Functional Variables Research Articles

Understanding complex processes better-A case study on increasing patient safety and efficiency in a central operating room

Various professional groups are involved in the daily work of the central operating room with the aim of providing the best possible treatment for each individual using modern medical technology (sociotechnical system) in acost-effective manner. Ensuring perioperative patient safety is of particular importance. At the same time, the efficient use of the central operating room is essential for the economic success of ahospital. Preoperative preparation is acomplex process with many substeps that are often difficult to manage. Historically, the focus has been on retrospective learning from errors and incidents. More recent approaches take asystemic view. Acentral idea is to consider the mostly positive course of treatment and the adjustments to daily work that are currently required by the people involved (Safety-II). By taking greater account of how the many components of the system interact, processes can be better understood and specific measures derived. This strengthens the system's ability to adapt to changes and disturbances, thus ensuring that goals are achieved. The functional resonance analysis method (FRAM) is an internationally recognized method for modelling work as done compared to work as imagined. This paper presents the application of FRAM to preoperative preparation in a major regional hospital. Is FRAM suitable for improving process understanding in preoperative preparation? An interdisciplinary project team identified relevant functions of preoperative preparation through document analysis and walkthroughs. Based on this, more than 30guided interviews were conducted with functionaries. The results were presented graphically and specific information, such as safety-related statements or reasons for the variability of functions, were also presented textually. In the next phase, statements were evaluated and compared with the target model and the job descriptions. The FRAM revealed the process as acomplex network of relationships. During the modelling process, avarying degree of centrality and variability of certain functions became apparent. From the observations, the project team selected those with high relevance for patient safety and for the efficiency of the overall process in order to prioritize starting points for deriving measures to increase resilience. These starting points relate either to single functions, such as surgical site marking or to multiple functions that are variable in their execution, such as delays due to nonsynchronized duty times. The FRAM conducted provides valuable new insights into the functioning of complex sociotechnical systems that go far beyond classical linear methods. The awareness of operational processes gained and the resulting dynamic view of interactions within the system enable specific measures to be derived that promote resilient behavior and reduce critical variability, thus contributing to increased patient safety and efficiency.

Transcutaneous auricular vagus nerve stimulation with task-oriented training improves upper extremity function in patients with subacute stroke: a randomized clinical trial.

Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising brain stimulation modality in poststroke upper extremity rehabilitation. Although several studies have examined the safety and reliability of taVNS, the mechanisms underlying motor recovery in stroke patients remain unclear. This study aimed to investigate the effects of taVNS paired with task-oriented training (TOT) on upper extremity function in patients with subacute stroke and explore the potential underlying mechanisms. In this double-blinded, randomized, controlled pilot trial, 40 patients with subacute stroke were randomly assigned to two groups: the VNS group (VG), receiving taVNS during TOT, and the Sham group (SG), receiving sham taVNS during TOT. The intervention was delivered 5 days per week for 4 weeks. Upper extremity function was measured using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), the Action Research Arm Test (ARAT). Activities of daily living were measured by the modified Barthel Index (MBI). Motor-evoked potentials (MEPs) were measured to evaluate cortical excitability. Assessments were administered at baseline and post-intervention. Additionally, the immediate effect of taVNS was detected using functional near-infrared spectroscopy (fNIRS) and heart rate variability (HRV) before intervention. The VG showed significant improvements in upper extremity function (FMA-UE, ARAT) and activities of daily living (MBI) compared to the SG at post-intervention. Furthermore, the VG demonstrated a higher rate of elicited ipsilesional MEPs and a shorter latency of MEPs in the contralesional M1. In the VG, improvements in FMA-UE were significantly associated with reduced latency of contralesional MEPs. Additionally, fNIRS revealed increased activation in the contralesional prefrontal cortex and ipsilesional sensorimotor cortex in the VG in contrast to the SG. However, no significant between-group differences were found in HRV. The combination of taVNS with TOT effectively improves upper extremity function in patients with subacute stroke, potentially through modulating the bilateral cortex excitability to facilitate task-specific functional recovery.

