Overlap Method Research Articles

Application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy

Objective: To explore the application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy. Methods: Overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance is suitable for patients with advanced gastric cancer (clinical stage: cT1b~4aN0~3M0) and esophageal invasion <3 cm, who underwent radical total gastrectomy+ overlap esophagojejunostomy. The main operation procedure was performed as follows: A titanium clip was used for fixation of the full anterior wall of esophagus before overlap esophagojejunostomy, and the side-to-side esophagojejunostomy was performed with the linear stapler under the guidance of gastric tube. Then the titanium clip was removed after confirming that the correct cavity was entered. Finally, the common outlet was closed by two barbed sutures. A descriptive case series study was conducted. The clinical data of patients who underwent laparoscopic radical gastrectomy and overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance in Guangdong Provincial Hospital of Chinese medicine and the First Affiliated Hospital of Guangzhou University of Chinese medicine from May 2021 to June 2023 were retrospectively analyzed. Results: A total of 42 patients were collected, and all of them were successfully completed laparoscopic total radical gastrectomy without conversion to laparotomy or perioperative death. The esophagojejunostomy time, operative time, intraoperative blood loss was 17(5-25) minutes, (258.8±38.0) minutes and 50(20-200) ml, respectively. The incidence of esophageal false lumen was 0%, and there were no intraoperative complications. The time of gastric tube removal, initial fluid diet intake and the duration of postoperative hospital were 2(1-5) , 4(1-8) and 8(4-21) days, respectively. There were no postoperative anastomotic hemorrhage, anastomotic stenosis and other related complications. One patient (2.38%) developed a Clavien-Dindo IIIb complication, which was abdominal hemorrhage after operation. The second surgical exploration confirmed that the patient was bleeding due to gastroduodenal artery rupture. After intraoperative suture hemostasis, fluid expansion, blood transfusion and other treatments, the patient was discharged on the 15th day after the operation. Three patients (7.14%) developed Clavien-Dindo grade II complications, including anastomotic leakage, chylous leakage and pulmonary infection, and were discharged after conservative treatment such as anti-infection and prolonged retention of drainage tube. Conclusions: Laparoscopic overlap method for intracorporeal esophagojejunostomy with anterior esophageal wall fixation and gastric tube guidance can shorten the time of esophagojejunostomy and prevent the occurrence of false lumen, and do not increase anastomose-related complications.

Assessing the Tumor Immune Landscape Across Multiple Spatial Scales to Differentiate Immunotherapy Response in Metastatic Non-Small Cell Lung Cancer

Although immune checkpoint inhibitor-based therapy has shown promising results in non-small cell lung cancer patients with high programmed death-ligand 1 expression, not all patients respond to therapy. The tumor microenvironment (TME) is complex and heterogeneous, making it challenging to understand the key agents and features that influence response to therapies. In this study, we leverage multiplex fluorescent immunohistochemistry to quantitatively assess interactions between tumor and immune cells in an effort to identify patterns occurring at multiple spatial levels of the TME. To do so, we introduce several computational methods novel to a data set of 1,269 multiplex fluorescent immunohistochemistry images from a cohort of 52 patients with metastatic non-small cell lung cancer. With the spatial G-cross function, we quantify the degree of cell interaction at an entire image level, where we see significantly increased activity of cytotoxic T cells and helper T cells with epithelial tumor cells in responders to immune checkpoint inhibitor-based (P = .022 and P < .001, respectively) and decreased activity of T-regulatory cells with epithelial tumor cells compared with nonresponders (P = .010). By leveraging spatial overlap methods, we define tumor subregions (which we call the tumor “periphery,” “edge.” and “center”) and discover more localized immune-immune interactions influencing positive response, including those between cytotoxic T cells and helper T cells with antigen presenting cells in these subregions specifically. Finally, we trained an interpretable deep learning model that identified key cellular regions of interest that most influenced response classification (area under the curve = 0.71 ± 0.02). Assessing spatial interactions within these subregions further revealed new insights that were not significant at the whole image level, particularly the elevated association of antigen presenting cells and T-regulatory cells with one another in responder groups (P = .024). Altogether, we demonstrate that elucidating patterns of cell composition and interplay across multiple levels of spatial analyses can improve our understanding of the TME and better differentiate patient responses to immunotherapy.

Accelerated Computer-Aided Screening of Optical Materials: Investigating the Potential of Δ-SCF Methods to Predict Emission Maxima of Large Dye Molecules.

