Similar Probability Research Articles

Trail vs. thicket: Evaluating conservation detection dog performance in varied terrain

AbstractUse of detection dogs has emerged as an effective survey method for rare and cryptic species, outperforming traditional methods. However, there is little information available on how survey conditions may affect survey efforts. This study investigates the detection probability, effective sweep width, and search time of a detection dog working on‐lead in varying vegetation and weather conditions in Florida. We established 4 200‐m long transects in habitats with varying vegetation structure: open field, open canopy forest, closed canopy forest, and trail. American mink (Neogale vison) scat was set along each transect, in locations unknown to the detection dog handler, at distances ranging from 0 to 24 m from the transect. Vegetation and weather conditions were recorded for each survey. Between August 2021 and October 2022, we conducted 28 surveys (112 total transect surveys). Across all transects the detection dog located 66% of hidden scats (n = 384). We calculated an effective sweep width of 49 m (24.5 m on either side of the transect) and detection probability decreased with distance from transect line. Contrary to expectations, vegetation structure and weather conditions did not influence detection probability, but vegetation structure did affect search time, an important variable to consider when designing surveys. Search time increased with increases in understory vegetation obstruction and basal area. Conducting surveys on trails showed promise as an effective search method, having similar detection probability to off‐trail transects and faster search times than the closed canopy forest transect. Trail surveys may be particularly useful for areas that would otherwise be impassable, but their effectiveness may vary based on the target species' behavior. Our study underscores the importance of understanding search metrics in conservation detection dog surveys to design effective and appropriate surveys for anticipated field conditions.

A surrogate FRAX model for Nepal

SummaryA surrogate FRAX® model for Nepal has been constructed using age- and sex-specific hip fracture rates for Indians living in Singapore and age- and sex-specific mortality rates from Nepal.IntroductionFRAX models are frequently requested for countries with little or no data on the incidence of hip fractures. In such circumstances, the development of a surrogate FRAX model is recommended based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.ObjectiveThis report describes the development and characteristics of a surrogate FRAX model for Nepal.MethodsThe FRAX model used the ethnic-specific incidence of hip fracture in the Indian community of Singapore, combined with the death risk for Nepal in 2015–2019. The number of hip fractures in 2015 and 2050 was estimated based on the United Nations’ predicted changes in population demography.ResultsThe surrogate model gave similar hip fracture probabilities to estimates from Sri Lanka, India and Pakistan but lower 10-year fracture probabilities for men and women at older ages compared to the model for Singapore, reflecting a higher mortality risk in Nepal compared with Singapore. There were very close correlations in fracture probabilities between the Nepalese and the Singapore models (r> 0.995) so that the use of the Nepalese model had little impact on the rank order of risk, i.e. a person at the xth percentile of risk with one model will be at the xth percentile of risk with the other. It was estimated that 6897 hip fractures arose in 2015 in individuals aged 50 years and older in Nepal, with a predicted 3-fold increase expected by 2050, when 23,409 hip fractures are expected nationally.ConclusionThe surrogate FRAX model for Nepal provides an opportunity to determine fracture probability within the Nepalese population and help guide decisions about treatment.

NCOG-47. DEFINING PERIOPERATIVE RISK FACTORS IN STEREOTACTIC BRAIN BIOPSIES AMONG DIFFERENT HISTOLOGIC DIAGNOSES

Abstract INTRODUCTION Stereotactic brain biopsies (SBB) are critical for diagnosing neoplastic central nervous system pathologies including gliomas, metastatic carcinomas (cA), and lymphomas. While SBB-related complications have been cited in the literature, we sought to characterize the perioperative risk factors/outcomes. METHODS We conducted a retrospective review of 615 patients who underwent a SBB at the same tertiary academic hospital between 2000-2020. Logistic regression was conducted across all recorded variables to assess the relative impact on intra/postoperative complications, and Kaplan-Meier curves were calculated to assess probability of 1-year hospice enrollment. RESULTS Of the 615 patients, the average (+/- SD) age was 56+/- 19 years with 286 (46.5%) female patients and the following histological groups: glioma (n=422), lymphoma (n=74), and metastatic cA (n=22). Complications included intraoperative bleeding (7.1%), general postoperative hemorrhage (34%), symptomatic postoperative hemorrhage (3.3%), and discharge-to-hospice (6.8%). General hemorrhage and discharge-to-hospice were most common in glioma (p < 0.001) and lymphoma patients (p=0.003), respectively. Independent risk factors for general hemorrhage included medical history (mental status deficits, glioma, GBM; p= 0-0.02) and biopsy characteristics (parietal lobe, subcortical, eloquent, M8 hole, multiple depths; p= 0-0.05). Preoperative systematic workups and history of lymphoma were independently associated with lower hemorrhage risk (p= <0.001). Risk factors for hospice discharge included preoperative deficits (gait, speech, and mental status; p=0.001-0.05) and postoperative complications (prolonged ICU, UTI, pneumonia; p<0.001). Of the 15 cases of symptomatic hemorrhage, there was a significantly greater representation of glioma patients (p<0.001) with 67% GBM patients and 50% with multiple-depth biopsies. These patients had similar probability of 1-year hospice enrollment compared to non-hemorrhagic patients (p= 0.92). DISCUSSION While complication rates were relatively similar among different histological categories, perioperative risk factors broadly differed based on the type of complication. Understanding perioperative risk factors in SBB may help inform surgical decision making and prognostication.

