Friedman Test Research Articles

Assessing the impact of the National Clean Air Programme in Uttar Pradesh's non-attainment cities: a prophet model time series analysis

BackgroundUttar Pradesh, India’s largest state, faces critical pollution levels, necessitating urgent action. The National Clean Air Programme (NCAP) targets a 40% reduction in particulate pollution by 2026. This study assesses the NCAP’s impact on 15 non-attainment cities in Uttar Pradesh using the Prophet forecasting model. MethodsMonthly data from 2016 to 2023 on AQI and PM10 concentrations were sourced from the Uttar Pradesh Pollution Control Board. Significant changes in mean AQI and PM10 levels from 2017 to 2023 were evaluated using the Friedman Test. Prophet models forecasted PM10 concentrations for 2025-26, with relative percentage changes calculated and model evaluation metrics assessed. FindingsMost cities exhibited unhealthy air quality. Jhansi had the lowest AQI (72·73) in 2023, classified as 'moderate' by WHO standards. Gorakhpur consistently showed 'poor' AQI levels, peaking at 249·31 in 2019. Western Uttar Pradesh cities such as Ghaziabad, Noida, and Moradabad had significant pollution burdens. Predictions showed Bareilly with over a 70% reduction in PM10 levels, Raebareli 58%, Moradabad 55%, Ghaziabad 48%, Agra around 41%, and Varanasi 40%, meeting NCAP targets. However, Gorakhpur and Prayagraj predicted increases in PM10 levels by 50% and 32%, respectively. Moradabad’s model showed the best performance with an R2 of 0·81, MAE of 17·27 μg/m3, and MAPE of 0·10. InterpretationForecasting PM10 concentrations in Uttar Pradesh's non-attainment cities offers policymakers substantial evidence to enhance current efforts. While existing measures are in place, our findings suggest that intensified provisions may be necessary for cities predicted to fall short of meeting program targets. The Prophet model's forecasts can pinpoint these at-risk areas, allowing for targeted interventions and regional adjustments to strategies. This approach will help promote sustainable development customized to each city's specific needs. FundingNo funding was issued for this research.

Text readability: its impact on reading comprehension and reading time

Recently, the readability of texts has become the focus of reading research because it is believed to have implications for reading comprehension, which is of utmost importance in the field of English as a foreign language (EFL), particularly in the teaching, learning and assessment of reading comprehension. Unfortunately, the influence of text readability on reading comprehension (and reading time) has not been well studied in the EFL context. Most text readability studies are conducted in medical contexts, but these studies are often limited in predicting readability scores for sample texts. To address this gap, the current study aimed to evaluate the influence of text readability levels (based on the Flesch-Kincaid grade level (FKGL)) on students’ reading comprehension and reading time. Data were collected through reading test and analyzed using SPSS version 22. The Friedman test revealed that the distribution of students' reading comprehension score (X2=197.532, p=0.000) and reading time (X2=215.323, p=0.000) are different in each text, suggesting that the readability of texts has a significant influence on both. This study contributed to the practices of reading instruction and assessment. Limitations and suggestions for further research are briefly discussed.

Effectiveness of Mindfulness Therapy as a Complement to Pharmacological Treatment in the Control of Blood Pressure in Hypertensive Adults: A Quasi-Experimental Study in Lima, Peru.

To evaluate the effectiveness of mindfulness therapy as an adjunct to pharmacological treatment for improving blood pressure (BP) control in hypertensive adult patients at a health center in Lima, Peru. This study employed a quasi-experimental design with a quantitative and longitudinal cohort approach. The participants included 50 adults who were diagnosed with hypertension and who regularly attended the health center in the Villa El Salvador district of Lima, Peru. The data were collected using three instruments: the Depression Anxiety Stress Scale (DASS 21), validated in Peru; a sociodemographic questionnaire; and a BP recording sheet. The Wilcoxon test was utilized to assess the effectiveness of mindfulness therapy on BP control, while the nonparametric Friedman test was used to evaluate the effectiveness of mindfulness therapy considering confounding factors. Therapy resulted in favorable outcomes for BP control. After eight sessions, the average systolic BP decreased from 122.8 to 115.0mm Hg (a reduction of 7%), and the average diastolic BP decreased from 78.1 to 69.9mm Hg (a reduction of 11%). Mindfulness is an effective complementary therapy for controlling BP in hypertensive adults. It also helps reduce confounding factors such as stress, anxiety, and depression.