Factors associated with clinical severity in chronic venous disease: The role of functional parameters

IntroductionChronic venous disease (CVD) is a highly prevalent disease that presents a wide spectrum of clinical expressions due to abnormalities in the venous system. Patients often have major functional changes that can limit daily activities. However, the functional factors associated with the severity of the disease remain poorly understood. ObjectiveTo identify the functional factors associated with CVD severity. MethodsSeventy-five patients with CVD (92.0% females, 49.6 ± 13.3 years) were evaluated through clinical examination, lower limb perimetry, ankle range of motion (AROM), and lower limb muscle strength by the Heel Rise test, and Sit-to-stand test. Patients were stratified according to the disease severity as mild (telangiectasia, varicose veins, or edema in the lower limbs) or severe CVD (trophic changes or venous ulcer). ResultsPatients with severe CVD (n = 13) were older (p = 0.002), predominantly male (p = 0.007), with reduced AROM in dorsiflexion (p = 0.028) and inversion (p = 0.009), reduced lower limb strength by the Heel Rise test (p = 0.040), and greater circumference of the calf (p = 0.020), ankle (p = 0.003), and plantar arch (p = 0.041) when compared to mild CVD (n = 62). Advanced age, male sex, lower ankle range of motion in dorsiflexion, and greater ankle and plantar arch circumferences were associated with CVD severity. However, the ankle circumference (OR 1.258, 95% CI: 1.008–1.570; p = 0.042), together with advanced age and male sex, was the only functional variable that remained independently associated with CVD severity. ConclusionThe increased ankle circumference was a determinant of the CVD severity and may assist in risk stratification and guide treatment goals in this population.

Unveiling the reliability of negative capacitance FinFET with confrontation of different HfO2-ferroelectric dopants

The CMOS compatibility of Negative Capacitance (NC) FETs has been enhanced tremendously after introducing a thin film-doped HfO2 as a ferroelectric (FE) layer. For a given FE layer, the NC property is governed by specific HfO2 dopants (e.g., La, Zr, Al, Sr, Gd, Y, and Si). Thus, the TCAD simulation considerably depends on the dopant-specific Landau parameters (αx,βx,γx,ρx,gx), and its solidity needs proper attention. Further, the reliability of the NC devices is severely affected by process variations, i.e., interface trap charges, work function variation, random dopant fluctuation, and ambient temperature (external), which modulates the device threshold voltage (Vth); in turn, the device aging. In this paper, using well-calibrated TCAD models, we investigated reliability for the different dopant-specific NC-FinFET, in terms of Vth, ON current (ION), and OFF current (IOFF) modulation induced by: (i) the interface trap variability (ITV) considering the different trap concentration and energy location; (ii) the work function variability (WFV) considering different metal grain sizes (Gr); (iii) the random dopant fluctuations (RDF); and (iv) the ambient temperature. In this way, the device aging is calculated by inspecting Vth shift by ±50mV. These investigations pave the path for realizing a reliable NC-FinFET design.

The efficacy and safety of prostatic urethral lift as a minimally invasive therapeutic modality to treat lower urinary tract symptoms while maintaining sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials.

