High Success Rate Research Articles

CommanderUAP: a practical and transferable universal adversarial attacks on speech recognition models

Most of the adversarial attacks against speech recognition systems focus on specific adversarial perturbations, which are generated by adversaries for each normal example to achieve the attack. Universal adversarial perturbations (UAPs), which are independent of the examples, have recently received wide attention for their enhanced real-time applicability and expanded threat range. However, most of the UAP research concentrates on the image domain, and less on speech. In this paper, we propose a staged perturbation generation method that constructs CommanderUAP, which achieves a high success rate of universal adversarial attack against speech recognition models. Moreover, we apply some methods from model training to improve the generalization in attack and we control the imperceptibility of the perturbation in both time and frequency domains. In specific scenarios, CommanderUAP can also transfer attack some commercial speech recognition APIs.

The archerfish uses motor adaptation in shooting to correct for changing physical conditions

The archerfish is unique in its ability to hunt by shooting a jet of water from its mouth that hits insects situated above the water’s surface. To aim accurately, the fish needs to overcome physical factors including changes in light refraction at the air-water interface. Nevertheless, archerfish can still hit the target with a high success rate under changing conditions. One possible explanation for this extraordinary ability is that it is learned by trial and error through a motor adaptation process. We tested this possibility by characterizing the ability of the archerfish to adapt to perturbations in the environment to make appropriate adjustments to its shots. We introduced a perturbing airflow above the water tank of the archerfish trained to shoot at a target. For each trial shot, we measured the error, i.e., the distance between the center of the target and the center of the water jet produced by the fish. Immediately after the airflow perturbation, there was an increase in shot error. Then, over the course of several trials, the error was reduced and eventually plateaued. After the removal of the perturbation, there was an aftereffect, where the error was in the opposite direction but washed out after several trials. These results indicate that archerfish can adapt to the airflow perturbation. Testing the fish with two opposite airflow directions indicated that adaptation took place within an egocentric frame of reference. These results thus suggest that the archerfish is capable of motor adaptation, as indicated by data showing that the fish produced motor commands that anticipated the perturbation.

The archerfish uses motor adaptation in shooting to correct for changing physical conditions.

The archerfish is unique in its ability to hunt by shooting a jet of water from its mouth that hits insects situated above the water's surface. To aim accurately, the fish needs to overcome physical factors including changes in light refraction at the air-water interface. Nevertheless, archerfish can still hit the target with a high success rate under changing conditions. One possible explanation for this extraordinary ability is that it is learned by trial and error through a motor adaptation process. We tested this possibility by characterizing the ability of the archerfish to adapt to perturbations in the environment to make appropriate adjustments to its shots. We introduced a perturbing airflow above the water tank of the archerfish trained to shoot at a target. For each trial shot, we measured the error, i.e., the distance between the center of the target and the center of the water jet produced by the fish. Immediately after the airflow perturbation, there was an increase in shot error. Then, over the course of several trials, the error was reduced and eventually plateaued. After the removal of the perturbation, there was an aftereffect, where the error was in the opposite direction but washed out after several trials. These results indicate that archerfish can adapt to the airflow perturbation. Testing the fish with two opposite airflow directions indicated that adaptation took place within an egocentric frame of reference. These results thus suggest that the archerfish is capable of motor adaptation, as indicated by data showing that the fish produced motor commands that anticipated the perturbation.

Real-world assessment of multipolar and point-by-point mapping for premature ventricular contraction ablation.

