Similar Cost Research Articles

Male allocation to ejaculation and mating effort imposes different life history trade-offs.

When males compete, sexual selection favors reproductive traits that increase their mating or fertilization success (pre- and postcopulatory sexual selection). It is assumed that males face a trade-off between these 2 types of sexual traits because they both draw from the same pool of resources. Consequently, allocation into mate acquisition or ejaculation should create similar trade-offs with other key life history traits. Tests of these assumptions are exceedingly rare. Males only ejaculate after they mate, and the costs of ejaculation are therefore highly confounded with those of mating effort. Consequently, little is known about how each component of reproductive allocation affects a male's future performance. Here, we ran an experiment using a novel technique to distinguish the life history costs of mating effort and ejaculation for mosquitofish (Gambusia holbrooki). We compared manipulated males (mate without ejaculation), control males (mate and ejaculate), and naïve males (neither mate nor ejaculate) continuously housed with a female and 2 rival males. We assessed their growth, somatic maintenance, mating and fighting behavior, and sperm traits after 8 and 16 weeks. Past mating effort significantly lowered a male's future mating effort and growth, but not his sperm production, while past sperm release significantly lowered a male's future ejaculate quantity, but not his mating effort. Immune response was the only trait impacted by both past mating effort and past ejaculation. These findings challenge the assumption that male reproductive allocation draws from a common pool of resources to generate similar life history costs later in life. Instead, we provide clear evidence that allocation into traits under pre- and postcopulatory sexual selection have different trait-specific effects on subsequent male reproductive performance.

Hospital costs of robotic-assisted and open treatment of large ventral hernias

Robotic-assisted treatment of ventral hernia offers many advantages, however, studies reported higher costs for robotic surgery compared to other surgical techniques. We aimed at comparing hospital costs in patients undergoing large ventral hernia repair with either robotic or open surgery. We searched from a prospectively maintained database patients who underwent robotic or open surgery for the treatment of the large ventral hernias from January 2016 to December 2022. The primary endpoint was to assess costs in both groups. For eligible patients, data was extracted and analyzed using a propensity score-matching. Sixty-seven patients were retrieved from our database. Thirty-four underwent robotic-assisted surgery and 33 open surgery. Mean age was 66.4 ± 4.1 years, 50% of patients were male. After a propensity score-matching, a similar total cost of EUR 18,297 ± 8,435 vs. 18,024 ± 7514 (p = 0.913) in robotic-assisted and open surgery groups was noted. Direct and indirect costs were similar in both groups. Robotic surgery showed higher operatory theatre-related costs (EUR 7532 ± 2,091 vs. 3351 ± 1872, p < 0.001), which were compensated by shorter hospital stay-related costs (EUR 4265 ± 4366 vs. 7373 ± 4698, p = 0.032). In the treatment of large ventral hernia, robotic surgery had higher operatory theatre-related costs, however, they were fully compensated by shorter hospital stays and resulting in similar total costs.

Resilience and Value: Pediatric Trauma Care in Safety Net Hospitals.

Background: In the setting of limited funding and high expectations for quality care, safety net hospitals play a crucial role in treating pediatric trauma patients. This study aimed to compare outcomes and hospitalization costs of pediatric trauma patients in safety net hospitals across the United States. Methods: The Nationwide Readmissions Database for 2016-2020 was queried for all patients under the age of 18years hospitalized for traumatic injury. Patients admitted to safety net hospitals were propensity matched 1:1 to all other patients. The primary outcome was mortality. The secondary outcomes were readmission within 1-year, mean length of stay (LOS), total charges, and total hospitalization costs including readmissions. Results: There were 176,325 patients meeting inclusion criteria, and 30,869 were admitted to safety net hospitals. All safety net patients were successfully matched across predictors, and 61,738 patients were included. The overall mortality rate was 1.4% (n = 834), and the mortality risk was similar in safety net hospitals (OR 1.11 [.96-1.27] P = .15). The overall readmission rate, mean LOS, and mean total cost were similar for safety net hospitals when compared to all hospitals. However, the overall mean total charge was $78,724 (±$224,884) and was lower in safety net hospitals ($76,575 [±$198,342], P = .02). Discussion: Safety net hospitals deliver comparable outcomes as other health care facilities when caring for pediatric trauma patients. Notably, these hospitals appear to undercharge for their services, despite incurring similar costs in the process. These results shed light on the resilience of safety net hospitals in delivering quality and cost-effective care.