Benign prostatic hyperplasia (BPH) is prevalent among elderly men, necessitating focused attention. The Prostatic Urethral Lift (PUL) procedure, a minimally invasive intervention, has emerged as a promising option for BPH management. It has shown remarkable results in ameliorating lower urinary tract symptoms (LUTS), enhancing quality of life, and preserving sexual function. This study aims to evaluate the effectiveness and safety of PUL in BPH patients. Key databases (MEDLINE, Cochrane CENTRAL, ScienceDirect, EBSCO, Google Scholar) were systematically searched using pertinent terms related to PUL and BPH. Following the PRISMA checklist, we considered only randomized controlled trials (RCTs) from 2013 to 2023. The assessment focused on LUTS, quality of life, sexual function, and adverse events within three months. Follow-up post-treatment mean values compared with controls (Sham) and the improvement from baseline to post-treatment follow-up duration were considered. Statistical analysis and risk of bias evaluation were conducted using Review Manager 5.4.1, presenting results as difference of mean values (MD) and risk ratios (RR). A meta-analysis with a Random Effects Model of 7 RCTs involving 378 confirmed BPH patients demonstrated significant improvements in the PUL arm including International Prostate Symptom Score (IPSS) (MD 5.51, p<0.0001), maximum urinary flow rate (Qmax) (MD 2.13, p=0.0001), BPH Impact Index (BPHII) (MD 2.14, p=0.0001), and IPSS-QoL (MD 1.50, p<0.0001), without significant increase of adverse events (RR 1.51; p=0.50). Positive outcomes were observed in sexual function variables and post-void residual measurements when post-treatment values were compared to baseline. PUL holds advantages over control interventions, providing encouraging prospects for BPH management. This study underscores the need for further exploration of PUL's efficacy and safety in BPH patients.

The combination of kidney function variables with cell cycle arrest biomarkers identifies distinct subphenotypes of sepsis-associated acute kidney injury: a post-hoc analysis (the PHENAKI study)

Background The severity and course of sepsis-associated acute kidney injury (SA-AKI) are correlated with the mortality rate. Early detection of SA-AKI subphenotypes might facilitate the rapid provision of individualized care. Patients and methods In this post-hoc analysis of a multicenter prospective study, we combined conventional kidney function variables with serial measurements of urine (tissue inhibitor of metalloproteinase-2 [TIMP-2])* (insulin-like growth factor-binding protein [IGFBP7]) at 0, 6, 12, and 24 h) and then using an unsupervised hierarchical clustering of principal components (HCPC) approach to identify different phenotypes of SA-AKI. We then compared the subphenotypes with regard to a composite outcome of in-hospital death or the initiation of renal replacement therapy (RRT). Results We included 184 patients presenting SA-AKI within 6 h of the initiation of catecholamines. Three distinct subphenotypes were identified: subphenotype A (99 patients) was characterized by a normal urine output (UO), a low SCr and a low [TIMP-2]*[IGFBP7] level; subphenotype B (74 patients) was characterized by existing chronic kidney disease (CKD), a higher SCr, a low UO, and an intermediate [TIMP-2]*[IGFBP7] level; and subphenotype C was characterized by very low UO, a very high [TIMP-2]*[IGFBP7] level, and an intermediate SCr level. With subphenotype A as the reference, the adjusted hazard ratio (aHR) [95%CI] for the composite outcome was 3.77 [1.92–7.42] (p < 0.001) for subphenotype B and 4.80 [1.67–13.82] (p = 0.004) for subphenotype C. Conclusions Combining conventional kidney function variables with urine measurements of [TIMP-2]*[IGFBP7] might help to identify distinct SA-AKI subphenotypes with different short-term courses and survival rates.

Functional movement variability to maintain delivery speed in cricket fast bowling

AbstractFast bowling in cricket involves a complex multiarticular action performed at high speed. Functional movement variability plays an important role in helping the performer to maintain the consistency of performance outcomes, although this has not previously been examined in cricket fast bowling in relation to maintaining consistent delivery speed. Therefore, this study investigated how variability of delivery stride movement timings contributes to maintaining consistent bowling speed. Footage of six deliveries from 92 male fast bowlers were analyzed. Delivery speed was recorded, and the time of back foot contact, front foot contact and ball release were identified. The variability of movement timings and the delivery speed were determined using the coefficient of variation. Results showed greater variability in delivery stride movement timings compared to delivery speed. These findings suggest that bowlers may use movement variability to adjust their functional movement coordination pattern during the bowling action to achieve consistent bowling speed.