Accurate simulation of electronic excited states of large chromophores is often difficult due to the computationally expensive nature of existing methods. Common approximations such as fragmentation methods that are routinely applied to ground-state calculations of large molecules are not easily applicable to excited states due to the delocalized nature of electronic excitations in most practical chromophores. Thus, special techniques specific to excited states are needed. Δ-SCF methods are one such approximation that treats excited states in a manner analogous to that for ground-state calculations, accelerating the simulation of excited states. In this work, we employed the popular initial maximum overlap method (IMOM) to avoid the variational collapse of the electronic excited state orbitals to the ground state. We demonstrate that it is possible to obtain emission energies from the first singlet (S1) excited state of many thousands of dye molecules without any external intervention. Spin correction was found to be necessary to obtain accurate excitation and emission energies. Using thousands of dye-like chromophores and various solvents (12,318 combinations), we show that the spin-corrected initial maximum overlap method accurately predicts emission maxima with a mean absolute error of only 0.27 eV. We further improved the predictive accuracy using linear fit-based corrections from individual dye classes to achieve an impressive performance of 0.17 eV. Additionally, we demonstrate that IMOM spin density can be used to identify the dye class of chromophores, enabling improved prediction accuracy for complex dye molecules, such as dyads (chromophores containing moieties from two different dye classes). Finally, the convergence behavior of IMOM excited state SCF calculations is analyzed briefly to identify the chemical space, where IMOM is more likely to fail.

Final results of a randomized controlled trial: comparison of the efficacy and safety between totally laparoscopic and laparoscopic-assisted total gastrectomy for advanced siewert III esophagogastric junction cancer and upper and middle third gastric cancer.

This study aimed to compare the efficacy and safety of TLTG with the overlap technique to LATG in patients with advanced Siewert III Esophagogastric Junction Cancer and upper and middle third gastric cancer. This single-center RCT enrolled 292 patients with the mentioned cancers, randomly assigned to TLTG overlap (n=146) or LATG (n=146) groups. Data on demographics, pathology, intraoperative variables, postoperative complications, recovery parameters, and 3-year survival were collected. Main outcome: postoperative complications within 30 days. Secondary outcomes: 3-year disease-free and overall survival. TLTG versus LATG: TLTG had shorter incision, faster flatus/defecation, reduced analgesia, less opioid use, and shorter hospital stay. Similar operation time, anastomosis time, blood loss, and lymph node harvest. TLTG had lower overall post-op complication rate (P=0.047), no significant difference in serious complications (P=0.310). Variances in anastomotic stenosis occurrence at 3 months. No rehospitalization or mortality at 30 days. No significant differences in 3-month disease-free survival (P=0.058) or overall survival (P=0.236). Overlap method for anastomosis in TLTG is safe and feasible for advanced middle-upper-third gastric cancer, with positive short-term outcomes. This technique has potential as the preferred esophagojejunostomy approach in TLTG. This trial has been registered at Chinese Clinical Trial Registry: XXXXXXXX (registration date: September 4, 2019).

Optimizing sheep B-cell epitopes in Echinococcus granulosus recombinant antigen P29 for vaccine development.

Echinococcus granulosus is a widespread zoonotic parasitic disease, significantly impacting human health and livestock development; however, no vaccine is currently available for humans. Our preliminary studies indicate that recombinant antigen P29 (rEg.P29) is a promising candidate for vaccine. Sheep were immunized with rEg.P29, and venous blood was collected at various time points. Serum was isolated, and the presence of specific antibodies was detected using ELISA. We designed and synthesized a total of 45 B cell monopeptides covering rEg.P29 using the overlap method. ELISA was employed to assess the serum antibodies of the immunized sheep for recognition of these overlapping peptides, leading to the preliminary identification of B cell epitopes. Utilizing these identified epitopes, new single peptides were designed, synthesized, and used to optimize and confirm B-cell epitopes. rEg.P29 effectively induces a sustained antibody response in sheep, particularly characterized by high and stable levels of IgG. Eight B-cell epitopes of were identified, which were mainly distributed in three regions of rEg.P29. Finally, three B cell epitopes were identified and optimized: rEg.P2971-90, rEg.P29151-175, and rEg.P29211-235. These optimized epitopes were well recognized by antibodies in sheep and mice, and the efficacy of these three epitopes significantly increased when they were linked in tandem. Three B-cell epitopes were identified and optimized, and the efficacy of these epitopes was significantly enhanced by tandem connection, which indicated the feasibility of tandem peptide vaccine research. This laid a solid foundation for the development of epitope peptide vaccine for Echinococcus granulosus.