Cost-efficient flow migration for SFC dynamical scheduling in geo-distributed clouds

Combining Network Function Virtualization (NFV) and Software Defined Network (SDN) enables the delivery of network services in a flexible and cost-efficient manner. NFV allows elasticity scheduling of Virtual Network Function (VNF) instances to adopt the dynamic variation of network flows, such as VNF instance scale out or in and load balancing. To implement the elasticity scheduling, existing flows need to be re-routed through the VNF instances. One major problem is how to select appropriate flows for migration to reduce migration cost and improve network performance after migration. In this paper, we propose a Cost-efficient Flow Migration framework, CFM, to jointly optimize flow migration cost and network performance after migration (including flow routing cost and maximum VNF instance load) for flow migration in Service Function Chain manner. Experimental results demonstrate that CFM can reduce flow routing cost after migration by 43%∼62% compared with previous works, while achieving similar flow migration cost in scale out/in scenario. In load balancing scenario, CFM can also reduce flow migration cost by 65%∼79% and flow routing cost after migration by 43%∼79% compared with previous works, while ensuring that the maximum VNF instance load does not significantly increase.

Robotic-Assisted Treatment of Large Incisional Abdominal Wall Hernias: A Cost Analysis

Abstract Background Robotic-assisted treatment of ventral hernia offers many advantages, however, studies reported higher costs for robotic surgery compared to other surgical techniques. Aims We aimed at comparing hospital costs in patients undergoing large ventral hernia repair with either robotic or open surgery. Methods We retrospectively searched from a prospectively maintained database patients who underwent robotic or open surgery for the treatment of the large ventral hernias from January 2016 to December 2022. The primary endpoint was to assess the costs incurred by the hospital in both groups. For eligible patients, data was extracted analyzed using a propensity score-matching. Results During the study period, 67 patients were retrieved from our database. 34 patients underwent robotic-assisted surgery while 33 underwent open surgery. Mean age was 66.4 years ±4.1 years, 50% of patients were male. After a propensity score-matching, a similar total cost of 18,297±8,435 EUR vs. 18,024±7,514, p=0.913 in robotic-assisted and open surgery groups were noted. Robotic surgery showed higher operatory theatre-related costs (7,532±2,091 EUR vs. 3,351±1,872 EUR, p&amp;lt;0.001), which were fully compensated by a shorter hospital stay of 5.3±4.5 vs. 10.4±5.2 days, p=0.002 (costs: 4,265±4,366 EUR vs. 7,373±4,698 EUR, p=0.032). Conclusion Our study showed that in the treatment of large ventral hernia, robotic surgery had higher operatory theatre-related costs, however, they were fully compensated by shorter hospital stays and resulting in similar total costs.

Cost and competitiveness of green hydrogen and the effects of the European Union regulatory framework

By passing the delegated acts supplementing the revised Renewable Energy Directive, the European Commission has recently set a regulatory benchmark for the classification of green hydrogen in the European Union. Controversial reactions to the restricted power purchase for electrolyser operation reflect the need for more clarity about the effects of the delegated acts on the cost and the renewable characteristics of green hydrogen. To resolve this controversy, we compare different power purchase scenarios, considering major uncertainty factors such as electricity prices and the availability of renewables in various European locations. We show that the permission for unrestricted electricity mix usage does not necessarily lead to an emission intensity increase, partially debilitating concerns by the European Commission, and could notably decrease green hydrogen production cost. Furthermore, our results indicate that the transitional regulations adopted to support a green hydrogen production ramp-up can result in similar cost reductions and ensure high renewable electricity usage.

