Reduction In Rate Research Articles

Dietary supplementation of Capsicum powder affects the growth, immunoglobulins, pro-inflammatory cytokines, adipokines, meat, and liver histology of aflatoxin B1 exposed broiler chickens

The effects of dietary supplementation with Capsicum annuum fruit pericarp powder (CPP) and Capsicum annuum fruit seed powder (CSP) on the health and performance of broiler chickens exposed to aflatoxin B1 (AFB1) was investigated. Four dietary groups were established: CON (control), AFT (0.5 mg/kg AFB1), CPAF (0.5 g/kg CPP and 0.5 mg/kg AFB1), and CSAF (0.5 g/kg CSP and 0.5 mg/kg AFB1). The AFT group shows a significant (P < 0.05) reduction in the relative growth rate compared to CON, CPAF, and CSAF. In contrast, the latter two groups exhibit growth rates similar (P > 0.05) to CON. Additionally, immunoglobulin levels (IgG, IgM, and IgA) in the AFT group are significantly (P < 0.05) lower compared to the other treatment groups. Serum interleukin-6 levels in the CPAF and CSAF groups were similar (P > 0.05) to CON but higher (P < 0.05) than in AFT. Tumor necrosis factor-alpha levels were elevated (P < 0.05) in AFT compared to the other treatment groups. Interferon-gamma concentrations in AFT were significantly (P < 0.05) lower than in the other treatment groups. The liver histology reveals that the AFT treatment group has periportal hepatic inflammation. In contrast, the CPAF and CSAF treatment groups exhibit normal hepatic microanatomy. In conclusion, 0.5 g/kg CPAF dietary supplementation may help to ameliorate the adverse effects of AFB1 exposure on broiler chicken health, specifically the growth, immune parameters and liver histology.

Influence of oxygen functional groups on the crack growth behavior of graphene with edge and middle crack: A molecular dynamics study

In the last decade, graphene has found a wide role and application in nanocomposites and nanodevices for its extraordinary properties. However, due to its low fracture toughness and brittleness, graphene is brittle, and crack growth occurs rapidly. As a result, crack growth behavior and control of its progression are important. In this study, molecular dynamics modeling was used to investigate the crack growth behavior and mechanical properties in functionalized graphene (with middle and edge crack) with different oxide groups (hydroxyl, epoxide, and carboxyl) at different percentages of graphene oxide (0–3 wt. %). The results show that functionalized graphene with oxide groups changes the properties of graphene, effectively reducing the crack growth in crack length (4.9 Å), crack opening displacement (1.4 Å), tensile strength for edge crack (74 to 54 Gpa), and middle crack (128 to 63 Gpa). Also, carboxyl and epoxide groups have a greater reduction in crack growth rate, opening displacement growth rate, and stress concentration. In addition, increase in the number of atoms in oxide groups around the initial crack (with radius 13 Å) reduces crack growth rate, opening displacement growth rate, and stress concentration. This study provides a broader insight into crack growth behavior in functionalized graphene with oxide groups.

Smart and UV-Resistant Edible Coating and Films Based on Alginate, Whey Protein, and Curcumin.

In this work, smart edible coating and films with excellent UV barrier properties were prepared from alginate, whey protein isolate, and curcumin. The primary focus of this investigation centered on assessing the impact of whey protein and curcumin on the physical and functional properties of the alginate films. Whey protein reduced the film transparency while simultaneously enhancing the hydrophobicity and antioxidant properties of the alginate film. Curcumin imparted a yellow hue to the film, consequently decreasing the transparency of the film. It also substantially improved hydrophobicity, antioxidant activity, and UV-blocking efficiency within the films. Remarkably, curcumin demonstrated a significant reduction in the water vapor transmission rate of the film. For the preservation of apples, a higher concentration of curcumin was required, which effectively suppressed the respiration rate and moisture loss post-harvest, resulting in an extended shelf-life for the apples. As a result, the coated apples exhibited significantly reduced enzymatic browning and weight loss in comparison to their uncoated counterparts. Furthermore, these curcumin-containing films underwent a reversible color change from orange to red when exposed to ammonia vapor. This attribute highlights the potential of the developed coating and film as a smart, active food packaging solution, particularly for light-sensitive food products.

