP-Growth algorithm. Bitwise-Based technique enhance the problems of multiple passes over the original database, hence, minimizes the execution time. Extensive experiments have been carried out to validate our technique, which outperform Apriori, Éclat, FP-growth, and H-mine in terms of execution time for Market Basket Analysis.

It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders.

Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.

Multidrug-resistant Escherichia coli and Klebsiella pneumoniae isolated from hospital sewage flowing through community sewage system and discharging into the Indian Ocean

BackgroundHospital sewage is a significant reservoir of antimicrobial-resistant pathogens and genes that pose a huge public health threat. In this study, we determined the occurrence of multidrug-resistant Escherichia coli and Klebsiella pneumoniae in sewage flowing from a referral hospital through the urban sewage system to the point of discharge in the Indian Ocean.ResultsA total of 400 sewage samples were collected, yielding 517 isolates. Of these, 32.3% (167/517) were from hospital sewage, while 67.7% (350/517) were from the community. E. coli was the most common isolate (44.5% (230/517)), followed by K. pneumoniae at 27.3% (141/517), and other gram-negative bacteria constituted 28.2% (146/517) of the isolates. Multidrug resistance (MDR) was seen in 80.9% (186/230) E. coli and 71.6% (101/141) K. pneumoniae. Of the MDR isolates, 27.2% (78/287) were resistant to four different classes of antibiotics, while 6.9% (20/287) exhibited resistance to eight classes. The most frequent MDR pattern was PEN/CEP/TET/QNL/SUL, seen in 14.2% (38/287) of the isolates. The isolation frequency of MDR E. coli and K. pneumoniae at different sampling sites was high, being 47.6% in hospital chambers, 62.0% in hospital ponds, 58.1% in the treated hospital wastewater, and 55.6% in the community stream draining into the Indian Ocean. Extended spectrum beta-lactamase production was observed in 40% (92/230) of E. coli and 36.2% (51/141) of K. pneumoniae isolates. Resistance to quinolones among E. coli was 54.8% (126/230) and was 39.7% in K. pneumoniae (56/141). Carbapenem resistance in E. coli was 39.6% (91/230), while among K. pneumoniae isolates was 32.6% (46/141).ConclusionsWe found high proportions of multidrug-resistant E. coli and K. pneumoniae in the wastewater flowing from the hospital through the community sewage system to the point where it enters the Indian Ocean. Biological treatment did not significantly reduce the proportion of resistant bacteria, posing a very serious public health threat. The release of these highly resistant pathogens into the Indian Ocean is of international concern.

Bidirectional Recurrent Network and Neuro-fuzzy Frequent Pattern Mining for Heart Disease Prediction

Bidirectional Recurrent Network and Neuro-fuzzy Frequent Pattern Mining for Heart Disease Prediction

Aerobic Physical Training Attenuates Oxidative Stress in the Spinal Cord of Adult Rats Induced by Binge-like Ethanol Intake.

Binge drinking is the most frequent consumption pattern among young adults and remarkably changes the central nervous system; thus, research on strategies to protect it is relevant. This study aimed to investigate the detrimental effects of binge-like EtOH intake on the spinal cord of male rats and the potential neuroprotective effects provided by moderate-intensity aerobic physical training. Male Wistar rats were distributed into the 'control group', 'training group', 'EtOH group', and 'training + EtOH'. The physical training protocol consisted of daily 30-min exercise on a treadmill for 5 consecutive days followed by 2 days off during 4 weeks. After the fifth day of each week, distilled water ('control group' and 'training group') or 3 g/kg of EtOH diluted at 20% w/v ('EtOH group' and 'training + EtOH group') was administered for 3 consecutive days through intragastric gavage to simulate compulsive consumption. Spinal cord samples were collected for oxidative biochemistry and morphometric analyses. The binge-like EtOH intake induced oxidative and tissue damage by decreasing reduced glutathione (GSH) levels, increasing lipid peroxidation (LPO), and reducing motor neurons (MN) density in the cervical segment. Even under EtOH exposure, physical training maintained GSH levels, reduced LPO, and prevented MN reduction at the cervical segment. Physical training is a non-pharmacological strategy to neuroprotect the spinal cord against oxidative damage induced by binge-like EtOH intake.

