Perform Sensitivity Analysis Research Articles

Uncertainty quantification of material parameters in modeling coupled metal and high explosive experiments

Experiments involving the coupling of metal and high explosives (HE) are of notable defense-related interest, and we seek to refine the uncertainty quantification associated with models of such experiments. In particular, our focus is on how uncertainty related to the metal constitutive model challenges our ability to infer high explosive model parameters when analyzing focused science experiments. We consider three focused experiments involving an HE accelerating metal: small plate tests with tantalum/LX-14 and tantalum/LX-17 pairings as well as a tantalum/LX-17 cylinder test. For all three models, we perform sensitivity analysis to ascertain the influence of metal strength on the coupled experimental response. Moreover, we calibrate each model in a Bayesian setting and study the quantification of metal strength on the inference of the HE parameters. Based on our results, we offer guidance for future metal/HE experiments.

Abstract 4138335: A drug target Mendelian randomization study of triglyceride lowering therapies for aortic stenosis

Introduction: Large observational and Mendelian randomization (MR) studies have demonstrated a strong association between elevated triglycerides (TG) and risk of aortic stenosis (AS). However, at present there remains no evidence for the use of lipid-lowering therapies to prevent or treat AS. To address this gap, we used a drug target MR approach to investigate whether emerging TG lowering therapies may reduce the risk of AS. Methods: We collected summary statistics for TG levels and AS from genome-wide association studies including 1,253,277 and 653,867 European participants, respectively. We first performed conventional MR techniques to investigate a causal relationship between TG levels and AS risk. Next, we identified genetic proxies for the TG-lowering therapies fenofibrate, volanesorsen and evinacumab as single nucleotide polymorphisms (SNPs) within 200kb of the target genes ( PPARA, APOC3 and ANGPTL3 , respectively) which were also significantly associated with TG at p<5x10 -8 and clumped using threshold r 2 <0.1. Inverse-variance weighted (IVW) was the primary analysis method. We then performed sensitivity analyses including weighted-median and MR-Egger. Additional outlier-exclusion analyses were performed using MR-PRESSO and Cook’s distance. Finally, we completed sensitivity analyses using a more stringent clumping threshold of r 2 <0.01. Results: Consistent with previous findings we found genetically predicted TG levels were significantly associated with increased risk of AS (IVW: OR 1.28 per standard deviation increase in genetically predicted log TG level, 95% CI 1.18-1.39, p<0.0001). We further found that genetically proxied volanesorsen was significantly associated with reduced risk of AS (OR 0.54, 95% CI 0.39-0.75, p=0.0002), which was robust in all sensitivity analyses. We did not find evidence of a causal relationship between genetically proxied fenofibrate (IVW: OR 0.50, 95% CI 0.09-2.76, p=0.43) or evinacumab (IVW: OR 1.03, 95% CI 0.73-1.44, p=0.88) and risk of AS. Conclusions: Genetically proxied APOC3 inhibition, but not PPARA or ANGPTL3 , was robustly associated with reduced risk of AS. This suggests that APOC3 inhibition may be a therapeutic opportunity for AS management and warrants further research in the clinical trial setting.

Open versus robotic transversus abdominis release for ventral hernia repair: an updated systematic review, meta-analysis, and meta-regression.