Plant size traits are key contributors in the spatial variation of net primary productivity across terrestrial biomes in China

Understanding the spatial variability of ecosystem functions is an important step forward in predicting changes in ecosystems under global transformations. Plant functional traits are important drivers of ecosystem functions such as net primary productivity (NPP). Although trait-based approaches have advanced rapidly, the extent to which specific plant functional traits are linked to the spatial diversity of NPP at a regional scale remains uncertain.Here, we used structural equation models (SEMs) to disentangle the relative effects of abiotic variables (i.e., climate, soil, nitrogen deposition, and human footprint) and biotic variables (i.e., plant functional traits and community structure) on the spatial variation of NPP across China and its eight biomes. Additionally, we investigated the indirect influence of climate and soil on the spatial variation of NPP by directly affecting plant functional traits.Abiotic and biotic variables collectively explained 62.6 % of the spatial differences of NPP within China, and 28.0 %–69.4 % across the eight distinct biomes. The most important abiotic factors, temperature and precipitation, had positive effects for NPP spatial variation. Interestingly, plant functional traits associated with the size of plant organs (i.e., plant height, leaf area, seed mass, and wood density) were the primary biotic drivers, and their positive effects were independent of biome type. Incorporating plant functional traits improved predictions of NPP by 6.7 %–50.2 %, except for the alpine tundra on the Qinghai-Tibet Plateau.Our study identifies the principal factors regulating NPP spatial variation and highlights the importance of plant size traits in predictions of NPP variation at a large scale. These results provide new insights for involving plant size traits in carbon process models.

Hybrid poisson-lagrange approach based on genetic algorithm for improving performance of induction motor

ABSTRACT This article presents an intelligent approach for controlling the mechanical parameters like speed, rotor position, and torque of an induction motor. These parameters have poor performance in terms of settling time, rise time, peak overshoot, and voltage deviation. To conquer such an issue, a hybrid Poisson-Lagrange (HPL) algorithm is proposed. This algorithm is a combination of Poisson distribution and the Lagrange multiplier. It begins with the mathematical modeling of a three-phase induction motor. A multi-objective function is framed with the help of the HPL algorithm. Further, unknown variables of the multi-objective function are trained with a genetic algorithm (GA), which is coined the HPL-GA algorithm. Similar types of control for mechanical parameters are also analyzed with fuzzy logic controllers (FLC) and field-oriented controllers (FOC). It is observed that peak overshoot, rise time, settling time of speed and torque, and sensitivity are found to be minimum with HPL-GA in comparison to FLC and FOC for various loading conditions. The voltage deviation is also found to be lowest with HPL-GA with respect to others for various loading conditions and thus such an approach makes the system highly efficient and robust.

Quality of life of families and siblings of children and adolescents with meningomyelocele.

Children with meningomyelocele may require continuous care. Consequently, there is a risk for caregiver burden and impact on family quality of life (QoL), including siblings' QoL. Some studies analysed caregivers' burden and family QoL separately. However, none of these studies evaluated siblings' QoL and the associations between these three dimensions. This study investigated the associations between caregivers' burden, family QoL and siblings' QoL in Brazilian families of children with meningomyelocele and its correlations with sociodemographic, functional and clinical variables. Siblings' QoL was specifically assessed using as a parameter the QoL of typically developed Brazilian children. One hundred and fifty families, 150 caregivers and 68 siblings completed the Family Quality of Life Scale, Burden Interview, KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires. Most families and caregivers reported a high family QoL and a low caregiver burden. Family QoL was significantly lower as caregivers' burden increased. Caregiver's burden was significantly lower with increasing family QoL levels. Self-reported siblings' QoL was significantly worse than that of typically developed peers. There were no significant differences between self and parent-reported siblings' QoL. Self-reported siblings' QoL was significantly worse as their age increased and better with increasing family QoL levels. Parent-reported siblings' QoL was significantly worse with increasing levels of caregiver's burden and significantly better as family QoL increased. There were no significant associations with functional and clinical variables. Despite the cross-sectional nature of the available data precludes any statements of causality, our results reinforce the relevance of knowing the factors that influence the QoL of families and siblings of children and adolescents with meningomyelocele and the relevance of actions aimed at reducing caregivers' burden, improving family QoL and meeting siblings' individual needs. Future multicenter studies may validate the generalizability of our findings.