Recovery of Executive Functions in Alcohol Use Disorder: role of Neuropsychological Rehabilitation

Abstract Background Alcohol Use Disorder (AUD) is a growing public health concern with high incidence of executive functions (EFs) changes, affecting disease progression and treatment effectiveness. Inconsistencies persist in studies on the role of neuropsychological rehabilitation (NR) in EF recovery within AUD interventions. Our aim is to analyse the effect of NR on EFs in AUD interventions. Methods A prospective cohort study included 65 participants of both sexes, diagnosed with AUD, free of psychiatric comorbidities or severe neurological conditions. They underwent alcohol detoxification in hospital/home from 2021 to 2023, completing three evaluation moments (M1-Baseline, M2-3 months, M3-6 months). Patients receiving usual treatment (WTG-weekly therapeutic groups) - were compared to those with additional Neuropsychological Rehabilitation (NRG) regarding Sociodemographic and Severity of Alcohol Dependence Questionnaires, Hospital Anxiety and Depression Scale, Frontal Assessment Battery (FAB), Number and Letters Subscale of Weschler Adult Intelligence Scale (WAIS). Our main outcome was FAB-general executive functioning, and secondary outcome was WAIS-working memory. Friedman test compared assessments across the three points (alpha 5%). Results Statistically significant differences were found for FAB in both groups, (p < 0.001) between M1 and both M2 and M3, indicating improved executive functioning, particularly in NRG. Working memory also improved in both groups (WTG: p = 0.036; NRG: p < 0.001), with NRG showing better M2 performance. Conclusions There is evidence that neuropsychological rehabilitation facilitates the recovery of executive functions and may play a pivotal role in relapse prevention. It is crucial that the treatment of these situations incorporates public health, preventive and damage minimization measures. KeyWords: Executive Function; Neuropsychological Rehabilitation; Alcohol Use Disorder. Key messages • Recovery of executive functions is crucial from a Public Heath perspective in AUD populations, minimizing morbidity, permanent disabilities and contributing to more effective healthcare services. • Integrating Neuropsychological Rehabilitation into standard Alcohol Use Disorder treatments can enhance treatment effectiveness, reducing disease burden.

AMIC achieves sustained clinical improvement in isolated patellar cartilage defects over 5 years, correlating with MRI.

To evaluate 5-year postoperative clinical outcomes of autologous matrix-induced chondrogenesis (AMIC) for isolated ICRS grade 3-4 patellar cartilage defects and correlate outcomes with magnetic resonance imaging (MRI). The hypothesis was that AMIC would improve clinical symptoms and induce neocartilage formation, visible on MRI, making it a safe and effective option for repairing focal patellar cartilage defects. The cohort comprised 13 focal patellar lesions in 12 patients. Pain visual analogue scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala score, EuroQol-5D Health Survey questionnaire and MRI data were assessed preoperatively and at 2 and 5 years postoperatively. All MRI scans were evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue System. Descriptive statistics were calculated on all data. Inferential analysis comparing outcome scores before and after surgery employed the nonparametric Wilcoxon signed-rank test, with the nonparametric Friedman test used to detect differences across multiple test attempts. p < 0.05 was considered statistically significant. Twelve patients (23-52 years old) with patellofemoral chondral full-thickness defects (2-4 cm2) were treated. At a 5-year follow-up, eleven knees showed MRI improvement. Two were asymptomatic and nine showed clear clinical improvement. Only one knee showed no clinical improvement. MRI revealed a defect filling with newly formed cartilage characterized by a less compact and heterogeneous signal. Cartilage degradation or joint damage was observed in two knees, and bone formation within the plate was identified in four. AMIC significantly improved patients' VAS pain, KOOS, EuroQol-5D and Kujala scores compared to preoperative baseline for up to 5 years postoperatively. Satisfactory clinical outcomes and new cartilage formation, as observed by MRI, are achieved with AMIC at mid-term follow-up for ICRS grade 3-4 in small-to-medium-sized patellar defects in patients under 52 years of age, with improvements maintained for up to 5 years. Level III.