Exploratory study on the impact of intraesophageal pressure on quality of life in patients following total gastrectomy: a retrospective cohort study

BackgroundThe usefulness of high-resolution impedance manometry (HRIM) in patients who underwent total gastrectomy with Roux-en-Y (R-Y) anastomosis has never been well validated. This study aimed to investigate whether intraesophageal pressure affects quality of life in patients who underwent total gastrectomy with R-Y anastomosis.MethodsThe participants comprised 12 patients who underwent total gastrectomy for gastric cancer between October 2014 and July 2022 and underwent a postsurgical HRIM examination. The association between the HRIM data and Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires was analyzed.ResultsEsophageal body motility was normal in almost all patients. The anastomosis shape (circular stapler and overlap method with linear stapler) did not influence intraesophageal pressure. The integrated relaxation pressure and lower esophageal sphincter (LES) residual pressure during swallowing-induced relaxation were involved in “diarrhea subscale” scores (p = 0.0244 and p = 0.0244, respectively). The average maximum intrabolus pressure was not involved in postgastrectomy symptom. The contractile front velocity correlated with the “indigestion subscale,” “diarrhea subscale,” and “constipation subscale” (p = 0.0408, p = 0.0143, and p = 0.0060, respectively). The distal latency, i.e., the time from upper esophageal sphincter relaxation to contractile deceleration, was also associated with the “abdominal pain subscale” (p = 0.0399). LES pressure and esophageal body motility affected patients’ quality of life after total gastrectomy.ConclusionsHRIM for the evaluation of intraesophageal pressure is useful for the functional assessment of esophagojejunostomy with the R-Y reconstruction after total gastrectomy.

Mono-lingual text reuse detection for the Urdu language at lexical level

Text reuse is the process of creating new texts from pre-existing ones. In recent years, Urdu Text Reuse Detection (U-TRD) has garnered the attention of researchers due to the ready availability of digital text all over the internet, which can be copied or paraphrased from other sources without proper attribution, making it easier to reuse but challenging to detect. Previous studies have explored the issue of U-TRD at the phrasal, sentence/passage, and document levels, using benchmark corpora and methods. However, the problem of U-TRD has not been investigated at the lexical level in terms of corpora and methods. To address this research gap, our study has developed a large benchmark corpus manually annotated at the lexical level. This corpus consists of 22,184 text pairs categorized into two levels of rewrite: (1) Derived (8,660) and (2) Non-Derived (13,524). Additionally, our research has involved the development, application, evaluation, and comparison of a range of methods, including baseline methods (uni-gram overlap and word embedding-based methods), along with state-of-the-art transformer-based methods and feature-fusion-based methods, using the proposed UTRD-Lex-23 corpus. Our study concludes that one of our proposed feature-fusion methods outperforms all other methods. The model we propose, which combines seven different Sentence Transformers (ST) (each producing 768 dimension vectors) with one uni-gram (at word level) and sixteen different features extracted from four different Word Embedding (WE) based models (yielding 300 dimension vectors), achieves an F1 score of 0.70601 using 10-fold cross validation. To foster and promote research in Urdu (a low-resourced language) proposed corpus will be freely and publicly available for research purposes.

The Liquid Jet Endstation for Hard X-ray Scattering and Spectroscopy at the Linac Coherent Light Source

The ability to study chemical dynamics on ultrafast timescales has greatly advanced with the introduction of X-ray free electron lasers (XFELs) providing short pulses of intense X-rays tailored to probe atomic structure and electronic configuration. Fully exploiting the full potential of XFELs requires specialized experimental endstations along with the development of techniques and methods to successfully carry out experiments. The liquid jet endstation (LJE) at the Linac Coherent Light Source (LCLS) has been developed to study photochemistry and biochemistry in solution systems using a combination of X-ray solution scattering (XSS), X-ray absorption spectroscopy (XAS), and X-ray emission spectroscopy (XES). The pump–probe setup utilizes an optical laser to excite the sample, which is subsequently probed by a hard X-ray pulse to resolve structural and electronic dynamics at their intrinsic femtosecond timescales. The LJE ensures reliable sample delivery to the X-ray interaction point via various liquid jets, enabling rapid replenishment of thin samples with millimolar concentrations and low sample volumes at the 120 Hz repetition rate of the LCLS beam. This paper provides a detailed description of the LJE design and of the techniques it enables, with an emphasis on the diagnostics required for real-time monitoring of the liquid jet and on the spatiotemporal overlap methods used to optimize the signal. Additionally, various scientific examples are discussed, highlighting the versatility of the LJE.

