Optimal Cut Research Articles

An Integrated Predictive Maintenance and Operations Scheduling Framework for Power Systems Under Failure Uncertainty

Maintenance planning plays a key role in power system operations under uncertainty as it helps providers and operators ensure a reliable and secure power grid. This paper studies a short-term condition-based integrated maintenance planning with operations scheduling problem while considering the possible unexpected failure of generators as well as transmission lines. We formulate this problem as a two-stage stochastic mixed-integer program with failure scenarios sampled from the sensor-driven remaining lifetime distributions of the individual system elements whereas a joint chance constraint consisting of Poisson Binomial random variables is introduced to account for failure risks. Because of its intractability, we develop a cutting-plane method to obtain an exact reformulation of the joint chance constraint by proposing a separation subroutine and deriving stronger cuts as part of this procedure. We also derive a second-order cone programming-based safe approximation of this constraint to solve large-scale instances. Furthermore, we propose a decomposition algorithm implemented in parallel fashion for solving the resulting stochastic program, which exploits the features of the integer L-shaped method and the special structure of the maintenance and operations scheduling problem to derive valid and stronger sets of optimality cuts. We further present preprocessing steps over transmission line flow constraints to identify redundancies. To illustrate the computational performance and efficiency of our algorithm compared with more conventional maintenance approaches, we design a computational study focusing on a weekly plan with daily maintenance and hourly operational decisions involving detailed unit commitment subproblems. Our computational results on various IEEE instances demonstrate the computational efficiency of the proposed approach with reliable and cost-effective maintenance and operational schedules. History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms—Discrete. Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijoc.2022.0154 .

Higher ultra processed foods intake is associated with low muscle mass in young to middle-aged adults: a cross-sectional NHANES study.

Ultra-processed foods (UPFs) have become a pressing global health concern, prompting investigations into their potential association with low muscle mass in adults. This cross-sectional study analyzed data from 10,255 adults aged 20-59 years who participated in the National Health and Nutritional Examination Survey (NHANES) during cycles spanning from 2011 to 2018. The primary outcome, low muscle mass, was assessed using the Foundation for the National Institutes of Health (FNIH) definition, employing restricted cubic splines and weighted multivariate regression for analysis. Sensitivity analysis incorporated three other prevalent definitions to explore optimal cut points for muscle quality in the context of sarcopenia. The weighted prevalence of low muscle mass was 7.65%. Comparing the percentage of UPFs calories intake between individuals with normal and low muscle mass, the values were found to be similar (55.70 vs. 54.62%). Significantly linear associations were observed between UPFs consumption and low muscle mass (P for non-linear = 0.7915, P for total = 0.0117). Upon full adjustment for potential confounding factors, participants with the highest UPFs intake exhibited a 60% increased risk of low muscle mass (OR = 1.60, 95% CI: 1.13 to 2.26, P for trend = 0.003) and a decrease in ALM/BMI (β = -0.0176, 95% CI: -0.0274 to -0.0077, P for trend = 0.003). Sensitivity analysis confirmed the consistency of these associations, except for the International Working Group on Sarcopenia (IWGS) definition, where the observed association between the highest quartiles of UPFs (%Kcal) and low muscle mass did not attain statistical significance (OR = 1.35, 95% CI: 0.97 to 1.87, P for trend = 0.082). Our study underscores a significant linear association between higher UPFs consumption and an elevated risk of low muscle mass in adults. These findings emphasize the potential adverse impact of UPFs on muscle health and emphasize the need to address UPFs consumption as a modifiable risk factor in the context of sarcopenia.