Host nest defence does not act as selective agent against plumage polymorphism in brood parasites.

Batesian mimicry in brood parasites is often viewed as an evolutionary strategy to mitigate host aggression. Female common cuckoos (Cuculus canorus) exhibit two morphs: the hawk-like grey and the rufous one, potentially maintained by apostatic selection. It was hypothesized that the grey morph's predator-like appearance deters host defences, while the rufous morph benefits from its rarity by evading host attention. Previous research predominantly utilized static cuckoo dummies, lacking insights into real-world interactions. We investigated the effectiveness of the cuckoo morphs in accessing great reed warbler (Acrocephalus arundinaceus) nests under natural conditions. Analysing video-recorded cuckoo attempts, we found no significant difference in nest-access success between the morphs. Both experienced a similar probability of physical attacks when hosts were present, and the rufous morph did not evade host detection more often compared with the grey morph. These results fail to support the assumptions of (a) Batesian mimicry, that hawk-like mimicry enhances nest access or reduces host aggression, and (b) apostatic selection, that the rarity of the rufous morph confers an advantage in successfully accessing the host nest. Future research should aim to identify stages in the cuckoo's life cycle or host interactions where colour polymorphism provides an evolutionary benefit.

Fair and Efficient Ridesharing: A Dynamic Programming-based Relocation Approach

Recommending routes by their probability of having a rider has long been the goal of conventional route recommendation systems. While this maximizes the platform-specific criteria of efficiency, it results in sub-optimal outcomes with the disparity among the income of drivers who work for similar time frames. Pioneer studies on fairness in ridesharing platforms have focused on algorithms that match drivers and riders. However, these studies do not consider the time schedules of different riders sharing a ride in the ridesharing mode. To overcome this shortcoming, we present the first route recommendation system for ridesharing networks that explicitly considers fairness as an evaluation criterion. In particular, we design a routing mechanism that reduces the inequality among drivers and provides them with routes that have a similar probability of finding riders over a period of time. However, while optimizing fairness the efficiency of the platform should not be affected as both of these goals are important for the long-term sustainability of the system. In order to jointly optimize fairness and efficiency we consider repositioning drivers with low income to the areas that have a higher probability of finding riders in future. While applying driver repositioning, we design a future-aware policy and allocate the areas to the drivers considering the destination of requests in the corresponding area. Extensive simulations on real-world datasets of Washington DC and New York demonstrate superior performance by our proposed system in comparison to the existing baselines.

The Potential of Aloe Vera in Solution and in Blended Nanofibers Containing Poly (3-Hydroxybutyrate-Co-3-Hydroxyvalerate) as Substrates for Neurite Outgrowth.