Palliative Care Utilization and Hospital Transfers in Veterans Treated in Telecritical Care-Supported Intensive Care Units Versus Non-Telecritical Care Intensive Care Units.

Background: Although telecritical care (TCC) implementation is associated with reduced mortality and interhospital transfer rates, its impact on goal-concordant care delivery in critical illness is unknown. We hypothesized that implementation of TCC across the Veterans' Health Administration system resulted in increased palliative care consultation and goals of care evaluation, yielding reduced transfer rates. Methods: We included veterans admitted to intensive care units between 2008 and 2022. We compared palliative care consultation and transfer rates before and after TCC implementation with rates in facilities that never implemented TCC. We used generalized linear mixed multivariable models to assess the associations between TCC initiation, palliative care consultation, and transfer and subsequently used mediation analysis to evaluate potential causality in this relationship. Results: Overall, 1,020,901 veterans met inclusion criteria. Demographic characteristics of patients were largely comparable across groups, although TCC facilities served more rural veterans. Palliative care consultation rates increased substantially in both ever-TCC and never-TCC hospitals during the study period (2.3%-4.3%, and 1.6%-4.7%, p < 0.01). Admissions post-TCC implementation were associated with an increased likelihood of palliative care consultation (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.01-1.15). TCC implementation was also associated with a reduction in transfer rates (OR 0.90, 95% CI 0.84-0.95). Mediation analysis did not demonstrate a causal relationship between TCC implementation, palliative care consultation, and reductions in interhospital transfer rate. Conclusions: TCC is associated with increased palliative care engagement, while TCC and palliative care engagement are both independently related to reduced transfers.

Nutritional physiology and body composition changes during a rapid ascent to high altitude.

Exposure to high altitude might cause the body to adapt with negative energy and fluid balance that compromise body composition and physical performance. In this field study involving 12 healthy adults, sex-balanced, and aged 29±4 years with a body mass index of 21.6±1.8kg/m2, we investigated the effects of a 4-day trekking up to 4556m a.s.l. on Monte Rosa (Alps, Italy). The food intake was recorded using food diaries and nutrient averages were calculated. The bio-impedance analysis was performed at low and high altitudes, and a wearable biosensor (Swemax) was used to track hydro-saline losses in two participants. Daily total energy intake was 3348 ± 386kcal for males and 2804 ± 415kcal for females (13%-14% protein, 35% fat, 44%-46% carbohydrates). Although there was a significant body weight loss (65.0±9.3vs. 64.2±9.10kg, p<0.001, d=1.398), no significant changes in body composition parameter were found but a trend in the increase of the bioelectrical phase angle in males (p=0.059, d = -0.991). Body water percentage significantly changed (p=0.026, η2 p=0.440), but the absolute water did not, suggesting that the weight loss was not due to water loss. Salivary and urinary osmolality did not change. A reduction in sweat rate at higher altitudes was observed in both participants. Interestingly, salivary leptin increased (p=0.014, η2 p=0.510), and salivary ghrelin decreased (p=0.036, η2 p =0.403). Therefore, the 4-day trekking at altitude of hypoxia exposure induced changes in satiety and appetite hormones. High altitude expeditions require more specific nutritional guidance, and using multiplex analysis could help in monitoring fluid balance and body composition.

Influence of calcium concentration on larval adhesion in a highly invasive fouling ascidian: From morphological changes to molecular mechanisms

Calcium ion (Ca2+) is involved in the protein-mediated larval adhesion of fouling ascidians, yet the effects of environmental Ca2+ on larval adhesion remain largely unexplored. Here, the larvae of fouling ascidian C. robusta were exposed to different concentrations of Ca2+. Exposures to low-concentration (0 mM and 5 mM) and high-concentration (20 mM and 40 mM) Ca2+ significantly decreased the adhesion rate of larvae, which was primarily attributed to the decreases in adhesive structure length and curvature. Changes in the expressions of genes encoding adhesion-, microvilli-, muscle contraction-, and collagen-related proteins provided a molecular-level explanation for adhesion rate reduction. Additionally, larvae likely prioritized their energy towards immunomodulation in response to Ca2+ stresses, ultimately leading to adhesion reduction. These findings advance our understanding of the influencing mechanisms of environmental Ca2+ on larval adhesion, which are expected to provide references for the development of precise antifouling strategies against ascidians and other fouling species.

