Operating Characteristics Research Articles

A possible role of lncRNA MEG3 and lncRNA MAFG-AS1 on miRNA 147-b in the pathogenesis of Behcet's disease.

Behcet's disease (BD) is a multisystem disease with altered Toll-like receptors (TLRs) on macrophages. Long noncoding RNA Maternally expressed gene 3 (lncRNA MEG3) and lncRNA Musculoaponeurotic fibrosarcoma oncogene family, protein G antisense 1 (MAFG-AS1) are regulators of microRNA (miRNA) 147-b, which is induced upon TLR stimulation. We included fifty BD patients, and fifty age and sex-matched controls. Real-time polymerase chain reaction (PCR) was used to measure the expression levels of serum lncRNA MEG3, lncRNA MAFG-AS1, and miRNA 147-b. LncRNA MEG3 and lncRNA MAFG-AS1 were significantly downregulated while miRNA 147-b was significantly upregulated in the BD patients' serum compared to the controls with p-value <0.001. Receiver operation characteristics (ROC) curve analysis revealed that the three biomarkers can discriminate between BD and control subjects with 76%, 100%, and 70% sensitivity respectively, and 100% specificity for all of them. There was a lower expression level of lnc RNA MEG3 among patients who had new eye involvement in the last month in comparison to those without new eye involvement (p-value=0.017). So, LncRNA MEG3, lncRNA MAFG-AS1, and miRNA147-b are promising diagnostic markers and therapeutic targets for BD patients. LncRNA MEG3 can be used as a predictor for new BD ocular involvement.

Tear fluid cytokine analysis: a non-invasive approach for assessing retinopathy of prematurity severity.

To determine whether there is a significant association between inflammatory cytokines in the tear fluid and the severity of Retinopathy of Prematurity (ROP). Retrospective cohort study. The cytokine levels in tear fluids were determined in 34 eyes with ROP and 18 eyes without ROP. There were 15 eyes with severe ROP requiring treatment and 19 eyes with mild ROP not requiring treatment. For severe ROP eyes, tear fluids were collected before treatment. Significantly higher levels of CCL2 and vascular endothelial growth factor (VEGF) were detected in eyes with severe ROP compared to eyes with mild ROP and no ROP. When assessed for cytokine levels that discriminate each disease group, CCL2 showed a significant odds ratio of 1.76 for severity change (/quintile, P = 0.032, after adjusting for birth weight). Correlation analysis showed that birth weight correlated with IL-1α levels, and decreased weight gain increased IFN-γ levels. We next determined tear fluid cytokines which discriminate severe ROP using receiver operating characteristics' analysis. We found that combination of higher CCL2 levels, higher VEGF levels, and lower IFN-γ levels in the tear fluid had a stronger predictive value for severe ROP (area under curve, 0.85). The levels of CCL2, VEGF, and IFN-γ in tear fluid may serve as useful biomarkers for assessing the severity of ROP.

Combined detection of serum EFNA1 and MMP13 as diagnostic biomarker for gastric cancer

We previously identified that serum EFNA1 and MMP13 were potential biomarker for early detection of esophageal squamous cell carcinoma. In this study, our aim is to explore the diagnostic value of serum EFNA1 and MMP13 for gastric cancer. We used enzyme-linked immunosorbent assay (ELISA) to detect the expression levels of serum EFNA1 and MMP13 in 210 GCs and 223 normal controls. The diagnostic value of EFNA1 and MMP13 was evaluated in an independent cohorts of GC patients and normal controls (n = 238 and 195, respectively). Receiver operating characteristics were used to calculate diagnostic accuracy. In training and validation cohorts, serum EFNA1 and MMP13 levels in the GC groups were significantly higher than those in the normal controls (P < 0.001). The area under the curve (AUC) of the combined detection of serum EFNA1 and MMP13 for GC was improved (0.794), compared with single biomarker used. Similar results were observed in the validation cohort. Importantly, the combined measurement of serum EFNA1 and MMP13 to detect early-stage GC also had acceptable diagnostic accuracy in training and validation cohort. Combined detection of serum EFNA1 and MMP13 could help identify early-stage GC, suggesting that it may be a promising tool for the early detection of GC.