Impacts of water regulation through a reservoir on drought dynamics and propagation in the Pilica River watershed

Study regionThe Pilica River watershed, located in central Poland, is the largest left tributary of the Vistula River basin. Study focusThe study aims to assess the impact of human activities on drought dynamics by considering the specific role of the Sulejów Reservoir. Identifying factors contributing to drought development is essential for decision-makers to implement appropriate management measures. The temporal overlap method is used to distinguish between climate and human-driven droughts. The changes in drought propagation are assessed using the time shift method at various accumulation time scales. To assess the spatial distribution of drought, we applied the Soil and Water Assessment Tool (SWAT) model to simulate soil moisture and streamflow response at a spatial scale. New hydrological insights for the regionThe findings highlight that about 75% of meteorological droughts lead to soil moisture droughts, and about 70% result in hydrological droughts. The results show the contribution of human activities to soil moisture drought (∼25%) and hydrological drought (∼10%), indicating that not all droughts are driven by meteorological factors alone. The key finding suggests a shorter and longer time scale of around 3 and 12 months for soil moisture drought and hydrological drought propagation analysis, respectively. Moreover, the decrease in the duration and severity of drought during 2005–2019 compared to 1997–2004 suggests that the magnitude of the reservoir impact depends on its purpose and operational strategies.

Accelerating the middle – rise building construction duration using BIM 4D, a case study in central Jakarta

Construction planning involves scheduling and sequencing of project activities for proper execution. Research was conducted to obtain and enhance construction project scheduling, which was good and in accordance with the targets achieved. The results of the project performance analysis in the 9th month using the Earned Value Method resulted in SPI <1 and SV <0, indicating that the project experienced delays. Scheduling using the PDM based on the actual duration of the project shows that the project will be completed in 511 days. The project duration can be accelerated to 429 days by combining overlap and overtime methods. The scheduling results were simulated using BIM 4D to generate a visualization of the scheduling to improve the project monitoring process.

Evaluating the strength of evidence of elemental profiling of polymers with LA-ICP-MS

LA-ICP-MS is a powerful technique for obtaining a forensic elemental profile of polymer evidence materials. However, the lack of homogeneous polymer reference standards hampers database creation and reliably matching a sample to a specific source. Therefore, the current study aims to evaluate the strength of evidence of forensic polymer comparisons by applying a matrix-matched reference standard with known concentrations for elements of interest. Four datasets of tapes, electrical wires, tubing, and jerrycans were compiled using LA-ICP-MS. It was found that quantification with the new PVC standard or by simply using the response of one element as internal standard significantly reduced the between-run variation. For each class of polymeric materials, characteristic elements could be identified with PCA and LDA. To facilitate classification, elemental concentrations were found to be typical for specific colors and types of polymeric materials. For forensic comparison, a score-based Bayesian likelihood ratio model and the t-test overlap method performed better than the feature-based model and 4-sigma criterion, in terms of rates of misleading evidence. Normalization to 13C and quantification with the PVC standard with and without prior normalization to 13C slightly reduced rates of misleading evidence. The t-test method showed an overall average false inclusion rate of only 0.45% and a false exclusion rate of 2.4%. Maximum calibrated likelihood ratios of 0.014 to 1778 were found for the tape dataset. In conclusion, this study demonstrates that with the use of proper standards, quantitative elemental profiling with LA-ICP-MS is a promising tool for forensic classification and comparison of polymers.

An interactive visualization tool for educational outreach in protein contact map overlap analysis.

Recent advancements in contact map-based protein three-dimensional (3D) structure prediction have been driven by the evolution of deep learning algorithms. However, the gap in accessible software tools for novices in this domain remains a significant challenge. This study introduces GoFold, a novel, standalone graphical user interface (GUI) designed for beginners to perform contact map overlap (CMO) problems for better template selection. Unlike existing tools that cater more to research needs or assume foundational knowledge, GoFold offers an intuitive, user-friendly platform with comprehensive tutorials. It stands out in its ability to visually represent the CMO problem, allowing users to input proteins in various formats and explore the CMO problem. The educational value of GoFold is demonstrated through benchmarking against the state-of-the-art contact map overlap method, map_align, using two datasets: PSICOV and CAMEO. GoFold exhibits superior performance in terms of TM-score and Z-score metrics across diverse qualities of contact maps and target difficulties. Notably, GoFold runs efficiently on personal computers without any third-party dependencies, thereby making it accessible to the general public for promoting citizen science. The tool is freely available for download for macOS, Linux, and Windows.