(141) Surgical Outcomes of Infrapubic Insertion of the Inflatable Penile Prosthesis in 175 Transmen After Phalloplasty

Abstract Introduction Historically, inflatable penile prostheses (IPP) insertion in a neophallus has an estimated 40-50% surgical revision rate. Objective To review the surgical outcomes of a single center’s experience with the infrapubic approach to insertion of the IPP after phalloplasty in transmen. Methods The infrapubic prosthesis insertion after phalloplasty (IPIP) technique involves a horizontal incision anterior to the pubic symphysis, which allows dissection of the neophallus channel, the Space of Retzius, and the scrotal pocket. Surgical outcomes using the Titan (Coloplast, Minneapolis, MN) IPP by a single surgeon (MLC) were analyzed between October 2017 and June 2023. Complications were reviewed and categorized into erosions, infections, device malposition and malfunction, and less common events like necrosis and urinary tract injury. Results The IPIP technique was performed on 175 phalloplasty patients by a single surgeon (MLC): 156 patients had a prior RF phalloplasty, and 19 had a prior ALT phalloplasty. The mean followup was 32.8 months. Surgical revision was required in 35 patients (20%). There were 10 pump erosions through the neoscrotum, 1 glans erosion, 9 infections, 6 pump malpositions in the neoscrotum, 6 cylinder malposition in the neophallus, 3 mechanical malfunctions with broken tubing, 2 urethral injuries, 2 bladder injuries, and 1 glans necrosis. There were no instances of implant detachment from the pubic bone anchor site, osteomyelitis, nor total phallus loss. Conclusions Data for the IPIP technique using the commercially available Coloplast Titan IPP suggest a reduction in neophallus prosthetic surgical revision rates compared to previous reports. Longer term studies with patient reported outcomes are required for further evaluation. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific.

Efficacy of tacrolimus capsules in patients undergoing high-risk keratoplasty

Purpose: To evaluate the efficacy of tacrolimus capsules in patients undergoing high-risk keratoplasty.&#x0D; Methods: 40 high-risk patients who underwent penetrating keratoplasty at The Third Hospital of Hebei Medical University, China between January 2016 and December 2021 were included in this study. These patients were divided into two groups based on the specific immunosuppressant administered post-surgery. Twenty patients were administered oral tacrolimus capsules in conjunction with 0.1 % tacrolimus eye drops, constituting the combination with systemic treatment group (group 1), while another twenty patients were solely administered 0.1 % tacrolimus eye drops, forming the topical treatment group (group 2). The occurrence of rejection, corneal neovascularization, corneal graft edema and visual acuity were documented in both groups.&#x0D; Results: In comparison to patients in group 2, patients in group 1 exhibited a significant reduction in rejection rate (p &lt; 0.05). Additionally, the average time of neovascularization in group 1 was delayed and the number of cases was lower (p &lt; 0.05). Furthermore, a smaller proportion of patients in group 1 experienced corneal graft edema (25 vs 60 %, p &lt; 0.05), while a higher percentage of patients in group 1 demonstrated improved visual acuity (90 vs 60 %, p &lt; 0.05).&#x0D; Conclusion: Concurrent administration of tacrolimus eye drops and capsules orally effectively mitigates anti-rejection reactions, regulation of neovascularization, management of graft edema and enhancement of visual acuity in high-risk keratoplasty patients when compared to the use of tacrolimus eye drops as a standalone treatment. These results have the potential to stimulate novel avenues of investigation in future clinical research.

Neural circuits of long-term thermoregulatory adaptations to cold temperatures and metabolic demands.