Posterior component separation using transversus abdominis release (TAR) is well established as an option for repair of large hernia defects. TAR can be performed robotically (rTAR) or open (oTAR) with limited data to demonstrate benefit and guide decision making. We conducted a systematic review and meta-analysis comparing rTAR and oTAR approaches for ventral hernia repair (VHR). We searched Pubmed, Embase, Cochrane, and Web of Science for studies comparing rTAR and oTAR for VHR. Hybrid rTAR was not included in our analysis. Our primary outcomes were overall postoperative and intraoperative complications, surgical site occurrences (SSO), SSO requiring surgical intervention (SSOPI), surgical site infection (SSI) superficial or deep, and fascial closure. Additional outcomes were operative time (OT), readmission, length of hospital stay (LOS). We performed sensitivity analysis to explore reasons for heterogeneity and outliers, and a proportional meta-analysis of conversion during rTAR. We performed a meta-regression exploring the relationship of BMI, hernia defect and mesh width rTAR/oTAR with the analyzed outcome within each study. 503 studies were screened and seven studies were included in this analysis. Our sample totaled 780 patients, of which 298 (38.2%) underwent rTAR. Defect width ranged between 8.7 to 13.5cm (cm) for rTAR and 10 to 13.5cm for oTAR. Mean mesh area ranged from 66.9 to 980cm2 and from 51.3 to 1344cm2 for rTAR and oTAR respectively. We found lower overall complications (9% versus 24.6%; RR 0.43; 95% CI 0.26 to 0.73; P < 0.01) and intraoperative complication (5.9% versus 9.1%; RR 0.44; 95% CI 0.22 to 0.88; P = 0.02) rates for the rTAR group. There was no difference in fascial closure between the groups (99% versus 94.6%; RR 1.05; 95% CI 0.99 to 1.11; P = 0.11). rTAR presented lower SSI rates (2.5% versus 7.8%; RR 0.33; 95% CI 0.13 to 0.8; P = 0.01). No differences were found in SSO (16.3% versus 13.7%; RR 0.87; 95% CI 0.51 to 1.48; P = 0.6) or SSOPI (5.4% versus 8.9%%; RR 0.5; 95% CI 0.22 to 1.15; P = 0.1) rates. No statistically significant differences were found in superficial SSI (0.76% versus 3%; RR 0.36; 95% CI 0.07 to 1.75; P = 0.21) and deep SSI (0% versus 4.2%; RR 0.23; 95% CI 0.02 to 3.12; P = 0.27). Open surgery presented a lower OT (MD -67.7min; P < 0.001), but robotic surgery showed a reduced LOS (-3.9days; 95% CI -4.8 to -3.1; P < 0.001). No differences were found in readmission and 1year recurrence rates. The proportional meta-analysis showed a conversion to open rate of 6.4 per 100 patients (95% CI 3.3 to 12 patients) during rTAR. Meta-regression presented no statistically significant influences of rTAR/oTAR mesh width and defect width relations and BMI, despite the analysis was limited by the low number of studies. Robotic TAR may be associated with lower intraoperative and postoperative complications, lower SSI, shorter LOS, and longer operative times when compared to oTAR. Given the limitations of the included studies, randomized trials are needed to better evaluate the impact of the robotic-assisted surgery for complex abdominal wall reconstruction. CRD42024540991.

MR Corge: Sensitivity analysis of Mendelian randomization based on the core gene hypothesis for polygenic exposures.

Mendelian randomization is being utilized to assess causal effects of polygenic exposures, where many genetic instruments are subject to horizontal pleiotropy. Existing methods for detecting and correcting for horizontal pleiotropy have important assumptions that may not be fulfilled. Built upon the core gene hypothesis, we developed MR Corge for performing sensitivity analysis of Mendelian randomization. MR Corge identifies a small number of putative core instruments that are more likely to affect genes with a direct biological role in an exposure and obtains causal effect estimates based on these instruments, thereby reducing the risk of horizontal pleiotropy. Using positive and negative controls, we demonstrated that MR Corge estimates aligned with established biomedical knowledge and the results of randomized controlled trials. MR Corge may be widely applied to investigate polygenic exposure-outcome relationships. An open-sourced R package is available at https://github.com/zhwm/MRCorge. Supplementary data are available at Bioinformatics online.

A comparison of stochastic and deterministic dynamics of tuberculosis model

Tuberculosis is a deadly infectious disease leading to a major health concern in Southern India while there are major obstacles to controlling its spread. Here, we present a mathematical model with five compartments. We categorize the infected compartment into two subcategories: latent TB-infected individuals and active TB-infected individuals. By introducing white noise in a deterministic system, we formulate a stochastic system. We investigate the model in deterministic and stochastic framework, followed by data calibration using TB infection data from Kanyakumari District in South India from 2019 to 2023. In the deterministic model, we derive the disease-free and endemic equilibrium points, compute the basic reproduction number, and examine their stability. Moreover, we perform sensitivity analysis to evaluate how variations in model parameters affect TB prevalence. In addition, we study the uniqueness of solutions of stochastic model. After that we derive the conditions for disease extinction and stochastic permanence, and execute extensive simulations to capture the variability and randomness in TB transmission dynamics. This study signifies that stochastic dynamics is richer than deterministic one in the way of mitigation TB transmission.