This pilot study investigated the potential of aloe vera (AV) to promote neurite outgrowth in organotypic dorsal root ganglia (DRG) explants (n = 230) from neonatal rats (n = 15). Using this invitro model of acute axotomy, we assessed neurite outgrowth exceeding 1.5 times the explant diameter (viable explants) and measured the longest neurite length. These parameters were evaluated under control conditions and in cultures supplemented with commercial AV and four aligned scaffolds: poly-L-lactate (PLLA), polydioxanone (PDS), poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), and blended PHBV/AV. After 6 days of culture, explants were immunostained using neuron-specific marker Tuj1 and Schwann cell marker S100. Measurements were obtained with Image J software and analyzed using Jamovi 2.3. In control and AV dilution media, the study revealed radial tissue growth from the explant body with randomly oriented neurites, whereas in all scaffolds, bidirectional tissue growth occurred parallel to nanofibers. Binomial logistic regression analyses indicated that viable explants were more likely in the control group compared to PDS (p = 0.0042) and PHBV (p < 0.0001), with non-significant differences when compared to AV dilution, PLLA, and PHBV/AV. AV dilution showed a greater association with viable explants than PLLA (p = 0.0459), while non-significant difference was found between AV dilution and PHBV/AV. Additionally, the PHBV/AV scaffold predicted higher odds of viable explants than PLLA (p = 0.0479), PDS (p = 0.0001), and PHBV (p < 0.0001). Groups with similar probabilities of obtaining viable explants (control, AV dilution, and PHBV/AV) exhibited non-significant differences in their longest neurite lengths. In conclusion, control, AV dilution, and PHBV/AV yielded the highest probability of developing viable explants and the longest neurite lengths. This is the first study demonstrating the direct permissiveness of AV for axonal outgrowth. Furthermore, the blended PHBV/AV scaffold showed significant potential as a suitable scaffold for axonal regrowth and Schwann cell migration, ensuring controlled tissue formation for tissue engineering applications.

Comparative mortality in pituitary adenomas subtypes: a tertiary referral center study.

Mortality in pituitary adenomas (PAs) has been extensively compared to general population. However, direct comparisons between PA subtypes are scarce. We aimed to compare mortality in various subtypes of PA (acromegaly, Cushing's disease (CD), macroprolactinomas and non-functioning pituitary macroadenomas (MacroNFPA)), within a single referral center. We retrospectively analyzed mortality and survival time in all 962 PAs admitted in our department between 2011 and 2023: acromegaly (n = 306), CD (n = 69), macroprolactinoma (n = 168) and MacroNFPA (n = 419). Median follow-up was 10.2 (5.2, 15.2) years. The overall survival probability was 90.9% and 78.1% after 10 and 20 years respectively with age at diagnosis as the only significant predictor. There were no significant differences in survival probability between various PA subtypes in the whole cohort. In patients over 45 years of age at diagnosis there was a significant difference in survival probability between the four groups (p = 0.01) in the first 15 years of follow-up. In head-to-head comparisons CD had a significantly higher mortality risk than patients with acromegaly (HR 3.38 [CI 95% 1.07 to 10.60]) even after adjusting for age and sex. Patients diagnosed with CD after 45 years of age have a significantly lower survival probability than other PA subtypes in the first 15 years of follow-up. All other PA subtypes had a similar survival probability after adjusting for age and sex. Due to advances in medical treatment of hormone secreting tumors, mortality in patients with PAs might increasingly depend more on tumor mass than on hormonal hypersecretion.

Redshifts of candidate host galaxies of four fast X-ray transients using VLT/MUSE

Context. Fast X-ray transients (FXTs) are X-ray flares that last from minutes to hours. Multi-wavelength counterparts to these FXTs have proven hard to find. As a result, distance measurements are made through indirect methods such as a host galaxy identification. Of the three main models proposed for FXTs, that is, supernova shock breakout emission (SN SBO), binary neutron star (BNS) mergers, and tidal dirsuption events (TDEs) of an intermediate-mass black hole (IMBH) disrupting a white dwarf (WD), the SN SBO predicts a much lower maximum peak X-ray luminosity (LX, peak). If the distance to FXTs were to be obtained, it would be a powerful probe for investigating the nature of these FXTs. Aims. We aim to obtain distance measurements to four FXTs by identifying candidate host galaxies. Through a redshift measurement of the candidate host galaxies, we derive LX, peak and the projected offset between the candidate host galaxy and the FXT. Methods. We obtained Very Large Telescope (VLT)/Multi Unit Spectroscopic Explorer (MUSE) observations of a sample of FXTs. We report the redshift of between 13 and 22 galaxies per FXT. We used these redshifts to calculate the distance, LX, peak and the projected offsets between the FXT position and the position of the sources. Additionally, we computed the chance alignment probabilities for these sources with the FXT postitions. Results. We find LX, peak &gt; 1044 erg s−1 when we assume that any of the sources with a redshift measurement is the true host galaxy of the corresponding FXT. For XRT 100831, we find a very faint galaxy (mR, AB = 26.5 ± 0.3, z ∼ 1.22, LX, peak ∼ 8 × 1045 erg s−1 if the FXT is at this distance) within the 1σ uncertainty region with a chance alignment probability of 0.04. For XRT 060207, we find a candidate host galaxy at z = 0.939 with a low chance alignment probability within the 1σ uncertainty region. However, we also report the detection of a late-type star within the 3σ uncertainty region with a similar chance alignment probability. For the remaining FXTs (XRT 030511 and XRT 070618), we find no sources within their 3σ uncertainty regions. The projected offsets between the galaxies and the FXT positions is &gt; 33 kpc at 1σ uncertainty. Therefore, if one of these candidate host galaxies turns out to be the true host galaxy, it would imply that the FXT progenitor originated from a system that received a significant kick velocity at formation. Conclusions. We rule out an SN SBO nature for all FXTs based on LX, peak and the projected offsets between the FXT position and the sources, assuming any of the candidate host galaxies with a redshift determination is the true host galaxy to the FXT. For XRT 100831, we conclude that the detected galaxy within the 1σ uncertainty position is likely to be the host galaxy of this FXT based on the chance alignment probability. From the available information, we are not able to determine whether XRT 060207 originated from the galaxy found within 1σ of the FXT position or was due to a flare from the late-type star detected within the 3σ uncertainty region. Based on LX, peak and the offsets within our sample, we are not able to distinguish between the BNS merger and the IMBD-WD TDE progenitor model. However, for the candidate host galaxies with an offset ≳30 kpc, we can conclude that the IMBH-WD TDE is unlikely due to the large offset.