Intraspecific variability of leaf form and function across habitat types.

Trait-based ecology has already revealed main independent axes of trait variation defining trait spaces that summarize plant adaptive strategies, but often ignoring intraspecific trait variability (ITV). By using empirical ITV-level data for two independent dimensions of leaf form and function and 167 species across five habitat types (coastal dunes, forests, grasslands, heathlands, wetlands) in the Italian peninsula, we found that ITV: (i) rotated the axes of trait variation that define the trait space; (ii) increased the variance explained by these axes and (iii) affected the functional structure of the target trait space. However, the magnitude of these effects was rather small and depended on the trait and habitat type. Our results reinforce the idea that ITV is context-dependent, calling for careful extrapolations of ITV patterns across traits and spatial scales. Importantly, our study provides a framework that can be used to start integrating ITV into trait space analyses.

Feel, move, or walk? Which has a greater contribution to functioning in total knee arthroplasty? A comparative study between two instrumentations based on a classification and regression tree

Background: This study aimed to know which variables most contribute to the functioning acquired in the third month using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and a multivariate analysis through classification and regression tree (CRT), comparing the conventional instrumentation (CI), and patient-specific instrumentation (PSI). Methods: This is an observational and retrospective study. The sample consisted of 252 patients, 68 receiving CI (27.0%) and 184 receiving PSI (73.0%). The functional variables of the study were: knee pain, passive flexion and extension, gait distance and the domains of the WOMAC index. Results: The CRT method identified that the only explanatory variable that contributed to the highest functioning in the CI group (13.2 in the WOMAC) was pain in the third month with a value ≤2.5 in the visual analog scale (VAS). In the PSI group, the variable that best explained functioning was pain in the first postoperative month (VAS ≤4.5), with the best functional result (2.8 in WOMAC) referring to the patients who walked &gt;320.5 m in the 6-minute walk test in the first month and who had flexion of &gt;112.5 in the third month. Conclusions: Feeling pain is the variable with the most significant explanatory power for the results achieved in functioning at the third month, regardless of the arthroplasty instrumentation employed. Moving the knee in higher flexion ranges and obtaining higher mean values of gait speed also positively influences functioning in patients subjected to PSI.

On Singular Functional Variables in Hyperidentities

On Singular Functional Variables in Hyperidentities

Cognitive Function and Variability in Antipsychotic Drug–Naive Patients With First-Episode Psychosis

Cognitive impairment contributes significantly to clinical outcome and level of function in individuals with psychotic disorders. These impairments are present already at psychosis onset at a group level; however, the question of heterogeneity in cognitive function among patients has not been systematically investigated. To provide an updated quantification of cognitive impairment at psychosis onset before patients receive potentially confounding antipsychotic treatment, and to investigate variability in cognitive function compared with healthy controls. In this systematic review and meta-analysis, PubMed articles were searched up to September 15, 2022. Original studies reporting data on cognitive function in antipsychotic drug-naive patients with first-episode psychosis (FEP) were included. Data were independently extracted by 2 researchers. Cognitive tasks were clustered according to 6 domains of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery and the domain of executive function. Random-effects model meta-analyses of mean differences and coefficient of variation ratios (CVRs) were performed, as well as meta-regressions, assessment of study quality, and publication bias. The main outcome measure was Hedges g for mean differences in cognition and CVR for within-group variability. Fifty studies were included in the analysis with a total of 2625 individuals with FEP (mean [SD] age, 25.2 [3.6] years, 60% male; 40% female) and 2917 healthy controls (mean [SD] age, 26.0 [4.6]; 55% male; 45% female). In all cognitive domains, the FEP group displayed significant impairment compared with controls (speed of processing: Hedges g = -1.16; 95% CI, -1.35 to -0.98; verbal learning: Hedges g = -1.08; 95% CI, -1.28 to -0.88; visual learning: Hedges g = -1.05; 95% CI, -1.27 to -0.82; working memory: Hedges g = -1.04; 95% CI, -1.35 to -0.73; attention: Hedges g = -1.03; 95% CI, -1.24 to -0.82; reasoning/problem solving: Hedges g = -0.90; 95% CI, -1.12 to -0.68; executive function: Hedges g = -0.88; 95% CI, -1.07 to -0.69). Individuals with FEP also exhibited a larger variability across all domains (CVR range, 1.34-1.92). Results of this systematic review and meta-analysis identified cognitive impairment in FEP before the initiation of antipsychotic treatment, with large effect sizes. The high variability within the FEP group suggests the need to identify those individuals with more severe cognitive problems who risk worse outcomes and could benefit the most from cognitive remediation.