Skimmed milk intake reduces the risk of ER− breast cancer: a Mendelian randomization analysis

BackgroundIn prior observational investigations, it has been demonstrated that the consumption of milk is associated with the incidence of breast cancer (BC). Despite the existence of a two-sample Mendelian randomization (MR) that suggests a causal relationship between milk intake and breast cancer risk, the outcomes still lack a definitive conclusion. This ambiguity may be attributed to variables such as the variety of milk ingested, estrogen levels, the specific type of BC, and potential confounding factors. Therefore, our principal objective is to establish the causal association between the consumption of skimmed milk and full cream milk and the risk of different types of BC through the utilization of two-sample and two-step MR analyses.MethodsIn this study, we analyzed single nucleotide polymorphisms associated with skimmed and full-cream milk consumption in a cohort of 360,806 individuals from European populations through genome-wide association studies. We conducted a two-sample MR analysis using three different methods: inverse variance weighting (IVW) was used as the main analysis, and MR-Egger and Weighted median were used as supplementary analyses to IVW. We also performed sensitivity analysis, which included leave-one-out analysis, Cochran's Q test to detect heterogeneity, and MR-Egger intercept analysis to detect potential biases caused by pleiotropy. We used two-step MR analysis to evaluate potential mediators of associations.ResultsIn the two-sample MR analysis, IVW analysis suggests a potential inverse causal relationship between skimmed milk and BC [OR 0.34, 95% CI (0.12–1.00), P = 0.05]. Subgroup analysis revealed that skimmed milk reduces the risk of estrogen receptor-negative (ER−) breast cancer [OR 0.18, 95% CI (0.04–0.90), P = 0.04], but not estrogen receptor-positive (ER+) breast cancer [OR 0.42, 95% CI (0.15–1.22), P = 0.11]. MR Egger reached similar results, that is, skimmed milk reduces the risk of ER− breast cancer [OR 0.006, 95% CI (0.00–0.70), P = 0.04], but not BC [OR 0.16, 95% CI (0.01–4.66), P = 0.30] and ER+ breast cancer [OR 0.50, 95% CI (0.02–12.61), P = 0.65]. Additionally, we found no causal relationship between full cream milk and BC (P > 0.05). In two-step MR analysis, we found evidence for a mediating role of BMI in the relationship between skimmed milk intake and ER-breast cancer risk.ConclusionOur findings strengthen the evidence for a protective effect of skimmed milk consumption on ER-breast cancer risk. Further two-step MR analyses suggest that this protective effect may partly result from body mass index (BMI). There is no evidence that full cream milk consumption affects the risk of BC.

Performance sensitivity analysis and aerodynamic optimization of compressor cascades by a turbulence adjoint method

Sensitivity, which is useful for evaluating the contributions of input variations to output changes, favors designers exploiting the most sensitive design parameters and completing design optimization in aerospace. This study introduces the turbulence adjoint method due to its low computational cost in calculating sensitivities with high accuracy and then solves the adjoint partial differential equations with respect to both the Reynolds-averaged Navier–Stokes and turbulence model equations with the assistance of an automatic differentiation tool. By utilizing the turbulence adjoint method, the sensitivities of aerodynamic performance to the blade profile modifications of two-dimensional and three-dimensional compressor cascades are calculated, allowing for the investigations of the impact of geometric variations on the changes in the flow field. Ultimately, aerodynamic optimization of the compressor cascades is conducted. After optimization, the adiabatic efficiency of the two-dimensional cascade increases by 3.11%, and it increases by 1.15% for the three-dimensional cascade. The variations in flow fields of both the original and optimized cascades are illustrated to discover the origins of performance improvements. The changes in blade profile are almost consistent with those forecasted from sensitivity analysis, demonstrating the potential superiority of the adjoint method for aerodynamic design.

Machine Learning Visualization Tool for Exploring Parameterized Hydrodynamics

Abstract We are interested in the computational study of shock hydrodynamics, i.e. problems involving compressible solids, liquids, and gases that undergo large deformation. These problems are dynamic and nonlinear and can exhibit complex instabilities. Due to advances in high performance computing it is possible to parameterize a hydrodynamic problem and perform a computational study yielding Ο(TB) of simulation state data. We present an interactive machine learning tool that can be used to compress, browse, and interpolate these large simulation datasets. This tool allows computational scientists and researchers to quickly visualize "what-if" situations, perform sensitivity analyses, and optimize complex hydrodynamic experiments.