Synthetic oversampling with Mahalanobis distance and local information for highly imbalanced class-overlapped data

Minority oversampling is currently one of the most popular and effective methods for handling imbalanced data. However, oversampling that relies on the observations of the minority class to generate new samples is not applicable in the scenario of imbalanced data with extremely scarce minority samples, because the strongly underrepresented minority class does not contain enough information to support the oversampling process. Since some recent studies have exhibited the effectiveness of using majority information to bootstrap oversampling, the neglect of class overlap in the sampling process would increase the overlapping degree and complicate the decision boundary. To this end, this paper proposes a Mahalanobis distance and Local information based OverSampling (MLOS) for highly imbalanced class-overlapped data. MLOS first employs the majority density to guide the sample synthesis, with Mahalanobis distance to extract the majority probability contour. Then for each minority seed sample, to avoid the generation of overlapping samples, MLOS constrain the synthetic process by finding the auxiliary sample (in its 5 nearest neighbors) with similar probability density value to the seed. Finally, MLOS uses a pair-wise data cleaning process to improve the visibility of the decision boundary according to the probability density of synthetic samples. Comparative experiments conducted on 16 highly imbalanced class-overlapped datasets, using 17 different methods, demonstrates the superiority of our proposed method in terms of three popular evaluation metrics AUC, G-mean and Recall for imbalance classification. The source code of MLOS is available at https://github.com/ytyancp/MLOS.

Development and evaluation of predictive models for pregnancy risk in UK dairy cows

One suggested approach to improve the reproductive performance of dairy herds is through the targeted management of subgroups of biologically similar animals, such as those with similar probabilities of becoming pregnant, termed pregnancy risk. We aimed to use readily available farm data to develop predictive models of pregnancy risk in dairy cows. Data from a convenience sample of 108 dairy herds in the UK were collated and each herd was randomly allocated, at a ratio of 80:20, to either training or testing data sets. Following data cleaning, there were a total of 78 herds in the training data set and 20 herds in the testing data set. Data were further split by parity into nulliparous, primiparous, and multiparous subsets. An XGBoost model was trained to predict the insemination outcome in each parity subset, with predictors from farm records of breeding, calving and milk recording. Training data comprised 74,511 inseminations in 45,909 nulliparous animals, 86,420 inseminations in 39,439 primiparous animals, and 158,294 inseminations in 32,520 multiparous animals. The final models were evaluated by predicting with the testing data, comprising 31,740 inseminations in 19,647 nulliparous animals, 38,588 inseminations in 16,215 primiparous animals, and 65,049 inseminations in 12,439 multiparous animals. Model discrimination was assessed by calculating the area under receiver operating characteristic curves (AUC); model calibration was assessed by plotting calibration curves and compared across test herds by calculating the expected calibration error (ECE) in each test herd. The models were unable to discriminate between insemination outcomes with high accuracy, with an AUC of 0.63, 0.59 and 0.62 in the nulliparous, primiparous and multiparous subsets, respectively. The models were generally well-calibrated, meaning the model-predicted pregnancy risks were similar to the observed pregnancy risks. The mean (SD) ECE in the test herds was 0.038 (0.023), 0.028 (0.012) and 0.020 (0.008) in the nulliparous, primiparous and multiparous subsets respectively. The predictive models reported here could theoretically be used to identify subgroups of animals with similar pregnancy risk to facilitate targeted reproductive management; or provide information about cows' relative pregnancy risk compared with the herd average, which may support on-farm decision-making. Further research is needed to evaluate the generalizability of these predictive models and understand the source of variation in ECE between herds; however, this study demonstrates that it is possible to accurately predict pregnancy risk in dairy cows using readily available farm data.