Metabolic profiling reveals circulating biomarkers associated with incident and prevalent Parkinson’s disease

The metabolic profile predating the onset of Parkinson’s disease (PD) remains unclear. We aim to investigate the metabolites associated with incident and prevalent PD and their predictive values in the UK Biobank participants with metabolomics and genetic data at the baseline. A panel of 249 metabolites was quantified using a nuclear magnetic resonance analytical platform. PD was ascertained by self-reported history, hospital admission records and death registers. Cox proportional hazard models and logistic regression models were used to investigate the associations between metabolites and incident and prevalent PD, respectively. Area under receiver operating characteristics curves (AUC) were used to estimate the predictive values of models for future PD. Among 109,790 participants without PD at the baseline, 639 (0.58%) individuals developed PD after one year from the baseline during a median follow-up period of 12.2 years. Sixty-eight metabolites were associated with incident PD at nominal significance (P < 0.05), spanning lipids, lipid constituent of lipoprotein subclasses and ratios of lipid constituents. After multiple testing corrections (P < 9×\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\ imes$$\\end{document}10−4), polyunsaturated fatty acids (PUFA) and omega-6 fatty acids remained significantly associated with incident PD, and PUFA was shared by incident and prevalent PD. Additionally, 14 metabolites were exclusively associated with prevalent PD, including amino acids, fatty acids, several lipoprotein subclasses and ratios of lipids. Adding these metabolites to the conventional risk factors yielded a comparable predictive performance to the risk-factor-based model (AUC = 0.766 vs AUC = 0.768, P = 0.145). Our findings suggested metabolic profiles provided additional knowledge to understand different pathways related to PD before and after its onset.

A Case Study on the Operational Performance Evaluation of a Manufacturing Process and System (MaPS) Sustainability Analysis Tool for Engineering Education

As the future product and process design decision-makers, students in engineering should have knowledge of sustainability and its application in industry. However, educators are challenged in training students in these concepts. Existing analysis tools are deficient in supporting sustainability assessment by nonexperts. To address this gap, the Manufacturing Process and System (MaPS) Sustainability Analysis tool was developed under the Constructionism in Learning: Sustainable Life Cycle Engineering (CooL:SLiCE) project. The technical aspects of developing a framework and its associated proof-of-concept MaPS Sustainability Analysis tool are reported in a separate study. Herein, the educational aspects of the MaPS Sustainability Analysis tool and its operational performance in terms of ease of use and usefulness to assess its suitability for the classroom are investigated. Undergraduate and graduate engineering students at Tampere University and Oregon State University were recruited to use and evaluate the tool. Through application of the Technology Acceptance Model (TAM), it was determined that the 24 study participants found the tool easy to use and useful in analyzing product design, manufacturing process, and supply chain sustainability performance. To move this proof of concept toward general use, key software operational characteristics and a GUI should be investigated to improve efficiency, effectiveness, satisfaction, and learnability of the MaPS Sustainability Analysis tool.

Development and validation of machine learning models to predict MDRO colonization or infection on ICU admission by using electronic health record data

BackgroundMultidrug-resistant organisms (MDRO) pose a significant threat to public health. Intensive Care Units (ICU), characterized by the extensive use of antimicrobial agents and a high prevalence of bacterial resistance, are hotspots for MDRO proliferation. Timely identification of patients at high risk for MDRO can aid in curbing transmission, enhancing patient outcomes, and maintaining the cleanliness of the ICU environment. This study focused on developing a machine learning (ML) model to identify patients at risk of MDRO during the initial phase of their ICU stay.MethodsUtilizing patient data from the First Medical Center of the People’s Liberation Army General Hospital (PLAGH-ICU) and the Medical Information Mart for Intensive Care (MIMIC-IV), the study analyzed variables within 24 h of ICU admission. Machine learning algorithms were applied to these datasets, emphasizing the early detection of MDRO colonization or infection. Model efficacy was evaluated by the area under the receiver operating characteristics curve (AUROC), alongside internal and external validation sets.ResultsThe study evaluated 3,536 patients in PLAGH-ICU and 34,923 in MIMIC-IV, revealing MDRO prevalence of 11.96% and 8.81%, respectively. Significant differences in ICU and hospital stays, along with mortality rates, were observed between MDRO positive and negative patients. In the temporal validation, the PLAGH-ICU model achieved an AUROC of 0.786 [0.748, 0.825], while the MIMIC-IV model reached 0.744 [0.723, 0.766]. External validation demonstrated reduced model performance across different datasets. Key predictors included biochemical markers and the duration of pre-ICU hospital stay.ConclusionsThe ML models developed in this study demonstrated their capability in early identification of MDRO risks in ICU patients. Continuous refinement and validation in varied clinical contexts remain essential for future applications.

