High-level Studies Research Articles

T−n (n: 2.4∼2.56) temperature dependence of thermal resistance at single-walled carbon nanotubes/SiO2 interface at

The burgeoning significance of energy coupling at interfaces of nm dimension aligns seamlessly with the rapid strides made in micro/nanoelectronics. The nm-scale interface thermal resistance (ITR) is strongly affected by temperature but is poorly understood to date due to extreme challenges in nm-scale characterization. This work reports a pioneering and high-level study on how temperature affects the ITR of single-walled carbon nanotube (SWCNT)-SiO2 interface with a < 8 nm lateral dimension. From 297 to 77 K, the ITR is observed to increase from 530 to 725 to (1.56–1.74)×104 K·m·W−1. The reported ITRs at room temperature are in line with reported data for SWCNT/SiO2 interface. The ITR variation with temperature is compared with the prediction based on the phonon diffuse mismatch model (DMM). A great qualitative agreement is observed while the DMM under the Debye approximation of linear dispersion underestimates the ITR. Our ITR dependency on temperature takes the form of T−n where n is found to be 2.4 and 2.56 for two different locations of the sample. Such observation resembles the dependency of specific heat on temperature far below the Debye temperature. We introduce a concept termed as the effective interface energy transmission velocity (vi,eff) in an attempt to rule out the role of specific heat in ITR-temperature dependence to uncover the intrinsic effect of temperature on interface energy coupling. Very interestingly, vi,eff shows little variation over a wide temperature range for various reported interfaces. Further exploration and refinement of this concept is expected in forthcoming research endeavors.

Evaluation of the Impact of the Addition of Atypical Antipsychotics to Continuous Infusion Propofol Therapy.

Purpose: The administration of sedatives to critically ill patients is a common practice in intensive care units (ICU) and has been associated with negative outcomes. To mitigate this, atypical antipsychotics are utilized as adjunctive therapy. This study aims to review and quantify overall effectiveness of the atypical antipsychotics quetiapine, risperidone, and olanzapine on reduction in the amount of continuous infusion propofol utilized in the ICU. Methods: This was an observational study that took place from February 27, 2021 to December 31, 2022. The primary outcome of this study was the percentage change in average propofol infusion rate (mcg/kg/min) from baseline to the greater than 24 to 48 hours period after atypical antipsychotic initiation. Secondary outcomes included ICU length of stay, duration of mechanical ventilation, QTc interval monitoring, and continuation of the antipsychotic without a valid indication. Descriptive statistics were utilized for the statistical analysis. Results: A total of 47 patients were included in the study. The average baseline propofol rate was 31 mcg/kg/min, which reduced 8.6% to 28.35 mcg/kg/min over the 0 to 24 hours period, was reduced by 19.4% compared to baseline to a rate of 25 mcg/kg/min during the greater than 24 to 48 hours period, and finally a percent reduction of 54.2% seen during the greater than 48 to 72 hours period to a rate of 14 mcg/kg/min. Conclusions: Patients who received an adjunctive antipsychotic saw resulting propofol rate reductions of 8.6% at 24 hours, 19.4% at 48 hours, and 54.2% at 72 hours. However, research on this topic should not end here, as further investigation with higher-level study design is needed to determine the true impact of these agents for this indication.

Theoretical Investigation on Electronic Excited States of the HSO Radical.

HSO radicals play an important role in the photochemical processes in combustion, the atmosphere, and the interstellar medium. In this work, we perform a high-level ab initio study on the electronic excited states of HSO using the internally contracted multireference configuration interaction methods including Davidson correction (icMRCI + Q) in combination with the correlation-consistent basis sets. The molecular geometries, vertical transition energies, oscillator strengths, and electronic configurations of 19 electronic states of HSO are computed. The electronic potential energy curves of HSO along the bond lengths and bond angles are presented. Based on our calculations, the interactions between the electronic states involved in the ultraviolet region and the mechanism of photodissociation are discussed, which will lay a foundation for revealing the dissociation dynamics of gas-phase HSO molecules in outer space and the earth's atmosphere.