The Multi–Disaster risk assessment: A-GIS based approach for Izmir City

Urban settlements currently face many disasters that are increasing in number and frequency every day such as floods, landslides, sea level rise, storms, drought, forest fires, etc. due to the negative consequences of global climate change caused by significantly exceeding the carrying capacity of nature. Cities are currently becoming less resistant to disaster risks because of the unhealthy settlements. These settlements are becoming widespread in terms of physical, economic and social conditions as a natural result of the urbanization in which planning processes are carried out in an uncontrolled and unsupervised manner. This situation makes it a necessity to develop strategies and policies aimed at reducing and/or eliminating possible disaster damages which are defined as high risk. From this viewpoint, the study aims to reveal the current disaster risks in urban areas with a dense population and building stock. Izmir city is determined as the study area. Spatial analyses are performed for disaster risk by using Geographical Information Systems (GIS) tools and Weighted Overlap method considering the natural and built environment elements that significantly affect the disaster risk. The findings obtained from the study and the determinations made within the scope of the Izmir Provincial Disaster Risk Reduction Plan (IRAP) prepared by the Disaster and Emergency Management Presidency (AFAD) are evaluated comparatively. As a result, it has been seen that the determinations put forward for disaster risks have shown consistency throughout Izmir city and the studies carried out at the local level have been prioritized in such a way as to be aimed at risk management and prevention planning by the time.

The effects of venovenous bypass use in liver transplantation with piggyback technique: a propensity score-weighted analysis.

Venovenous bypass (VVB) use during liver transplantation (LT) is notably variable among the centres and it is actually restricted to surgically complex cases, severely unstable recipients or grafts from high-risk donors. Historically, VVB was associated with the classical LT with caval cross clamping, while not much is known about the safety of this technique applied to piggyback LT. This retrospective observational study evaluated the effects of VVB applied to piggyback LT on mortality, hospital outcomes, postoperative graft and other organ dysfunction. We retrospectively collected data about recipient status, surgical complexity and graft quality of all the piggyback LTs performed at the Transplant Unit of IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy, from January 2012 to December 2022. A propensity score (PS) was built taking into account the variables possibly associated with either VVB choice and the investigated outcomes with the average treatment overlap method. PS-weighted general linear models (GLMs) were developed to investigate the adjusted effect of VVB use on the selected outcomes. The final analysis included 874 LT cases, of whom 74 (8.5%) underwent VVB. The effective sample sizes after PS-weighting were 280.2 and 64.3 patients in the no-VVB and VVB groups, respectively. PS-weighted GLMs did not show any differences regarding hospital and graft-related outcomes. However, significantly higher odds ratios for serum creatinine > 2mg/dL and AKIN stage 2 or 3 during the first 24h after ICU admission together with a higher renal replacement therapy need during ICU stay were reported for VVB exposure in the weighted analyses. This study suggests similar mortality and length of stay but a higher risk for postoperative acute kidney injury in patients undergoing piggyback LT with VVB.

Investigation of nanocomposite PNIPAm‐g‐graphene with pre‐lower critical solution temperature rapid thermal response function for chip adaptive cooling: A molecular dynamics and computational fluid dynamics simulations