Study and transient neutronics analysis of a 10kWth space heat pipe reactor based on a new dual protection control scheme with control annulus and movable radial reflector

This paper mainly focusses on a new dual protection control scheme based on the control annulus and movable radial reflector for a 10kWth space heat pipe reactor. Through the radial reflector, reactive coarse adjustment can be achieved, while reactive fine adjustment can be achieved through B4C control annulus. Both control schemes allow for independent control. Firstly, the steady-state neutron analysis method is conducted to evaluate the critical safety performance of different core control schemes when the reactor falls into sand or water. The first control scheme uses a movable radial reflector, which can still enable the reactor to maintain a keff below 0.85 when the reactor is soaked into the sand or water. The second control scheme uses an independent B4C control annulus, which enables the reactor to maintain a keff below 0.95 when the reactor is soaked into the sand or water. Through the dual protection control scheme, it can ensure the critical safety for the reactor when the launch or drop accident occurs. Moreover, a transient neutronics analysis is conducted to evaluate the operating characteristics and transient neutronics performance for the reactor. The results showed that compared to the control scheme of Kilopower, when the positive reactivity is introduced, the transient neutron dynamics parameters of this dual protection control scheme are superior to that of Kilopower. And it showed that the dual protection control scheme provides an improved control design for the further design and optimization of control scheme for the space reactors.

Optimizing Grid-Connected Inverter Performance Through Voltage Stability Control

Everyday, non-renewable energy sources are being depleted while energy use rises. In response to these arguments, we ought to generate more renewable energy. But a big problem with renewable energy is that its production is weather-dependent. In overcast and unfavorable weather, the energy generated on the grid side is insufficient to match the demand on the load side. The primary load-side issues may be non-linear loads that lower the energy network’s power quality or excessive or unmanaged energy demand. When compared to the production of renewable energy, energy sources that are connected to the grid through an electronic converter or inverter have quite different operating characteristics. The stability of the grid and solutions to the grid-to- transmission-line stability issue are the main topics of this study. The benefits of using inverters in a power system from the grid to the transmission line with MPPT and PI controllers are examined in this article. A robust control system with an inverter-equipped PI controller and MPPT addresses the main problem.

Research on the design and optimal control of the power take-off (PTO) system for underwater eel-type power generators

Wave energy and ocean current energy are considered stable, reliable, and highly predictable renewable energy sources. The development of ocean current energy conversion technology is crucial in addressing power shortages. However, the low velocity of most ocean currents worldwide, typically less than 1.5 m/s, poses a challenge for traditional ocean current energy capture devices. Current estimations of power generation from underwater devices often significantly differ from actual results. This study presents an eel-type power generation device designed for underwater use, investigates the design and optimization of a hydraulic power take-off (PTO) system suitable for such devices, and examines key components of the hydraulic PTO system like variable hydraulic motors and generators. Analytical research was conducted to understand its operational characteristics, with a focus on components such as the accumulator, speed control valve, and energy storage flywheel. The article also delves into the hydrodynamic and energy conversion characteristics of the device under shallow water wave and current conditions, enhancing the hydraulic PTO system model and establishing an integrated calculation model for real-time data transmission during the calculation process. Through evaluations of pitch angle and power generation under varying sea conditions, the study explores the impact of hydraulic motor displacement and damping coefficient on the hydrodynamic and power generation characteristics of the device, further validated through sea trials. The study findings indicate a high level of parameter adaptation among the components of the hydraulic system. The addition of an accumulator to the system results in smoother output response curves, suggesting that the accumulator absorbs impacts and stabilizes the hydraulic power transmission system. The proposed comprehensive calculation method enables a more precise prediction of the performance of the eel power generation device in real marine environments, capturing its movement behavior and power generation characteristics. Adjusting the motor displacement or damping coefficient under specific conditions can optimize the total damping of the hydraulic PTO system for maximum power output. The optimal power point of the hydraulic power generation system varies for different sea conditions, with a potential power generation efficiency of up to 80.3% under certain circumstances.