Effect of Hyaluronic Acid Mucoadhesives on Palatal Wound Healing and Postoperative Discomfort in Free Gingival Graft Surgery: A Clinical Trial

Objectives: This study aimed to assess the effect of hyaluronic acid (HA) mucoadhesives with two different concentrations on palatal epithelial wound healing and postoperative discomfort following free gingival graft (FGG) surgery. Materials and Methods: In this triple-blind, randomized, controlled clinical trial, 39 patients undergoing FGG surgery were randomly allocated to three groups (N=13). Following palatal graft harvesting, the two experimental groups received mucoadhesives containing 0.8% and 0.2% HA, while the control group received mucoadhesives without HA. In all groups, the donor site was protected with periodontal dressing. Epithelization, color match, contour, and distortion were assessed at 3, 7, 14, 21, and 42 days, postoperatively using the Landry's healing index and modified Manchester Scar Proforma (mMSP) index. Pain level and response to thermal stimuli were evaluated after 3, 7, 14, and 21 days using a visual analog scale (VAS). Data were analyzed by the Chi-square, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon signed-rank tests (alpha=0.05). Results: Significant differences were observed in the mMSP index scores among the groups at 3, 7, 14, and 42 days, favoring HA groups (P&lt;0.05). The Landry's healing index score was significantly higher in 0.8% HA group on day 21 (P=0.023), compared to the control group. No significant differences were found in pain score or thermal stimulus responses among the groups (P&gt;0.05). Conclusion: Mucoadhesives containing HA were found to enhance palatal wound healing, leading to improved outcomes in terms of epithelization, color match, contour, and distortion reduction.

Effects of metformin phonophoresis and exercise therapy on pain, range of motion, and physical function in chronic knee osteoarthritis: randomized clinical trial

BackgroundKnee osteoarthritis (KOA) is a common musculoskeletal disorder. Therapeutic ultrasound (US) is a safe and effective treatment for KOA. It relieves knee pain and enhances function. Metformin (MF) regulates chondrocytes, hence providing chondroprotection. Furthermore, it efficiently reduces knee articular cartilage degeneration and retards the progression of osteoarthritis. However, the localized administration of MF by phonophoresis for KOA has yet to be studied.PurposeTo assess the possible effects of metformin phonophoresis (MFPH) plus exercise therapy (EX) compared to MFPH alone or the US on knee pain, function, and range of motion (ROM) in chronic KOA patients.MethodsSeventy-eight patients with unilateral mild to moderate chronic KOA were included. Patients were randomly assigned to three groups: group A (MFPH + EX), group B (MFPH alone), and group C (US). The US group used an acoustic-neutral gel, while the MFPH group used a gel containing 1.2% MF. The exercises included hamstring stretches, calf stretches, and knee strengthening exercises. Treatment in the three groups continued for four weeks (three sessions per week). The Visual Analog Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the goniometer were used to assess knee pain, function disability, and ROM, respectively. All measures were recorded before, 2 weeks, and 4 weeks after the intervention in all groups. Multivariate Analysis of Variance (MNOVA) was performed to compare the effects within and between groups for knee ROM and function disability. The Kruskal-Wallis test and the Friedman test analyzed the pain intensity.ResultsWhen the baseline patient characteristics were compared, there were no significant differences in means of age, gender, body mass index (BMI), or lower limb dominance across the three groups (p > 0.05). After 4 weeks of intervention, clinical outcomes significantly improved in all three groups (p < 0.05). However, patients in the MFPH + EX group improved significantly in all outcomes compared to the MFPH and US groups (p < 0.05).ConclusionPost-treatment results showed a statistically and clinically significant improvement in pain intensity, knee ROM, and function in the MFPH group; however, combining MFPH with exercises is more beneficial in reducing KOA symptoms.Trial registrationClinical Trial Registry at (pactr.samrc.ac.za) database.NO: PACTR202311507335269. Date: November 9, 2023 (retrospectively registered).

Antimicrobial and anti-endotoxin activity of N-acetylcysteine, calcium hydroxide and their combination against Enterococcus faecalis, Escherichia coli and lipopolysaccharides.