An ONIOM-Based High-Level Thermochemistry Study on Hydrogen Abstraction Reactions of Large Straight-Chain Alkanes by Hydrogen, Hydroxyl, and Hydroperoxyl Radicals

Accurate thermochemical data are of great importance in developing quantitatively predictive reaction mechanisms for transportation fuels, such as diesel and jet fuels, which are primarily composed of large hydrocarbon molecules, especially large straight-chain alkanes containing more than 10 carbon atoms. This paper presents an ONIOM[QCISD(T)/CBS:DFT]-based theoretical thermochemistry study on the hydrogen abstraction reactions of straight-chain alkanes, n-CnH2n+2, (n = 1–16) by hydrogen (H), hydroxyl (OH), and hydroperoxyl (HO2) radicals. These reactions, with n ≥ 10, pose significant computational challenges for prevalent high-level ab initio methods. However, they are effectively addressed using the ONIOM-based method. One notable aspect of this study is the consideration of the high symmetry of straight-chain alkanes. This symmetry allows us to study half of the reactions, employing a generalized approach. Therefore, a total of 216 reactions are systematically studied for the three reaction systems. Our results align very well with those from the widely accepted high-level QCISD(T)/CBS method, with discrepancies between the two generally less than 0.10 kcal/mol. Furthermore, we compared large straight-chain alkanes (n-C16H34 and n-C18H38) with large methyl ester molecules (C15H31COOCH3 and C17H33COOCH3) to elucidate the impact of functional groups (ester group and C=C double bond) on the reactivity of the long-chain structure. These findings underscore the accuracy and efficiency of the ONIOM-based method in computational thermochemistry, particularly for large straight-chain hydrocarbons in transportation fuels.

What is New on Diabetic Neuropathy? Insights from the 2023 ADA and EASD Conferences.

Diabetic neuropathy is a common complication of diabetes; yet its pathophysiology is still incompletely understood and until today, there is no specific treatment against it. In the two 2023 large congresses on diabetes (American Diabetes Association, ADA, European Association for the Study of Diabetes, EASD), several high-level studies have been presented. They have attempted to delineate the pathophysiology of DN, the characteristics of affected patients, and future potential treatments. We herein review the presented studies on diabetic neuropathy at these diabetes congresses and discuss the needs for future research on this topic.

Thermochemistry of Furan and Its Derivatives: A High-Level Ab Initio Study

Thermochemistry of Furan and Its Derivatives: A High-Level Ab Initio Study

A Lateral Extra-articular Procedure Reduces the Failure Rate of Revision Anterior Cruciate Ligament Reconstruction Surgery Without Increasing Complications: A Systematic Review and Meta-analysis

Background: Lateral extra-articular procedures are becoming increasingly popular in association with anterior cruciate ligament (ACL) reconstruction, especially in patients with persistent rotatory instability and in a high-risk population. However, few studies have investigated the outcomes of the lateral extra-articular procedure as an associated procedure in an ACL revision (R-ACLR) setting and its benefit with respect to isolated intra-articular reconstruction. Hypothesis: Lateral extra-articular procedures reduce the failure rate of revision ACL reconstruction (R-ACLR). Purpose: To compare subjective outcomes, knee stability, and failure and complication rates between patients who underwent ACL revision with and without an associated lateral extra-articular procedure. Study Design: Systematic review and meta-analysis; Level of evidence, 3. Methods: A systematic search of the PubMed, Cochrane, and OVID databases was performed on September 2022 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Eligible studies were trials directly comparing patients who had isolated ACL revision with patients who had ACL revision associated with lateral extra-articular procedures at a minimum follow-up of 2 years. A meta-analysis was performed, and bias and the quality of the evidence were rated according to the Newcastle-Ottawa Scale. The meta-analysis was conducted according to the PRISMA guidelines. Results: Eight studies were included: a total of 334 patients were treated with isolated revision (isolated (R-ACLR)) and 342 treated with combined revision and a lateral extra-articular procedure (combined (R-ACLR)). For the failure rate, the meta-analysis showed a significantly decreased relative risk reduction of 54% (P = .004) in patients with combined (R-ACLR) with respect to isolated R-ACL, whereas no difference in complication rate was observed. The combined (R-ACLR) group demonstrated a decreased risk ratio of 50% (P = .002) for having a positive pivot-shift test result and a relative risk reduction of 68% (P = .003) for having a grade 2-3 pivot shift when compared with the isolated (R-ACLR) group. Finally, no significant differences were observed among the lateral extra-articular procedures. Conclusion: The addition of a lateral extra-articular procedure to revision ACL significantly reduced the failure rate and postoperative pivot shift without increasing the complication rate. Anterolateral ligament reconstruction and a lateral extra-articular procedure with iliotibial band were effective in improving the outcomes of revision ACL reconstruction. Further high-level studies could help to clarify which subgroup of patients could particularly benefit from an anterolateral procedure in the context of ACL revision.