Fischer-Tropsch Synthesis for the Production of Sustainable Aviation Fuel: Formation of Tertiary Amines from Ammonia Contaminants.

Fischer-Tropsch synthesis combined with product workup is a promising route toward synthetic aviation fuel from renewable hydrogen and carbon sources like biomass, CO2, and waste. Cost savings can be achieved by reducing the number of gas treatment steps in new plants, but the consequence of contaminants in the feed needs investigation. While feeding 2.6 ppmV ammonia to a Fischer-Tropsch reactor, it was shown that ammonia was predominantly chemically converted into organic amines, with most nitrogen found in the water phase (89%), followed by heavy wax (7%) and light wax (1%). The concentration difference between water and light wax was shown to be due to the post-condensation separation of amines on polarity. Amines up to a chain length of 120 were detected in the heavy wax with MALDI-FT-ICR-MS, which, in combination with the high nitrogen content, suggests that amines have a similar chain growth probability compared to the main hydrocarbon products. Detailed product analysis with three independent analytical techniques showed that tertiary N,N-dimethylalkylamines were by far the most abundant amine class. This suggests that ammonia is decomposed on the cobalt surface and, potentially as a dimethylamine fragment, incorporated in the growing chain. Further evidence was obtained from the abundance of trimethylamine and from the reconciled nitrogen product analysis up to C100, which showed that the amine product distribution followed from naphtha onward the same ASF kinetics as alkanes and oxygenates while being distinctively different from the alkene distribution. The presented findings provide further avenues for studies of the Fischer-Tropsch reaction mechanism and indicate the opportunity of cost saving on gas treatment, while further validation is required to assess the impact on hydrocracking and product quality.

Characteristics and Outcomes Among US Commercially Insured Transgender Adults With Cirrhosis: A National Cohort Study.

The National Institute on Minority Health and Health Disparities has noted that transgender individuals experience unique health disparities. We sought to describe the landscape of transgender patients with cirrhosis. We identified all transgender and cisgender adults in Optum's deidentified Clinformatics Data Mart Database between 2007 and 2022 using validated billing codes and calculating age-standardized prevalence of cirrhosis among cisgender vs transgender adults. Among those with incident cirrhosis diagnoses, we calculated age-standardized incidence densities of liver-related outcomes (decompensation, transplantation, hepatocellular carcinoma) and all-cause mortality. We examined 5-year survival using inverse probability treatment weighting to balance transgender and cisgender populations on demographic and clinical characteristics. Among 64,615,316 adults, 42,471 (0.07%) were transgender. Among 329,251 adults with cirrhosis, 293 (0.09%) were transgender. Trans- (vs cis-) genders had higher prevalence of cirrhosis (1,285 [95% confidence interval (CI) 1,136-1,449] per 100,000 vs 561 [559-563] per 100,000). Among adults with cirrhosis, trans- (vs cis-) genders had higher proportions of anxiety (70.7% [56.9-86.9] vs 43.2% [42.7-43.8]), depression (66.4% [53.3-81.7] vs 38.4% [37.9-38.9]), HIV/AIDS (8.5% [3.9-16.1] vs 1.6% [1.5-1.7]), and alcohol (57.5% [46.0-71.1] vs 51.0% [50.5-51.6]) and viral (30.5% [22.8-39.8] vs 24.2% [23.9-24.5]) etiologies, although etiologies had overlapping CIs. Trans- (vs cis-) genders had similar incidence densities of death (12.0 [95% CI 8.8-15.3] vs 14.0 [13.9-14.2] per 100 person-years), decompensation (15.7 [10.9-20.5] vs 14.1 [14.0-14.3]), and liver transplantation (0.3 [0.0-0.8] vs 0.3 [0.3-0.4]). In inverse probability treatment weighting survival analysis, transgender and cisgender individuals had similar 5-year survival probabilities (63.4% [56.6-71.1] vs 59.1% [58.7-59.4]). Trans- (vs cis-) gender adults have double the prevalence of cirrhosis, and the majority have a diagnosis of anxiety and/or depression. These results are informative for researchers, policymakers, and clinicians to advance equitable care for transgender individuals.