The mammalian brain controls heat generation and heat loss mechanisms that regulate body temperature and energy metabolism. Thermoeffectors include brown adipose tissue, cutaneous blood flow and skeletal muscle, and metabolic energy sources include white adipose tissue. Neural and metabolic pathways modulating the activity and functional plasticity of these mechanisms contributenot only to the optimization of function during acute challenges, such as ambient temperature changes, infection and stress, but also to longitudinal adaptations to environmental and internal changes. Exposure of humans to repeated and seasonal cold ambient conditions leads to adaptations in thermoeffectors such as habituation of cutaneous vasoconstriction and shivering. In animals that undergo hibernation and torpor, neurally regulated metabolic and thermoregulatory adaptations enable survival during periods of significant reduction in metabolic rate. In addition, changes in diet can activate accessory neural pathways that alter thermoeffector activity. This knowledge may be harnessed for therapeutic purposes, including treatments for obesity and improved means of therapeutic hypothermia.

Influence of Fluorescence Lifetime Selections and Conformational Flexibility on Brightness of FusionRed Variants.

Fluorescent proteins (FPs) for bioimaging are typically developed by screening mutant libraries for clones with improved photophysical properties. This approach has resulted in FPs with high brightness, but the mechanistic origins of the improvements are often unclear. We focused on improving the molecular brightness in the FusionRed family of FPs with fluorescence lifetime selections on targeted libraries, with the aim of reducing nonradiative decay rates. Our new variants show fluorescence quantum yields of up to 75% and lifetimes >3.5 ns. We present a comprehensive analysis of these new FPs, including trends in spectral shifts, photophysical data, photostability, and cellular brightness resulting from codon optimization. We also performed all-atom molecular dynamics simulations to investigate the impact of side chain mutations. The trajectories reveal that individual mutations reduce the flexibility of the chromophore and side chains, leading to an overall reduction in nonradiative rates.

Optimization of intraoperative lumpectomy specimen labeling

BackgroundAccurate lumpectomy specimen orientation is critical as incorrect orientation may result in excision of the wrong lumpectomy margin. Our goal was to determine if specimen orientation achieved by labeling three surfaces is superior to two. MethodsThis was a prospective single-institution study including 22 breast surgical oncologists. Intraoperative labeling of either two or three surfaces of the lumpectomy specimen was based on surgeon preference. The specimen was delivered to Pathology where it was oriented by the pathology team and the surgeon then determined if the specimen was correctly oriented or if re-orientation was required. Surgeons subsequently recorded orientation technique and if re-orientation was required. Specimen weight, patient age, and BMI were recorded. Fisher’s exact test and two-sample Wilcoxon rank-sum test were used to determine p-values. ResultsOf 268 specimens, 40 (14.9%) required re-orientation. Labeling specimens on three surfaces was superior to two (22 of 195 (11.2%) versus 18 of 73 (24.6%), p = 0.01). Specimens requiring re-orientation were more likely to be heavier (36 g vs. 24 g, p = 0.02). In multivariable analysis, labeling specimens on three surfaces resulted in a 70% reduction in discordance rates between the surgeon and pathology team (OR 0.3, p = 0.001). Using mean weight of lumpectomy specimens, specimens >33 g were more likely to require reorientation (OR 2.8, p = 0.004). Age and BMI did not impact the need for re-orientation. ConclusionLumpectomy specimen labeling using three surfaces was superior to two. Surgeons should routinely orient their specimens on three or more surfaces to decrease discordance rates.

Role of temperature in tribolayers in fretting wear of γ-TiAl alloy

The formation of tribolayers may play significant influences on fretting wear. At elevated temperature, the adhesion among wear debris and the increased diffusion rate facilitate the formation of tribolayers. However, the intensification of oxidation at elevated temperature and the low diffusion rate in oxides may play an adverse role. The present study aims to investigate the role of temperature in tribolayers in fretting wear using a γ-TiAl alloy. Scanning electron microscope, energy dispersive spectrometer, Raman spectrometer, transmission electron microscope and nanoindentation were utilized to investigate the wear debris, tribolayers, and wear scars. The fretting tests showed that, compared with that at room temperature (RT) and 350 °C, significant reduction in wear rate and decrease in the fluctuation of friction coefficient occurred at 550 and 750 °C. It was further revealed that when temperature raised from room temperature (RT) to 750 °C, the oxidation of the wear debris increased slightly and the diffusion coefficients increased prominently, which facilities the formation of well tribo-sintered tribolayers. The well tribo-sintered tribolayers presented homogenous structure, nanocrystalline grains with excellent mechanical properties, and resulted in the improvement in the fretting wear resistance of the γ-TiAl alloy at 550 and 750 °C.