We aimed to assess the acute and midterm efficacy of premature ventricular contraction (PVC) ablation guided by multielectrode and point-by-point (PbP) mapping. This is a retrospective, international multicentre study of consecutive patients referred for PVC ablation in 10 hospital centres from January 2017 to December 2021. Based on the mapping approach, two cohorts were identified: the 'Multipolar group', where a dedicated high-density mapping catheter was employed, and the 'PbP group', where mapping was performed with the ablation catheter. Procedural endpoints, safety, and acute (procedural) and midterm efficacies were assessed. Of the 698 patients included in this study, 592 received activation mapping [46% males, median age of 55 (41-65) years]-248 patients in the Multipolar group and 344 patients in the PbP group. A higher number of activation points [432 (217-843) vs. 95 (42-185), P < 0.001], reduced mapping time (40 ± 38 vs. 61 ± 50 min, P < 0.001), and shorter procedure time (124 ± 60 vs. 143 ± 63 min, P < 0.001) were reported in the Multipolar group. Both groups had high acute success rates (84.7% with Multipolar mapping vs. 81.3% with PbP mapping, P = 0.63), as well as midterm efficacy (83.4% vs. 77.4%, P = 0.08), with no significant differences in the risk of adverse events (6.0% vs. 3.5%, P = 0.24). However, for left-sided PVC ablation specifically, there was a higher midterm efficacy in the Multipolar group (80.7% vs. 69.5%, P = 0.04), with multipolar mapping being an independent predictor of success [adjusted OR = 2.231 (95% CI, 1.476-5.108), P = 0.02]. The acute and midterm efficacies of PVC ablation are high with both multipolar and PbP mapping, although the former allows for quicker procedures and may potentially improve the outcomes of left-sided PVC ablation.

Endodontic Surgery and Post-Treatment Apical Periodontitis: A Systematic Review

Background It has been demonstrated that using innovative root-end filling materials speeds up the success of Endodontic Microsurgery (EMS) on teeth having root filling but still suffering from posttreatment Apical Periodontitis (AP). However, this has reopened the discussion about the long-term effectiveness of EMS conducted on such teeth. Objectives This study aimsto assess the long-term clinical and radiographic outcomes of endodontic surgical procedures in molars with radiographic evidence of secondary AP. Methodology A literature review was undertaken utilizing different databases, including MEDLINE (through PubMed), EMBASE, and Web of Science. The terms used for the search were ‘endodontic microsurgery,’ ‘apical microsurgery,’ ‘periapical disorders,’ ‘root canal therapy,’ ‘apicoectomy,’ ‘retreatment,’ ‘treatment result,’ “retrograde obturation,” and ‘success rate.’ In order to choose the most reliable longitudinal data, specific inclusion and exclusion criteria were established in advance. Only studies that met inclusion criteria for clinical and radiographic outcomes were considered, including prospective clinical studies and randomized clinical trials with at least two-year follow-ups. Results The study of the databases yielded 561 articles in total. From the 115 articles with full texts available, unrelated articles (105) were removed. Our inclusion criteria were met by an overall of ten studies (six prospective clinical studies and four randomized clinical trials). With intervals for follow-up ranging from two to thirteen years, a pooled success rate of 91% from all 451 treated teeth included in the randomized clinical trials and a pooled success rate of 79% from a total of 839 encompassed teeth in the prospective clinical studies were observed. During the same length of time of observation, survival rates ranged from 78% to 100%. Smoking status, tooth position and type, the presence or absence of dentinal abnormalities, the thickness of the bone between the teeth (interproximal bone), and the substance used to fill the space at the end of the roots are the five predictive variables revealed. Conclusion When EMS is performed by skilled endodontists who can deliver high success rates and reliable results, teeth afflicted by secondary AP have a good prognosis and can be preserved.

Parathyroidectomy: still the best choice for the management of severe secondary hyperparathyroidism.