Frequent Pattern Matching in Data Mining using Modified Apriori Algorithm with Portioned Data Set Approaches

Frequent Pattern Matching in Data Mining using Modified Apriori Algorithm with Portioned Data Set Approaches

Leaky barriers to gene sharing between locally co-existing coagulase-negative Staphylococcus species

Coagulase-negative Staphylococcus (CoNS) are opportunistic pathogens implicated in many human and animal infections. The evolutionary history of CoNS remains obscure because of the historical lack of recognition for their clinical importance and poor taxonomic sampling. Here, we sequenced the genomes of 191 CoNS isolates representing 15 species sampled from diseased animals diagnosed in a veterinary diagnostic laboratory. We found that CoNS are important reservoirs of diverse phages, plasmids and mobilizable genes encoding antimicrobial resistance, heavy metal resistance, and virulence. Frequent exchange of DNA between certain donor-recipient partners suggests that specific lineages act as hubs of gene sharing. We also detected frequent recombination between CoNS regardless of their animal host species, indicating that ecological barriers to horizontal gene transfer can be surmounted in co-circulating lineages. Our findings reveal frequent but structured patterns of transfer that exist within and between CoNS species, which are driven by their overlapping ecology and geographical proximity.

Efficient buffeting analysis of long-span bridges under non-stationary winds: A 2D interpolation enhanced approach

The buffeting analysis of long-span bridges under non-stationary winds is a crucial consideration in the context of exceptional winds recurring in frequent and violent patterns. The time–frequency representation is widely used for the solution of structural non-stationary buffeting responses due to its popularity and simplicity. However, the traditional approach consumes considerable computational resources to achieve high accuracy, which renders the approach computationally inefficient. In such a case, a 2D interpolation enhanced approach is developed for the efficient buffeting analysis of long-span bridges under non-stationary wind actions. Central to this approach is the 2D interpolation applied to the reconstruction of structural buffeting responses, accompanied by the well-designed non-uniformly distributed interpolation knots. For the enhanced approach, the computations in solving governing equations are only required at limited interpolation knots instead of at each frequency and time instant, which yields a dramatic reduction of computational resources and efforts. By taking a long-span suspension bridge as an example, a parametric analysis is conducted to investigate the effect of interpolation intervals on the simulation efficiency and accuracy, and the preferred suggestions are made accordingly. Then, the effectiveness of the enhanced approach is further verified via a case study by focusing on the evolutionary spectra and non-stationary buffeting responses. The analytical results indicate that the enhanced approach is particularly efficient in simulating non-stationary buffeting responses of long-span bridges with few losses of accuracy.

Bacillary Positive Tuberculous Body Fluid Smears: A Perspective on How Fast to Use Acid Fast.

Background Tuberculous effusions are common. Classically, they are described as bacteria poor and lymphocyte rich. Our experience, however, has been more varied. We compiled this rare group of bacteria-positive tuberculous fluids to document their cytologic spectrum and to look for possible predictors of bacillary positivity. Methods Fifty-one cases of bacillary positive fluids were identified and their clinicopathological details were noted. Per case, the smear background was assigned as either clear, caseous, suppurative, granular proteinaceous or frankly hemorrhagic. Fine, punched-out vacuoles in the smear background were also noted. The bacillary load in each case was classified from scanty to 3+. Eventually, the clinicopathologic variables were tabulated for frequency and studied for any association with bacillary presence. Results Only 19 of the 51 patients had a history of tuberculosis. Retropositive patients comprised a small proportion (9.8%) and did not always indicate strong (3+) bacillary positivity. The granular proteinaceous background was the most frequent (35%) pattern. Only a suppurative background was associated with strong bacillary positivity. Fine vacuoles were seen almost always with caseous and granular proteinaceous backgrounds but without statistical significance. Conclusion Tuberculous effusions can have diverse smear backgrounds, not necessarily one rich in caseous material. When tuberculosis is known or clinically suspected, non-classical findings such as abundant neutrophils or suppurative background should not dissuade one from requisitioning mycobacterial stains. In fact, acid-fast stains should probably routinely accompany Giemsa slides of clinically idiopathic effusions in endemic areas since it is still the cheapest and fastest method for a conclusive diagnosis.

Fast Frequent Patterns Mining by Multiple Sampling With Tight Guarantee Under Bayesian Statistics.

