Success Rate Research Articles

Subjective Long-Term Outcomes After Vaginal Native Tissue Hysteropexy: Cohort Study.

There are still doubts about long-term satisfaction rates of native tissue uterine preserving surgical techniques for pelvic organ prolapse. The objective of this study was to compare long-term subjective success rates and satisfaction rates between vaginal sacrospinous hysteropexy (SSHP) and vaginal hysterectomy with uterosacral ligament suspension (VH-USLS). This was a retrospective single-center, observational matched cohort study in women receiving either SSHP or VH-USLS between 2004 and 2021. Primary outcome was overall subjective success (combined outcome of absence of bulge nor retreatment, and satisfaction with operation) at least 12 months after surgery. Satisfaction with the operation was defined as a combined Patient Global Impression of Improvement rating ≤ 2 and a patient satisfaction score ≥7. Of 583 patients, 192 patients could be matched (SSHP, 96; VH-USLS, 96), with 55% (SSHP, 60; VH-USLS, 45) participating at the telephone interview. Mean follow-up time was 77 months for VH-USLS, and 36 months for SSHP, respectively. No difference in overall subjective success rates was found between the groups (45% VH-USLS and 51% SSHP; P = 0.54). Overall satisfaction was similar between both groups (70% vs 71%, P = 0.90). Logistic regression found no influence of duration of follow-up and the overall subjective success rate. Both procedures would be recommended to a relative or friend by a large majority of patients (88% vs 85%, P = 0.761). Operative time and hospitalization time were significantly shorter in the SSHP group. No serious complications were reported. Overall success rates did not differ between both procedures after at least 1 year of follow-up with relatively high satisfaction rates. Sacrospinous hysteropexy had shorter operative time and shorter duration of hospitalization.

Value-Based Subgoal Discovery and Path Planning for Reaching Long-Horizon Goals.

Learning to reach long-horizon goals in spatial traversal tasks is a significant challenge for autonomous agents. Recent subgoal graph-based planning methods address this challenge by decomposing a goal into a sequence of shorter-horizon subgoals. These methods, however, use arbitrary heuristics for sampling or discovering subgoals, which may not conform to the cumulative reward distribution. Moreover, they are prone to learning erroneous connections (edges) between subgoals, especially those lying across obstacles. To address these issues, this article proposes a novel subgoal graph-based planning method called learning subgoal graph using value-based subgoal discovery and automatic pruning (LSGVP). The proposed method uses a subgoal discovery heuristic that is based on a cumulative reward (value) measure and yields sparse subgoals, including those lying on the higher cumulative reward paths. Moreover, LSGVP guides the agent to automatically prune the learned subgoal graph to remove the erroneous edges. The combination of these novel features helps the LSGVP agent to achieve higher cumulative positive rewards than other subgoal sampling or discovery heuristics, as well as higher goal-reaching success rates than other state-of-the-art subgoal graph-based planning methods.

Adaptive Constraint Penalty-Based Multiobjective Operation Optimization of an Industrial Dynamic System With Complex Multiconstraint.

Aiming at the operation optimization of the wastewater treatment process (WWTP) with nonstationary time-varying dynamics and complex multiconstraint, this article proposes a novel adaptive constraint penalty decomposed multiobjective evolutionary algorithm with synthetical distance (SD)-based cross-generation crossover. First, the concept of spatial SD is presented to comprehensively evaluate the similarity of individual solutions from two aspects of distance and angle, and the individual information between two adjacent generations is used to enhance the diversity of individuals and accelerate the convergence of the algorithm. Second, aiming at the complex multiconstraint during the operation optimization of WWTP, an adaptive penalty algorithm is further adopted to punish the individual solutions that violate the constraints, so as to improve the handling efficiency and success rate of constraints. Furthermore, in view of the time-varying dynamics of actual WWTP, a recursive bilinear subspace identification method based on sliding window is adopted to establish the optimization models as well as the constraint models with self-learning parameter, which provides accurate model guarantee for high-performance multiobjective operation optimization. Finally, the effectiveness, superiority, and practicability of the proposed method are verified through test function experiments as well as operation optimization control experiments of WWTP.

Adaptive Perturbation for Adversarial Attack.

In recent years, the security of deep learning models achieves more and more attentions with the rapid development of neural networks, which are vulnerable to adversarial examples. Almost all existing gradient-based attack methods use the sign function in the generation to meet the requirement of perturbation budget on L∞ norm. However, we find that the sign function may be improper for generating adversarial examples since it modifies the exact gradient direction. Instead of using the sign function, we propose to directly utilize the exact gradient direction with a scaling factor for generating adversarial perturbations, which improves the attack success rates of adversarial examples even with fewer perturbations. At the same time, we also theoretically prove that this method can achieve better black-box transferability. Moreover, considering that the best scaling factor varies across different images, we propose an adaptive scaling factor generator to seek an appropriate scaling factor for each image, which avoids the computational cost for manually searching the scaling factor. Our method can be integrated with almost all existing gradient-based attack methods to further improve their attack success rates. Extensive experiments on the CIFAR10 and ImageNet datasets show that our method exhibits higher transferability and outperforms the state-of-the-art methods.