Management of secondary hyperparathyroidism (SHPT) is a challenging endeavor with several factors contruibuting to treatment failure. Calcimimetic therapy has revolutionized the management of SHPT, leading to changes in indications and appropriate timing of parathyroidectomy (PTX) around the world. We compared response rates to clinical vs. surgical approaches to SHPT in patients on maintenance dialysis (CKD 5D) and in kidney transplant patients (Ktx). A retrospective analysis of the one-year follow-up findings was carried out. CKD 5D patients were divided into 3 groups according to treatment strategy: parathyroidectomy, clinical management without cinacalcet (named standard - STD) and with cinacalcet (STD + CIN). Ktx patients were divided into 3 groups: PTX, CIN (cinacalcet use), and observation (OBS). In CKD 5D we found a significant parathormone (PTH) decrease in all groups. Despite all groups had a higher PTH at baseline, we identified a more pronounced reduction in the PTX group. Regarding severe SHPT, the difference among groups was evidently wider: 31%, 14% and 80% of STD, STD + CIN, and PTX groups reached adequate PTH levels, respectively (p<0.0001). Concerning the Ktx population, although the difference was not so impressive, a higher rate of success in the PTX group was also observed. PTX still seems to be the best treatment choice for SHPT, especially in patients with prolonged diseases in unresourceful scenarios.

Feasibility study utilizing a combinatorial functional precision medicine platform, Optim.AI, to help guide treatment for pancreatic cancer.

e13614 Background: Functional screening methods are increasingly applied to guide patient treatment and could be beneficial in indications with poor survival and response rates, such as pancreatic cancer. However, challenges faced when implementing ex vivo testing include complexities in obtaining sufficient tumor cells for different cancer types and maximizing the number of treatments tested with limited sample material. The latter is especially significant in informing clinical decision making as combination therapies are common with cancer, exponentially increasing the number of regimens to select from. To address this hurdle, we developed Optim.AI, a combinatorial functional precision medicine platform, which utilizes efficiently designed experiments and small data AI to expand to over 530,000 phenotypic response data points and predictively rank all actionable treatments within a 12-drug panel. In this feasibility study, we explored the application of Optim.AI on patient-derived tumor cells in pancreatic cancer. Methods: We established a procedure to run Optim.AI with isolated tumor cells from pancreatic cancer patients. After dissociation, these cells were then incubated to allow for 3D organoid formation within the following week. Upon organoid formation, the cells were treated with an FDA-approved panel of chemotherapy and targeted drugs. Cell viability was quantified post-drug treatment for analysis with Optim.AI software to rank all possible single to 4-drug combinatorial therapies for report generation. Results: The viability of the cells post-processing was high (mean = 97.4% live cells), passing the quality check of having at least 60% live cells before proceeding with Optim.AI testing. The success rate of organoid formation was 100% within 1 week of sample processing. The turnaround time from the receipt of samples to dissemination of the reports to clinicians was approximately a week (mean = 7.67 days). Z’ factor, a measurement of statistical effect size for high throughput screening, was demonstrated to be more than 0.5 for the reports generated, indicative of very good assays. The top ranked drug combinations were sensitive, with their normalized cell viability reported to be under 0.2, while the prior line of treatment was shown to be resistant, 100% concordant with previously observed clinical outcomes. Notably, Gemcitabine with either a HDAC or PI3K inhibitor was ranked high amongst the reports generated. Conclusions: Optim.AI had a high success rate in generating reports within a very short timeframe for pancreatic cancer. Comparing the top ranked therapies against the prior lines of treatment allows the clinicians to better evaluate the alternative treatments. Based on this initial feasibility study, Optim.AI could potentially be viable in guiding clinicians in managing treatment options for pancreatic cancer patients.

A successful management of Candy Cane syndrome post Roux-en-Y gastric bypass: a rare case report

Introduction and importance: Candy Cane syndrome (CCS) is a rare condition in which the proximal gastrojejunal attachment’s afferent blind limb is elongated. This can lead to different symptoms, including nausea and vomiting, with less commonly described reflux and regurgitation symptoms. Case presentation: A 38-year-old female presented with a chronic complaint of postprandial pain, discomfort, and reflux lasting for about 2 years after a previous Roux-en-y gastric bypass (RYGB) surgery. Upper endoscopy was done and raised suspicion for CCS. The patient underwent an exploratory laparoscopy, which confirmed the diagnosis. Surgical resection of the afferent limb was done, and all symptoms were completely resolved at the postoperative follow-up. Clinical discussion: CCS is considered a rarely described complication that can occur after RYGB gastric bypass surgery. Diagnosing this condition includes performing upper gastrointestinal (GI) studies and endoscopy, which reveal a redundant afferent limb. Laparoscopy serves as a dual-purpose tool, confirming the diagnosis of CCS and providing a definitive curative intervention. Surgical resection has a high success rate, with evidence supporting its efficacy in relieving symptoms. Conclusion: As the popularity of Bariatric surgeries rises, it is crucial to consistently consider CCS, despite its rarity, as a potential complication. Although diagnosing CCS can be challenging, physicians should maintain a high index of suspicion, especially in patients presenting with upper GI symptoms following metabolic surgeries.