AbstractTemperature‐sensitive hydrogels have been widely used for rapid adaptive cooling in electronic device thermal management with promising applications. However, existing temperature‐sensitive hydrogels can only regulate the flow in the chip cooling system after the ambient temperature reaches their lower critical solution temperature (LCST). Before reaching LCST, effective rapid heat dissipation for electronic chips is not achievable. This study aims to develop a temperature‐sensitive hydrogel that can provide assisted adaptive cooling for electronic chips before reaching its LCST. This requires the hydrogel to have a thermal conductivity far surpassing existing hydrogel materials. Using the temperature‐sensitive hydrogel PNIPAm and graphene molecules as base materials, this research utilized molecular dynamics simulations to graft graphene molecules onto PNIPAm molecules in different ways, resulting in the temperature‐sensitive hydrogel material PNIPAm‐g‐graphene. Non‐equilibrium molecular dynamics (NEMD) was employed to calculate the thermal conductivity of this material under different temperature conditions. The results indicate that the thermal conductivity of PNIPAm‐g‐graphene can reach up to 1.95474 W/m K (graphene grafted at CH3 functional group, temperature at 280 K). Compared to the thermal conductivity of PNIPAm under the same conditions (0.45 W/m K), the increase in thermal conductivity is significant, demonstrating excellent thermal conductivity compared to PNIPAm. Subsequently, this study analyzed the underlying mechanisms of different thermal conductivities in materials obtained by grafting graphene molecules at different points using the method of overlap in Phonon Density of States Curves (PDOS) from the perspective of interfacial thermal conduction. Finally, through computational fluid dynamics (CFD) simulations, this study investigates the chip's adaptive cooling performance with PNIPAm‐g‐graphene material. The results show that, compared to traditional temperature‐sensitive hydrogels, PNIPAm‐g‐graphene can achieve efficient adaptive cooling of chip hotspots before the cooling fluid temperature reaches its LCST value. This finding is significant for the field of chip cooling. The study proposes a new method for rapid, adaptive cooling of chip hotspots and explores its feasibility from the perspectives of molecular dynamics and CFD simulation. It holds importance in the thermal management of electronic devices and the rapid adaptive cooling of electronic chips.

Benchmarking DFT-based excited-state methods for intermolecular charge-transfer excitations.

Intermolecular charge-transfer is a highly important process in biology and energy-conversion applications where generated charges need to be transported over several moieties. However, its theoretical description is challenging since the high accuracy required to describe these excited states must be accessible for calculations on large molecular systems. In this benchmark study, we identify reliable low-scaling computational methods for this task. Our reference results were obtained from highly accurate wavefunction calculations that restrict the size of the benchmark systems. However, the density-functional theory based methods that we identify as accurate can be applied to much larger systems. Since targeting charge-transfer states requires the unambiguous classification of an excited state, we first analyze several charge-transfer descriptors for their reliability concerning intermolecular charge-transfer and single out the charge-transfer distance calculated based on the variation of electron density upon excitation (DCT) as an optimal choice for our purposes. In general, best results are obtained for orbital-optimized methods and among those, the maximum overlap method proved to be the most numerically stable variant when using the initial MOs as reference orbitals. Favorable error cancellation with optimally-tuned range-separated hybrid functionals and a rather small basis set can provide an economical yet reasonable wavefunction when using time-dependent density functional theory, which provides relevant information about the excited-state character to be used in the orbital-optimized methods. The qualitative agreement makes these fast calculations attractive for high-throughput screening applications.

Inter-software and inter-threshold reliability of quantitative paraspinal muscle segmentation

PurposeChanges in the cross-sectional area (CSA) and functional cross-sectional area (FCSA) of the lumbar multifidus (MF) and erector spinae muscles (ES) are factors that can contribute to low back pain. For the assessment of muscle CSA and composition there are various software and threshold methods used for tissue segmentation in quantitative analysis. However, there is currently no gold standard for software as well as muscle segmentation. This study aims to analyze the measurement error between different image processing software and different threshold methods for muscle segmentation.MethodsMagnetic resonance images (MRI) of 60 patients were evaluated. Muscle CSA and FCSA measurements were acquired from axial T2-weighted MRI of the MF and ES at L4/L5 and L5/S1. CSA, FCSA, and FCSA/CSA ratio were measured independently by two observers. The MRI images were measured using two different software programs (ImageJ and Amira) and with two threshold methods (Circle/Overlap method) for each software to evaluate FCSA and FCSA/CSA ratio.ResultsInter-software comparisons revealed high inter-rater reliability. However, poor inter-rater reliability were obtained with different threshold methods. CSA, FCSA, and FCSA/CSA showed excellent inter-software agreement of 0.75–0.99 regardless of the threshold segmentation method. The inter-rater reliability between the two observers ranged between 0.75 and 0.99. Comparison of the two segmentation methods revealed agreement between 0.19 and 0.84. FCSA and FCSA/CSA measured via the Overlap method were significantly higher than those measured via the Circle method (P < 0.01).ConclusionThe present study showed a high degree of reliability with very good agreement between the two software programs. However, study results based on different threshold methods should not be directly compared.