Eco-sustainable design of seawater sea-sand slag-based geopolymer mortars incorporating ternary solid waste

This study aimed to explore the feasibility of utilizing geopolymer as alternatives to Ordinary Portland Cement (OPC) in marine engineering. Eco-friendly seawater sea-sand slag-based geopolymer mortars (SS-SGMs) were prepared by blending seawater, sea-sand, Basalt Fibres (BF), Polypropylene Fibres (PPF), and ternary solid waste. The effects of activator modulus, alkaline content, water-to-binder ratio, and the volume fractions of BF and PPF on the mechanical performance, environmental impact, and cost of SS-SGMs were researched using the L16(4)5 Taguchi orthogonal method. Three evaluation methods were used to assess the impact of the different factors. First, the influence of a single factor was analyzed using methods of range and variance analysis. Subsequently, three new evaluation metrics were proposed to consider the synergistic effects of mechanical performance, environment, and cost. Finally, a Gray-Technique of Ordering Preferences by Similarity to Ideal Solution (Gray-TOPSIS) model was established, and the influence weights of each factor were proposed, thereby determining the optimal solution in a multi-index evaluation system. The recommended optimal mix proportion for SS-SGMs was determined as follows: activator modulus of 1.0, alkaline content of 4%, water-to-binder ratio of 0.42, PPF volume fraction of 0.4%, and BF volume fraction of 0.3%. Compared to OPC with the same strength grade, SS-SGMs demonstrated similar costs, a reduction in carbon emissions by approximately 75–83%, a decrease in energy consumption by around 50–67%, and lower drying shrinkage than traditional geopolymer. Under the influence of seawater, the products of SS-SGMs were capable of forming chloride-ion adsorbing products like hydrotalcite and Brucite. Additionally, the formation of C4AH13 and ion clusters can enhance the matrix density, thereby improving the mechanical performance of SS-SGMs.

Dual Tasking Affects the Outcomes of Instrumented Timed up and Go, Sit-to-Stand, Balance, and 10-Meter Walk Tests in Stroke Survivors.

Stroke can impair mobility, with deficits more pronounced while simultaneously performing multiple activities. In this study, common clinical tests were instrumented with wearable motion sensors to study motor-cognitive interference effects in stroke survivors (SS). A total of 21 SS and 20 healthy controls performed the Timed Up and Go (TUG), Sit-to-Stand (STS), balance, and 10-Meter Walk (10MWT) tests under single and dual-task (counting backward) conditions. Calculated measures included total time and gait measures for TUG, STS, and 10MWT. Balance tests for both open and closed eyes conditions were assessed using sway, measured using the linear acceleration of the thorax, pelvis, and thighs. SS exhibited poorer performance with slower TUG (16.15 s vs. 13.34 s, single-task p < 0.001), greater sway in the eyes open balance test (0.1 m/s2 vs. 0.08 m/s2, p = 0.035), and slower 10MWT (12.94 s vs. 10.98 s p = 0.01) compared to the controls. Dual tasking increased the TUG time (~14%, p < 0.001), balance thorax sway (~64%, p < 0.001), and 10MWT time (~17%, p < 0.001) in the SS group. Interaction effects were minimal, suggesting similar dual-task costs. The findings demonstrate exaggerated mobility deficits in SS during dual-task clinical testing. Dual-task assessments may be more effective in revealing impairments. Integrating cognitive challenges into evaluation can optimize the identification of fall risks and personalize interventions targeting identified cognitive-motor limitations post stroke.