Predictive role of intracranial PD-L1 expression in a real-world cohort of NSCLC patients treated with immune checkpoint inhibition following brain metastasis resection

BackgroundEmerging evidence suggests that treatment of NSCLC brain metastases with immune checkpoint inhibitors (ICIs) is associated with response rates similar to those of extracranial disease. Programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) serves as a predictive biomarker for ICI response. However, the predictive value of brain metastasis-specific (intracranial) PD-L1 TPS is not established. We investigated the role of intra- and extracranial PD-L1 TPS in NSCLC patients treated with ICI following brain metastasis resection.MethodsClinical data from NSCLC patients treated with ICI following brain metastasis resection (n = 64) were analyzed. PD-L1 TPS of brain metastases (n = 64) and available matched extracranial tumor tissue (n = 44) were assessed via immunohistochemistry. Statistical analyses included cut point estimation via maximally selected rank statistics, Kaplan–Meier estimates, and multivariable Cox regression analysis for intracranial progression-free survival (icPFS), extracranial progression-free survival (ecPFS), and overall survival (OS).ResultsPD-L1 expression was found in 54.7% of brain metastases and 68.2% of extracranial tumor tissues, with a median intra- and extracranial PD-L1 TPS of 7.5% (0 – 50%, IQR) and 15.0% (0 – 80%, IQR), respectively. In matched tissue samples, extracranial PD-L1 TPS was significantly higher than intracranial PD-L1 TPS (p = 0.013). Optimal cut points for intracranial and extracranial PD-L1 TPS varied according to outcome parameter assessed. Notably, patients with a high intracranial PD-L1 TPS (> 40%) exhibited significantly longer icPFS as compared to patients with a low intracranial PD-L1 TPS (≤ 40%). The cut point of 40% for intracranial PD-L1 TPS was independently associated with OS, icPFS and ecPFS in multivariable analyses.ConclusionOur study highlights the potential role of intracranial PD-L1 TPS in NSCLC, which could be used to predict ICI response in cases where extracranial tissue is not available for PD-L1 assessment as well as to specifically predict intracranial response.

Construction and validation of chronic pain prediction model after total knee arthroplasty.

To explore the risk factors of chronic pain after total knee arthroplasty (TKA) and to establish and verify a prediction model. As a retrospective observational study, medical records of 239 patients who underwent TKA in Affiliated Hospital of Jiangnan University from January 2020 to December 2022 were reviewed. Fifty four patients suffered from chronic pain after TKA surgery. Univariate and multivariate logistic regression were used to analyze factors associated with the occurrence of chronic pain after TKA. A nomogram prediction model was established based on the identified independent risk factors, and its predictive effectiveness was evaluated. Gender, postoperative 24-hourss numerical rating scale (NRS) and postoperative three months Hospital for Special Surgery Knee-Rating (HSS) scores were independent risk factors for chronic pain after TKA (p<0.05). The area of the receiver operating characteristic (ROC) of the nomogram model based on these factors was 0.904 (95% confidence interval [CI): 0.861-0.947), which indicates a good predictive value for the postoperative chronic pain. When the optimal cut off value was selected, the sensitivity and specificity of the model were 92.6% and 74.1%, respectively, indicating that the predictive model is effective. Gender, postoperative 24-hours NRS and postoperative three months HSS score are independent risk factors for chronic pain after TKA. The nomogram prediction model based on these factors is effective and can provide auxiliary reference for patients with chronic pain after TKA.

A Study on the Rock-Breaking Characteristics of an Arcing-Blade Cutter under Different Cutting Parameters

To analyze the rock-breaking characteristics of an arcing-blade cutter in cutting red sandstone, a two-cutter cutting model was established based on the finite element method. Then, the cutting processes of the arcing-blade cutter at penetrations of 2 mm, 4 mm, and 6 mm with different cutter spacings were investigated, and the changing rules of the rock-breaking load, rock crushing state, and rock-breaking efficiency were obtained. Subsequently, the obtained simulation results were validated through linear cutting experiments. The research results showed that, as the penetration of the arcing-blade cutter increased, the rock-breaking load also increased; specifically, under 2 mm penetration, the rock-breaking load remained stable, irrespective of the cutter spacing. However, under 4 mm and 6 mm penetration, the vertical and rolling force increased and then stabilized with an increase in the cutter spacing, while the lateral force decreased and then stabilized, attributed to the synergistic effect between the cutters. At 2 mm penetration, the absence of interaction between the cutting of two cutters in sequence resulted in two separate crushed areas on the rock surface. However, at 4 mm and 6 mm penetration, the rock ridge could be crushed under a smaller cutter spacing. Meanwhile, with an increase in the cutter spacing, the synergistic effect between the cutters diminished, causing the rock ridge between two cuttings to remain uncrushed. The specific energy at the 4 mm and 6 mm penetrations decreased initially with an increase in the cutter spacing, then increased, and eventually stabilized. The optimal cutter spacings at these penetrations were determined as 50 mm and 60 mm, respectively. Conversely, at 2 mm penetration, the specific energy remained almost unchanged with an increase in the cutter spacing, maintaining at a high level and resulting in a low efficiency in cutting rock.