The management of endodontic infections is a complex challenge, mainly due to the involvement of diverse microorganisms and their by-products. This study aimed to evaluate the efficacy of N-acetylcysteine (NAC), calcium hydroxide (Ca(OH)2), and their combined application as intracanal medications in combating Enterococcus faecalis, Escherichia coli, and lipopolysaccharides (LPS) from E. coli. A total of 60 single-rooted human teeth were carefully selected and divided into six groups. These tooth canals were deliberately exposed to E. faecalis (ATCC 29212) and E. coli (ATCC 25922) to induce biofilm formation. Subsequently, the specimens were treated with NAC, Ca(OH)2, or a combination of both substances. Three samples of the root canals were collected at three moments: the first sample (S1) was to confirm the initial contamination, the second sample (S2) was immediately post-instrumentation, and the third sample (S3) was collected after the use of the intracanal medication. The antimicrobial efficacy of these intracanal medications was assessed by enumerating colony-forming units per milliliter (CFU/mL). In addition to this, the kinetic chromogenic Limulus Amebocyte Lysate (LAL) assay by Lonza was used to quantify LPS from E. coli. Data tested for normality; then, Kruskal-Wallis and Friedman tests were used, and Dunn's for multiple comparisons. The findings of this study showed significant reductions in the microbial load of E. faecalis and E. coli by S3. Notably, there were no statistically significant differences among the treatment groups concerning these microorganisms. However, it was observed that only the combination of NAC and Ca(OH)2 led to a noteworthy decrease in the quantity of E. coli's LPS after 7-days, demonstrating a statistically significant difference from the other treatment groups. NAC + Ca(OH)2 combination, applied for a duration of 7-days, proved to be more suitable in reducing the presence of E. faecalis, E. coli, and LPS from E. coli within the context of endodontic infections.

Mitigating local minima in extracting optimal parameters for photovoltaic models: An optimizer leveraging multiple initial populations (OLMIP)

The accurate identification of parameters in photovoltaic models is of paramount importance to accurately predict the electrical behavior of photovoltaic systems and improve their performance. Nowadays, this task poses a multimodal optimization problem, aiming to find the best combination of parameters that fit the model to real data. This article presents a proposal for an Optimizer Leveraging Multiple Initial Populations (OLMIP) that aims to achieve optimal solutions while effectively avoiding undesirable local optima. By utilizing a separate evolution strategy involving four distinct initial populations, followed by the construction of an elite population, the algorithm can explore multiple regions of the search space and escape local minima. Experiments were conducted with four models: the single diode, double diode, triple diode from RTC France cell, and Photowatt-PWP201 module. The mean squared errors obtained are 9.860219E-04, 9.824849E-04, 9.824849E-04, and 2.425075 E−03, respectively. These results indicate that the algorithm achieves superior or comparable accuracy to that of six competitors. Furthermore, the statistical analysis of the results, including the Wilcoxon and Friedman tests, confirms the robustness and effectiveness of the approach used for parameter estimation in photovoltaic systems. These findings open up new prospects for the improvement and optimization of photovoltaic systems.

Influence of sonic activation of epoxy-resin and calcium silicate sealer on postoperative pain: a patient-blinded, parallel group, randomized clinical trial

BackgroundThis clinical study aims to compare postoperative pain after single-visit root canal treatment of teeth with asymptomatic apical periodontitis using epoxy-resin-based AH Plus and calcium silicate-based Endosequence BC sealers with or without sonic activation.MethodsThis study included 72 individuals with one first or second mandibular premolar tooth with asymptomatic apical periodontitis. They were randomly divided into four groups according to the root canal sealer (AH Plus or Endosequence BC) and activation protocol (sonic activation or non-activation) (n = 18). The participants were ask to rate their postoperative pain intensity on a NRS scale as none, minimal, moderate, or severe after 24 h, 48 h, 72 h, and 7 days following treatment. Patients were also asked to record the number of prescribed analgesic medication tablets (400 mg of ibuprofen) taken. Statistical analysis were performed using the Mann-Whitney U test, the Friedman test, the Spearman’s correlation test, the Chi-square test. Significance level was established at 0.05.ResultsThere was no statistically significant difference in postoperative pain scores or analgesic intake between AH Plus and Endosequence BC sealers regardless of the activation protocol (p > 0.05). There was no statistically significant difference in postoperative pain scores between the sonic activation and non-activation groups (p > 0.05). A weak positive correlation was detected between Endoactivator sonic activation and sealer extrusion (r = 0.36).ConclusionsAH Plus and EndoSequence BC root canal sealers showed similar results in terms of prevalance and intensity of postoperative pain. Sonic activation and non-activation groups had similar postoperative pain scores.Clinical trial registrationThe study was retrospectively registered with ClinicalTrials.gov (NCT06403293). Date of Registration: 07/05/24.