Research and Practice on Implementing Segmented Production Technology of Horizontal Well during Extra-High Water Cut Stage with Bottom Water Reservoir

Bohai X oilfield has reached the extra-high water cut stage of more than 95%, dominated by the bottom water reservoir. The oilfield mainly adopts horizontal-well exploitation, with the characteristics of high difficulty and low success rate for well water plugging. To solve the above problem, the segmented production technology of horizontal wells was developed to guide oilfield applications and tap their potential. In the segmented design stage, the horizontal section is objectively segmented by drilling condition analysis, optimally based on drilling through interlayers or permeability discrepancy formation, simultaneously combined with the numerical simulation method. When implementing measures, annulus chemical packer materials are squeezed between segments to effectively inhibit the fluid flow between the open hole and the sand-packing screen pipe. Moreover, the packers are used to seal between segments to effectively restrain the flow between the screen and the central tube, achieving the establishment of compartments. In the production process, the valve switch on the central tube can be independently controlled by a remotely adjustable method to achieve optimal production. This segmented production technology was successfully tested for the first time in Bohai oilfield. Up to now, a total of six compartment measures have been implemented, remarkably decreasing water cut and increasing oil production for horizontal wells in the bottom water reservoir. This method does not require water testing, and the optimal production section can be chosen through segmented independent production, greatly improving the success rate of water-plugging measures for horizontal wells. This technology opens up a new mode for the efficient development of horizontal wells in bottom water reservoirs and is planned to be widely promoted and applied in similar oilfields.

Cube-Evo: A Query-Efficient Black-Box Attack on Video Classification System

The current progressive research in the domain of black-box adversarial attack enhances the reliability of deep neural network (DNN)-based video systems. Recent works mainly carry out black-box adversarial attacks on video systems by query-based parameter dimension reduction. However, the additional temporal dimension of video data leads to massive query consumption and low attack success rate. In this article, we embark on our efforts to design an effective adversarial attack on popular video classification systems. We deeply root the observations that the DNN-based systems are sensitive to adversarial perturbations with high frequency and reconstructed shape. Specifically, we propose a systematic attack pipeline Cube-Evo, aiming to reduce the search space dimension and obtain the effective adversarial perturbation via the optimal parameter group updating. We evaluate the proposed attack pipeline on two popular datasets: UCF101 and JESTER. Our attack pipeline reduces query consumption and achieves a high success rate on various DNN-based video classification systems. Compared with the state-of-the-art method Geo-Trap-Att, our pipeline averagely reduces 1.6× query consumption in untargeted attacks and 2.9× in targeted attacks. Besides, Cube-Evo improves 13% attack success rate on average, achieving new state-of-the-art results over diverse video classification systems.

Basalt powder as a promising candidate material for improving the properties of fly ash geopolymer cement

Recently, power plants’ manufacturing processes have evolved, and the amount of fly ash (FA) produced has gradually dropped. After years of investigation, FA has been used with a high rate of success. Therefore, FA, which is needed to manufacture geopolymers, may become more scarce and more expensive. To fill this gap, natural materials can be blended with FA to manufacture geopolymers. In this article, for the first time, a fascinating possibility has emerged for the possible application of natural basalt powder (BP) in FA geopolymer cement. As a partial replacement, several ratios of BP, from 2.5 % to 40 %, were mixed with FA. Geopolymer cement was then produced by activating both neat FA and those combined with BP. An inquiry was carried out to evaluate the influence of different ratios of BP on the flowability, compressive strength, environmental conditions resistance, transport properties, crystalline phases, hydration products, and microstructure of FA geopolymer cement cured in air and water. Regardless of whether the inclusion of BP decreased the flowability, the results showed that the inclusion of 2.5–20 % BP has a positive effect on improving the properties of FA geopolymer cement. The ideal ratio of BP was 10 %. Air curing was found more effective than water curing.