Risk Factors of Response to Neoadjuvant Chemotherapy in Patients with Luminal (HER2 Negative) Breast Cancer: Roc Curve and Logistic Regression Model Results

Background: Neoadjuvant chemotherapy (NAC) is less effective for luminal human epidermal growth factor receptor 2 (HER2) negative breast cancer (BC) patients and generally shows a low pathological complete response (pCR) after NAC compared to HER2 positive and triple negative breast cancer (TNBC). This study aimed to determine the factors associated with histopathologic response following NAC in luminal (HER2 negative) BC. Methods: This is a cross-sectional study conducted on 255 estrogen (ER) positive and HER2 negative BC patients after NAC between January 2018 and July 2023. Demographic and clinicopathological characteristics of the patients were collected for the statistical analysis. Chi-Square tests were used in the qualitative comparisons between study groups. Receiver Operating Characteristic (ROC) analysis was used for the diagnostic performance of Ki-67 expression and ER in determining the pCR rates. Using the Youden index, optimum cut points were determined. Also, multivariate logistic regression analysis was applied to determine the independent variables associated with the dependent variable (pCR). Results: After NAC, pCR was achieved in the breast in 35 (14%) patients, in the axilla in 44 (17%) patients, and in both the breast and axilla in 18 (7%) patients. Ki-67 expression was the only common variable associated with the breast, axilla and both the breast and axilla pCR. The most appropriate Ki-67 expression cut-off value for determining the breast and axilla complete response was found to be 40%. ER positivity level was only associated with pCR in the breast and the cut-off value was found to be 85%. Conclusion: The results of this study raise the possibility of patients with luminal (HER2 negative) BC with Ki-67 expression higher than 40% benefiting from chemotherapy, as they showed increased pCR rates.

Optimizing Rack Locations in the Mobile-Rack Picking System: A Method of Integrating Rack Heat and Relevance

The flexible movement of racks in the mobile-rack picking system (MRPS) significantly improves the picking efficiency of e-commerce orders with the characteristics of “one order multi–items” and creates a challenging problem of how to place racks in the warehouse. This is because the placement of each rack in the MRPS directly influences the distance that racks need to be moved during order picking, which in turn affects the order picking efficiency. To handle the rack location optimization problem (RLOP), this work introduces a novel idea and methodology, taking into account the heat degree and the relevance degree of racks, to enhance the efficiency of rack placements in the MRPS. Specifically, a two-stage solution strategy is implemented. In stage 1, an integer programming model (Model 1) is developed to determine the heat and relevance degree of racks, and it can be solved quickly by the Gurobi. Stage 2 entails developing a bi-objective integer programming model (Model 2) with the objective to minimize the travel distances of robots in both heavy load and no-load conditions, using the rack heat and relevance degree as inputs. In light of the challenge of decision coupling and the vast solution space in stage 2, we innovatively propose two lower bounds by slacking off the distance between storage locations. A matheuristic algorithm based on Benders decomposition (MABBD) is designed, which utilizes Benders-related rules to reconstruct Model 2, introduces an enhanced cut and an improved optimal cut with RLOP characteristics, and designs the warm start strategy and the master variable fixed strategy. Given the substantial size of real-life problems, the Memetic algorithm (MA) is specifically devised to address them. Instances of varying sizes are also employed to validate the science and efficacy of the model and algorithm.