Sampling from large dataset is commonly used in the frequent patterns (FPs) mining. To tightly and theoretically guarantee the quality of the FPs obtained from samples, current methods theoretically stabilize the supports of all the patterns in random samples, despite only FPs do matter, so they always overestimate the sample size. We propose an algorithm called multiple sampling-based FPs mining (MSFP). The MSFP first generates the set of approximate frequent items (AFI), and uses the AFI to form the set of approximate FPs without supports ( AFP*), where it does not stabilize the value of any item's or pattern's support, but only stabilizes the relationship ≥ or < between the support and the minimum support, so the MSFP can use small samples to successively obtain the AFI and AFP*, and can successively prune the patterns not contained by the AFI and not in the AFP*. Then, the MSFP introduces the Bayesian statistics to only stabilize the values of supports of AFP*'s patterns. If a pattern's support in the original dataset is unknown, the MSFP regards it as random, and keeps updating its distribution by its approximations obtained from the samples taken in the progressive sampling, so the error probability can be bound better. Furthermore, to reduce the I/O processes in the progressive sampling, the MSFP stores a large enough random sample in memory in advance. The experiments show that the MSFP is reliable and efficient.

Correlation between high-resolution computed tomography appearance and histopathological features in the diagnosis of interstitial lung diseases. A real-life study.

According to current guidelines, a surgical biopsy is rarely required when a high-confidence radiologic interstitial lung disease (ILD) diagnosis is made on thin-section high-resolution computed tomography (HRCT). Nevertheless, disowning HRCT scans diagnosed by biopsy are more common than presumed. Our study aimed to describe the concordance rate between HRCT scans and pathological diagnoses of ILDs obtained by surgical biopsy. The current guideline suggests the use of surgical lung biopsy (SLB) in patients with newly detected ILD of unknown cause. Patients who underwent mini-invasive surgical biopsies for interstitial lung diseases from January 2018 to August 2022 were analyzed. The HRCT scans were reviewed by an observer blinded to the patient's clinical information. The concordance between histological and HRCT-scan were assessed. Data from 104 patients with uncertain low confidence diagnosis of interstitial lung diseases at HRCT were analyzed. Most of the patients are male (65; 62.5%). The more frequent HRCT pattern were: alternative diagnoses (46; 44.23%), UIP probable (42; 40.38%), UIP indeterminate (7; 6.73%), and non-specific interstitial pneumonia (NSIP) (9, 8.65%). The more common histological diagnosis was UIP definite (30; 28.84%), hypersensitivity pneumonia [HP](19; 18.44%), NSIP (15; 14.42%), sarcoidosis (10; 9.60%). In 7 (20%) cases, the final pathological finding denies HRCT-scans diagnoses; indeed, a moderate agreement was observed between HRCT-scan findings and the definitive histological diagnosis (kappa index: 0.428). HRCT-scan has limitations if the objective is to define interstitial lung diseases accurately. Consequently, pathological assessment should be taken into account in order to provide more accurate tailored treatment strategies because the risk is to wait from 12 to 24 months to ascertain if the ILD will be treatable as progressive pulmonary fibrosis (PPF). Undeniably true, video-assisted surgical lung biopsy (VASLB) with endotracheal intubation and mechanical ventilation is associated with a risk of mortality and morbidity that is far from nil. Nevertheless, in recent years a VASLB approach performed in awake subjects under loco-regional anesthesia (awake-VASLB) has been suggested as an effective method to obtain a highly confident diagnosis in patients with diffuse pathologies of the lung parenchyma.

OPP-Miner: Order-Preserving Sequential Pattern Mining for Time Series.

Traditional sequential pattern mining methods were designed for symbolic sequence. As a collection of measurements in chronological order, a time series needs to be discretized into symbolic sequences, and then users can apply sequential pattern mining methods to discover interesting patterns in time series. The discretization will not only cause the loss of some important information, which partially destroys the continuity of time series, but also ignore the order relations between time-series values. Inspired by order-preserving matching, this article explores a new method called order-preserving sequential pattern (OPP) mining, which does not need to discretize time series into symbolic sequences and represents patterns based on the order relations of time series. An inherent advantage of such representation is that the trend of a time series can be represented by the relative order of the values underneath time series. We propose an OPP-Miner algorithm to mine frequent patterns in time series with the same relative order. OPP-Miner employs the filtration and verification strategies to calculate the support and uses the pattern fusion strategy to generate candidate patterns. To compress the result set, we also study to find the maximal OPPs. Experimental results validate that OPP-Miner is not only efficient but can also discover similar subsequences in time series. In addition, case studies show that our algorithms have high utility in analyzing the COVID-19 epidemic by identifying critical trends and improve the clustering performance. The algorithms and data can be downloaded from https://github.com/wuc567/Pattern-Mining/tree/master/OPP-Miner.