A semi-definite optimization method for maximizing the shared band gap of topological photonic crystals

Topological photonic crystals (PCs) can support robust edge modes to transport electromagnetic energy in an efficient manner. Such edge modes are the eigenmodes of the PDE operator for a joint optical structure formed by connecting together two photonic crystals with distinct topological invariants, and the corresponding eigenfrequencies are located in the shared band gap of two individual photonic crystals. This work is concerned with maximizing the shared band gap of two photonic crystals with different topological features in order to increase the bandwidth of the edge modes. We develop a semi-definite optimization framework for the underlying optimal design problem, which enables efficient update of dielectric functions at each time step while respecting symmetry constraints and, when necessary, the constraints on topological invariants. At each iteration, we perform sensitivity analysis of the band gap function and the topological invariant constraint function to linearize the optimization problem and solve a convex semi-definite programming (SDP) problem efficiently. Numerical examples show that the proposed algorithm is superior in generating optimized optical structures with robust edge modes.

Efficacy and safety of P2Y12 inhibitors plus aspirin versus aspirin alone in ischemic stroke or high-risk transient ischemic attack: a meta-analysis of randomized controlled trials

Abstract Background Patients with mild ischemic stroke or transient ischemic attack (TIA) have an increased risk of recurrent stroke within 90 days after the onset of the initial thrombotic event. Antiplatelet therapy plays an essential role in reducing the risk of stroke recurrence. However, data regarding the efficacy and safety of dual antiplatelet therapy (DAPT) with P2Y12 inhibitors (clopidogrel/ticagrelor) and aspirin versus aspirin monotherapy is limited. Purpose We performed an updated systematic review and meta-analysis to evaluate the effectiveness of DAPT versus aspirin monotherapy in patients with mild ischemic stroke or TIA in the light of new published evidence. Moreover, we investigated whether antiplatelet therapy started within 72 hours is effective in reducing recurrent stroke as compared to the conventionally used 24-hour time window for initiating DAPT. Methods PubMed/MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) that compared DAPT with aspirin plus clopidogrel to aspirin alone started within 24 hours or 72 hours in patients with acute mild ischemic stroke or high-risk TIA from inception to December 31st, 2023. A random-effects model was used to pool risk ratios (RRs) and 95% confidence intervals (CIs) for clinical endpoints. Results Five RCTs with 27,563 patients were included in this study. DAPT significantly reduced the risk of recurrent stroke by 23% (RR: 0.77; 95% CI: 0.70-0.83; p&amp;lt;0.00001), ischemic stroke by 26% (RR: 0.74; 95% CI: 0.68-0.81; p&amp;lt;0.00001), and major adverse cardiovascular events (MACE) by 23% (RR: 0.77; 95% CI: 0.71-0.84; p&amp;lt;0.00001). However, DAPT was associated with a significantly increased risk of moderate or severe bleeding (RR: 2.19; 95% CI: 1.38-3.48; p=0.0009) and hemorrhagic stroke (RR: 2.08; 95% CI: 1.13-3.82; p=0.02). No significant differences were observed for all-cause death (RR: 1.28; 95% CI: 0.95-1.71; p=0.10), cardiovascular death (RR: 1.38; 95% CI: 0.81-2.33; p=0.23), and myocardial infarction (RR: 1.63; 95% CI: 0.77-3.46; p=0.20). We performed sensitivity analysis based on the hazard ratio reported by RCTs which showed comparable results. Subgroup analysis based on treatment onset time (therapy initiation within 24 hours of thrombotic event vs therapy initiation within 72 hours of thrombotic event) showed that both strategies were effective in reducing the risk of recurrent stroke. Subgroup analysis based on the duration of DAPT (21 days vs. 90 days) showed that DAPT for 90 days was associated with an increased risk of moderate or severe bleeding as compared to therapy lasting for 21 days. Conclusion DAPT with P2Y12 inhibitors and aspirin reduces the risk of recurrent stroke and MACE but is associated with an increased risk of moderate or severe bleeding.