Sample size calculation for data reliability and diagnostic performance: a go-to review

Sample size, namely the number of subjects that should be included in a study to reach the desired endpoint and statistical power, is a fundamental concept of scientific research. Indeed, sample size must be planned a priori, and tailored to the main endpoint of the study, to avoid including too many subjects, thus possibly exposing them to additional risks while also wasting time and resources, or too few subjects, failing to reach the desired purpose. We offer a simple, go-to review of methods for sample size calculation for studies concerning data reliability (repeatability/reproducibility) and diagnostic performance. For studies concerning data reliability, we considered Cohen’s κ or intraclass correlation coefficient (ICC) for hypothesis testing, estimation of Cohen’s κ or ICC, and Bland-Altman analyses. With regards to diagnostic performance, we considered accuracy or sensitivity/specificity versus reference standards, the comparison of diagnostic performances, and the comparisons of areas under the receiver operating characteristics curve. Finally, we considered the special cases of dropouts or retrospective case exclusions, multiple endpoints, lack of prior data estimates, and the selection of unusual thresholds for α and β errors. For the most frequent cases, we provide example of software freely available on the Internet.Relevance statement Sample size calculation is a fundamental factor influencing the quality of studies on repeatability/reproducibility and diagnostic performance in radiology.Key points• Sample size is a concept related to precision and statistical power.• It has ethical implications, especially when patients are exposed to risks.• Sample size should always be calculated before starting a study.• This review offers simple, go-to methods for sample size calculations.Graphical

Establishment of an ovarian cancer exhausted CD8+T cells-related genes model by integrated analysis of scRNA-seq and bulk RNA-seq

Ovarian cancer (OC) was the fifth leading cause of cancer death and the deadliest gynecological cancer in women. This was largely attributed to its late diagnosis, high therapeutic resistance, and a dearth of effective treatments. Clinical and preclinical studies have revealed that tumor-infiltrating CD8+T cells often lost their effector function, the dysfunctional state of CD8+T cells was known as exhaustion. Our objective was to identify genes associated with exhausted CD8+T cells (CD8TEXGs) and their prognostic significance in OC. We downloaded the RNA-seq and clinical data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. CD8TEXGs were initially identified from single-cell RNA-seq (scRNA-seq) datasets, then univariate Cox regression, the least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression were utilized to calculate risk score and to develop the CD8TEXGs risk signature. Kaplan–Meier analysis, univariate Cox regression, multivariate Cox regression, time-dependent receiver operating characteristics (ROC), nomogram, and calibration were conducted to verify and evaluate the risk signature. Gene set enrichment analyses (GSEA) in the risk groups were used to figure out the closely correlated pathways with the risk group. The role of risk score has been further explored in the homologous recombination repair deficiency (HRD), BRAC1/2 gene mutations and tumor mutation burden (TMB). A risk signature with 4 CD8TEXGs in OC was finally built in the TCGA database and further validated in large GEO cohorts. The signature also demonstrated broad applicability across various types of cancer in the pan-cancer analysis. The high-risk score was significantly associated with a worse prognosis and the risk score was proven to be an independent prognostic biomarker. The 1-, 3-, and 5-years ROC values, nomogram, calibration, and comparison with the previously published models confirmed the excellent prediction power of this model. The low-risk group patients tended to exhibit a higher HRD score, BRCA1/2 gene mutation ratio and TMB. The low-risk group patients were more sensitive to Poly-ADP-ribose polymerase inhibitors (PARPi). Our findings of the prognostic value of CD8TEXGs in prognosis and drug response provided valuable insights into the molecular mechanisms and clinical management of OC.