Waveform systematics in identifying strongly gravitationally lensed gravitational waves: posterior overlap method

Gravitational lensing has been extensively observed for electromagnetic signals, but not yet for gravitational waves (GWs). Detecting lensed GWs will have many astrophysical and cosmological applications, and becomes more feasible as the sensitivity of the ground-based detectors improves. One of the missing ingredients to robustly identify lensed GWs is to ensure that the statistical tests used are robust under the choice of underlying waveform models. We present the first systematic study of possible waveform systematics in identifying candidates for strongly lensed GW event pairs, focusing on the posterior overlap method. To this end, we compare Bayes factors from all posteriors using different waveforms included in GWTC data releases from the first three observing runs (O1–O3). We find that waveform choice yields a wide spread of Bayes factors in some cases. However, it is likely that no event pairs from O1 to O3 were missed due to waveform choice. We also perform parameter estimation with additional waveforms for interesting cases, to understand the observed differences. We also briefly explore if computing the overlap from different runs for the same event can be a useful metric for waveform systematics or sampler issues, independent of the lensing scenario.

Cusp overlap method for self-expanding transcatheter aortic valve replacement.

Conduction disturbances and the need for permanent pacemaker (PPM) implantation remains a common complication for transcatheter aortic valve replacement (TAVR), particularly when self-expanding (SE) valves are used. We compared in-hospital and 30-day rates of new PPM implantation between patients undergoing TAVR with SE valves using the conventional three-cusp coplanar implantation technique and the cusp-overlap technique. We retrospectively compared patients without a pre-existing PPM who underwent a TAVR procedure with SE Evolut R or PRO valves using the cusp-overlap technique from July 2018 to September 2020 (n = 519) to patients who underwent TAVR using standard three-cusp technique from April 2016 to March 2017 (n = 128) in two high volume Canadian centers. There was no significant difference in baseline RBBB between the groups (10.4% vs. 13.2; p = 0.35). The rate of in-hospital new complete heart block (9.4% vs. 23.4%; p ≤ 0.001) and PPM implantation (8% vs. 21%; p ≤ 0.001) were significantly reduced when using the cusp-overlap technique. The incidence of new LBBB (30.4% vs. 29%; p = 0.73) was similar. At 30 days, the rates of new complete heart block (11% vs. 23%; p ≤ 0.001) and PPM implantation (10% vs. 21%, p ≤ 0.001) remained significantly lower in the cusp-overlap group, while the rate of new LBBB (35% vs. 30%; p = 0.73) was similar. Cusp-overlap approach offers several potential technical advantages compared to standard three-cusp view, and may result in lower PPM rates in TAVR with SE Evolut valve.

Application of overlap anastomosis in digestive tract reconstruction during minimally invasive Ivor-Lewis esophagectomy.

This study aims to assess the feasibility of the Overlap anastomosis technique in minimally invasive Ivor-Lewis esophagectomy. An accompanying video presentation elucidates our surgical procedures. A retrospective review of 46 patients diagnosed with middle and lower esophageal cancer was conducted. These patients underwent minimally invasive Ivor-Lewis esophagectomy with Overlap anastomosis between January 2019 and December 2020. A consistent team of surgeons performed all procedures. The initial phase involved laparoscopic stomach mobilization, intra-abdominal lymphadenectomies, and preparation of the tubular stomach. Subsequently, with the patient in the left decubitus position, thoracoscopy was used to dissect the esophagus, excise the diseased segment, and conduct mediastinal lymph node dissection. The final stage encompassed the intrathoracic gastroesophageal anastomosis using the Overlap method. All surgeries were completed without converting to an open approach, achieving complete resection. There were no operative fatalities, with an average surgery duration of 259.4min. Average statistics included intraoperative blood loss of 92.3ml, 16.2 lymph nodes dissected, and a postoperative hospital stay of 10.3days. Postoperative complications comprised three instances of hoarseness due to recurrent laryngeal nerve palsy, two cases of aspiration pneumonia, one occurrence of chylothorax, and one gastric emptying disorder. Anastomotic technique-related complications were minimal, with only one patient experiencing an anastomotic leak that resolved spontaneously and two patients facing anastomotic stenosis, which was subsequently alleviated. Our findings posit that the Overlap anastomosis method is safe and efficient for minimally invasive Ivor-Lewis esophagectomy, marked by a notably low rate of anastomosis-related complications. Further evaluation of its long-term implications remains necessary.