Lightweight Image Encryption Based on A Hybrid Approach

A secure image could be achieved by encryption, a technique for securing images over different media transmission lines with privacy and keeping them safe for the receiver. This paper proposes an image encryption approach to achieve excellent security by combining a lightweight encryption algorithm with the chaotic Peter De Jong map. The Lilliput algorithm, lightweight encryption, uses the Peter De-Jones map to produce keys. The suggested approach achieved a suitable level of complexity that matched the historical demands for transmission images. Two methods were used to conduct the tests on a standard image collection: an encrypted image and a generated key. Standard metrics find the similarity between the input and output images to achieve an accurate proposal performance. The encrypted image's entropy was assessed and discovered that it matched the original image values exactly. The results were satisfactory regarding obtaining a precise correlation rate between the original and encrypted photos. The decryption and reconstruction of the image were completed quickly and steadily, with a high success rate and excellent outcomes. The proposed approach was evaluated on a dataset of well-known test photos with unique features, including varying degrees of lightness and shade to create the perfect test.

Clinical application of two types of Hook-Wire needle localization procedures for pulmonary small nodule biopsy.

With the widespread use of low-dose spiral computed tomography (LDCT) and increasing awareness of personal health, the detection rate of pulmonary nodules is steadily rising. To evaluate the success rate and safety of two different models of Hook-Wire needle localization procedures for pulmonary small nodule biopsy. Ninety-four cases with a total of 97 pulmonary small nodules undergoing needle localization biopsy were retrospectively analyzed. The cases were divided into two groups: Group A, using breast localization needle steel wire (Bard Healthcare Science Co., Ltd.); Group B, using disposable pulmonary nodule puncture needle (SensCure Biotechnology Co., Ltd.). All patients underwent video-assisted thoracoscopic surgery (VATS) for nodule removal on the same day after localization and biopsy. The puncture localization operation time, success rate, complications such as pulmonary hemorrhage, pneumothorax, hemoptysis, and postoperative comfort were observed and compared. In Group A, the average localization operation time for 97 nodules was 15.47 ± 5.31 minutes, with a success rate of 94.34%. The complication rate was 71.69% (12 cases of pneumothorax, 35 cases of pulmonary hemorrhage, 2 cases of hemoptysis), and 40 cases of post-localization discomfort were reported. In Group B, the average localization operation time was 25.32 ± 7.83 minutes, with a 100% success rate. The complication rate was 29.55% (3 cases of pneumothorax, 15 cases of pulmonary hemorrhage, 0 cases of hemoptysis), and 3 cases reported postoperative discomfort. According to the data analysis in this study, Group B had a lower incidence of puncture-related complications than Group A, along with a higher success rate and significantly greater postoperative comfort. The disposable pulmonary nodule puncture needle is safer and more effective in pulmonary small nodule localization biopsy, exhibiting increased comfort compared to the breast localization needle. Additionally, the incidence of complications is significantly lower.