Probabilistic analysis of a sustainable landfill cover considering stress-dependent water retention model and copula-based random fields

Material properties, crucial design parameters in landfill cover systems, can exhibit spatial variability due to non-uniform particle size and uneven compaction, affecting cover performance. Additionally, cover thickness, another key design parameter, can induce stress variation and influence soil-water retention capability. Previous designs always ignored these uncertainties and stress effects, potentially leading to unreasonable design schemes. This study aims to provide design recommendations for a three-layer landfill cover system under heavy rainfall, considering these factors simultaneously by the random finite element method (RFEM). The stress effects are captured using a stress-dependent soil-water retention curve (SDSWRC) and the hysteresis in the SDSWRC is considered in probabilistic analyses. For practical applications, uncertainties in two easily controllable particle size parameters, D10 and D60, are depicted by copula-based cross-correlated random fields. Based on empirical equations, the spatial variability of SDSWRC and water permeability function (WPF) can be further characterised by D10 and D60 random fields. It is found that considering SDSWRC and its spatial variability (e.g., shape) can overestimate percolation by at least 1.7 times compared to deterministic analysis using SWRC. The spatial variability of SDSWRC shape has a more significant impact than spatially variable saturated water permeability on cover system performance. Among candidate copulas, the CClayton copula (survival copula of Clayton copula) yields the most conservative results due to its upper tail dependence. The particle size and thickness of the bottom layer influence the cover system performance more than the upper two layers. A bottom layer with D10≤ 0.009 mm and D60/D10≥ 7.54, and thickness ≥ 0.8 m is recommended to achieve a satisfactory performance level with a 100-year design life.

Spectra-phenology integration for high-resolution, accurate, and scalable mapping of foliar functional traits using time-series Sentinel-2 data

Foliar functional traits are essential for understanding plant adaptation strategies and ecosystem function. Due to limited in-situ observational data, there is a growing interest in upscaling these traits from field sites to regional and global levels. However, limitations persist: (1) global/national scale upscaling that relies on plant functional type (PFT) maps, environmental variables or coarse resolution multispectral images, which fail to capture local-scale trait variability; (2) airborne imaging spectroscopy that enables high-resolution and accurate mapping but is restricted to site scale and is costly; and (3) multispectral satellites like Sentinel-2 that offer global coverage but have limited spectral bands and resolution. While previous research has demonstrated the connection between traits and vegetation phenology, our study seeks to build upon this foundation by further exploring the integration of phenological information for large-scale trait prediction. We examined the integration of Sentinel-2 data with its time series (for phenology information) to map 12 foliar functional traits across 14 National Ecological Observatory Network (NEON) sites in the eastern United States. Our results show that time-series Sentinel-2 models effectively capture the variance in these 12 traits (R2 = 0.60–0.80) when compared with benchmark trait data generated by state-of-the-art airborne imaging spectroscopy. The models adequately capture considerable trait variations observed within sites and PFTs. Our approach outperforms existing methods that rely on environmental variables, or a single Sentinel-2 image as predictors across examined NEON sites in eastern United States. Interestingly, including environmental variables in our models does not significantly improve predictive power. Further analysis reveals that a ‘fast-slow’ principal axis predominantly explains the covariation in Enhanced Vegetation Index amplitude (a proxy for leaf longevity), leaf mass per area, and leaf nitrogen content across PFTs. This finding highlights the importance of incorporating phenological information for trait mapping and suggests a potential mechanism underlying these spectra-based models. Our proposed method, which simultaneously achieves high accuracy, large-scale scalability, and high spatial resolution, represents a promising avenue for future global trait mapping. Validation on a larger scale to fully realize its potential in addressing fundamental ecological questions will be a key future focus.