First trimester maternal infections and offspring congenital heart defects: a systematic review and meta-analysis

Abstract Background Maternal infections early in pregnancy have been proposed as playing a role in the development of congenital heart defects. We aimed to summarise contemporary evidence regarding the association between first-trimester maternal infection and risk of offspring congenital heart defects. Methods For this systematic review and meta-analysis, we searched Medline and Embase for studies reporting associations of at least one measure of maternal infection during pregnancy and offspring congenital heart disease in humans and published in English between January 1, 1990 and February 13, 2024. Studies were eligible for inclusion if they reported rates of offspring congenital heart defects among both infected and non-infected mothers, and included a minimum of 50 offspring with congenital heart defects. We stratified associations by type of infection and type of heart defect when data from at least two studies were available. We used inverse variance weighted random-effect meta-analyses to pool the estimates. In main analyses, we pooled crude estimates from studies reporting maternal infections during the first trimester of pregnancy. We performed sensitivity analyses to include studies that i) investigated infections later in pregnancy or at unspecified time-points, and ii) adjusted for potential confounders such as maternal age, socioeconomic status, or ethnicity. Findings: We identified 11 studies (7 case control studies, 4 cohort studies) with data from 1,805,115 pregnancies. Nine of these studies assessed maternal infectious status through self-reported questionnaires or medical records, two used laboratory antibody testing and three reported on specific infectious pathogens. Studies reported on various types of bacterial and viral infections, including influenza, urinary tract infections, cytomegalovirus, herpes simplex virus, or chlamydia, with varying effect sizes. Ten studies reported a positive association between maternal infection variables and offspring congenital heart defects, with a pooled odds ratio (OR) and 95% confidence interval of 1.56 (1.27, 1.91) across all types of infections. Associations differed by individual subtype of congenital heart defects, with ORs ranging from 1.28 (0.89, 1.85) for pulmonary atresia to 1.75 (1.23, 2.49) for ventricular septal defects. Sensitivity analyses that included infections measured later in pregnancy, or adjusted rates for potential confounders, showed broadly similar trends but attenuated effect sizes. Interpretation: First trimester maternal infections are associated with increased risk of congenital heart defects. Associations appear to vary by type of infection and type of congenital heart defect, and to extend beyond infections commonly tested for during routine pregnancy screening. Larger-scale studies are warranted to confirm these findings using laboratory antibody testing and investigating how these associations vary by specific pathogens and subtypes of congenital heart defects.

Effectiveness of an Impella versus intra-aortic balloon pump in patients who received extracorporeal membrane oxygenation: a nationwide inpatient database study

Abstract Background/Introduction Previous studies have suggested that left ventricular (LV) unloading with an intra-aortic balloon pump (IABP) or percutaneous ventricular assist device (Impella) in combination with extracorporeal membrane oxygenation (ECMO) is associated with lower mortality; however, it is unclear which is better. Purpose This study aimed to evaluate the effectiveness of LV unloading with an Impella versus IABP on in-hospital mortality and other clinical outcomes. Methods Using the Japanese Diagnosis Procedure Combination database from September 28, 2016, to March 31, 2022, we identified inpatients who received an Impella or IABP in combination with ECMO (ECPella or ECMO+IABP group, respectively). The primary outcome was in-hospital mortality and the secondary outcomes were the length of hospital stay, length of ECMO, total hospitalization cost, and complications including major bleeding, an ischemic stroke, vascular complications, and renal replacement therapy during hospitalization. Propensity score matching was performed to compare the outcomes between the groups. We performed sensitivity analyses excluding patients who received extracorporeal cardiopulmonary resuscitation. Results Of 14,525 eligible patients, 603 (4.2%) received ECPella and 13,922 (96%) received ECMO+IABP. After propensity score matching, there was no significant difference in in-hospital mortality between the two groups (58.9% versus 56.6%; risk difference, 2.3%; 95% confidence interval, -3.9% to 8.5%). A Kaplan–Meier analysis with the log-rank test showed no significant difference in the 60-day in-hospital mortality between the two groups (P value = 0.114) (Figure 1). The ECPella group had a longer hospital stay (mean 42.8 days versus 33.7 days; risk difference, 9.1 days; 95% confidence interval, 2.6 to 15.6 days), a higher total hospitalization cost (12,573,000 yen versus 6,857,000 yen; risk differences, 5,716,000 yen; 95% confidence interval, 4,439,000 yen to 6,993,000 yen), and more frequent major bleeding (8.1% versus 5.8%; risk difference, 2.0%; 95% confidence interval, 0.007% to 4.0%), vascular complications (4.1% versus 2.2%; risk difference, 2.0%; 95% confidence interval, 0.04% to 3.9%), and renal replacement therapy during hospitalization (50.6% versus 41.1%; risk difference, 9.5%; 95% confidence interval, 3.0% to 15.9%) than the ECMO+IABP group (Figure 2). The results of the sensitivity analyses, excluding 6,360 patients (44%) who received extracorporeal cardiopulmonary resuscitation, showed similar results to those for the main analyses. Conclusions This nationwide inpatient database study showed that ECPella was not associated with a survival benefit but was associated with a longer hospital stay, a higher total hospitalization cost, and more complications than ECMO+IABP.Figure 1Figure 2