Assessing the impact of distal femoral morphology using Citak's ratio: an independent risk factor for aseptic loosening in rotating hinge knee prosthesis.

Aseptic loosening (AL) is a frequent complication after rotating hinge knee (RHK) prosthesis. Citak's ratio has recently been developed to describe and classify distal femoral morphology into 3 groups (A, B, C). It consists in a ratio between the diameters of the femoral canal at 20cm from the knee joint line and at 2cm from the adductor tubercle. The objective of the study was to identify whether the femoral distal anatomical shape described with this ratio represents a risk factor for AL in RHK prosthesis. Retrospective study of patients who had undergone primary or revision RHK prosthesis, with a follow-up of minimum 4 years. Citak's ratio was calculated, and patients were classified depending on its value. Univariate and bivariate statistical analysis was performed to identify AL risk factors. Receiver Operating Characteristics (ROC) analyses were conducted to examine diagnostic quality of the parameters of interest. Thirty-three patients were included. Most of them females (ratio 26:7), with a mean age of 78.2 (SD 6.9). Three patients presented AL (rate of 9%), all of them classified into group C (100%). Citak's ratio was significantly related to the AL rate (p < 0.001), and so was the femoral canal diameter at 20cm from the knee joint (p 0.010). The ROC curve analysis yielded an Area Under the Curve (AUC) of 0.922 (CI 95% 0.819-1.000) for the Citak´s ratio. The inner femoral diameter at 20cm proximal to the knee joint line and Citak's ratio help indentify patients at risk of AL after RHK prosthesis, and thus a better planning of the surgery.

Machine Learning Based Prediction of Post-operative Infrarenal Endograft Apposition for Abdominal Aortic Aneurysms

Challenging infrarenal aortic neck characteristics have been associated with increased risk of a type Ia endoleak after endovascular aneurysm repair (EVAR). Short apposition (< 10 mm circumferential shortest apposition length [SAL]) on the first post-operative computerised tomography angiography (CTA) has been associated with type Ia endoleak. Therefore, this study aimed to develop a model to predict post-operative SAL in patients with an abdominal aortic aneurysm based on the pre-operative shape. A statistical shape model was developed to obtain principal component scores. The dataset comprised patients treated with standard EVAR without complications (n = 93) enriched with patients with a late type Ia endoleak (n = 54). The infrarenal SAL was obtained from the first post-operative CTA and subsequently binarised (< 10 mm and ≥ 10 mm). The principal component scores that were statistically different between the SAL groups were used as input for five classification models, and evaluated by means of leave one out cross validation. Area under the receiver operating characteristics curves (AUC), accuracy, sensitivity, and specificity were determined for each classification model. Of the 147 patients, 24 patients had an infrarenal SAL < 10 mm and 123 patients had a SAL ≥ 10 mm. The gradient boosting model resulted in the highest AUC of 0.77. Using this model, 114 (78.0%) patients were correctly classified; sensitivity (< 10 mm apposition was correctly predicted) and specificity (≥ 10 mm apposition was correctly predicted) were 0.70 and 0.79, and were based on a threshold of 0.21, respectively. A model was developed to predict which patients undergoing EVAR will achieve sufficient graft apposition (≥ 10 mm) in the infrarenal aortic neck based on a statistical shape model of pre-operative CTA data. This model can help vascular specialists during the planning phase to accurately identify patients who are unlikely to achieve sufficient apposition after standard EVAR.