Photodynamic Therapy Induced Mitochondrial Targeting Strategies for Cancer Treatment: Emerging Trends and Insights.

The perpetuity of cancer prevalence at a global level calls for development of novel therapeutic approaches with improved targetability and reduced adverse effects. Conventional cancer treatments have a multitude of limitations such as nonselectivity, invasive nature, and severe adverse effects. Chemotherapy is also losing its efficacy because of the development of multidrug resistance in the majority of cancers. To address these issues, selective targeting-based approaches are being explored for an effective cancer treatment. Mitochondria, being the moderator of a majority of crucial cellular pathways like metabolism, apoptosis, and reactive oxygen species (ROS) homeostasis, are an effective targeting site. Mitochondria-targeted photodynamic therapy (PDT) has arisen as a potential approach in this endeavor. By designing photosensitizers (PSs) that preferentially accumulate in the mitochondria, PDT offers a localized technique to induce cytotoxicity in cancer cells. In this review, we intend to explore the crucial principles and challenges associated with mitochondria-targeted PDT, including variability in mitochondrial function, mitochondria-specific PSs, targeted nanocarrier-based monotherapy, and combination therapies. The hurdles faced by this emerging strategy with respect to safety, optimization, clinical translation, and scalability are also discussed. Nonetheless, mitochondria-targeted PDT exhibits a significant capacity in cancer treatment, especially in combination with other therapeutic modalities. With perpetual research and technological advancements, this treatment strategy is a great addition to the arsenal of cancer treatment options, providing better tumor targetability while reducing the damage to surrounding healthy tissues. This review emphasizes the current status of mitochondria-targeted PDT, limitations, and future prospects in its pursuit of safe and efficacious cancer therapy.

Housing market, oil prices, and macroeconomic volatility in the G7

AbstractIn this paper, we investigate house price shocks on the macroeconomic variables (financial market, inflation, and real sector) of the G7 economies. We use the GVAR to capture the spillover effects from the U.S. housing market and oil prices on these economies from 1991M3–2022M10. We identify the U.S. house price shock using the Structural Generalized Impulse Response Function, house supply and demand variables, and regional divergence. We find that the domestic stock markets and industrial production are the most sensitive to house price shocks. We further compare the importance of house and oil prices on domestic fluctuations. The estimates reinforce the previous findings: U.S. house prices are responsible for a quarter of the domestic volatility of the stock markets and industrial production. In the other macroeconomic segments, the effects of house prices are present, but in lower values. Our results show that house prices provoke more domestic fluctuations than oil prices. Finally, we also found that short and long‐term credit markets, as well as stock markets, transmit the house price shock to industrial production. Consequently, we provide potential channels to comprehend the spillover effect of U.S. house prices on international markets.

New organizational principles and 3D cytoarchitectonic maps of the dorsolateral prefrontal cortex in the human brain.