Investigation of an optimal control strategy for a cholera disease transmission model with programs

Cholera is a disease of poverty affecting people with inadequate access to safe water and basic sanitation. Conflict, unplanned urbanization and climate change all increase the risk of cholera. In this article, an optimal control deterministic mathematical model of cholera disease with cost-effectiveness analysis is developed and analyzed considering both direct and indirect contact transmission pathways. The model qualitative behaviors, such as the invariant region, the existence of a positive invariant solution, the two equilibrium points (disease-free and endemic equilibrium), and their stabilities (local as well as global stability) of the model are studied. Moreover, the basic reproduction number of the model is obtained. We also performed sensitivity analysis of the basic parameters of the model. Then an optimal control problem is designed with a control functional having five controls: vaccination, treatment, environment sanitation and personal hygiene, and water quality improvement program. We examined the existence and uniqueness of the optimal controls of the system. Through the implementation of Pontryagin's maximum principle, the characterization of the optimal controls optimality system is established. The numerical simulation results the integrated control strategies demonstrated that strategy 2, 7, and 12 are effective programs to combat cholera disease from the community. Based on the local circumstances, available funds, and resources, it is recommended to the government stakeholders and policymakers to execute any one of the three integrated intervention programs.

Association between gout and cancers: A systematic review and meta-analysis.

This study aimed to investigate the association between gout and cancer risk. This study was registered with the Prospective Registry for International Systematic Reviews (ID: CRD42023465587). We searched PubMed, Embase, Scopus, Cochrane, and Web of Science databases for studies related to gout and cancer risk, with a timeframe from the date the database was created to September 2023. We assessed the methodological quality of the included studies using the Newcastle-Ottawa scale and assessed heterogeneity between studies using the I2 statistic. Depending on the heterogeneity, we calculated pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using fixed-effects or random-effects models. In addition, we performed sensitivity analyses and publication bias tests. In this study, we conducted a meta-analysis of 6 studies encompassing a total of 1279,804 participants. Our analysis revealed that individuals with gout are at a heightened risk of developing cancer in general (HR = 1.18, 95% CI = 1.04-1.34, P < .001). Moreover, specific types of cancer displayed a significant correlation with gout, including gastric cancer (HR = 1.31, 95% CI = 1.07-1.62, P = .012), liver cancer (HR = 1.24, 95% CI = 1.01-1.52, P < .001), lung cancer (HR = 1.26, 95% CI = 1.03-1.53, P = .001), and bladder cancer (HR = 1.57, 95% CI = 1.02-2.41, P < .001). Furthermore, gout exhibited a marginally increased risk for other cancer types, such as head and neck cancer and esophageal cancer, although these associations did not attain statistical significance. Our study suggests that gout is a risk factor for cancer, especially for stomach, liver, lung, and bladder cancers. Patients with gout have an increased risk of developing overall cancers, lung cancer, liver cancer, stomach cancer, and bladder cancer. However, more high-quality epidemiologic studies are needed to explore the association between gout and individual cancers more accurately.

Causal association of immune cells and endometritis: a Mendelian randomization study