Pn@MF@SiO2 Double‐Shelled Phase Change Microcapsules with High Latent Heat and Low Leakage Rate

AbstractMicroencapsulation of paraffin with melamine formaldehyde shell (Pn@MF) shows the drawbacks of low thermal conductivity. Hence, we constructed SiO2 shells on Pn@MF phase change microcapsules by interfacial polycondensation to obtain Pn@MF@SiO2 double‐shelled microcapsules. The effect of tetraethoxysilane (TEOS) contents on the performance of Pn@MF@SiO2 was discussed in detail. As the TEOS contents increased, the thermal conductivity of Pn@MF@SiO2 gradually increased, reaching up to 0.376 W m−1 K−1. The Pn@MF@SiO2 have exhibited superior leakage‐proof properties and thermal reliability through double‐shelled protection, and the highest reduction in leakage rate reached 45.06 % compared to Pn@MF microcapsules. The Pn@MF@SiO2‐3 with the lowest enthalpy still exhibit a latent heat storage capacity of more than 176 J/g, which displayed outstanding latent heat storage/release capability and good anti‐permeable property.

Farm animal exposure, respiratory illnesses, and nasal cell gene expression

BackgroundFarm exposures in early life reduce the risks for childhood allergic diseases and asthma. There is less information about how farm exposures relate to respiratory illnesses and mucosal immune development. ObjectiveWe hypothesized that children raised in farm environments have a lower incidence of respiratory illnesses over the first two years of life than non-farm children. We also analyzed whether farm exposures or respiratory illnesses were related to patterns of nasal cell gene expression. MethodsThe Wisconsin Infant Study Cohort included farm (n=156) and non-farm (n=155) families with children followed to age 2 years. Parents reported prenatal farm and other environmental exposures. Illness frequency and severity were assessed using illness diaries and periodic surveys. Nasopharyngeal cell gene expression in a subset of 64 children at age two years was compared to farm exposure and respiratory illness history. ResultsFarm vs. non-farm children had nominally lower rates of respiratory illnesses (rate ratio 0.82 [0.69,0.97]) with a stepwise reduction in illness rates in children exposed to 0, 1, or ≥2 animal species, but these trends were non-significant in a multivariable model. Farm exposures and preceding respiratory illnesses were positively related to nasal cell gene signatures for mononuclear cells and innate and antimicrobial responses. ConclusionsMaternal and infant exposure to farms and farm animals was associated with nonsignificant trends for reduced respiratory illnesses. Nasal cell gene expression in a subset of children suggests that farm exposures and respiratory illnesses in early life are associated with distinct patterns of mucosal immune expression.

Entropy generation for thermo-magnetic fractional order convective flow in complex porous enclosures: a numerical study

PurposeThis study aims to analyze the impact of fractional derivatives on heat transfer and entropy generation during transient free convection inside various complex porous enclosures, such as triangle, L-shape and square-containing wavy surfaces. These porous enclosures are saturated with Cu-water nanofluid and subjected to the influence of a uniform magnetic field.Design/methodology/approachIn the present study, Darcy’s model is used for the momentum transport equation in the porous matrix. Additionally, the Caputo time fractional derivative is introduced in the energy equation to assess the heat transfer phenomenon. Furthermore, the total entropy generation has been computed by combining the entropy generation due to fluid friction (Sff), heat transfer (Sht) and magnetic field (Smf). The complete mathematical model is further simulated using the penalty finite element method, and the Caputo time derivative term is approximated using the L1 scheme. The study is conducted for various ranges of the Rayleigh number (102≤Ra≤104), Hartmann number (0≤Ha≤20) and fractional order parameter (0<α<1) with respect to time.FindingsIt has been observed that the fractional order parameter α governs the characteristics of entropy generation and heat transfer within the selected range of parameters. The Bejan number associated with heat transfer (Beht), fluid friction (Beff) and magnetic field (Bemf) further demonstrate the dominance of flow irreversibilities. It becomes evident that the initial evolution state of streamlines, isotherms and local entropy varies according to the choice of α. Additionally, increasing Ra values from 102 to 104 shows that the heat transfer rate increases by 123.8% for a square wavy enclosure, 7.4% for a triangle enclosure and 69.6% for an L-shape enclosure. Moreover, an increase in the value of Ha leads to a reduction in heat transfer rates and entropy generation. In this case, Bemf→1 shows the dominance of the magnetic field irreversibility in the total entropy generation.Practical implicationsRecently, fractional-order models have been widely used to express numerous physical phenomena, such as anomalous diffusion and dispersion in complex viscoelastic porous media. These models offer a more accurate representation of physical reality that classical models fail to capture; this is why they find a broad range of applications in science and engineering.Originality/valueThe fractional derivative model is used to illustrate the flow pattern, heat transfer and entropy-generating characteristics under the influence of a magnetic field. Furthermore, to the best of the author’s knowledge, a fractional-derivative-based mathematical model for the entropy generation phenomenon in complex porous enclosures has not been previously developed or studied.