Analysis of the features of the shielding system of polymer insulation structures of high voltage electrical equipment

In the article, the authors analysed the existing shielding systems of insulating structures of high-voltage devices together with electrodes under high potential. At the same time, the possibilities of using toroidal screens of various designs and the conditions of their installation in gas-filled equipment structures (gas-filled current and voltage measuring transformers, arresters, etc.) using polymer insulating materials are considered. Based on the analysis of literary sources, the most effective method of estimating the electric load parameters for determining the electric field strength distribution along the continuous insulating structure of gas-filled high-voltage devices with axial symmetry is proposed. This design is a support-insulating shell filled with SF6 as an internal insulating medium. Methodical materials are recommended that allow you to estimate the electrical load parameters (voltage and field strength) depending on the design features of the device and the shielding system used to level the electric field. Based on them, it is possible to evaluate the effectiveness of the calculation coefficients of the shielding system of gas-filled high-voltage equipment in the design process and during the improvement of individual design solutions. The results of the analytical evaluation by such methods are in good agreement with the data of experimental studies and statistical information obtained as a result of monitoring the work of insulating structures, taking into account real operating conditions and the influence of external factors. The introduction of the obtained materials allows you to take into account the influence of external factors and operational characteristics inherent in measuring transformers and overvoltage limiters. To explain the results of the analysis of methodical materials carried out in the article, as an example, the results of calculations of the support-insulation shell of the gas-filled current transformer of the TOG series, which was the most affected during operation, are given. in adverse conditions, given under such conditions as external pollution, humidity and their combination, as well as under conditions of overvoltage of various origins, etc. On the basis of the presented materials, it is possible to more accurately determine the effectiveness of various screenings. system, as well as how to predict the field strength distribution parameters under the influence of the shielding system, taking into account its design features. In addition, on the basis of the conclusions formed in the work, it is possible to plan and conduct an additional series of calculations and experimental tests taking into account the features of specific structures. Thus, the obtained results can be used to evaluate the external insulation parameters of both gas-filled measuring transformers and similar high-voltage equipment of distribution devices and transformer substations.

Development and Validation of PRE-SARC (PREdiction of SARCopenia Risk in Community Older Adults) Sarcopenia Prediction Model

ObjectiveReliable identification of high-risk older adults who are likely to develop sarcopenia is essential to implement targeted preventive measures and follow-up. However, no sarcopenia prediction model is currently available for community use. Our objective was to develop and validate a risk prediction model for calculating the 1-year absolute risk of developing sarcopenia in an aging population. MethodsOne prospective population-based cohort of non-sarcopenic individuals aged 60 years or older were used for the development of a sarcopenia risk prediction model and model validation. Sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia consensus. Stepwise logistic regression was used to identify risk factors for sarcopenia incidence within a 1-year follow-up. Model performance was evaluated using the area under the receiver operating characteristics curve (AUROC) and calibration plot, respectively. ResultsThe development cohort included 1042 older adults, among whom 87 participants developed sarcopenia during a 1-year follow-up. The PRE-SARC (PREdiction of SARCopenia Risk in community older adults) model can accurately predict the 1-year risk of sarcopenia by using 7 easily accessible community-based predictors. The PRE-SARC model performed well in predicting sarcopenia, with an AUROC of 87% (95% CI, 0.83-0.90) and good calibration. Internal validation showed minimal optimism, with an adjusted AUROC of 0.85. The prediction score was categorized into 4 risk groups: low (0%-10%), moderate (>10%-20%), high (>20%-40%), and very high (>40%). The PRE-SARC model has been incorporated into an online risk calculator, which is freely accessible for daily clinical applications (https://sarcopeniariskprediction.shinyapps.io/dynnomapp/). ConclusionsIn community-dwelling individuals, the PRE-SARC model can accurately predict 1-year sarcopenia incidence. This model serves as a readily available and free accessible tool to identify older adults at high risk of sarcopenia, thereby facilitating personalized early preventive approaches and optimizing the utilization of health care resources.