Research exploring the link between immune cell profiles and the development of endometritis remains scant. This gap necessitates further study to decode the complex interrelations influencing this condition. In this analysis, we leveraged two-sample Mendelian randomization to examine the causal ties between the phenotypes of immune cells and the incidence of endometritis. Our evaluation hinged on data from 3757 participants hailing from Sardinia, focusing on a diverse array of 731 immune phenotypes, and cross-referenced with endometritis data sourced from the UK Biobank. To ensure rigor, we performed sensitivity analyses, utilized MR-Egger and MR-Presso to check for pleiotropy, and applied Cochran’s Q test for assessing the heterogeneity of our findings. Our investigation identified numerous immune characteristics associated with endometritis. For certain immune traits, a lower risk of endometritis was observed, including: Absolute Counts of CD39 + CD4 + T cells, CD25 + CD39 + CD4 regulatory T cells, and CD25 + + CD8 + T cells; Absolute Counts of Switched Memory B cells; CD19 expression on IgD + CD38dim and Switched Memory B cells; CD20 expression on IgD + CD38− Unswitched Memory B cells; percentage of Switched Memory B cells among lymphocytes; CD16-CD56 expression on HLA DR + Natural Killer cells; percentage of CD11c + CD62L− monocytes; CD86 expression on monocytes; CCR2 expression on CD14 + CD16 + monocytes; and CD14 expression on Monocytic Myeloid-Derived Suppressor Cells, with Odds Ratios (ORs) between 0.413 and 0.703. On the contrary, increased risks of endometritis were linked with: the percentage of Effector Memory CD4 + T cells within the CD4 + T cell population; percentages of HLA DR + T cells and HLA DR + CD8 + T cells among T cells; CD4 expression on CD28 + CD4 + T cells; CD20 expression on CD20- CD38- B cells; percentage of IgD + CD24 + B cells within the B cell population; CD62L expression on CD62L + myeloid Dendritic Cells; and Absolute Counts of Plasmacytoid Dendritic Cells, with ORs from 1.473 to 2.677, indicating these traits potentially elevate the risk of developing endometritis. Our research delineates distinct causal links between specific immune cell phenotypes and endometritis, offering new perspectives that could contribute to the pinpointing of new therapeutic avenues for this condition.

Translabyrinthine versus Retrosigmoid Approach for Vestibular Schwannoma: A Systematic Review and An Updated Meta-Analysis.

Several approaches can be used in the surgical treatment of vestibular schwannoma (VS), and the best approach remains uncertain in the literature. This systematic review and meta-analysis aim to compare the translabyrinthine approach (TLA) with the retrosigmoid approach (RSA) for VS in terms of postoperative complications. PubMed, Web of Science, Embase, and Cochrane. The primary outcome was cerebrospinal fluid (CSF) leak; secondary outcomes were facial nerve dysfunction (FND), length of stay (LOS), and meningitis. Statistical analysis was performed using RStudio 2024.04.1 + 748. Heterogeneity was assessed with I² statistics. We performed sensitivity analysis with subgroup analysis and meta-regression. Risk of bias was assessed using ROBINS-I. Out of 1140 potential articles, 21 met the inclusion criteria. Among the 4572 patients, 2687 and 1885 patients in the TLA and RSA groups, respectively. No significant differences were found in CSF leak (odds ratio [OR] 1.03; 95% confidence interval [CI] 0.81,1.32; P = .794) or meningitis (OR 1.05; 95% CI 0.45, 2.43; P = .73). Meta-regression showed no association with CSF leak and the number of cases per center or publication year. The TLA is associated with a shorter LOS (MD -1.20; 95% CI -1.39, -1.01; P < .01) and a higher chance of having and HB 4 or lower compared to patients who underwent RSA (OR 0.30; 95% CI 0.10, 0.89; P = .03). There was no difference in the odds of CSF leak or meningitis between the groups. In addition, the TLA has a shorter LOS and a higher chance of a better facial nerve outcome compared to the RSA.

A novel Ca-Ni looping with carbonation heat thermochemical regeneration method for post-combustion CO2 capture: System integration, energy-saving mechanism, and performance sensitivity analysis

Thermal coupling between the calcium looping (CaL) process and chemical looping combustion (CaL-CLC) offers advantages to avoid electricity consumption of air separation, and the CaL-CLC has presented superior performance realizing CO2 capture. However, in these CaL-CLC and CaL configurations for post-combustion CO2 capture, the carbonation heat is recovered for steam generation with a significant temperature difference, leading to considerable irreversible loss. To prevent the temperature mismatch during carbonation heat recovery, this paper proposes the concept of Ca-Ni looping with the carbonation heat thermochemical regeneration method. Additionally, a novel system integrating with a combined cycle is introduced to effectively decarbonize flue gas. Results show that the proposed system has superior performance compared with the reference system based on the Ca-Cu looping method. The specific energy consumption for CO2 avoided (SPECCA) decreased from 2.13 MJ/kg CO2 in the reference system to 1.43 MJ/kg CO2. Exergy analysis indicates that a total 6.3 % exergy destruction reduction is realized by replacing the Cu-based chemical looping combustion with the Ni-based oxidation reaction for calcination heat supply. Furthermore, the energy utilization diagram (EUD) reveals the mechanism of exergy destruction reduction caused by the thermal coupling between reaction processes. Besides, the impact of key operating parameters on the proposed system performance is investigated. Overall, the proposed Ca-Ni looping with carbonation heat regeneration method enhances the utilization of mid-temperature carbonation heat by converting it into high-grade thermal energy suitable for combined cycles, thereby offering a promising alternative for low-energy-consumption CO2 capture.