Prediction of Disease Progression and Clinical Response in Systemic Sclerosis: Experience From a Proof-of-Concept Trial.

Using the modified Rodnan skin score (mRSS) as a surrogate for disease activity, a phase 2a study in patients with systemic sclerosis (SSc) measured efficacy of the autotaxin inhibitor ziritaxestat. Mathematical modeling of mRSS was used to predict disease progression, examine candidate trial designs, and predict the probability of successfully discriminating treatment effect. Patients with SSc receiving 600 mg of ziritaxestat or placebo for 24 weeks were included, in addition to data up to week 52 of the open-label extension (OLE). Longitudinal mRSS data were described using a disease progression model; drug effect was a binary variable. Parameters used to predict the OLE mRSS outcome were estimated using data from the 24-week double-blind phase and validated with observed data. Three trial designs were simulated to identify which had the highest probability of detecting a treatment effect. Power to detect a treatment effect was quantified using the simulations. Maximum decreases from baseline in mRSS were 50.4% (ziritaxestat) and 34.7% (placebo). Study designs based on 300 patients randomized 2:1 or 1:1 to 600 mg of ziritaxestat or placebo had similar probabilities of detecting a significant treatment effect. Power to detect a treatment effect was >80% for all simulations. Disease progression and drug effect could be predicted beyond the range of observed data. This modeling and simulation approach may inform future trial design, including study duration, and predict the probability of success.

Complications and revisions in metal-backed anatomic total shoulder arthroplasty: a comparative study of revision rates between stemless and stemmed humeral components

BackgroundThe primary objective of this study was to evaluate and compare the incidence of complications and revision surgeries between in two of convertible metal-back glenoid systems in total shoulder arthroplasty (aTSA) groups over a follow-up period of up to five years. MethodsA retrospective analysis included 69 shoulders from 65 patients with primary aTSA. Patients were divided into Group 1 (n=31), receiving convertible cementless stemmed aTSA (Lima SMR) and Group 2 (n=38), receiving humeral head replacement aTSA (Arthrex, Eclipse) both with metal-back glenoid components. Clinical and radiological assessments were conducted at 2, 5, and 10 years postoperatively. Assessments included the following: Constant Score, DASH, SPADI, SSV, Glenohumeral Distance, Critical Shoulder Angle and Lateral Acromion Index. In addition, we compared complications, revision rates and survival rates between groups using Kaplan-Maier curves and Log-Rank-test. ResultsBaseline demographics and preoperative outcome scores showed no significant differences between groups (p≥0.05). The overall revision rate did not significantly differ between groups (Group 1:32% vs. Group 2:24%, p=0.60), nor did the mean time to revision (p=0.27). The mean follow-up was 71±41 months (Group 1: 94±48 months, Group 2: 53±23 months, p<0.001). Kaplan-Meier analysis showed similar mid-term survival probabilities (p=0.94). Revision reasons included rotator cuff insufficiency (n=4 in Group 1, n=2 in Group 2) and glenoid wear/loosening (n=5 in Group 1, n=7 in Group 2). Interestingly, Group 1 demonstrated no occurrence of glenoid metal baseplate or humeral loosening, while complex revisions were more common in the Group 2. At 2 and 5 years, non-revised patients in both groups had similar outcome scores. ConclusionMetal-backed glenoid implants in combination with both stemless and stemmed humeral components in aTSA exhibit comparable revision rates and survival probabilities. Rotator cuff insufficiency and polyethylene wear are the two most common complications leading to revision. To facilitate ongoing monitoring and optimize patient safety, we implemented a modification in the follow-up protocol, transitioning to annual appointments or earlier when necessary. This study underscores the unsolved disadvantages in metal-back components and the importance of a mid- to long-term longitudinal assessment of those patients.

Analysis of early intermediate states of the nitrogenase reaction by regularization of EPR spectra

Due to the complexity of the catalytic FeMo cofactor site in nitrogenases that mediates the reduction of molecular nitrogen to ammonium, mechanistic details of this reaction remain under debate. In this study, selenium- and sulfur-incorporated FeMo cofactors of the catalytic MoFe protein component from Azotobacter vinelandii are prepared under turnover conditions and investigated by using different EPR methods. Complex signal patterns are observed in the continuous wave EPR spectra of selenium-incorporated samples, which are analyzed by Tikhonov regularization, a method that has not yet been applied to high spin systems of transition metal cofactors, and by an already established grid-of-error approach. Both methods yield similar probability distributions that reveal the presence of at least four other species with different electronic structures in addition to the ground state E0. Two of these species were preliminary assigned to hydrogenated E2 states. In addition, advanced pulsed-EPR experiments are utilized to verify the incorporation of sulfur and selenium into the FeMo cofactor, and to assign hyperfine couplings of 33S and 77Se that directly couple to the FeMo cluster. With this analysis, we report selenium incorporation under turnover conditions as a straightforward approach to stabilize and analyze early intermediate states of the FeMo cofactor.