A nomogram combining neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI) to predict distant metastasis in gastric cancer

In this study, We aim to explore the association between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) and distant metastasis of gastric cancer and develop an efficient nomogram for screening patients with distant metastasis. A total of 1281 inpatients with gastric cancer were enrolled and divided into the training and validation set.Univariate, Lasso regression and Multivariate Logistic Regression Analysis was used to identify the risk factors of distant metastasis. The independent predictive factors were then enrolled in the nomogram model. The nomogram’s predictive perform and clinical practicality was evaluated by receiver operating characteristics (ROC) curves, calibration curves and decision curve analysis. Multivariate Logistic Regression Analysis identified d-dimer, CA199, CA125, NLR and PNI as independent predictive factors. The area under the curve of our nomogram based on these factors was 0.838 in the training cohort and 0.811 in the validation cohort. The calibration plots and decision curves demonstrated the nomogram’s good predictive performance and clinical practicality in both training and validation cohort. Therefore,our nomogram could be an important tool for clinicians in screening gastric cancer patients with distant metastasis.

The use of echocardiography compared to electrocardiogram when screening for left ventricular hypertrophy in hypertensive patients: A cross-sectional study.

Left ventricular hypertrophy (LVH) is often used as an indicator to assess hypertension-mediated organ damage (HMOD), alongside hypertensive retinopathy (HR) and nephropathy. Assessment of HMOD is crucial when making decisions about treatment optimization. Despite longstanding debate over its reliability to detect LVH, it is common practice to perform an electrocardiogram (ECG) instead of directly assessing left ventricular mass with echocardiography. In this study, the presence of LVH was evaluated using both ECG and echocardiography among consecutive patients suspected of therapy-resistant hypertension or secondary hypertension in the outpatient clinic of the Department of Internal Medicine at the Diakonessen Hospital, Utrecht, the Netherlands, between July 15, 2017, and July 31, 2020. The primary endpoints were the specificity and sensitivity of ECG as a diagnostic tool for LVH, with echocardiography serving as the reference method. Among the 329 participants, we identified 70 individuals (21.3%) with true LVH based on echocardiography. The ECG displayed a sensitivity of 47.9% and a specificity of 75.3%. Moreover, the area under the receiver operating characteristics curve was 0.604. In conclusion, ECG demonstrates limited value in identifying LVH. Considering the importance of accurately assessing HMOD for treatment optimization of hypertension, the role of ECG as a diagnostic tool for LVH is, therefore, questionable. Instead, we recommend employing standard echocardiography as a more reliable diagnostic.

Mapping annual soil loss in the southeast of Peshawar basin, Pakistan, using RUSLE model with geospatial approach

ABSTRACT Soil erodibility is challenging for agricultural soils, sustainable farming systems and water-food security in developing countries. Regional scale precise estimation of soil erosion is vital to save fertile soils. For this purpose, geospatial technology is the researchers’ top choice. The Revised Universal Soil Loss Equation (RUSLE) has the potential plausible estimates of soil erosion in the region. The study area comprises parts from two basins (Peshawar and Nizampur) having distinct land surface characteristics. This difference made the applicability of RUSLE model challenging. The influencing factors were combined using weighted sum in GIS. The study area was categorized into five soil erosion zones: very low (0–0.1 t ha−1 year−1), low (0.1–0.50 t ha−1 year−1), moderate (0.50–0.7 t ha−1 year−1) high (0.7–1 t ha−1 year−1), and very high (>1 t ha−1 year−1). The 1,748 km2 (174800 hectares) study region has an annual soil loss of 0.1 to > 1.0 t ha−1 year−1. The overall accuracy of the estimated soil erosion was found to be 90% with Kappa coefficient of 87.25% and receiver operating characteristics area under the curve (ROC-AUC) score of 0.819. This study’s will help to address the climate change-induced challenges of soil erosion in agricultural lands.

Assessment of Use of Subcutaneous Mastectomy with Silicon Prostheses as Treatment of Early Breast Cancer