Endoscopic combined intrarenal surgery versus percutaneuos nephrolithotomy for complex pediatric stone disease: A comparative analysis of efficacy and safety

INTRODUCTIONDecision-making for complex pediatric urinary system stone disease is still a challenge for pediatric urologists. The interest in supine percutaneous nephrolithotomy (PCNL) is increasing among centers to achieve high surgical success rates with less morbidity. Despite advanced retrograde intrarenal surgery armamentarium, percutaneous approaches remain the first-line surgical treatment modality for >2 cm and complex renal stones. There are no comparative studies yet in the literature for pediatric endoscopic combined intrarenal surgery (ECIRS) OBJECTIVEIn this study, we aimed to contribute to the literature by evaluating the safety and efficacy of ECIRS by comparing it with PCNL. STUDY DESIGNPatients under 18 years of age who underwent PCNL and ECIRS for urinary tract stone disease at our Pediatric Urology department between 2012 and 2024 were included. Preoperative (demographic characteristics, stone characteristics, biochemical parameters), perioperative (duration of surgery, number of accesses, lasing and fluoroscopy times, endoscopic and fluoroscopic stone-free rates) and postoperative (hospital stay, urinary tract infection, complication and radiological stone-free rates) parameters were retrospectively evaluated. RESULTSA total of 68 children [28 (41%) girls and 40 (59%) boys] aged 5 (0-17) years were included in the study. ECIRS was performed in 19 (28%), supine in 28 (41%) and prone PCNL in 21 (30%) patients. Age (p = 0.029), Guy's stone score (p<0.001), S.T.O.N.E. (p<0.001), and Seoul National University Renal Stone Complexity (S-ReSC) scores (p=0.001) for preoperative parameters were found to be higher in ECIRS group over both PCNL methods (Summary Table). However, Clinical Research Office of the Endourological Society (CROES) score was seen lower for ECIRS group patients compared to other groups (p=0.028).Surgery time (in favor of supine over prone PCNL), fluoroscopy time (in favor of ECIRS and Supine PCNL over Prone PCNL), preferred laser type (prone PCNL group was mostly performed with holmium laser, whereas other groups were balanced between Holmium and Thulium Fiber Laser) and exit strategy (the preferred exit strategy was DJ Stent in most of the ECIRS patients, whereas nephrostomy tube was used in some of the PCNL group) showed significant difference among the groups as perioperative parameters (p=0.042, <0.001, <0.001, <0.001, respectively). Surgery time was lower for supine PCNL compared to prone PCNL. For postoperative parameters, stone-free rates, complication rates and urinary tract infections were similar between the 3 groups, while a difference was detected in terms of length of hospital stay in favor of ECIRS over both supine and prone PCNL (p = 0.006). DISCUSSIONThe current trial suggests that stone-free and complication rates of ECIRS and supine PCNL were similar in the pediatric complex stone patients. Although, the stones in the ECIRS group we found to be more complex. Also, ECIRS was superior to PCNL in terms of fluoroscopy exposure and hospital stay. CONCLUSIONWith the widespread use of new generation ureteral access sheaths and flexible ureterorenoscopes, ECIRS may have an important role in treatment of complex pediatric kidney stones.

Impact of successful antegrade and retrograde CTO PCI on short-term prognosis

BackgroundChronic total occlusion (CTO) percutaneous coronary intervention (PCI) carries risk of complications and should be attempted when the anticipated benefits exceed the potential risks. The primary indication for CTO–PCI is symptom improvement. However, the impact of CTO–PCI on angina and subsequent incidence of major adverse cardiovascular event (MACE) rate remains controversial. Our aim was to study the impact of technically successful elective CTO–PCI on the procedural success rate and short-term MACE. The current study was a prospective cohort study that included a total of 80 patients who were referred to our center (Ain Shams University Hospitals) for elective CTO–PCI and underwent technically successful CTO–PCI. Data were collected on patient arrival to our department, and then, the patients were observed during hospital admission to record any In-Hospital MACE. These patients were then followed up for 6 months to record improvement or worsening of their symptoms and to assess occurrence of any MACE including hospitalization and undergoing symptom-driven coronary angiography.ResultsThe mean age of our patients was 56 ± 9.6 years, and 73 patients (91%) were men. Sixty-two patients (77.5%) were done via an antegrade approach, and 18 patients (22.5%) were done via a retrograde approach with an overall procedural success rate of 91.25% (antegrade 93.5%, retrograde 83.3%). The overall mean procedure time was 102 min, the mean contrast volume used was 371 ml, and the mean cumulative air kerma dose was 7.2 Gy. The retrograde group required longer procedure times, larger volumes of contrast and higher exposure to radiation. The overall in-hospital MACE was 8.75%. Sixty-five patients in our study (81.25%) showed an improvement in the grade of their exertional dyspnea or angina within the 6-month follow-up period. Thirteen patients in our study (16.25%) needed re-hospitalization within a 6-month period after PCI. The overall target lesion revascularization rate at 6 months was 8.75%.ConclusionsTechnically successful CTO PCI in a well-equipped center with highly qualified CTO operators resulted in high procedural success rates and low incidence of short-term MACE.