The impact of civil commitment laws for substance use disorder on opioid overdose deaths.

Our study analyzed the impact of civil commitment (CC) laws for substance use disorder (SUD) on opioid overdose death rates (OODR) in the U.S. from 2010-21. We used a retrospective study design using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset to analyze overdose death rates from any opioid during 2010-21 using ICD-10 codes. We used t-tests and two-way ANOVA to compare the OODR between the U.S. states with the law as compared to those without by using GraphPad Prism 10.0. We found no significant difference in the annual mean age-adjusted OODR from 2010-21 between U.S. states with and without CC SUD laws. During the pre-COVID era (2010-19), the presence or absence of CC SUD law had no difference in age-adjusted OODR. However, in the post-COVID era (2020-21), there was a significant increase in OODR in states with a CC SUD law compared to states without the law (p = 0.032). We also found that OODR increased at a faster rate post-COVID among both the states with CC SUD laws (p < 0.001) and the states without the law (p = 0.019). We found higher age-adjusted OODR in states with a CC SUD law which could be due to the laws being enacted in response to the opioid crisis or physicians' opposition to or unawareness of the law's existence leading to underutilization. Recent enactment of CC SUD law(s), a lack of a central database for recording relapse rates, and disparities in opioid overdose rate reductions uncovers multiple variables potentially influencing OODR. Thus, further investigation is needed to analyze the factors influencing OODRs and long-term effects of the CC SUD laws.

Self-harm by single- and multi-agent medication poisoning in a retrospective analysis of a Poison Control Center database from January 2018 to December 2022.

Medication poisoning is the most common method of self-harm. Longitudinal studies incorporating pre- and post-COVID-19 pandemic data are required to describe the phenomenon and to evaluate the long-term impact on mental health. Calls to the Poison Control Center of Policlinico Umberto I Hospital - Sapienza University of Rome, Italy, were analyzed retrospectively for characteristics and clinical presentation of cases of interest from January 2018 to December 2022. A total of 756 cases of self-harm by medication poisonings were recorded in the study period. A reduction in rate of cases in 2020 was followed by a return to pre-pandemic levels by 2021. When separately analyzing single- and multi-agent cases, occurrence of cases involving just one medication increased since early 2021, with a peak in 2022 (7.8% of total calls, 95% CI 6.2-9.5, from 4.9%, 95% CI 4.1-5.8 in 2018). This increase in the rate of cases, mostly of none or mild severity, was driven by youth aged 12-21, in which the relative proportion of single- versus multi-agent cases showed an increasing trend since 2020 (from 42.6% in 2018 to 78.6% in 2022). Acetaminophen was the medication most frequently involved and benzodiazepines the largest class. A psychiatric background was increasingly seen in 2022, especially in age group 12-21. Single-agent medication self-harm may be an increasingly prevailing phenomenon. Young adolescents with a psychiatric background might be most vulnerable to this behavior in the COVID-19 pandemic aftermath. Healthcare professionals should expect favorable clinical outcome and improve both counseling and psychotherapy supervision in individuals at risk.

Rate of hospitalization and length of hospital stay during and post docetaxel for darolutamide in metastatic hormone-sensitive prostate cancer using ARASENS.