Bovine pulp extracellular matrix hydrogel for regenerative endodontic applications: in vitro characterization and in vivo analysis in a necrotic tooth model

BackgroundRegenerative endodontic procedures (REPs) offer the promise of restoring vitality and function to a previously necrotic and infected tooth. However, the nature of regenerated tissues following REPs remains unpredictable and uncontrollable. Decellularized extracellular matrix scaffolds have gained recent attention as scaffolds for regenerative endodontics.ObjectivesPreparation and characterization of a bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel for regenerative endodontic applications. Biocompatibility and regenerative capacity of the prepared scaffold were evaluated in vivo in a canine animal model.MethodsFifteen freshly extracted bovine molar teeth were used to prepare P-ECM hydrogels following approval of the institutional review board of the faculty of dentistry, Alexandria University. Decellularization and lyophilization of the extracted pulp tissues, DNA quantification and histological examination of decellularized P-ECM were done. P-ECM hydrogel was prepared by digestion of decellularized pulps. Prepared scaffolds were evaluated for protein content and release as well as release of VEGF, bFGF, TGF-β1 and BMP2 using ELISA. Rabbit dental pulp stem cells’ (rDPSCs) viability in response to P-ECM hydrogels was performed. Finally, proof-of-concept of the regenerative capacity of P-ECM scaffolds was assessed in an infected mature canine tooth model following REPs versus blood clot (BC), injectable platelet-rich fibrin (i-PRF) or hyaluronic acid (HA). Statistical analysis was done using independent t test, the Friedman test and chi-square tests (p value ≤ 0.05).ResultsDNA was found to be below the cut-off point (50 ng/mg tissue). Histological evaluation revealed absence of nuclei, retention of glycosaminoglycans (GAGs) and collagen content, respectively. P-ECM hydrogel had a total protein content of (493.12 µg/µl) and protein release was detected up to 14 days. P-ECM hydrogel also retained VEGF, bFGF, TGF-β1 and BMP2. P-ECM hydrogel maintained the viability of rDPSCs as compared to cells cultured under control conditions. P-ECM hydrogel triggered more organized tissues compared to BC, i-PRF and HA when used in REPs for necrotic mature teeth in dogs. Periapical inflammation was significantly less in HA and P-ECM groups compared to blood-derived scaffolds.ConclusionBovine dental pulp-derived extracellular matrix (P-ECM) hydrogel scaffold retained its bioactive properties and demonstrated a promising potential in regenerative endodontic procedures compared to conventional blood-derived scaffolds.

Optimization of SVR and CatBoost models using metaheuristic algorithms to assess landslide susceptibility

In this study, a landslide susceptibility assessment is performed by combining two machine learning regression algorithms (MLRA), such as support vector regression (SVR) and categorical boosting (CatBoost), with two population-based optimization algorithms, such as grey wolf optimizer (GWO) and particle swarm optimization (PSO), to evaluate the potential of a relatively new algorithm and the impact that optimization algorithms can have on the performance of regression models. The Kerala state in India has been chosen as the test site due to the large number of recorded incidents in the recent past. The study started with 18 potential predisposing factors, which were reduced to 14 after a multi-approach feature selection technique. Six susceptibility models were implemented and compared using the machine learning algorithms alone and combining each of them with the two optimization algorithms: SVR, CatBoost, SVR-PSO, CatBoost-PSO, SVR-GWO, and CatBoost-GWO. The resulting maps were validated with an independent dataset. The performance rankings, based on the area under the receiver operating characteristic curve (AUC) metric, are as follows: CatBoost-GWO (AUC = 0.910) had the highest performance, followed by CatBoost-PSO (AUC = 0.909), CatBoost (AUC = 0.899), SVR-GWO (AUC = 0.868), SVR-PSO (AUC = 0.858), and SVR (AUC = 0.840). Other validation statistics corroborated these outcomes, and the Friedman and Wilcoxon-signed rank tests verified the statistical significance of the models. Our case study showed that CatBoost outperformed SVR both in case the models were optimized or not; the introduction of optimization algorithms significantly improves the results of machine learning models, with GWO being slightly more effective than PSO. However, optimization cannot drastically alter the results of the model, highlighting the importance of setting up of a rigorous susceptibility model since the early steps of any research.