Recovery Potential in Patients Who Died After Withdrawal of Life-Sustaining Treatment: A TRACK-TBI Propensity Score Analysis.

Among patients with severe traumatic brain injury (TBI), there is high prognostic uncertainty but growing evidence that recovery of independence is possible. Nevertheless, families are often asked to make decisions about withdrawal of life-sustaining treatment (WLST) within days of injury. The range of potential outcomes for patients who died after WLST (WLST+) is unknown, posing a challenge for prognostic modeling and clinical counseling. We investigated the potential for survival and recovery of independence after acute TBI in patients who died after WLST. We used Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) data and propensity score matching to pair participants with WLST+ to those with a similar probability of WLST (based on demographic and clinical characteristics), but for whom life-sustaining treatment was not withdrawn (WLST-). To optimize matching, we divided the WLST- cohort into tiers (Tier 1 = 0-11%, Tier 2 = 11-27%, Tier 3 = 27-70% WLST propensity). We estimated the level of recovery that could be expected in WLST+ participants by evaluating 3-, 6-, and 12-month Glasgow Outcome Scale-Extended (GOSE) and Disability Rating Scale outcomes in matched WLST- participants. Of 90 WLST+ participants (80% male, mean [standard deviation; SD] age = 59.2 [17.9] years, median [IQR] days to WLST = 5.4 [2.2, 11.7]), 80 could be matched to WLST- participants. Of 56 WLST- participants who were followed at 6 months, 31 (55%) died. Among survivors in the overall sample and survivors in Tiers 1 and 2, more than 30% recovered at least partial independence (GOSE ≥4). In Tier 3, recovery to GOSE ≥4 occurred at 12 months, but not 6 months, post-injury. These results suggest a substantial proportion of patients with TBI and WLST may have survived and achieved at least partial independence. However, death or severe disability is a common outcome when the probability of WLST is high. While further validation is needed, our findings support a more cautious clinical approach to WLST and more complete reporting on WLST in TBI studies.

Consequences of the Improved Wave Statistics on a Hull Girder Reliability of Double Hull Oil Tankers

This paper investigates the change in hull girder failure probabilities and partial safety factors caused by the implementation of the new procedure for direct computation of wave loads recommended by the International Association of Classification Societies (IACS). Differences between new and previous procedures are primarily related to the different associated scatter diagrams, and secondarily due to the assumptions on wave spectrum, wave energy spreading, and ship speed. This study performs a comparative structural reliability analysis of the global longitudinal bending of five oil tankers of different sizes between two procedures for wave load computation. Firstly, failure probabilities are compared, and secondly, modified partial safety factors are proposed, resulting in similar failure probabilities according to two separate procedures. It is found that implementation of the new revision of the IACS procedure for direct computation of wave loads results in a reduction of the minimum required ultimate vertical bending capacity of a ship hull by 10%. In addition to the novel investigation of the safety of oil tankers using a revised wave scatter diagram, this study offers a new rapid method for calculation of extreme vertical wave bending moments based on the regression of the parameters of the Weibull function, used for the long-term probability distribution of wave-induced loads.

Benign Prostatic Hyperplasia Surgery: A Snapshot of Trends, Costs, and Surgical Retreatment Rates in the USA