Experience of percutaneous closure of small to large patent ductus arteriosus with Nit-Occlud® device in a tertiary referral hospital in Colombia.

The decision to close patent ductus arteriosus should always be individualized and taken together with the child's family once the risks and benefits of both choices have been exposed. This study aims to report the experience and outcomes in patients undergoing endovascular closure of small to medium-size PDA with a Nit-Occlud® device in a tertiary referral hospital in Colombia. Longitudinal descriptive study, which included all patients under 18 years of age who underwent percutaneous ductal closure with Nit-Occlud® device between January 1, 2011, and February 1, 2023. Patients with associated complex congenital heart disease requiring surgical management, pregnant patients, and patients with incomplete data regarding studied variables were excluded from the study. Eighty-seven patients were documented, with a mean age, weight, and height at closure of 51 months, 14 kg, and 95.83 cm, respectively. About 70% of the patients (n = 61) were female, 76% were under 6-years-old and only one patient was over 15. The average size of the ductus at the pulmonary end was 2 mm. Four of the total number of patients did not achieve PDA closure during the procedure. Of the remaining 83, complete immediate closure was achieved in 81 patients. A device exchange for a larger device was required during the same procedure in one of the cases. Two patients presented residual shunt of 0.5 mm during follow-up, and one required a new procedure for device closure 10 months later. Only one device presented repeatedly embolization to the aorta, requiring surgical removal. As a technical difficulty, one device presented repeated passage into the aorta, so it was decided to remove it before releasing it to avoid complications, and given the complex anatomy of the ductus, surgical closure was indicated. Among the complications, one patient presented a hematoma of the subcutaneous tissue in the right thigh, which improved with medical management, and no deaths related to the procedure were registered. Using the Nit-Occlud® device to close small to moderate-sized ductus remains a safe and effective strategy with successful closure rates at 1-year follow-up irrespective of age, weight, height, or whether it involves a small or medium-sized duct. Despite our limitations, results concerning adverse effects are comparable to those observed in multicentric studies conducted in other regions.

Unveiling the Threat: Investigating Distributed and Centralized Backdoor Attacks in Federated Graph Neural Networks

Graph neural networks (GNNs) have gained significant popularity as powerful deep learning methods for processing graph data. However, centralized GNNs face challenges in data-sensitive scenarios due to privacy concerns and regulatory restrictions. Federated learning has emerged as a promising technology that enables collaborative training of a shared global model while preserving privacy. Although federated learning has been applied to train GNNs, no research focuses on the robustness of Federated GNNs against backdoor attacks. This article bridges this research gap by investigating two types of backdoor attacks in Federated GNNs: centralized backdoor attack (CBA) and distributed backdoor attack (DBA). Through extensive experiments, we demonstrate that DBA exhibits a higher success rate than CBA across various scenarios. To further explore the characteristics of these backdoor attacks in Federated GNNs, we evaluate their performance under different scenarios, including varying numbers of clients, trigger sizes, poisoning intensities, and trigger densities. Additionally, we explore the resilience of DBA and CBA against two defense mechanisms. Our findings reveal that both defenses cannot eliminate DBA and CBA without affecting the original task. This highlights the necessity of developing tailored defenses to mitigate the novel threat of backdoor attacks in Federated GNNs.

Development of the Children’s ACuTe UltraSound (CACTUS) point-of-care ultrasound (POCUS)-accredited training in the UK: a descriptive study

Point-of-care ultrasound (POCUS) is an established, evidence-supported tool that can be used in neonatal and paediatric medicine, offering clinicians immediate diagnostic insights, assessment of interventions and improved safety profiles and...

Heatmap creation with YOLO-Deep SORT system customized for in-store customer behavior analysis

Due to the limitations of the hardware system, analysis of retail stores has caused problems such as excessive workload, incomplete analysis, slow analysis speed, difficult data collection, non-real-time data collection, passenger flow statistics, and density analysis. However, heatmaps are a viable solution to these problems and provide adaptable and effective analysis. In this paper, we propose to use the deep sequence tracking algorithm together with the YOLO object recognition algorithm to create heatmap visualizations. We will present key innovations of our customized YOLO-Deep SORT system to solve some fundamental problems in in-store customer behavior analysis. These innovations include our use of footpad targeting to make bounding boxes more precise and less noisy. Finally, we made a comprehensive evaluation and comparison to determine the success rate of our system and found that the success rate was higher than the systems we compared in the literature. The results show that our heatmap visualization enables accurate, timely, and detailed analysis.

Comparative meta-analysis of endovascular strategies for intracranial dissecting aneurysms: Flow diverters versus stents with or without coiling.