A new technique for determination of the optimum cut height according to the fabric type in garment production

Purpose Fabrics, which are one of the raw materials of the clothing industry, constitute approximately 40–45% of the total cost of an apparel product. Due to the labor-intensive nature of this industry and failure to apply scientific methods along with the manufacturing processes, the wastes in the raw materials, including fabrics, become higher. Besides, quality deficiencies are encountered due to the same reasons. This study aims to determine the optimum total fabric layer height based on the fabric type during the cutting process with a straight knife cutting machine, which provided a decrease in the cutting errors. Design/methodology/approach Frequently used fabric types in an enterprise operating in organic cotton knitwear were listed. During the cutting tests, the straight knife cutting machine was used as the cutting device. The weight and thickness values of the fabrics were obtained to provide a comparison basis. Two different algorithms were created to evaluate the defective pieces according to fabric type, cutting height and error placement. Cutting resistances of these fabrics were also determined to evaluate the defect reasons. In the end, optimum total fabric layer count and total cutting height suggestions were proposed for each fabric type for a minimum cutting error. Findings At the end of this study, the error-free layers were identified per fabric type. At the same time, the optimum cutting height was suggested for each fabric basis. For 40/1 single jersey fabrics, the cutting height should be between 2.10 cm and 10.40 cm; for 30/1 single jersey fabrics, between 1.65 cm and 5.70 cm; for 20/1 single jersey fabrics, between 1.83 cm and 6.70 cm; for two-thread fleece fabrics, between 2.13 cm and 4.70 cm; and for three-thread fleece fabrics, between 0 cm and 4.90 cm. Research limitations/implications Within the scope of the study, since the products made of knitted fabric were produced more frequently and in large quantities, the study was carried out with 15 different types of knitted fabrics at 10 different layers. The same methods should be applied for woven, denim and nonwoven fabric types, which would shed light on the following studies. Originality/value Due to scarce research carried out on the cutting procedure of the clothing industry in regards to sustainability, this study aims to contribute to this area. The main difference between this study and the studies that mostly make mathematical predictions about the cutting procedure is that it is practice-oriented.

Establishing pediatric age-adjusted shock index cut points in trauma patients younger than 1 year.

Shock Index is used to predict injury severity and adverse outcomes in trauma patients, but pediatric age-adjusted shock index (SIPA) has superior performance in pediatric patients older than 1 year. Pediatric age-adjusted shock index scores younger than 1 year have not been well studied. This project aimed to establish and evaluate SIPA cut point data points for patients younger than 1 year. Using age-based vital signs, we developed cut point values for patients younger than 1 year using our institutional trauma data. All trauma patients younger than 12 months were included, and clinical outcomes were recorded. Pediatric age-adjusted shock index cut points were defined using age-specific vital sign limits (SIPA-VS) and tested against optimal cut points defined by receiver operating characteristic analysis (SIPA-ROC) and a cut point of 1.2 (SIPA-Nordin), which is used for patients aged 1 to 4 years. Student's t test, χ 2 tests, analysis of variance, and test characteristics were used to analyze groups. A total of 609 pediatric trauma patients younger than 12 months were identified from 2018 to 2022. Pediatric age-adjusted shock index scores were calculated for 483 patients. There were 406 patients with blunt trauma and 17 with penetrating. SIPA-Nordin was elevated in 81.6% (n = 397) of patients, compared with SIPA-VS 21% (n = 101) and SIPA-ROC 31% (n = 150). In comparison with SIPA-Nordin, both SIPA-VS and SIPA-ROC score exhibited superior specificity and negative predictive values for multiple outcomes. Elevated SIPA-ROC scores had statistically significant associations with intensive care unit admission, mechanical ventilation, severe anemia, transfusion during hospital admission, and in-hospital mortality. Pediatric age-adjusted shock index is a useful tool in identifying patients at risk for several complications of severe traumatic injury. Pediatric age-adjusted shock index cut points had high negative predictive value and specificity for many outcomes. This study proposes cut point values that may aid in clinical decision making for trauma patients younger than 1 year. Diagnostic Test/Criteria; Level IV.