Theoretical Investigation on excited dipole bound states of alkali-containing diatomic anions

Abstract Information about electronic excited states of molecular anions plays an important role in investigating the electron attachment and detachment processes. Here we present a high-level theoretical study on the electronic structures of twelve alkali-metal-containing diatomic anions MX- (MX = LiH, LiF, LiCl, NaF, NaCl, NaBr, RbCl, KCl, KBr, RbI, KI, and CsI). The equation-of-motion electron-attachment coupled-cluster singles and doubles (EOM-EA-CCSD) method is carried out to calculate the electron binding energies (EBEs) of 10 electronic excited states of each of the twelve molecule anions. With addition of different s-/p-/d- diffusion functions in the basis set, we have identified possible excited dipole bound states (DBSs) of each anion. With the investigation of EBEs on the twelve MXs with dipole moment (DM) up to 12.1 D, we evaluate the dependence of the number of anionic excited DBSs on molecular DM. The results indicate that, there exists at least two or three DBSs of anions with the molecular DM larger than 7 D and a molecule with DM &gt; 10 D can sustain a π-DBS of the anion. Our study would shed some implications on the excited DBSs electronic states of alkali-metal-containing diatomic molecules.

SystemC framework for architecture modelling of electronic systems in future particle detectors

The prototyping cost in advanced technology nodes and the complexity of future detectors require the adoption of a system design approach common in the industry: design space exploration through high-level architectural studies to achieve clear and optimized specifications.This contribution proposes a configurable SystemC framework to simulate the readout chain from the front-end chips to the detector back-end. The model is transaction accurate, includes an event generator, interfaces with real physics events, and provides metrics such as readout efficiency, latency, and average queue occupancy.This contribution details the structure of the framework and describes a case study based on the LHCb VeLo upgrade II.

The Effect of Using Elsa Speak App for First-Semester Students’ English Speaking Proficiency

In English language learning, achieving adequate and accurate spoken proficiency is crucial. As one of the applications responding to this speaking needs, the ELSA Speak App has become a central tool for language learners. Despite the broader studies on the effectiveness of the ELSA Speak App for secondary school in the literature, less attention has been given to the higher education level study. Considering this condition, the principal objective of this research was to investigate the efficacy of the ELSA Speak App in enhancing English speaking proficiency for students in the Department of English Education UIN Jakarta. Employing a quantitative method, the study selected the pre-experimental design with a nonequivalent pretest-posttest configuration where the performance of one group of 31 students was measured. The study’s findings show that the ELSA Speak App effectively fosters fluency and accuracy enhancements in acquiring EFL students' Speaking skills. Notably, the app stimulates autonomous learning through its key feature, AI instant feedback

Robotic-Assisted Knee Arthroplasty: Insights and Implications From Current Literature.