Prevalence, length, and patterns of Anterior Loop among the South Indian population: A comparative study between Panoramic Radiography and Cone Beam Computed Tomography.

To assess the prevalence, length, and patterns of the anterior loop of the inferior alveolar nerve by panoramic radiography and cone beam computed tomography (CBCT). A prospective study was conducted on 300 mental foramen regions by exposing them to panoramic radiography and CBCT scan. Two individual observers evaluated the images to assess the presence of an anterior loop, the mean length of the loop, and the most frequent pattern of the loop in our population. The prevalence of the anterior loop for male patients and female patients by panoramic radiography was 34% and 32% on the right side and 30% and 36% on left side, respectively. By CBCT, the corresponding values were 69% and 72% on the right and left side, respectively, for male patients, and 73% and 81% on the right and left side, for female patients, respectively. The results from our study strongly emphasize the need for CBCT imaging before planning for procedures in the mental foramen region because the prevalence, length, and pattern of loop significantly varies with respect to age, sex, and population.

Implementasi Data Mining Pada Penjualan Pakaian dengan Algoritma FP-Growth

The amount of competition in the business world, especially in the sales industry, required developers to find a strategy that could increase sales and marketing of products sold, one of which was using clothing sales data with data mining. Data Mining was an iterative and interactive process to find new patterns or models that can be generalized for the future, valuable, and understandable in a massive database. HAS Stores in the arrangement of goods layout still place goods according to groups and types of goods, so that it has an impact on service and item search when consumers want to buy more than one item and are located far apart. Therefore, this study aims to apply the FP-Growth Algorithm to find out the most sold clothing sales at HAS Stores in Batam city. This study uses the Association Rule method by utilizing the FP-Growth Algorithm. This study aimed to apply the FP-Growth Algorithm to determine the most sold clothing sales at HAS Stores in Batam city. Through the mining process with the FP-Growth (Frequent Pattern Growth) algorithm, the types of clothes sold will be obtained, and how much inventory the store needs to provide the clothing stock. The results showed that the most sold clothing products were Gamis and Jilbab through the calculation of support 53,33% and confidence 100%. Regarding these results, marketing strategies can be focused on the product and set a layout that customers can easily see.

Safe zone of supraclavicular nerve during clavicle fixation and its anatomical variations, a cadaveric study.

Supraclavicular nerve injury is usually at risk during clavicular fracture fixation. This study aimed to examine the anatomical features and estimate the precise location of supraclavicular nerve branches related to adjacent structural landmarks and to evaluate the differences between sex and side. To highlight the clinical purposes and surgical relevance, this study attempted to define a surgical safe zone that would probably protect the supraclavicular nerve during clavicle fixation. A total of 64 shoulders obtained from 15 female and 17 male adult cadavers were examined, identifying the branching patterns of the supraclavicular nerve, measuring the clavicle length and the course of the supraclavicular nerve referring to the sternoclavicular (SC) and acromioclavicular (AC) joint. Data were categorized by sex and side, and their differences were evaluated using Student T-Test and Mann-Whitney U Test. Clinically relevant predictable safe zones were also statistically analyzed. The results revealed 7 branching patterns of the supraclavicular nerve. The medial and lateral nerve branches formed a shared trunk, and the medial nerve branches separated to form the intermediate branch, i.e., the most frequent pattern (67.19%). The safe zones were determined to be 6.1mm among both sexes of the SC joint medially, and 0.7mm among females and 0mm among males of the AC joint laterally. Surgical incisions between 29.3 to 51.2% and 60.5 to 79.7% of the clavicle length from the SC joint were the safe zones at the midclavicular shaft among both sexes. The findings of this study have provided new insights into the anatomy of the supraclavicular nerve and its variations. It has been revealed that the terminal branches of the nerve consistently pass over the clavicle in a predictable pattern, emphasizing the importance of considering the supraclavicular nerve's safe zones during clinically relevant surgeries. Nevertheless, due to individual anatomical variations, meticulous dissection between these safe zones is necessary to avoid iatrogenic nerve injury among patients. Basic Science Study, Anatomic Study.