National Collegiate Athletic Association Athletic Trainers’, Head Coaches’, and Student-Athletes’ Perceptions of Professional Titles Used in Sport PsychologyA

The purpose of this convergent mixed-methods study was to explore National Collegiate Athletic Association (NCAA) Division I athletic trainer (AT), head coach, and student-athlete perceptions of three commonly used sport psychology professional titles in the United States: Certified Mental Performance Consultant (CMPC), mental conditioning coach, and sport psychologist. Participants included 73 ATs, 79 head coaches, and 76 student-athletes. Participants completed an online questionnaire that assessed their previous exposure to these professionals, the services they believed these professionals could provide, their confidence in sport psychology consultation from these professionals, and their stigma tolerance of these professionals. A series of Friedman tests found that ATs and student-athletes perceived significantly more confidence in the services of a sport psychologist compared to a CMPC and a mental conditioning coach. A series of Kruskal-Wallis tests revealed that student-athletes perceived significantly more stigma in using services from all three professionals than head coaches and ATs. Participants reported that sport psychologists could provide mental performance and mental health services, while CMPCs and mental conditioning coaches primarily provided mental performance services. However, short answer responses from many ATs and head coaches about CMPCs demonstrated some doubt and misunderstanding of this professional title.

The Impact of Deployment of National Police Reservists on the Overall Security Incidents in Elgeyo Marakwet County, Kenya

The use of police reservists has been recognized as a key strategy in enhancing security, especially in conflict-prone regions like Elgeyo Marakwet County, Kenya. Their unique advantage lies in their proximity to the local community, quick response capabilities, and familiarity with both the terrain and the people they serve. These traits, combined with their role in community policing, have proven vital in addressing resource-based conflicts and cattle rustling. Despite challenges such as limited personnel and the presence of firearms, reservists have significantly contributed to reducing violence and fostering better relations between law enforcement and local communities. The data used in this paper was part of a study that examined the relationship between the deployment of National Police Reservists and security incidents in Elgeyo Marakwet County, Kenya. Through a cross-sectional survey, data was collected from community members through a questionnaire (n = 362), interviews (the County Commander, Subcounty Commanders, Officer Commanding Police Stations and administrative Chiefs; n = 7) and FGDs (n = 7 police reservists). The Friedman Test was conducted to evaluate whether the deployment of NPRs led to reduction in the frequency of security incidents. Qualitative data, was analysed thematically. The study established that the deployment of National Police Reservists (NPRs) had a significant impact on crime reduction (χ²(4) = 11.800, p = .019). The community considered the police reservists as effective in maintaining peace and security, with residents reporting increased safety and expressing strong trust in their abilities. There was a high level of trust in the reservists' ability to protect the community. The potential challenges in the deployment of National Police Reservists include logistical constraints, inadequate communication infrastructure, limited training and resource shortages. The study recommends the continued deployment of NPRs while monitoring and evaluating their impact regularly. In addition, there is need to build on the strong community trust in NPRs by enhancing community engagement and communication. There is need to invest to increase resource allocation to the NPRs as well as address the logistical constraints faced by reservists.

Comparison of different iterative reconstruction algorithms with contrast-enhancement boost technique on the image quality of CT pulmonary angiography for obese patients

ObjectiveTo evaluate the effect of the contrast-enhancement-boost (CE-boost) postprocessing technique on improving the image quality of obese patients in computed tomography pulmonary angiography (CTPA) compared to hybrid iterative reconstruction (HIR) and model-based iterative reconstruction (MBIR) algorithms.MethodsThis prospective study was conducted on 100 patients who underwent CTPA for suspected pulmonary embolism. Non-obese patients with a body mass index (BMI) under 25 were designated as group 1, while obese patients (group 2) had a BMI exceeding 25. The CE-boost images were generated by subtracting non-contrast HIR images from contrast-enhanced HIR images to improve the visibility of pulmonary arteries further. The CT value, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were quantitatively assessed. Two chest radiologists independently reviewed the CT images (5, best; 1, worst) across three subjective characteristics including diagnostic confidence, subjective image noise, and vascular contrast. The Friedman test and Dunn-Bonferroni correction were used for statistical analysis.ResultsThe CE-boost had significantly higher CT values than HIR and MBIR in both groups (all p < 0.001). The MBIR yielded the lowest image noise compared with HIR and CE-boost (all p < 0.001). The SNR and CNR of main pulmonary artery (MPA) were significantly higher in CE-boost than in MBIR (all p < 0.05), with HIR showing the lowest values (all p < 0.001). Group 2 MBIR received significantly better subjective image noise scores, while the diagnostic confidence and vascular contrast scored highest with the group 2 CE-boost (all p < 0.05).ConclusionCompared to the HIR algorithm, both the CE-boost technique and the MBIR algorithm can improve the image quality of CTPA in obese patients. CE-boost had the greatest potential in increasing the visualization of pulmonary artery and its branches.