Distinct risk factors of lateral lymph node metastasis in patients with papillary thyroid cancer based on age stratification

IntroductionStudies have revealed that age is associated with the risk of lateral lymph node metastasis (LLNM) in papillary thyroid cancer (PTC). This study aimed to identify the optimal cut point of age for a more precise prediction model of LLNM and to reveal differences in risk factors between patients of distinct age stages.MethodsA total of 499 patients who had undergone thyroidectomy and lateral neck dissection (LND) for PTC were enrolled. The locally weighted scatterplot smoothing (LOWESS) curve and the ‘changepoint’ package were used to identify the optimal age cut point using R. Multivariate logistic regression analysis was performed to identify independent risk factors of LLNM in each group divided by age.ResultsYounger patients were more likely to have LLNM, and the optimal cut points of age to stratify the risk of LLNM were 30 and 45 years old. Central lymph node metastasis (CLNM) was a prominent risk factor for further LNM in all patients. Apart from CLNM, sex(p = 0.033), tumor size(p = 0.027), and tumor location(p = 0.020) were independent predictors for patients younger than 30 years old; tumor location(p = 0.013), extra-thyroidal extension(p < 0.001), and extra-nodal extension(p = 0.042) were independent risk factors for patients older than 45 years old.ConclusionsOur study could be interpreted as an implication for a change in surgical management. LND should be more actively performed when CLNM is confirmed; for younger patients with tumors in the upper lobe and older patients with extra-thyroidal extension tumors, more aggressive detection of the lateral neck might be considered.

Comparison of Clinical Frailty Scale and Edmonton Frail Scale in older adults presenting to the emergency department

Introduction: This study aimed to compare the prognostic values of Edmonton Frail Scale and Clinical Frailty Scale in the emergency department and determine their suitability for patient management. Materials and Method: This study was conducted as a single-center prospective observational study. Patients aged 65 and older who presented to the emergency department were included. Clinical Frailty Scale and Edmonton Frail Scale scores, the emergency department outcomes, length of stay in the emergency department, 30-day mortality, and 30-day readmission data of the patients were recorded. ROC analysis was performed to examine the predictive values on outcomes. DeLong Test was used to compare the predictive values. Results: This study included 400 patients. Intensive care unit admission was significantly more frequent in the frail group according to both Edmonton Frail Scale and Clinical Frailty Scale. The length of stay in the emergency department was significantly longer in the frail group in both classifications. The mortality rate was significantly higher in the frail group in both classifications. The optimal cut off value for predicting mortality was found to be 9 for Edmonton Frail Scale and 7 for Clinical Frailty Scale. There was no significant difference between the predictive values of two scales. Conclusion: We found that two frail scales have good predictive values for adverse outcomes, such as mortality and the need for Intensive care unit admission in the emergency department. We believe that both scores would be valuable in guiding decisions for the emergency department usage due to their similar predictive values. Keywords: Geriatrics; Emergency Service; Hospital; Frailty; Frail Elderly; Mortality.

Coordinated Planning of Integrated Electric and Heating System Considering the Optimal Reconfiguration of District Heating Network

The tight coupling of electric and heating systems would make it necessary to consider the coordinated planning of the energy facilities. The seasonal district heating network (DHN) reconfiguration can notably impact the planning results and offer a potential approach for better wind penetration. To address this issue, a coordinated planning of electric and heating (CPEH) model is proposed in this paper by considering the seasonally DHN reconfiguration, which is formulated as a mixed-integer linear programming problem. Considering the computation difficulties brought in by numerous operation scenarios involved in the CPEH problem, a scenario-oriented generalized Benders decomposition (S-BD) algorithm is proposed to solve the CPEH model with higher efficiency by generating feasibility and optimality cuts with a unified form. The numerical simulations and a practical case in Jilin, China, are simulated to demonstrate the efficiency of the S-BD and illustrate the potential benefits of DHN reconfiguration in enhancing wind energy penetration.

Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion.