Treatment of unfavorable bleeding patterns in contraceptive implant users: a randomized clinical trial of curcumin

Some users of the etonogestrel contraceptive implant experience bothersome bleeding, which can reduce contraceptive satisfaction and continuation. Few strategies exist to manage this bleeding. The exact mechanism of progestin-induced bleeding is unknown, but it is likely multifactorial (eg, impaired angiogenesis, "leaky" fragile vasculature, and inflammation). Curcumin, the active ingredient in turmeric, has anti-inflammatory, antiproliferative, and antiangiogenic properties, which may make it a useful agent for implant-associated bothersome bleeding. This study aimed to evaluate whether curcumin decreases frequent or prolonged bleeding or spotting in contraceptive implant users. The study was a randomized, double-blind, placebo-controlled trial. Here, etonogestrel implant users with frequent or prolonged bleeding or spotting were enrolled and randomized to either 600-mg Theracurmin HP (Immunovites, Las Vegas, NV) or placebo daily for 30 days. The term "frequent" was defined as ≥2 independent bleeding or spotting episodes, and the term "prolonged" was defined as ≥7 consecutive days of bleeding or spotting in a 30-day interval. Implant use was confirmed by clinical examination and negative gonorrhea and chlamydia and pregnancy tests. Enrolled participants initiated study treatment after 3 consecutive days of bleeding or spotting; if no bleeding or spotting occurred within 30 days of enrollment, the participants were withdrawn from the study. Study treatments were encapsulated to maintain a similar appearance. Participants used text messages to record daily bleeding patterns and study drug compliance. Bleeding was defined as a day that required the use of protection with a pad, tampon, or liner, and spotting was defined as a day with minimal blood loss that did not require the use of any protection. Our primary outcome was the total number of days without bleeding or spotting during the 30 days of study drug or placebo exposure. The secondary outcomes included total number of bleeding-free days, bleeding episodes, and satisfaction. A sample size of 22 per group provided 80% power at an alpha level of .05 to demonstrate a 6-day difference between groups. From February 2021 to November 2022, 58 individuals enrolled in the study with 54 participants (93%) completing 30 days of treatment (26 in the curcumin group and 28 in the placebo group). Of note, 1 individual in the curcumin arm did not experience a qualifying bleeding event and, thus, never initiated treatment and, per protocol, was withdrawn from the study. Participant characteristics did not differ between groups, including length of implant use at study enrollment (placebo, 521±305 days; curcumin, 419±264 days). The study groups did not differ concerning any bleeding-related outcome (mean days without bleeding or spotting: curcumin, 16.7±6.9; placebo, 17.5±4.8; P=.62; mean bleeding-free days: curcumin, 23.4±4.9; placebo, 22.4±4.5; P=.44; bleeding episodes: curcumin, 2.0±0.8; placebo, 2.1±0.8; P=.63). In addition, satisfaction with the implant as contraception and acceptability of bleeding over the study period did not differ by study group (P=.54 and P=.30, respectively). Daily use of curcumin did not improve bleeding patterns in users of the etonogestrel contraceptive implant experiencing frequent or prolonged bleeding patterns.

Foveal microvascular features following inverted flap technique for closure of large macular holes.

To describe the anatomical and functional outcomes following use of the inverted flap technique (IFT) to close idiopathic macular holes (MH) of diameter greater than 400 μm. To compare the changes in the macular microvascularization following surgery in operated and healthy fellow eyes. Retrospective study of 24 patients who underwent vitrectomy and IFT for large MH closure. The main variables were closure pattern, best corrected visual acuity (BCVA) and recovery of the external limiting membrane (ELM) and ellipsoid zone (EZ). Foveal avascular zones (FAZ) and vessel and perfusion densities, obtained by OCT angiography scans, were compared with those in healthy fellow eyes. Complete MH closure was achieved in 95.8% (23/24) of patients 6 months after surgery. There was a significant improvement in postoperative BCVA, from 1.0 to 0.4 logMAR (p < 0.001). The most frequent closure pattern was 1a (62.5%, 15/24), followed by 2c (12.5%, 3/24). The closure pattern was not correlated with height, minimum or maximum diameters or macular hole index (MHI) (p > 0.05). ELM and EZ recovery occurred in 87.5% and 83.3% of cases, respectively. FAZ were smaller in operated eyes than in the fellow eyes (p = 0.012). There were no differences in the vessel or perfusion densities between the operated and fellow eyes (p > 0.05). Use of the inverted flap technique for large MH closure provides a high rate of functional and anatomical recovery. We observed a reduction in the FAZ following surgery, with no differences in the macular microvascularization parameters, suggesting that the technique is safe.

Regional spreading pattern is associated with clinical phenotype in amyotrophic lateral sclerosis.