Abstract Background Breast cancer is the most common cancer among women and the second most common cause of cancer death in the United States. Approximately 268,600 new breast cancer diagnoses and 41,760 cancer- related deaths in the U.S. were estimated for 2019. SSM (skin sparing mastectomy) is defined as a simple or radical surgery with modified minimal incisions that retain the widest possible coverage and sub-cutaneous breast groove but dry the NAC, flaws of previous biopsies and/or scarring caused by diagnostic percutaneous biopsies. Access to the armpit for a possible sentinel-node biopsy or axillary dissection is obtained through the same incision. An additional incision may be necessary to perform the reconstructive procedure (e.g., microsurgical axillary anastomosis). Objective To study the risks and benefits of use subcutaneous mastectomy with silicon prosthesis as treatment of early breast cancer: as regards the impact of radiotherapy administration on implant, psychological impact, operative time and post-operative complications including complication of silicon, effect on wound healing. Patients and Methods This prospective interventional study was conducted at tertiary care hospital at the general surgery department in Ain Shams University hospitals and Misr University for Science and Technology (MUST) hospital and from November 2021, till July 2022 and performed on total 15 females suffering from stage I-II infiltrating breast carcinomas. Results The current study revealed that mean ±SD of age of the studied cases was 46.3±7.4. Regarding tumor site, LOQ was the most frequent (40.0%), followed by UIQ (33.3%), then UOQ (20.0%) and lastly LIQ (6.7%). Concerning T grades, T1 was in (46.7%), while the remaining (53.3%) were T2. Concerning N grades, N0 was in (73.3%), while the remaining (26.7%) were N1. Sentinel lymph nodes done in 73.3% of cases. As regards operative characteristics, Axillary clearance done in less than half of cases (46.7%), while nipple sparing achieved in less than quarter of cases (20.0%). As regards post-mastectomy treatment, majority of cases (86.7%) received hormonal therapy, adjuvant radiotherapy to axilla was (46.7%), chemotherapy (33.3%), while immunotherapy was (6.7%). As regards postoperative side effects, Pain was the most frequent postoperative side effect; detected in (33.3%) of cases, followed by seroma (20.0%), then flap necrosis (13.3%), and the least frequent was hematoma (6.7%). As regards postoperative patients’ satisfaction, mean ±SD of Postoperative patients’ satisfaction was 7.3±1.5 with range 5.0 − 10.0. Near half of the studied cases (46.7%) had 7.0 − 8.0 satisfaction grade. Conclusion Skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate subcutaneous silicon implantation are an acceptable and safe method for breast reconstruction. It offers a number of advantages including ease of dissection for surgeons, improved symmetry, and low complication rates. With improvements in surgical techniques in preserving mastectomy skin flap viability, the traditionally higher rates of complications in subcutaneous implants may be outdated. The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes to evaluate a cost benefit analysis and patient and surgeon assessment of outcomes to directly compare with traditional submuscular single- or 2- stage implant-based reconstruction.

Cervicothoracic ventral-dorsal rhizotomy for treatment of brachial hypertonia in cerebral palsy.

Cervicothoracic ventral-dorsal rhizotomy (VDR) is a potential treatment of medically refractory hypertonia in patients who are not candidates for intrathecal baclofen, particularly in cases of severe upper limb hypertonia with limited to no function. A longitudinal cohort was identified to highlight our institutional safety and efficacy using cervicothoracic VDR for the treatment of hypertonia. Retrospective data analysis was performed for patients that underwent non-selective cervicothoracic VDR between 2022 and 2023. Non-modifiable risk factors, clinical variables, and operative characteristics were collected. Six patients (three female) were included. Four patients underwent a bilateral C6-T1 VDR, one patient underwent a left C7-T1 VDR, and another underwent a left C6-T1 VDR. Three patients had quadriplegic mixed hypertonia, one patient had quadriplegic spasticity, one patient had triplegic mixed hypertonia, and one patient had mixed hemiplegic hypertonia. The mean difference of proximal upper extremity modified Ashworth scale (mAS) was - 1.4 ± 0.55 (p = 0.002), and - 2.2 ± 0.45 (p < 0.001) for the distal upper extremity. Both patients with independence noted quality of life improvements as well as increased ease with dressing and orthotics fits. Caregivers for the remaining four patients noted improvements in caregiving provision, mainly in dressing, orthotics fit, and ease when transferring. Cervicothoracic VDR is safe and provides tone control and quality of life improvements in short-term follow-up. It can be considered for the treatment of refractory hypertonia. Larger multicenter studies with longer follow-up are necessary to further determine safety along with long-term functional benefits in these patients.