To create and validate an automated pipeline for detection of early signs of irreversible ischemic change from admission CTA in patients with large vessel occlusion (LVO) stroke. We retrospectively included 368 patients for training and 143 for external validation. All patients had anterior circulation LVO stroke, endovascular therapy with successful reperfusion, and follow-up diffusion-weighted imaging (DWI). We devised a pipeline to automatically segment Alberta Stroke Program Early CT Score (ASPECTS) regions and extracted their relative Hounsfield unit (rHU) values. We determined the optimal rHU cut points for prediction of final infarction in each ASPECT region, performed 10-fold cross-validation in the training set, and measured the performance via external validation in patients from another institute. We compared the model with an expert neuroradiologist for prediction of final infarct volume and poor functional outcome. We achieved a mean area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity of 0.69±0.13, 0.69±0.09, 0.61±0.23, and 0.72±0.11 across all regions and folds in cross-validation. In the external validation cohort, we achieved a median [interquartile] AUC, accuracy, sensitivity, and specificity of 0.71 [0.68-0.72], 0.70 [0.68-0.73], 0.55 [0.50-0.63], and 0.74 [0.73-0.77], respectively. The rHU-based ASPECTS showed significant correlation with DWI-based ASPECTS (rS = 0.39, p<0.001) and final infarct volume (rS = -0.36, p<0.001). The AUC for predicting poor functional outcome was 0.66 (95%CI: 0.57-0.75). The predictive capabilities of rHU-based ASPECTS were not significantly different from the neuroradiologist's visual ASPECTS for either final infarct volume or functional outcome. Our study demonstrates the feasibility of an automated pipeline and predictive model based on relative HU attenuation of ASPECTS regions on baseline CTA and its non-inferior performance in predicting final infarction on post-stroke DWI compared to an expert human reader.

The optimal high-temperature piezoelectric cuts of α-BiB3O6 crystals and their fatigue behaviors at high-temperature and low-pressure

The optimal piezoelectric crystal cut of the α-BiB3O6 crystal exhibited excellent temperature stability over a wide temperature range of 20–650 °C.

Prediction of Unexplained Recurrent Miscarriages Using Thromboelastography.

This study investigates the thromboelastography (TEG) changes in patients with unexplained recurrent spontaneous abortion (URSA) to identify effective diagnostic markers for URSA. We retrospectively analyzed 160 URSA patients from the Gynecology Department of the First People's Hospital of Lianyungang (June 2017 - June 2020) and compared them with 190healthy, fertile women without adverse pregnancy histories (control group). TEG parameters were assessed using logistic regression, applying stepwise selection for model optimization. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, determining sensitivity and specificity. The Youden index identified optimal cut points for predictive probabilities. Significant differences were observed between the URSA and control groups in coagulation reaction time (R), clot formation time (K), clot formation rate (Angle-α), and maximum clot strength (MA) (P<0.05). Multivariable logistic regression identified R, Angle-α, and MA as independent URSA risk factors. The model demonstrated excellent discrimination (AUC: 0.940; 95% CI: 0.918-0.962). The optimal cut point of predictive probability (Youden index) was P=0.355, yielding a sensitivity of 0.925 and specificity of 0.795. URSA patients exhibit a hypercoagulable state even when not pregnant. More research is needed to validate our findings and explore the potential clinical implications of anticoagulants in treating URSA.

The Revised Hearing Handicap Inventory and Pure-Tone Average Predict Hearing Aid Use Equally Well.

This study aimed to (a) compare the Revised Hearing Handicap Inventory (RHHI) and pure-tone average (PTA) in their abilities to predict hearing aid use and (b) report the optimal cut-point values on the RHHI and PTA that predict hearing aid use. Participants were from a community-based cohort study. We evaluated the ability of the RHHI and PTA as (a) continuous variables and (b) binary variables characterized by the optimal cut point determined by the Youden Index to predict hearing aid use. RHHI scores range from 0 to 72, and PTA was defined as averaged thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 kHz in the worse ear. We used logistic regression models and receiver operating characteristic curves with corresponding concordance statistics (c-statistics) and 95% confidence intervals (CIs) to determine the predictive ability of models and chi-square tests to determine whether c-statistics were significantly different. This study included 581 participants (Mage = 72.9 [SD = 9.9] years; 59.9% female; 14.3% Minority race). The c-statistics for the RHHI (0.79, 95% CI [0.75, 0.83]) and PTA (0.81, 95% CI [0.78, 0.85]), as continuous variables, were not significantly different (p = .25). The optimal cut points for the RHHI and PTA to predict hearing aid use were 6 points and 32.5 dB HL, respectively. The c-statistics for the RHHI (0.72, 95% CI [0.68, 0.76]) and PTA (0.75, 95% CI [0.71, 0.79]), as binary variables, were not significantly different (p = .27). The RHHI and PTA are similar in their ability to predict hearing aid use.