Increasing evidence shows that disease spreading in amyotrophic lateral sclerosis (ALS) follows a preferential pattern with more frequent involvement of contiguous regions from the site of symptom onset. The aim of our study was to assess if: (i) the burden of upper (UMN) and lower motor neuron (LMN) involvement influences directionality of disease spreading; (ii) specific patterns of disease progression are associated with motor and neuropsychological features of different ALS subtypes (classic, bulbar, primary lateral sclerosis, UMN-predominant, progressive muscular atrophy, flail arm, flail leg); and (iii) specific clinical features may help identify ALS subtypes, which remain localized to the site of onset for a prolonged time (regionally entrenching ALS). A single-centre, retrospective cohort of 913 Italian ALS patients was evaluated to assess correlations between directionality of the disease process after symptom onset and motor/neuropsychological phenotype. All patients underwent an extensive evaluation including the following clinical scales: Penn Upper Motor Neuron Score (PUMNS), MRC Scale for Muscle Strength and the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). The most frequent initial spreading pattern was that towards adjacent horizontal regions (77.3%), which occurred preferentially in patients with lower MRC scores (P = 0.038), while vertical diffusion (21.1%) was associated with higher PUMNS (P < 0.001) and with reduced survival (P < 0.001). Non-contiguous disease spreading was associated with more severe UMN impairment (P = 0.003), while contiguous disease pattern with lower MRC scores. Furthermore, non-contiguous disease spreading was associated with more severe cognitive impairment in both executive and visuospatial ECAS domains. Individuals with regionally entrenching ALS were more frequently female (45.6% versus 36.9%; P = 0.028) and had higher frequencies of symmetric disease onset (40.3% versus 19.7%; P < 0.001) and bulbar phenotype (38.5% versus 16.4%; P < 0.001). Our study suggests that motor phenotypes characterized by a predominant UMN involvement are associated with a vertical pattern of disease progression reflecting ipsilateral spreading within the motor cortex, while those with predominant LMN involvement display more frequently a horizontal spreading from one side of the spinal cord to the other. These observations raise the hypothesis that one of the mechanisms underlying disease spreading in ALS pathology is represented by diffusion of toxic factors in the neuron microenvironment. Finally, it is possible that in our cohort, regionally entrenching ALS forms are mainly observed in patients with atypical bulbar phenotypes, characterized by a slowly progressive course and relatively benign prognosis.

Assessing the Effect of Conduit Pattern and Type of Recharge on the Karst Spring Hydrograph: A Synthetic Modeling Approach

It is widely accepted that spring hydrographs are an effective tool for evaluating the internal structure of karst aquifers because they depict the response of the whole aquifer to recharge events. The spring hydrograph is affected by various factors such as flow regime, geometry, type of recharge, and hydraulic properties of conduit. However, the effect of conduit network geometry received less attention and required more comprehensive research studies. The present study attempted to highlight the impact of the two most frequent patterns of karst conduits (i.e., branchwork and network maze) on the characteristic of the spring hydrograph. Therefore, two conduit patterns, branchwork and network maze, were randomly generated with MATLAB codes. Then, MODFLOW-CFP was used to quantify the effect of conduit pattern, conduit density, and diffuse or concentrated recharge on the spring hydrograph. Results reveal that peak discharge, fast-flow recession coefficient, and the return time to baseflow are mainly affected by conduit network pattern, conduit network density, and recharge, respectively. In contrast, the time to reach peak flow only reacts to recharge conditions. Large variations in conduit density produce tangible changes in the baseflow recession coefficient.

Occupational Therapists in Patient Navigation: A Scoping Review of the Literature.

This review seeks to understand the literature on patient navigator programs (PNPs) that employ occupational therapists (OTs), including the role (conceptualization), functions (operationalization) of OTs who work as patient navigators (PNs) and the settings and populations they serve. This review also mapped the role of PNs to the 2021 Competencies for Occupational Therapists in Canada. Scoping review methodology by Arksey and O'Malley (2005) was employed. Data were analyzed thematically and numerically to identify frequent patterns. Ten articles were included. Within PNPs, OTs worked in hospitals and communities, but their role was rarely well-defined. Five competency domains (i.e., communication and collaboration, culture, equity and justice, excellence in practice, professional responsibility, and engagement with the profession) were evident in existing PNPs that included OTs. This review supports the increasing interest in OTs as PNs by demonstrating the alignment between the OT competencies and roles and functions of OTs working within PNPs.