Areas of the dorsolateral prefrontal cortex (DLPFC) are part of the frontoparietal control, default mode, salience, and ventral attention networks. The DLPFC is involved in executive functions, like working memory, value encoding, attention, decision-making, and behavioral control. This functional heterogeneity is not reflected in existing neuroanatomical maps. For example, previous cytoarchitectonic studies have divided the DLPFC into two or four areas. Macroanatomical parcellations of this region rely on gyri and sulci, which are not congruent with cytoarchitectonic parcellations. Therefore, this study aimed to provide a microstructural analysis of the human DLPFC and 3D maps of cytoarchitectonic areas to help address the observed functional variability in studies of the DLPFC. We analyzed ten human post-mortem brains in serial cell-body stained brain sections and mapped areal boundaries using a statistical image analysis approach. Five new areas (i.e., SFG2, SFG3, SFG4, MFG4, and MFG5) were identified on the superior and middle frontal gyrus, i.e., regions corresponding to parts of Brodmann areas 9 and 46. Gray level index profiles were used to determine interregional cytoarchitectural differences. The five new areas were reconstructed in 3D, and probability maps were generated in commonly used reference spaces, considering the variability of areas in stereotaxic space. Hierarchical cluster analysis revealed a high degree of similarity within the identified DLPFC areas while neighboring areas (frontal pole, Broca's region, area 8, and motoric areas) were separable. Comparisons with functional imaging studies revealed specific functional profiles of the DLPFC areas. Our results indicate that the new areas do not follow a simple organizational gradient assumption in the DLPFC. Instead, they are more similar to those of the ventrolateral prefrontal cortex (Broca's areas 44, 45) and frontopolar areas (Fp1, Fp2) than to the more posterior areas. Within the DLPFC, the cytoarchitectonic similarities between areas do not seem to follow a simple anterior-to-posterior gradient either, but cluster along other principles. The new maps are part of the publicly available Julich Brain Atlas and provide a microstructural reference for existing and future imaging studies. Thus, our study represents a further step toward deciphering the structural-functional organization of the human prefrontal cortex.

Multiple factors influence decision making for the surgical treatment in patients with renal cell carcinoma.

Surgical strategy in renal cell carcinoma (RCC) is considered based on the renal function. Partial nephrectomy (PN) preserves kidney function better than radical nephrectomy (RN), lowering risk of chronic kidney disease (CKD). The aim was to evaluate whether renal function and other clinical variables were important for surgical treatment selection. Patients with RCC, surgically treated between 1994 and 2018 were included. There were 663 patients in all stages, 265 women and 398 men, mean age 66 years. estimated glomerular filtration rate (eGFR), WHO performance status (WHO-PS), Charlson comorbidity index (CCI), surgery, T-stage, M-stage, RCC type, tumor size, age, and gender were extracted from the medical records. Statistical analysis included Mann-Whitney U, X2-test, and logistic regression analysis. Of 663 patients, 455 were treated with RN and 208 with PN. In all patients, preoperative eGFR was significantly higher in PN (80.8) than in RN (77.1, p = 0.015). Using logistic regression tumor size (odds ratio [OR]: 0.96; 95% confidence interval [CI]: 0.95-0.98, T-stage (OR: 0.46; 95% CI: 0.33-0.65), WHO-PS (OR: 0.39; 95% CI: 0.04-0.57), and CCI (OR: 1.23; 95% CI: 1.05-1.44), associated to treatment selection, while eGFR, M-stage, age, and gender did not. In cTa subgroup, eGFR was also higher in PN (84.6) than in RN (75.0, p = 0.007). Using logistic regression, tumor size (OR: 0.93; 95% CI: 0.83-0.98) and WHO-PS (OR: 0.36; 95% CI: 0.20-0.66) associated to treatment selection, while eGFR, CCI, age, and gender did not. Tumor size, CCI scores, T-stage, and WHO-PS, all had an impact on the surgical strategy for all RCC patients. In patients with T1a RCC, tumor size and WHO-PS associated independently with treatment decision. After adjusted analysis, renal function lost its independent association with the treatment strategy in RCC patients.