An advanced RIME Optimizer with Random Reselection and Powell Mechanism for Engineering Design

Abstract RIME is a recently introduced optimization algorithm that draws inspiration from natural phenomena. However, RIME has certain limitations. For example, it is prone to falling into Local Optima (LO), thus failing to find the Global Optima (GO), and has the problem of slow convergence. To solve these problems, this paper introduces an improved RIME algorithm (PCRIME), which combines the random reselection strategy and the Powell mechanism. The random reselection strategy enhances population diversity and helps to escape LO, while the Powell mechanism helps to improve the convergence accuracy and thus find the optimal solution. To verify the superior performance of PCRIME, we conducted a series of experiments at CEC 2017 and CEC 2022, including qualitative analysis, ablation studies, parameter sensitivity analysis, and comparison with various advanced algorithms. We used the Wilcoxon signed-rank test and the Friedman test to confirm the performance advantage of PCRIME over its peers. The experimental data show that PCRIME has superior optimization ability and robustness. Finally, this paper applies PCRIME to five real engineering problems and proposes feasible solutions and comprehensive performance index definitions for these five problems to prove the stability of the proposed algorithm. The results show that the PCRIME algorithm can not only effectively solve practical problems, but also has excellent stability, making it an excellent algorithm.

Unaltered Responses of Distal Motor Neurons to Non-Targeted Thoracic Spinal Cord Stimulation in Chronic Pain Patients.

Spinal cord stimulation (SCS) represents an established interventional pain therapeutic; however, the SCS effects of SCS waveforms on motor neuron recruitment of the lower limbs of chronic pain patients remain largely unknown. We investigated these effects by performing isometric ankle-dorsal flexions at varying force levels under four SCS conditions: SCS Off (1week), burst SCS (40Hz), SCS Off (acute), and tonic SCS (130Hz). Muscle activity was recorded via high-density surface electromyography (64-electrode grid) on the tibialis anterior muscle. Motor unit action (MUs) potentials were analyzed for recruitment and de-recruitment thresholds, discharge rate, inter-spike interval, and common synaptic input. In this prospective study, we included nine patients (five females; four males; mean age 59years) with chronic pain treated with thoracic (Th7-Th8) epidural spinal stimulation. A total of 97 MUs were found for 15% maximal voluntary torque (MVT) and 83 for 30%MVT, an average of 10.8±3.7 for 15%MVT and 10.4±3.5 for 30%MVT. While a few subject-specific variations were observed, our study suggests that the different SCS frequencies applied do not significantly influence motor unit discharge characteristics in the TA muscle among the participants (p values at 15%MVT were 0.586 (Chi2=1.933), 0.737 (Chi2=1.267), 0.706 (Chi2=1.4) and 0.586 (Chi2=1.933), respectively. The p values of the Friedman test at 30%MVT were 0.896 (Chi2=0.6), 0.583 (Chi2=1.95), 0.896 (Chi2=0.6) and 0.256 (Chi2=4.05). No significant difference was found for the different stimulation types for the delta (0-5Hz), alpha (5-12Hz), and beta (15-30Hz) bands at both force levels. In summary, we did not observe any changes in motor unit oscillatory activity at any low and high bandwidths, indicating that SCS using different waveforms (tonic/burst) does not significantly influence motor neuron recruitment for non-motor individuals with chronic pain.

Image quality of photon-counting detector CT for visualization of maxillofacial anatomy in comparison with energy-integrating detector CT and intraoperative C-arm CBCT