Switching to a 100% remote follow-up of implantable cardiac electronic devices: Organizational model and results of a single center experience.

During the SARS-CoV-2 COVID-19 pandemic, the global health system needed to review important processes involved in daily routines such as outpatient activities within the hospital, including follow-up visits of implantable cardiac electronic devices (CIEDs) carried out in office. The aim of this study is to describe our 3.5 years of real-world experience of a full remote CIED follow-up, evaluate the success rate of remote transmissions, and verify the adopted organizational model. From April 2020 to November 2023, all patients with an activated and well-functioning remote monitoring (RM) system and automatic algorithms, like autocapture and autosensing, underwent exclusive RM follow-up. Unscheduled in-office visits were only prompted by remote yellow or red alerts. Patients were divided into two groups, based on available technology: Manual Transmission System (MTS) and Automatic Transmission System (ATS). The ATS group, in addition to ensuring a daily transmission of any yellow or red alerts, was checked at least every 15 days to ensure a valid connection. An automatic transmission was scheduled once a year, irrespective of alerts occurred. The MTS group provided a manual transmission every 6 months. One thousand nine hundred thirty-seven consecutive patients were included in the study. By the end of November 2023, a total of 1409 patients (1192 in the ATS and 217 in the MTS group) were still actively followed by our remote clinic (384 expired, 137 dismissed, 7 transferred). The overall success rate of transmissions with the adopted organizational model was 96.6% in the ATS group (connection index) and 87% in the MTS group. Conventional in-hospital follow-up visits decreased by 44%. Total clinic working time, resulting from the sum of the time spent during in-hospital and remote follow-up, after an initial increase, was progressively reduced to the actual -25%. Mortality rate for any cause was 7.5% per year in remote follow-up patients and 8.3% (p=NS) in in-office patients. In the ATS group, no device malfunctions were notified to our remote clinic, before we had already realized it through appropriate alerts. The available technology makes moving to a 100% remote clinic possible, without overwhelming clinic workflow, safely. Adopting an appropriate organizational model, it is possible to maintain high transmission success rates. The automatic transmissions allow a more frequent control of patients with CIED.

Precise treatment of pelvic fracture urethral injury associated with urethrorectal fistula.

To evaluate the effect of a new strategy of transperineal anastomotic urethroplasty (TAU) with proximal transection in treating pelvic fracture urethral injury (PFUI) associated with urethrorectal fistula (URF). A retrospective review of all patients treated by TAU with proximal transection and fistula repair for PFUI associated with URF was performed between August 2013 and July 2022. Information on demographics, peri-operative variables, and postoperative follow-up outcomes was collected. Successful surgery was defined as restoration of a uniform urethral calibre using flexible cystoscopy (third postoperative month) without strictures or leakage, with no further interventions required. Functional outcomes, including erectile function (assessed using the five-item International Index of Erectile Function) and urinary continence, were assessed. Forty patients diagnosed with PFUI associated with URF and treated by TAU with proximal transection and rectal fistula repair were enrolled. Six patients (15.0%) had a history of failed urethral reconstruction. The mean stenosis length and fistula diameter were 2.9 cm and 1.2 cm, respectively. All patients underwent faecal diversion before urethroplasty. After a median (range) follow-up of 45 (3-115) months, the final success rate was 90.0% (36/40). Postoperative complications included haematoma in three patients, epididymo-orchitis in three, wound infection in one, wound bleeding in one, delayed wound healing in three, and wound numbness in three. The overall incidence of postoperative erectile dysfunction reached 75.0%, with a median (range) score of 9 (0-19). Normal continence was achieved in 31 patients (77.5%). Occasional incontinence without the need for urinal pads occurred in eight patients, whereas one patient required urinal pads. Transperineal anastomotic urethroplasty with proximal transection is a precise and effective surgical strategy for treating PFUI associated with URF. This strategy ensures a high success rate and improves surgical efficiency.