228 Background: ARASENS was a randomized, double-blind, Phase III trial of darolutamide (daro) + docetaxel + androgen deprivation therapy (ADT) vs. placebo (pbo) + docetaxel + ADT in patients with metastatic hormone sensitive prostate cancer (mHSPC). We sought to compare rates of hospitalizations and length of hospital stay (LoS) per patient due to any reason, and due to adverse events (AE) during or post docetaxel using data from ARASENS. Methods: We used mixed effects negative binomial regression to estimate time-varying rate of hospitalization and LoS by patient. Patients with records that began on the same start date were considered duplicates and were condensed into one visit, using the latest end date. Patients with multiple records with overlapping time periods were combined into one visit. A constant hospitalization rate assumption was considered inappropriate since docetaxel is administered for 6-cycles (~4.14 months). Hospitalizations that began within and after first 4 months of treatment were grouped together. Conversely, LoS was assumed to be time invariant. Results: The first 4 months of treatment (when patients were receiving docetaxel) were associated with increased hospitalization both due to any reason and to AE (Table 1). Daro was associated with a numerical reduction in rate of hospitalization (per year) due to any reason during docetaxel (0.75 days [95% CI: 0.61, 0.88]) vs. pbo (0.91 days [95% CI: 0.75, 1.07]) and after docetaxel (0.31 days [95% CI: 0.26, 0.37]) vs. pbo (0.38 days [95% CI: 0.31, 0.45]). A similar trend was observed for hospitalizations due to AE. Daro was associated with a marginally longer LoS per hospitalization compared with pbo (+1.90 days). Similar results were seen for LoS due to AE (+1.67 days). Conclusions: Daro was associated with a numerically lower rate of hospitalization, but marginally longer LoS compared to pbo. A lower rate of hospitalization was observed post docetaxel as opposed to during docetaxel. Clinical trial information: NCT102799602 . [Table: see text]

Optimized in-loop filtering in versatile video coding using improved fast guided filter

&lt;p&gt;Devices with varying display capabilities from a common source may face degradation in video quality because of the limitation in transmission bandwidth and storage. The solution to overcome this challenge is to enrich the video quality. For the mentioned purpose, this paper introduces an improved fast guided filter (IFGF) for the contemporary video coding standard H.266/VVC (versatile video coding), a continuation of H.265/HEVC (high efficiency video coding). VVC includes several types of coding techniques to enhance video coding efficiency over existing video coding standards. Despite that, blocking artifacts are still present in the images. Hence, the proposed method focuses on denoising the image and the increase of video quality, which is measured in terms of peak signal-to-noise (PSNR). The objective is achieved by using an IFGF for in-loop filtering in VVC to denoise the reconstructed images. VTM (VVC test model)-17.2 is used to simulate the various video sequences with the proposed filter. This method achieves a 0.67% Bjontegaard delta (BD)-rate reduction in low-delay configuration accompanied by an encoder run time increase of 4%.&lt;/p&gt;

A Cautionary Tale: Malaligned Incentives in Total Hip and Knee Arthroplasty Payment Model Reforms Threaten Promising Innovation and Access to Care

Over the past several years, there have been notable changes and controversies involving Medicare reimbursement for total hip (THA) and total knee arthroplasty (TKA). We have seen the development and implementation of experimental bundled payment model pilot programs goals of improving quality and decreasing overall costs of care during the last decade. Many orthopaedic surgeons have embraced these programs and have demonstrated the ability to succeed in these new models by implementing strategies, such as preservice optimization, to shift care away from inpatient or postdischarge settings and reduce postoperative complications. However, these achievements have been met with continual reductions in surgeon reimbursement rates, lower bundle payment target pricings, modest increases in hospital reimbursement rates, and inappropriate valuations of THA and TKA Common Procedural Terminology (CPT) codes. These challenges have led to an organized advocacy movement and spurred research involving the methods by which improvements have been made throughout the entire episode of arthroplasty care. Collectively, these efforts have recently led to a novel application of CPT codes recognized by payers to potentially capture presurgical optimization work. In this paper, we present an overview of contemporary payment models, summarize notable events involved in the review of THA and TKA CPT codes, review recent changes to THA and TKA reimbursement, and discuss future challenges faced by arthroplasty surgeons that threaten access to high-quality THA and TKA care.