Influence of subsidy policies against insurances on controlling the propagation of epidemic security risks in networks

Subsidies are used to further control the propagation of epidemic security risks as they offer users incentives to practice security investment behaviors. However, previously proposed subsidy policies have typically been studied without insurance, and it is still challenging to build effective subsidy strategies when users can transfer some of the infection loss to the insurer by purchasing insurance, because these external incentives may alter users' decisions to purchase insurance. To this end, we designed three subsidy policies in a scenario where purchasing insurance is one of the available strategies to users: under SPIns and SPInsp, the subsidies are used as the insurance funds and the risk precaution aspect of the insurance funds, respectively, and under SPInsd, a fraction of the subsidies are used to support some free-riding users with high node importance in their purchase of insurance, and the remaining subsidies are used as the precaution aspect of the insurance funds. The subsidy policies are studied with a formulated security investment game model on scale-free networks from the perspectives of the public and insurer. The results show that SPInsd can always work effectively and outperforms others in limiting the extent of an epidemic outbreak with similar or lower social costs, and without a reduction in profit for the insurer. More importantly, an interesting phenomenon emerges in the SPInsp scenario: under specific insurance parameters, the increase in subsidy funding has a negative impact on preventing the risk spread, leading to larger final epidemic sizes. In addition, the effectiveness of SPInsd on scale-free networks with larger average degree or network size and random networks are also studied. We anticipate this work can provide useful insights for policy makers with respect to design and implementation of optimal subsidy policies related to the control of epidemic security risks under an insurance scenario.

Optimizing Power Generation Scheduling: A Comparative Analysis of Metaheuristic Algorithms

Purpose: This research compares six optimization methods, including the Mayfly Optimization Algorithm, Genetic Algorithm, Simulated Annealing, Firefly Algorithm, and Differential Evolution (DE). Design/Methodology/Approach: The evaluation of any algorithm is predicated on its ability to strike a balance between meeting demand, taking into account renewable energy sources, and lowering the total cost of producing power. Findings: The analysis shows that although PSO and GA converge to similar overall costs, the algorithms' performances differ. Then come SA, FA, and DE in close succession, with the Mayfly Optimization Algorithm showing higher total costs than the other techniques. Originality: By addressing difficult power generating scheduling problems, this work advances our understanding of the benefits and drawbacks of various optimization techniques.

Similar Efficacy and Lower Cost Associated With Ceftazidime Compared to Tobramycin Coupled With Vancomycin in Antibiotic Spacers in the Treatment of Periprosthetic Joint Infection

BackgroundVancomycin and tobramycin have traditionally been used in antibiotic spacers. In 2020, our institution replaced tobramycin with ceftazidime. We hypothesized that the use of ceftazidime/vancomycin (CV) in antibiotic spacers would not lead to an increase in treatment failure compared to tobramycin/vancomycin (TV). MethodsFrom 2014 to 2022, we identified 243 patients who underwent a stage I revision for periprosthetic joint infection. The primary outcome was a recurrent infection requiring antibiotic spacer exchange. We were adequately powered to detect a 10% difference in recurrent infection. Patients who had a prior failed stage I or two-stage revision for infection, acute kidney injury prior to surgery, or end-stage renal disease were excluded. Given no other changes to our spacer constructs, we estimated cost differences attributable to the antibiotic change. Chi-square and t-tests were used to compare the two groups. Multivariable logistic regressions were utilized for the outcomes. ResultsThe combination of TV was used in 127 patients; CV was used in 116 patients. Within one year of stage I, 9.8% of the TV group had a recurrence of infection versus 7.8% of the CV group (P = .60). By final follow-up, results were similar (12.6 versus 8.6%, respectively, P = .32). Adjusting for potential risk factors did not alter the results. Cost savings for ceftazidime versus tobramycin are estimated to be $68,550 per one hundred patients treated. ConclusionsReplacing tobramycin with ceftazidime in antibiotic spacers yielded similar periprosthetic joint infection eradication success at a lower cost. While larger studies are warranted to confirm these efficacy and cost-saving results, our data justifies the continued investigation and use of ceftazidime as an alternative to tobramycin in antibiotic spacers.