Diffusion-Weighted MRI as a Quantitative Imaging Biomarker in Colon Tumors.

To assess the use of quantitative diffusion-weighted MRI (DW-MRI) as a diagnostic imaging biomarker in differentiating between benign colon adenoma, early, and advanced cancer of the colon, as well as predicting lymph node involvement, and finally comparing mucinous-producing colon cancer with adenomas and non-mucinous colon cancer. Patients with a confirmed tumor on colonoscopy were eligible for inclusion in this study. Using a 3.0 Tesla MRI machine, the main tumor mean apparent diffusion coefficient (mADC) was obtained. Surgically resected tumor specimens served as an endpoint, except in mucinous colon cancers, which were classified based on T2 images. A total of 152 patients were included in the study population. The mean age was 71 years. A statistically significant mADC mean difference of -282 × 10-6 mm2/s [-419--144 95% CI, p < 0.001] was found between colon adenomas and early colon cancer, with an AUC of 0.80 [0.68-0.93 95% CI] and an optimal cut off value of 1018 × 10-6 mm2/s. Only a small statistically significant difference (p = 0.039) in mADC was found between benign tumors and mucinous colon cancer. We found no statistical difference in mADC mean values between early and advanced colon cancer, and between colon cancer with and without lymph node involvement. Quantitative DW-MRI is potentially useful for determining whether a colonic tumor is benign or malignant. Mucinous colon cancer shows less diffusion restriction when compared to non-mucinous colon cancer, a potential pitfall.

Evaluation of systemic inflammatory and fibrosis indices in Saprochaete capitata infections: a retrospective case-control study

Abstract Objectives Evaluation of inflammation and liver fibrosis by using well established indices of serum biomarkers in hepatitis caused by viral agents has been reported in recent studies. But the diagnostic performance and prediction of liver damage in S. capitata infections has not yet been reported. The aim of the current study was to investigate the levels of systemic inflammatory indices based on liver enzymes and platelets, their effectiveness in detecting S. capitata infection and its degree of damage to the liver. Methods We investigated the diagnostic performance of seven serum inflammation and fibrosis markers as fibrosis-4 (FIB-4) score, AST/platelet ratio (APRI), AST/ALT ratio (De Ritis ratio), albumin/ALP ratio (AAR), platelet/albumin ratio (PAR), pan-immune-inflammation value (PIV) and GGT/platelet ratio (GPR) in total 62 S. capitata infected patients using cut-offs through receiver operating characteristics (ROC) analysis. Results Area under the curve of FIB-4 score was statistically significantly higher than ones of De Ritis ratio, AAR, PIV, APR, GPR, APRI index in determining liver damage in patients with S. capitata. The optimal cut off point for FIB-4 score was defined that the levels above 27.57 for FIB-4 score may be used for the diagnosis of S. capitata with 89 % of sensitivity and 91 % of specificity. Conclusions Serum fibrosis and immune-inflammation indices are independent, useful predictors, and FIB4 score is superior to the others in the diagnosis of inflammation and liver damage in S. capitata. These biomarkers may also be useful to specialists to follow up on the medical processes of these patients.

Novel Hematological Parameters in the Assessment of the Extent of Cardiac Implantable Electronic Device-Related Infections