Effectiveness and efficiency of immunisation strategies to prevent RSV among infants and older adults in Germany: a modelling study

BackgroundRecently, several novel RSV immunisation products that protect infants and older adults against RSV disease have been licensed in Europe. We estimated the effectiveness and efficiency of introducing these RSV immunisation strategies in Germany.MethodsWe used a Bayesian framework to fit a deterministic age-structured dynamic transmission model of RSV to sentinel surveillance and RSV-specific hospitalisation data in Germany from 2015 to 2019. The calibrated model was used to evaluate different RSV intervention strategies over 5 years: long-acting, single-dose monoclonal antibodies (mAbs) in high-risk infants aged 1–5 months; long-acting mAbs in all infants aged 1–5 months; seasonal vaccination of pregnant women and one-time seasonal vaccination of older adults (75 + /65 + /55 + years). We performed sensitivity analysis on vaccine uptake, seasonal vs. year-round maternal vaccination, and the effect of under-ascertainment for older adults.ResultsThe model was able to match the various RSV datasets. Replacing the current short-acting mAB for high-risk infants with long-acting mAbs prevented 1.1% of RSV-specific hospitalisations in infants per year at the same uptake. Expanding the long-acting mAB programme to all infants prevented 39.3% of infant hospitalisations per year. Maternal vaccination required a larger number to be immunised to prevent one additional hospitalisation than a long-acting mAB for the same uptake. Vaccination of adults older than 75 years at an uptake of 40% in addition to Nirsevimab in all infants prevented an additional 4.5% of all RSV hospitalisations over 5 years, with substantial uncertainty in the correction for under-ascertainment of the RSV burden.ConclusionsImmunisation has the potential to reduce the RSV disease burden in Germany.

Communication dynamics of congestion warning information considering the attitudes of travelers

Traffic congestion is a serious problem faced by many cities worldwide today. Congestion warning information is one of the important influencing factors of urban road congestion; To this end, based on the dynamics of infectious diseases, a congestion warning information dissemination model considering the attitudes of travelers and the network structure was constructed. The existence and stability of the equilibrium points of non congestion warning information and congestion warning information in the model were analyzed, and the optimal control strategy of the model was proposed. Numerical simulation was conducted to verify the results of theoretical analysis, simulate and analyze the impact of changes in various parameters in the model on the dissemination of congestion warning information, and perform sensitivity analysis on several parameters. The results indicate that travelers are more inclined towards “fast” modes of transportation and have a stronger willingness to share congestion warning information. The dissemination range of warning information is wider, which can play a positive role in reducing traffic congestion pressure.

Using genetic variations to reveal the complex relationships between vegetarianism and well-being, depressive symptoms and neuroticism.

The relationship between vegetarianism and mental well-being remains a debated topic in traditional observational studies. Recent studies have revealed the genetic factors in vegetarianism. We aimed to use genetic variations to explore the potential causal relationships between vegetarianism and mental well-being, offering insights from a new perspective. We conducted the inverse variance weighted approach as the primary analysis to explore the bidirectional genetic associations between vegetarianism (N = 442,589) and depressive symptoms (N = 180,866), neuroticism (N = 170,910), and subjective well-being (N = 298,420). The analysis used the summary data from the largest genome-wide association studies (GWAS). We also performed sensitivity analyses to ensure the robustness of the findings, accounting for potential heterogeneity and pleiotropy. Genetically predicted vegetarianism showed positive causal relationships with depressive symptoms (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.03-10.31; p = 0.044) and neuroticism (OR, 6.72; 95% CI, 2.29-19.74; p = 5.31 × 10-4), as well as a negative causal relationship with subjective well-being (OR, 0.20; 95% CI, 0.05-0.77; p = 0.019). Additionally, depressive symptoms were found to have a causal influence on vegetarianism (OR, 1.01; 95% CI, 1.00-1.02; p = 6.87 × 10-3). No significant heterogeneity or pleiotropy was detected. Vegetarianism is causally correlated with negative mental well-being, reflected in an increased risk of depressive symptoms and neuroticism, as well as lower subjective well-being. Further research should explore the underlying mechanisms in broader populations.