Robotic-assisted knee arthroplasty has emerged as a promising development, aiming to enhance surgical precision and patient outcomes. This literature review examines the clinical efficacy, cost implications, environmental impact, and potential of telesurgery in robotic-assisted total knee arthroplasty (RATKA) and robotic-assisted unicompartmental knee arthroplasty (RAUKA) relative to conventional techniques. A thorough literature search was conducted across medical databases. Clinical and radiological outcomes of RATKA and RAUKA were extracted and analyzed. Direct costs, operating time, surgeon learning curve, environmental implications, and the futuristic concept of telesurgery were also considered. Subjective patient assessments such as WOMAC, Oxford Knee Score, and SF-36, alongside objective measures like HSS score and KSS, were commonly used. Radiological parameters like hip-knee-ankle (HKA) and femorotibial angle provided insights into post-operative alignment. Evidence indicated sporadic high-level design studies, often with limited samples. Cost remains a major constraint with robotic systems, though high-volume cases might offset expenses. Environmental assessments revealed robotic surgeries generate a higher carbon footprint. Telesurgery, an evolving field, could transcend geographical boundaries but is not without challenges, including high costs, latency issues, and cyber threats. While robotic-assisted surgeries may hold promise in the future, substantial barriers, including acquisition costs, potential surgeon deskilling, and environmental concerns, need addressing. Greater robot utilization may drive costs down with more competitors entering the market. Continued research, especially multi-center RCTs, is pivotal to solidifying the role of robotic systems in knee arthroplasty.

CONSUMO DE VITAMINA D DURANTE A PANDEMIA DE COVID – 19 E IMPACTOS NA SAÚDE: UMA REVISÃO SISTEMÁTICA

During the COVID-19 pandemic, vitamin D consumption was highly indicated by the actions on the immune system. This study describes vitamin D intake during the COVID-19 pandemic and its impact on health through systematic review, following the Prisma method. Five databases were used (PubMed, BVS, Scopus, CAPES and Embase). Of the 163 articles found, 11 were selected after eligibility criteria. Nine associated vitamin D deficiency with COVID-19, one assessed vitamin D administration in survivor rate and one analyzed the amount and values of vitamin D acquisition. Vitamin D levels in the pandemic are lower, as is exposure to the sun, the main form of vitamin synthesis. Studies have shown lower levels in more severe cases and greater need for non-invasive ventilation. Further studies of high levels of evidence are recommended.

Quality of evidence supporting the role of hyperbaric oxygen therapy for diabetic foot ulcers.

The goal of this overview of systematic reviews (SRs) and meta-analyses (MAs) was to methodically gather, evaluate and summarize the data supporting the use of hyperbaric oxygen therapy (HBOT) to treat diabetic foot ulcers (DFUs). The Cochrane Library, Embase, PubMed, Web of Science and Embase were all searched thoroughly to identify SRs/MAs that qualified. AMSTAR-2 tool, PRISMA checklists and GRADE system were applied by two reviewers independently to assess the methodological quality, reporting and evidence quality of the included SRs/MAs, respectively. Eleven SRs/MAs were enrolled in this overview. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the limitations of items 2, 4 and 7. For the PRISMA, the overall quality of reporting is not satisfactory due to missing reporting on protocol, search, as well as additional analysis. The majority of outcomes had low- to moderate-quality evidence, and no high-quality evidence was found to support the role of HBOT for DFUs, according to GRADE. To conclude, the potential of HBOT in treating DFUs is supported by evidence of low to moderate quality. More rigorously designed, high-level studies are needed in the future to determine the evidence for HBOT for DFU, including the timing, frequency and duration of HBOT interventions.

Epidemiological trends of pyogenic spondylodiscitis in Germany: an EANS Spine Section Study

Pyogenic spondylodiscitis presents significant diagnostic and therapeutic challenges. In Germany, a comprehensive understanding of its epidemiology and inpatient management outcomes is limited, hindering the optimisation of therapeutic strategies. This study aimed to characterise the evolving epidemiological trends of pyogenic spondylodiscitis in Germany, and concurrently evaluate inpatient management strategies and outcomes. We performed a retrospective population-based study of spondylodiscitis cases in Germany from 2005 to 2021, utilising data from the German Federal Statistical Office database. The parameters assessed were incidence trends, demographic characteristics, inpatient management strategies, and inpatient mortality. The study found a significant rise in the population-adjusted incidence of spondylodiscitis in Germany from 2005 to 2021, increasing by 104% from 5.4 to 11.0 cases per 100,000 individuals (p < 0.001). The highest number of diagnoses was recorded in 2019. Age group-adjusted data revealed the largest relative changes in the “90 + ” age group, followed by the “80–89” and “70–79” age groups. These increases were not solely attributable to population changes but were also confirmed after calculating the age-group-adjusted incidence rates. Additionally, our statistical analysis demonstrated that both age and year significantly influenced the incidence of spondylodiscitis. Over the same period, inpatient mortality also surged significantly by 347% (p < 0.001), with the highest increase recorded in the 90 + age group, observing a 2450% rise (p < 0.001). The mean length of inpatient stay decreased by 15% (p < 0.05). Concurrently, there was a significant increase in surgical interventions using spinal stabilisation procedures (p < 0.001), which might suggest a shift in the treatment paradigm for spondylodiscitis. The results underscore a concerning rise in spondylodiscitis incidence and mortality in Germany, particularly affecting the ageing population. A notable shift towards surgical intervention was observed. The data highlights the urgent necessity for high-level evidence studies comparing surgical versus conservative treatment, thereby guiding optimised therapeutic strategies.