Impact Analysis of a new, Cross-sector Service Provision of Gastroenterologic Endoscopic Services in Accordance with 115f SGB V (Hybrid-DRG): Allocation Matrix and Cost Analysis

With the introduction of §115f SGB V, the prerequisites for "sector-equal remuneration" ('Hybrid DRG') have been created. In an impact analysis, we assigned inpatient gastroenterological endoscopic (GAEN) cases in a matrix of future hybrid DRG versus outpatient surgery (AOP) or inpatient treatment. In selected DRGs (G47B, G67A, G67B, G67C, G71Z, H41D, H41E) an allocation matrix of GAEN cases was created on medical grounds. For this purpose, service groups from the DGVS service catalog ('Leistungskatalog') were assigned to the groups: 'Hybrid-DRG', 'AOP' and 'Inpatient' by a group of experts based on the DGVS position paper. Cost data from the DGVS-DRG project for the 2022 data year from 36 InEK calculation hospitals with a total of 232,476 GAEN cases were evaluated. 26 service groups from the DGVS service catalog were assigned to a "Hybrid-DRG", 24 to the "inpatient" group, and 12 to the "AOP" group. 7 performance groups were splitted "depending on the OPS code" and classified at this level. Cases with additional fees were excluded from a hybrid DRG because these cannot be agreed there.The cost analysis shows that services that are already in the AOP have a similar cost level to services that have been classified as 'Hybrid-DRG'. With the cost calculation, a cost level could be presented for the hybrid DRGs formed. Based on clearly defined structural, procedural and personnel requirements, services from suitable DRGs can be transferred to a hybrid DRG. Assigning services without the involvement of clinical experts seems extremely difficult. Case assignment based on arbitrary contextual factors increases complexity without demonstrably increasing the quality of the assignment and needs to be further developed. A cost analysis can be derived from the known inpatient costs and must serve as the basis for the 2025 Hybrid DRG catalog.

The cost-effectiveness of a bimekizumab versus IL-17A inhibitors treatment-pathway in patients with active axial spondyloarthritis in Scotland

Objective To estimate the cost-effectiveness of a treatment-pathway initiated with bimekizumab, a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F and IL-17A, in patients with axial spondyloarthritis (axSpA) compared with IL-17Ai's, ixekizumab, and secukinumab, from the NHS Scotland perspective. Methods The axSpA treatment-pathway was modeled using a decision tree followed by a lifetime Markov model. The pathway included first- and second-line biologic disease-modifying antirheumatic drugs (bDMARD), followed by best supportive care (bDMARD, nonbiologic). Bimekizumab followed by any bDMARD (“BKZ”) was compared with IL-17Ai’s: secukinumab 150 mg followed by a blend (“SEC”) of dose up-titration to secukinumab 300 mg and any bDMARD, or ixekizumab followed by any bDMARD (“IXE”). Transition to the next therapy was triggered by Bath Ankylosing Spondylitis Disease Activity Index-50% (BASDAI50) non-response or any-cause discontinuation. A published network meta-analysis provided efficacy data. EuroQoL-5-dimensions utilities were derived by mapping from Ankylosing Spondylitis Disease Activity Score. Costs included disease management (linked to functional limitations), biologics acquisition (list prices), administration and monitoring (NHS 2021/22). Discounting was 3.5%/year. Probabilistic results from patients with non-radiographic axSpA and ankylosing spondylitis were averaged to reflect the axSpA disease spectrum. Scenario and sensitivity analyses were performed. Results The incremental cost-effectiveness ratio (ICER) of BKZ was £24,801/quality-adjusted life-year (QALY) vs. SEC (95% credible interval £24,163–£25,895). BKZ had similar costs (Δ -£385 [−£15,239–£14,468]) and QALYs (Δ 0.039 [−0.748–0.825]) to IXE, with £1,523 (£862–£2,222) net monetary benefit. Conclusions remained unchanged in most scenarios. Results’ drivers included BASDAI50 response rate and disease management cost. Limitations Results were based on list prices. Data concerning up-titration to secukinumab 300 mg was scarce. Conclusions The bimekizumab treatment-pathway represents a cost-effective option across the axSpA disease spectrum in Scotland. Bimekizumab is cost-effective compared to a secukinumab-pathway that includes dose up-titration, and has similar costs and QALYs to an ixekizumab-pathway.