Prediction of viral families and hosts of single-stranded RNA viruses based on K-Mer coding from phylogenetic gene sequences

There are billions of virus species worldwide, and viruses, the smallest parasitic entities, pose a serious threat. Therefore, fighting associated disorders requires an understanding of the genetic structure of viruses. Considering the wide diversity and rapid evolution of viruses, there is a critical need to quickly and accurately classify viral species and their potential hosts to better understand transmission dynamics, facilitating the development of targeted therapies. Recognizing this, this study has investigated the classes of RNA viruses based on their genomic sequences using Machine Learning (ML) and Deep Learning (DL) models. The PhyVirus dataset, consisting of pathogenic Single-stranded RNA viruses of Baltimore group four (+ssRNA) and five (-ssRNA) with different hosts and species, was analyzed. The dataset containing viral gene sequences was analyzed using the K-Mer coding technique, which is based on base words of various lengths. The study used classical ML algorithms (Random Forest, Gradient Boosting and Extra Trees) and the Fully Connected Deep Neural Network, a Deep Learning algorithm, to predict viral families and hosts. Detailed analyses were performed on the classifier performance in scenarios with different train-test ratios and different word lengths (k-values) for K-Mer. The observed results show that Fully Connected Deep Neural Network has a high success rate of 99.60 % in predicting virus families. In predicting virus hosts, the Extra Trees classifier achieved the highest success rate of 81.53 %. This study is considered to be the first classification study in the literature on this dataset, which has a very large family and host diversity consisting of gene sequences of Single-stranded RNA viruses. Our detailed investigations on how varying word lengths based on K-Mer coding in gene sequences affect the classification into viral families and hosts make this study particularly valuable. This study shows that ML and DL methods have the potential to produce valuable results in phylogenetic studies. In addition, the results and high-performance values show that these methods can be successfully used in regenerative applications of gene sequences or in studies such as the elimination of losses in gene sequences.

Towards Precision Navigation: Curved lane Detection System in Vehicles

Abstract: Curved lane detection is a critical componentof advanced driver assistance systems (ADAS) and autonomous vehicles, playing a pivotal role in ensuring safeand efficient navigation on complex roadways. In the pursuitof enhancing accuracy and expediting processing speed in road lane detection, researchers have proposed numerous methodologies. Despite these efforts, several challenges persist, including variations in lane markings, fluctuations in lighting conditions, and the emergence of shadows. Addressing these obstacles is crucial for establishing dependable lane detection systems. The curve lane detection algorithm exhibits a robust performance, as evidenced by the experimental results, which consistently reveal a notably high success rate in accurately identifying and delineating curved lanes

Az arteria meningea media embolisatio szerepe a krónikus subduralis haematoma kezelési algoritmusában, legújabb evidenciák és saját tapasztalataink

<p>Chronic subdural hematoma is one of the most common diseases requiring a neurosurgical operation that affect elderly and fragile patients. In addition to standard neurosurgical operations (trepanation and craniotomy), embolization of the meningeal artery media is an alternative solution. Several review aerticles have confirmed the very high rate of success and safety of the endovascular treatment. We present the technical details and results of our 10 consecutive selective media meningeal artery embolization procedures for residual chronic subdural hematomas. Our interventions were performed without complications and all resulted in complete recovery.&nbsp;</p>.