Tranexamic Acid Use in Arthroscopic Rotator Cuff Repair is an Effective and Safe Adjunct to Improve Visualization: A Systematic Review and Meta-analysis.

Although tranexamic acid (TXA) is being increasingly used in orthopedic arthroplasty and lower-extremity arthroscopic procedures, although its use in arthroscopic rotator cuff repair (ARCR) is less widely reported. The aim of this study was to evaluate the clinical effectiveness and safety of TXA administration in ARCR. A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to compare clinical outcomes in patients who underwent ARCR with or without TXA. Literature was retrieved using the Cochrane Library, MEDLINE, PubMed, and Embase electronic databases. The primary outcome of this study was visual clarity. Secondary outcomes contained total operative time, postoperative pain score, amount of blood loss, shoulder swelling (change in shoulder circumference), volume of irrigation fluid, number of adjustments of the pump pressure for irrigation, and adverse cardiovascular events. Seven studies (3 and 4 with level I and II evidence, respectively), which included 272 and 265 patients who underwent arthroscopy with and without TXA, respectively, met the eligibility criteria. Pooled analysis showed significant improvements in visual clarity (mean difference, 9.10%; 95% CI, 4.05 to 14.15; p = .0004) and total operative time (mean difference, -11.24 min; 95% CI, -19.90 to -2.57; p= .01) associated with perioperative TXA application. None of the trials reported adverse events and complications associated with TXA. The best available evidence indicates that TXA administration could significantly improve arthroscopic visual clarity and effectively save operative time in ARCR without increasing the incidence of adverse events. Furthermore, the optimal dose, route, and timing of TXA application in ARCR surgery remains to be validated by future high-level evidence studies.

Treatment options for dogs diagnosed with sinonasal aspergillosis

PICO question In dogs diagnosed with SNA, does inclusion of debridement in the treatment protocol improve clinical outcomes compared to dogs treated without debridement? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed No papers that directly addressed the PICO were reviewed. Four retrospective case series which partially addressed the PICO question were discussed in the appraisal. Strength of evidence Zero. Outcomes reported None. Conclusion No conclusions can be made based on the current level of evidence, however the studies discussed in the appraisal suggest that there may be an association between the inclusion of debridement in the treatment protocol for SNA and an improved clinical outcome. Undertaking further higher-level studies (comparative, blind, prospective, randomised) would be required to confirm this. Ethical implications would not preclude such studies, for there is evidence that treatment protocols including topical deposition of antifungal agents alone are efficacious. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Return to Play After Femoroacetabular Impingement.

Femoroacetabular impingement (FAI) is a pathomechanical process whereby abnormal contact between proximal femur and acetabulum at end range of hip motion induces chondrolabral lesions within the hip joint. Surgery followed by a rehabilitation program or physical therapy with possible addition of an intra-articular corticosteroid injection are the two predominant treatments. The majority of authors recognize that a well-designed rehabilitation protocol is essential to achieve good outcomes with both nonoperative and surgical treatment. However, there is little evidence about what is the best rehabilitation protocol and most of the literature available is based on expert level opinion. This current review investigates the recent literature on nonoperative and postoperative rehabilitation protocol and return to play in FAI patients and describes our approach. Historically, rehabilitation protocols for treatment of FAI as well as return to play protocols were based on experts' opinion and low-level evidence studies. In order to improve standardization of protocols and to allow a better comparison in between different protocols, different authors have created standardized rehabilitation protocols with consensus building methods comparing them with other treatment options in high-level evidence trials (FASHIoN trial, etc.). Despite the excellent results reported after nonoperative and post-surgical rehabilitation, and the high RTP rate after FAI treatment, there is a significant variability in between protocols. Further high-level evidence studies are necessary in order to establish a gold standard in rehabilitation and RTP protocols.