CTM: Cross-time temporal module for fine-grained action recognition

Dynamic contextual attribute information in the time dimension is the key to fine-grained action recognition. Temporal contextual relationships cannot be captured by conventional 2D CNNs; good local time can be obtained by the 3D CNNs, but the 3D CNNs are computationally intensive and lack capability for global time. A parallel cross-time temporal module-CTM is proposed in this article, which aims to efficiently capture dynamic contextual information of both local and global temporal dimensions. With our study, we think that the 2D CNNs can better mine temporal features to enrich the contextual relationships of temporal dimensions. The CTM can be embedded into any existing 2D CNNs baseline in a plug-and-play manner, yielding a feature framework that can capture complex spatio-temporal modeling (CTNet) with a tiny additional computational cost. In the extensive validation experiments on three datasets(i.e., SomethingV1&V2, Jester, Diving48), both action recognition accuracy and runtime inference speed are obviously better than existing temporal contextual baseline optimization schemes with similar computational cost complexity, when the CTM embedded into any 2D CNNs framework to enhance the baseline.

Cost-Effectiveness of HIV Screening in Emergency Departments: Results From the Pragmatic Randomized HIV Testing Using Enhanced Screening Techniques in Emergency Departments Trial

Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this study was to compare programmatic costs and cost-effectiveness of nontargeted and 2 forms of targeted opt-out HIV screening in EDs using results from a multicenter, pragmatic randomized clinical trial. This economic evaluation was nested in the HIV Testing Using Enhanced Screening Techniques in Emergency Departments (TESTED) trial, a multicenter pragmatic clinical trial of different ED-based HIV screening strategies conducted from April 2014 through January 2016. Patients aged 16 years or older, with normal mental status and not critically ill, or not known to be living with HIV were randomized to 1 of 3 HIV opt-out screening approaches, including nontargeted, enhanced targeted, or traditional targeted, across 4 urban EDs in the United States. Each screening method was fully integrated into routine emergency care. Direct programmatic costs were determined using actual trial results, and time-motion assessment was used to estimate personnel activity costs. The primary outcome was newly diagnosed HIV. Total annualized ED programmatic costs by screening approach were calculated using dollars adjusted to 2023 as were costs per patient newly diagnosed with HIV. One-way and multiway sensitivity analyses were performed. The trial randomized 76,561 patient visits, resulting in 14,405 completed HIV tests, and 24 (0.2%) new diagnoses. Total annualized new diagnoses were 12.9, and total annualized costs for nontargeted, enhanced targeted, and traditional targeted screening were $111,861, $88,629, and $70,599, respectively. Within screening methods, costs per new HIV diagnoses were $20,809, $23,554, and $18,762, respectively. Enhanced targeted screening incurred higher costs but with similar annualized new cases detected compared with traditional targeted screening. Nontargeted screening yielded an incremental cost-effectiveness ratio of $25,586 when compared with traditional targeted screening. Results were most sensitive to HIV prevalence and costs of HIV tests. Nontargeted HIV screening was more costly than targeted screening largely due to an increased number of HIV tests performed. Each HIV screening strategy had similar within-strategy costs per new HIV diagnosis with traditional targeted screening yielding the lowest cost per new diagnosis. For settings with budget constraints or very low HIV prevalences, the traditional targeted approach may be preferred; however, given only a slightly higher cost per new HIV diagnosis, ED settings looking to detect the most new cases may prefer nontargeted screening.