BackgroundAccurate diagnostic imaging is crucial for managing facial fractures, which are a common global occurrence. This study aimed to compare the image quality of Photon Counting Detector CT (PCD-CT) with state-of-the-art Energy Integrating Detector CT (EID-CT) and intraoperative C-arm CBCT (CBCT) in visualizing maxillofacial anatomy using a cadaveric sheep head model. MethodsThree fresh sheep heads were used, with surgical interventions simulating metal implants in two of them. The specimens were imaged using PCD-CT, EID-CT, and CBCT, following which quantitative assessments of signal-to-noise ratio, sharpness, and artifacts were conducted. A visual grading study was performed by six observers, using criteria focusing on the mandible, orbit, and soft tissues. Statistical analyses included Friedman tests for comparing modalities and Kendall’s W and Gwet’s AC1 for assessing inter- and intrarater agreement. ResultsPCD-CT demonstrated a significantly higher signal-to-noise ratio (p = 0.03) and bone sharpness (p < 0.001) compared to CBCT. In visual grading, PCD-CT outperformed CBCT, but not EID-CT, particularly in delineating mandibular and orbital structures. EID-CT and PCD-CT showed slightly more severe hypodense artifacts (p = 0.01) but were comparable in streak artifact presentation. The interrater and intrarater agreements indicated consistent evaluations across and within observers. ConclusionPCD-CT exhibits superior image quality over CBCT in key parameters essential for maxillofacial imaging, while no apparent improvement was shown compared to state-of-the-art EID-CT. PCD-CT offers enhanced visualization of critical anatomical structures, suggesting its potential as a preferred modality in managing maxillofacial trauma. The findings in this study align with limited existing research on PCD-CT, underscoring its promise for advanced diagnostic imaging in maxillofacial applications.

Fractional Derivative to Symmetrically Extend the Memory of Fuzzy C-Means

The fuzzy C-means (FCM) clustering algorithm is a widely used unsupervised learning method known for its ability to identify natural groupings within datasets. While effective in many cases, FCM faces challenges such as sensitivity to initial cluster assignments, slow convergence, and difficulty in handling non-linear and overlapping clusters. Aimed at these limitations, this paper introduces a novel fractional fuzzy C-means (Frac-FCM) algorithm, which incorporates fractional derivatives into the FCM framework. By capturing non-local dependencies and long memory effects, fractional derivatives offer a more flexible and precise representation of data relationships, making the method more suitable for complex datasets. Additionally, a genetic algorithm (GA) is employed to optimize a new least-squares objective function that emphasizes the geometric properties of clusters, particularly focusing on the Fukuyama–Sugeno and Xie–Beni indices, thereby enhancing the balance between cluster compactness and separation. Furthermore, the Frac-FCM algorithm is evaluated on several benchmark datasets, including Iris, Seed, and Statlog, and compared against traditional methods like K-means, SOM, GMM, and FCM. The results indicate that Frac-FCM consistently outperforms these methods in terms of the Silhouette and Dunn indices. For instance, Frac-FCM achieves higher Silhouette scores of most cases, indicating more distinct and well-separated clusters. Dunn’s index further shows that Frac-FCM generates clusters that are better separated, surpassing the performance of traditional methods. These findings highlight the robustness and superior clustering performance of Frac-FCM. The Friedman test was employed to enhance and validate the effectiveness of Frac-FCM.

Changes in Trait Mindfulness after a Brief Mindfulness Training Program of Self-Breathing.

Developing and cultivating mindfulness exerts a positive effect on psychological and cognitive performance. Sharpening the skill requires continuous mindfulness-based training (MT), which can be challenging for people leading busy lives. Therefore, the current study examined whether trait mindfulness can be improved by a flexible and brief MT program of self-breathing using a pre-post intervention design. Trait mindfulness was assessed using the Japanese version of the Five Facet Mindfulness Questionnaire (FFMQ) before the intervention (pre), after 2 weeks (during), and 4 weeks after the intervention started (post). Data were analyzed using the Friedman test followed by the Dunn-Bonferroni correction. The study sample consisted of 22 healthy participants aged from 20 to 60 years with no previous experience with yoga or meditation equivalent to MT. The mean number of days of MT practice was 26.4, and 11 participants had interruptions. The median values of pre-, during-, and post-total FFMQ scores were 115.5, 123, and 129, respectively. Significant differences were observed in the total pre and post (p < 0.001) and during and post (p = 0.002) FFMQ scores, though a medium effect was found (r = 0.30) only between the pre and post scores. Of the five sub-scales of FFMQ, significant differences were observed only between pre and post Observing (p = 0.01), Nonreactivity (p < 0.001), and Describing (p = 0.01), and during and post Nonjudging (p = 0.016), and Nonreactivity (p = 0.025). Our findings suggest that the simple, brief, and flexible self-breathing method employed in this study has a substantial effect on fostering trait mindfulness and, therefore, can be adopted by people with hectic daily schedules.