Intracapsular tonsillectomy: setting a new standard.

Tonsillectomy is one of the most common surgical procedures performed on children in the United States. Since 2002, the intracapsular technique has been studied as a safer and less painful alternative to total tonsillectomy. Concerns have been raised, however, as to the potential for regrowth and long-term outcomes regarding this technique. Studies support the use of intracapsular tonsillectomy in the management of sleep disordered breathing, including in syndromic populations, as well as for tonsillitis. In addition, safety profiles continue to be improved over that of extracapsular dissection. While the incidence of regrowth ranges depending on the study and duration of follow up, it remains acceptably low. The most consistent independent risk factor for revision surgery includes young age. While total tonsillectomy is more thoroughly studied historically, an important absence in the literature is a definitive superiority over the intracapsular technique. With continued high-level studies, as well as additional examination of long-term outcomes, we should continue to see greater acceptance of intracapsular tonsillectomy as a standard of practice in a vulnerable population.

A High-level Ab Initio Study of the Destruction of Methanimine under UV Radiation

The photodecomposition of methanimine (CH2NH) in the interstellar medium through several possible pathways is investigated by means of high-level multireference configuration interaction ab initio calculations. Among these pathways are photodissociation pathways involving hydrogen-atom elimination from both the CH2 and NH groups, and fragmentation into CH2 and NH. Potential-energy curves for the ground and several excited electronic states, as well as nonadiabatic couplings between them, are calculated. Possible dissociation mechanisms are discussed for the different pathways. It is found that the minimum excitation energy required for methanimine dissociation is above 7 eV. By using a two-dimensional representation of methanimine, CH2NH → CHNH2 isomerization is explored as an additional methanimine decomposition pathway. Hydrogen-atom elimination from the CH2 group is also investigated along the isomerization pathway. The results show that the isomerization proceeds by overcoming a transition state that in the first two excited states would require excitation energies similar to or somewhat lower than the typical minimum energies needed for breaking the molecule through the fragmentation pathways. Therefore, CH2NH → CHNH2 isomerization can effectively contribute to methanimine decomposition, competing efficiently with the photodissociation pathways. The radiation content present in the interstellar medium makes possible the occurrence of all the pathways studied.

Is ulnar shortening osteotomy or the wafer procedure better for ulnar impaction syndrome?: A systematic review and meta-analysis.

Wrist pain on the ulnar side is often caused by ulnar impaction syndrome (UIS). Idiopathic UIS requires surgical treatment when conservative treatment fails. The 2 main surgical procedures used are the wafer procedure and ulnar shortening osteotomy (USO) of the metaphysis or diaphysis. This review aimed to analyze comparative studies of the 2 procedures in UIS to determine clinical outcomes and complications. One prospective and 5 retrospective comparison trials were retrieved from the PubMed, Embase, and Cochrane Library databases. The primary outcomes were treatment effectiveness; pain visual analog scale (VAS), disabilities of the arm, shoulder, and hand (DASH) score, Mayo wrist, and Darrow scores. The incidence of postoperative complications formed the secondary outcome. The selected studies included 107 patients who underwent the wafer procedure (G1) and 117 patients who underwent USO (G2). The wafer procedure had the benefits of less postoperative immobilization and an early return to work. However, there were no significant differences in the postoperative pain improvement and functional scores. All 6 studies reported high total complication rates and reoperation with USO. The most frequent complication was implant-related discomfort or irritation; subsequent plate removal was the most common reason for a secondary operation. There was no difference in pain improvement or the postoperative functional score between the groups. Nevertheless, postoperative complications were the major pitfalls of USO. As the specialized shortening system advances further, a high-level study will be necessary to determine the surgical option in UIS.