Management of acetabular bone loss in revision total hip replacement: a narrative literature review.

Due to growing numbers of primary total hip replacement (THR), the revision THR burden is also increasing. Common indications for revision are osteolysis, infection, instability, and mechanical failure of implants, which can cause acetabular bone loss. Massive acetabular bone defects and pelvic discontinuity are extremely challenging problems. Many techniques have been utilized to address bone loss while maintaining a stable revision THR. Structural allografts, cemented prosthesis, reconstruction cages, and custom triflanged implants have all been used successfully albeit with relatively high complications rates. We have tried to highlight emerging trends to utilize Custom Made Monoflange or Triflange Acetabular Components to reconstruct massive acetabular defects with favourable midterm implant survival, better functional outcomes, relatively lesser complications, and almost similar cost of prosthesis as compared to conventional reconstruction techniques. However, long-term data and study is still recommended to draw a definitive conclusion. In this narrative review article, we searched PubMed and Cochrane for studies on managing acetabular bone loss in revision THR with a focus on recent literature for mid to long-term outcomes and compared results from various studies on different reconstruction methods. Hemispherical cementless acetabular prosthesis with supplemental screws are commonly utilized to manage mild to moderate acetabular bone loss. Recent trends have shown much interest and paradigm shift in patient specific custom triflange acetabular components (CTAC) for reconstructing massive acetabular defects and pelvic discontinuity. Studies have reported high patient satisfaction, improved patient reported daily functioning, high mid-term implant survival, similar complications, and encouraging all cause re-revision rate. However, more prospective and quality studies with larger sample sizes are needed to validate the superiority of CTACs over conventional acetabular implants. There is no consensus regarding the best option for reconstructing massive acetabular defects. Thorough preoperative workup and planning is an absolute requirement for successful revision THR. While most of the moderate acetabular bone loss can be managed with cementless hemispherical acetabular shells with excellent long-term outcomes, reconstructing massive acetabular bone defects in revision THR remains a challenge. Depending on the size and location of the defect, various constucts have demonstrated long-term success as discussed in this review, but complications are not negligible. CTACs provide a treatment for massive bone loss that may be otherwise difficult to achieve anatomic stability with other constructs. Although long-term data is sparse, the cost and complication rate is comparable to other reconstruction methods.

FMRNet: Image Deraining via Frequency Mutual Revision

The wavelet transform has emerged as a powerful tool in deciphering structural information within images. And now, the latest research suggests that combining the prowess of wavelet transform with neural networks can lead to unparalleled image deraining results. By harnessing the strengths of both the spatial domain and frequency space, this innovative approach is poised to revolutionize the field of image processing. The fascinating challenge of developing a comprehensive framework that takes into account the intrinsic frequency property and the correlation between rain residue and background is yet to be fully explored. In this work, we propose to investigate the potential relationships among rain-free and residue components at the frequency domain, forming a frequency mutual revision network (FMRNet) for image deraining. Specifically, we explore the mutual representation of rain residue and background components at frequency domain, so as to better separate the rain layer from clean background while preserving structural textures of the degraded images. Meanwhile, the rain distribution prediction from the low-frequency coefficient, which can be seen as the degradation prior is used to refine the separation of rain residue and background components. Inversely, the updated rain residue is used to benefit the low-frequency rain distribution prediction, forming the multi-layer mutual learning. Extensive experiments demonstrate that our proposed FMRNet delivers significant performance gains for seven datasets on image deraining task, surpassing the state-of-the-art method ELFormer by 1.14 dB in PSNR on the Rain100L dataset, while with similar computation cost. Code and retrained models are available at https://github.com/kuijiang94/FMRNet.