Background: Patients with infectious complications related to the presence of cardiac implantable electronic devices (CIED) constitute a heterogeneous group, ranging from local pocket infection (PI) to lead-related infectious endocarditis (LRIE) infection spreading along the leads to the endocardium. The detection of isolated LRIE and the assessment of the spread of infection in a patient with PI is often difficult and requires complex imaging and microbiological tests. The aim of the current study is to evaluate the usefulness of new simple hematological parameters in detecting infectious complications in patients with CIED, differentiating vegetation and vegetation-like masses, and assessing the extent of infections in patients with PI. Methods: A retrospective analysis of clinical data of 2909 patients (36.37% with CIED-related infections), undergoing transvenous lead extraction (TLE) procedures in three high-volume centres in the years 2006–2020, was conducted. Receiver operating characteristic (ROC) curve analysis was used to assess the sensitivity and specificity of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), and lymphocyte-to-platelet ratio (LPR) in the diagnosis of CIED infections, evaluate the spread of the infectious process in patients with PI and differentiate additional structures related to the presence of lead. Results: The values of NLR and NPR were significantly higher in infectious patients than non-infectious controls (3.07 vs. 2.59; p &lt; 0.001, and 0.02 vs. 0.01; p = 0.008) and the area under the ROC curve (AUC) was 0.59; p &lt; 0.001 and 0.56; p &lt; 0.001, respectively. The high specificity of the new markers in detecting the infectious process was demonstrated: 72.82% for NLR (optimal cut-off value: 3.06) and 79.47% for NPR (optimal cut off value: 0.02). The values of NLR and NPR were significantly higher in patients with vegetations than in non-infectious patients with the presence of additional lead-related masses (3.37 vs. 2.61; p &lt; 0.001 and 0.03 vs. 0.02; p = 0.008). The AUC of NLR and NPR for the prediction of vegetations was 0.65; p &lt; 0.001 and 0.60; p &lt; 0.001 with the highest specificity of NPR (82.78%) and an optimal cut-off value of 0.03. NLR and NPR were higher in patients with LRIE compared to isolated PI (4.11 vs. 2.56; p &lt; 0.001 and 0.03 vs. 0.02; p &lt; 0.001) and the ROC curve analysis for coexistence LRIE with PI showed the AUC for NLR: 0.57; p &lt; 0.001 and AUC for NPR: 0.55; p = 0.001. High specificity in the detection of coexistence between PI and LRIE was demonstrated for NLR (87.33%), with an optimal cut-off value of 3.13. Conclusions: Novel hematological markers (NLR and NPR) are characterized by high specificity in the initial diagnosis of CIED infections, with optimal cut-off values of 3.06 and 0.02. NLR is also useful in the assessment of the spread of infection in patients with PI, with a calculated optimal cut-off value of 3.13. NPR may be helpful in the differentiation of vegetation and vegetation-like masses with an optimal cut-off value of 0.03.

ORGANIZATIONAL AND TECHNOLOGICAL PARAMETERS OF CLAY SOIL MIXING TECHNOLOGY

Purpose. Strengthen the effectiveness of the use of jet and mechanical methods for the preparation of soil-cement reinforcing elements as a factor of increasing efficiency based on the identified interdependencies between technological parameters and other displays of technology. Methodology. Drilling mixing technologies for the production of soil-cement reinforcing elements in industrial and industrial practice are based on clay mechanical and jet methods, which pose significant problems. An assessment of the technical indicators of both technologies has revealed consistent directions for achieving the highest targets. Research in a sufficient amount of the world supports the practice of producing soil-concrete elements in casting machines, for which the laboratory has specially designed and prepared experimental equipment. It’s obvious working parts are to cut the soil with knives and air-cement jets and mix the mixture thoroughly. The pouch exhibits transport and cutting functions of various parameters. According to the indicators of the importance of soil concrete and changing the beam of the molded element, the effectiveness of the method in the presence of a mass of cement injected into the soil and cutting was determined. The dimensions of the element were established after hardening the soil concrete with a stretch of 28 inches in the first place in the soil with subsequent digging, vibrating, and testing for the purpose. Findings. The advantages of the technology of mechanical clay preparation of elements have been established due to the simplified and accessible technology, but the relatively small span of soil-concrete moldings changes the efficiency of the method. Jet technologies give the elements a great grip, but require a unique use of a high vice. Both technologies create low-value soil concrete through varying amounts of water. Originality. The combination of mechanical and jet-powered equipment in one drilling allows for the accumulation of obvious resources, which allows you to put a few technologies into the bag, remove soil-concrete elements of moving indicators. news and productivity. There are also problems with regulating cement and water mixing. Practical value. Based on these steps and the identified optimal cut of the wind jet, the value of soil concrete increases to 12...16 MPa and the span of the elements increases by 120...140 mm.