BackgroundAn increasing number of novel surgical treatments (NSTs) for benign prostatic hyperplasia (BPH) have been proposed over time to achieve similar functional outcomes to, but better perioperative and sexual outcomes than traditional procedures. ObjectiveTo assess the trends in the utilization and costs of BPH surgical procedures over the past decade, and to analyze the need for surgical retreatment after each procedure. Design, setting, and participantsA retrospective observational population-based analysis was conducted using the PearlDiver Mariner (PearlDiver Technologies, Colorado Springs, CO, USA) database, including all-payer nationally available claims records collected from 2011 to 2022. Outcome measurements and statistical analysisThe number and type of BPH surgical procedures per year, costs associated with each BPH surgical treatment, incidence of BPH surgical retreatment rate, and time to BPH surgical retreatment were assessed. Negative binomial regression and Cochran-Armitage test were used for the temporal trend analysis. A multivariable logistic regression analysis evaluated the predictors of BPH surgical retreatment. Results and limitationsIn the study period, 274 808 patients received surgical treatment for BPH. The most common procedure was transurethral resection of the prostate (TURP; 71.7%). The overall utilization of BPH surgical treatment increased over the study period. Traditional surgery remained most performed for the entire period (87.8%), but a statistically significantly rising trend of NSTs was recorded. The mean reimbursements paid per procedure was 1.43 times higher (p < 0.001) for NSTs than for traditional procedures. The surgical retreatment rate was 9.4%. The mean time to surgical retreatment was 25.3 mo, with 85.5% of cases re-treated within 5 yr. At the multivariable analysis, transurethral incision of the prostate, photoselective vaporization of the prostate, prostatic urethral lift, convective water vapor energy, and prostatic artery embolization had a significantly greater likelihood of surgical retreatment than TURP. Holmium/thulium laser enucleation of the prostate (HoLEP/ThuLEP), open simple prostatectomy (SP), and laparoscopic/robot-assisted SP were associated with a lower probability of resurgery than TURP, but a similar probability between these procedures. Retrospective design and a lack of relevant clinical data were the main limitations. ConclusionsOver the past decade, there has been a progressive increase in the adoption of NSTs. The rate of surgical retreatment appears <10%, with patients undergoing SP and HoLEP/ThuLEP experiencing a statistically significantly lower probability of surgical retreatment. Patient summaryWe investigated the trends, costs, and surgical retreatments of benign prostatic hyperplasia surgery. Transurethral resection of the prostate remains the most common procedure. Novel surgical treatments are associated with an upward trend, despite appearing more expensive overall. Retreatment is necessary in <10% of patients and generally within 5 yr.

Evaluating the impact of air terminal geometry on lightning intercept efficacy under a strong background electric field

A comparative analysis of the attachment efficacy of sharpened vs blunted air terminals under a strong background DC electric field, similar to conditions found in naturally occurring lightning events, is presented. Testing was conducted using an oil-free, 17-stage, 1.4 MV bipolar Marx generator with a biased discharge plane that emulated the conditions found prior to the lightning return stroke. The biased discharge plane allowed the introduction of a strong DC electric field and subsequent corona formation on a time scale much longer than the brief duration over which the downward leader propagates. Initial observations indicate that despite a higher background electric field at the sharpened terminals, leading to pre-discharge corona formation where none is seen on the blunt terminal, both the sharpened and blunted terminals exhibit similar attachment probabilities during discharge events, with some discharge events attaching to both terminals.

Demographic assessment of reintroduced bearded vultures in the Alps: Success in the core, challenges in the periphery

Abstract Regular assessment of reintroduced populations is essential to guide management and provide lessons for other reintroduction projects. Bearded vulture Gypaetus barbatus reintroduction in the Alps began in 1986 with the release of the first fledglings, the first successful reproduction was recorded in 1997, and the population has grown steadily since. A previous assessment suggested that no further releases would be required to establish a self‐sustaining population from a demographic point of view. However, this conclusion was based on a small sample size and spatially homogeneous demographic rates of released individuals, which may differ from and be spatially variable among wild‐hatched individuals. Using longitudinal data and breeding site survey data, we constructed an integrated population model to examine the demography of the entire Alpine population, spatially stratified into a core and a periphery. We performed retrospective population analyses to identify demographic reasons for spatial differences in population growth and conducted population viability analyses to assess the impact of future threats and reintroduction options. In 2021, an estimated 172 (CRI: 147–198) females were present in the Alps, of which 65 (CRI: 63–67) were breeders. Adult survival and productivity were higher in the core than in the periphery, so the population grew more strongly in the core than in the periphery. Differences in adult survival contributed most to the differences in population growth between the two areas. The population viability analysis predicts that the Alpine population will double in 10 years but that an increase in the mortality hazard above 0.055 will lead to a population decline. Unlike the population in the core, the population in the periphery is dependent on further releases at this stage. Bearded vulture reintroductions in the Alps have succeeded in creating a self‐sustaining population with higher reproductive success and similar survival probabilities to the autochthonous Pyrenean population. In general, management should focus on preventing further mortality risks. In the periphery, reducing current mortality and increasing reproductive success are essential to make the population independent of releases.