Off-Pump Coronary Artery Bypass Grafting Does Not Confer Superior Outcomes Among Frail Patients

Off-pump coronary revascularization (OPCAB) has been proposed to benefit patients who are at a greater surgical risk because it avoids the use of extracorporeal circulation. Although, historically, older patients were considered high-risk candidates, recent studies implicate frailty as a more comprehensive measure of perioperative fitness. Yet, the outcomes of OPCAB in frail patients have not been elucidated. Thus, using a national cohort of frail patients, we assessed the impact of OPCAB relative to on-pump coronary revascularization (ONCAB). Patients who underwent first-time elective coronary revascularization were tabulated from the 2010 to 2020 Nationwide Readmissions Database. Frailty was assessed using the previously-validated Johns Hopkins Adjusted Clinical Groups indicator. Multivariable models were used to consider the independent associations between OPCAB and the key outcomes. Of ∼26,529 frail patients, 6,322 (23.8%) underwent OPCAB. After risk adjustment and compared with ONCAB, OPCAB was linked with similar odds of in-hospital mortality but greater likelihood of postoperative cardiac arrest (adjusted odds ratio [AOR] 1.53, confidence interval [CI] 1.13 to 2.07) and myocardial infarction (AOR 1.44, CI 1.23 to 1.69). OPCAB was further associated with greater odds of postoperative infection (AOR 1.22, CI 1.02 to 1.47) but decreased need for blood transfusion (AOR 0.68, CI 0.60 to 0.77). In addition, OPCAB faced a +0.86-day increase in length of stay (CI 0.21 to 1.51) but similar costs (β $1,610, CI -$1,240 to 4,460) relative to ONCAB. Although OPCAB was associated with no difference in mortality compared with ONCAB, it was linked with greater likelihood of postoperative cardiac arrest and myocardial infarction. Our findings demonstrate that ONCAB remains associated with superior outcomes, even in the growing population of frail patients who underwent coronary revascularization.

Low-mode deflation for twisted-mass and RHMC reweighting in lattice QCD

We propose improved estimators to compute the reweighting factors which are needed for lattice QCD calculations that rely on twisted-mass reweighting for the light quark contribution and the Rational Hybrid Monte Carlo (RHMC) algorithm for non-degenerate quark masses. This is the case for a number of modern large-scale simulations based on O(a) improved Wilson fermions. We find a significant reduction of uncertainties for the reweighting factors at similar computational cost compared to the conventional estimation. This leads to a significant increase in precision for phenomenologically relevant observables with high correlation to the low eigenmodes of the Wilson-Dirac operator in the presence of exceptionally small eigenvalues. Supplementary details regarding the spectral gap of the light quark Dirac operator on the 2+1 flavor large-volume ensembles explored in this study can be found in an accompanying appendix.

Energy vulnerability of detached home owners in Finland: An explorative study

Vulnerability to energy poverty occurs when a household has difficulties to meet adequate energy service levels. Recent energy crises manifested the consequences of energy vulnerability also in the Nordic countries. This study brings evidence on energy poverty in Finland, using a large household energy survey dataset (N = 4,295). The ten-per-cent limit threshold is used to measure objective energy vulnerability and the subjective measure is based on the regularity of households’ self-assessed psychological burden regarding their energy expenditures. In our dataset, 18 % of households in detached and semi-detached houses were objectively energy poor and 27 % felt a regular energy-cost burden. Heating type, building age, education level and gender were significant determinants. Ownership of a ground-source heat pump and usage of solid wood reduces winter energy poverty in Finland. Women, particularly in older age groups were significantly more vulnerable than men. For some groups, objective and subjective measurement produced distinctively different results. Households using oil heating in a hybrid heating arrangement were more vulnerable in the objective measurement but they did not feel a similar subjective energy cost burden. Families with children felt subjectively more burdened by their energy expenses than other groups, but they were not more energy-poor along the objective measurement. This is one of the first energy vulnerability studies based on large amount of citizen survey data in Finland and we recommend that further research focuses particularly on how different social groups can access and use different heating installations as this is a key determinant of energy vulnerability in countries with substantial domestic heating energy needs.