Intracranial dissecting aneurysms present a challenging subset linked to considerable morbidity and mortality, necessitating effective therapeutic strategies to prevent complications. Traditional treatments face technical limitations, while emerging endovascular modalities like stent-assisted coiling, multiple stenting, and flow-diverting devices (FDDs) offer promise in reducing periprocedural risks and enhancing patient outcomes. The aim of this study is to compare the safety and efficacy outcomes of endovascular treatment for intracranial dissecting aneurysms using FDDs versus stents (with or without coiling). A systematic review and meta-analysis were conducted following established guidelines. The search included PubMed, Scopus, Web of Science, and Embase databases up to July 30, 2023. Eligible studies reporting outcomes of interest in both FDD and stent-treated groups were included, and the data was extracted and analyzed using STATA software. Six studies were analyzed, involving 131 patients in the FDD group and 199 patients in the stent group. The pooled rates for favorable functional outcomes (86.8% vs. 86%), mortality (3.9% vs. 6%), adequate occlusion (79.7% vs. 86.3%), aneurysm recurrence (1.3% vs. 13.3%), in-stent stenosis/thrombosis (7% vs. 6.9%), ischemic events/infarctions (6.7% vs. 7.8%), retreatment (7% vs. 8.6%), and technical success (100% vs. 98.7%) were comparable in individuals treated with FDDs and stents (p > 0.05 in all cases). Additionally, complete occlusion rates were not significantly different between FDD (62.7%) and stent-treated patients (75.2%) (p = 0.06). However, after excluding one study in a leave-one-out analysis of the random effects meta-analysis, a significant difference in the pooled rates of this outcome was observed between the FDD (59.2%) and stent (75.2%) groups (p = 0.034). FDDs present a promising approach for the treatment of intracranial dissecting aneurysms, yielding outcomes that are roughly comparable to stent-based methods. However, the absence of randomized trials and data limitations highlight the need for further research to enhance treatment strategies.

Evaluation of post-surgical complications between "Rendez-vous" technique vs. standard care in patients with choledocholithiasis

"Rendez-vous" (RV) technique is a mixed-technique which uses both laparoscopic and endoscopic skills; however, the evidence is contradictory regarding the implementation of this technique or the 2-step sequential technique (endoscopic retrograde cholangiopancreatography [ERCP] followed by laparoscopic cholecystectomy [LC]) in the management of cholecysto-choledocholitiasis. To estimate the association between the implementation of RV technique and the presence of post-surgical complications as primary outcome, using as comparator the 2-step sequential technique. An observational, analytical, retrospective study was conducted, using as exposed cohort the medical records from patients with a diagnosis of cholelithiasis, cholecystitis, or mild biliary pancreatitis. The exposed cohort underwent RV technique, while the unexposed cohort were those which underwent two step technique. There was a lower post-surgical complication rate in the RV group (0%) compared with the 10.1% (p = 0.3617) in the control group. Also, RV technique showed a lesser hospitalization time (p = 0.0377) and a lesser post-surgical hospitalization time (p < 0.0001). RV technique is superior when compared with the 2-step sequential technique (ERCP followed by LC), based on a better surgical success rate, a fewer complications rate and less hospitalization time.

Cube-Evo: A Query-Efficient Black-Box Attack on Video Classification System

The current progressive research in the domain of black-box adversarial attack enhances the reliability of deep neural network (DNN)-based video systems. Recent works mainly carry out black-box adversarial attacks on video systems by query-based parameter dimension reduction. However, the additional temporal dimension of video data leads to massive query consumption and low attack success rate. In this article, we embark on our efforts to design an effective adversarial attack on popular video classification systems. We deeply root the observations that the DNN-based systems are sensitive to adversarial perturbations with high frequency and reconstructed shape. Specifically, we propose a systematic attack pipeline Cube-Evo, aiming to reduce the search space dimension and obtain the effective adversarial perturbation via the optimal parameter group updating. We evaluate the proposed attack pipeline on two popular datasets: UCF101 and JESTER. Our attack pipeline reduces query consumption and achieves a high success rate on various DNN-based video classification systems. Compared with the state-of-the-art method Geo-Trap-Att, our pipeline averagely reduces 1.6× query consumption in untargeted attacks and 2.9× in targeted attacks. Besides, Cube-Evo improves 13% attack success rate on average, achieving new state-of-the-art results over diverse video classification systems.

Parathyroidectomy: still the best choice for the management of severe secondary hyperparathyroidism.

Management of secondary hyperparathyroidism (SHPT) is a challenging endeavor with several factors contruibuting to treatment failure. Calcimimetic therapy has revolutionized the management of SHPT, leading to changes in indications and appropriate timing of parathyroidectomy (PTX) around the world. We compared response rates to clinical vs. surgical approaches to SHPT in patients on maintenance dialysis (CKD 5D) and in kidney transplant patients (Ktx). A retrospective analysis of the one-year follow-up findings was carried out. CKD 5D patients were divided into 3 groups according to treatment strategy: parathyroidectomy, clinical management without cinacalcet (named standard - STD) and with cinacalcet (STD + CIN). Ktx patients were divided into 3 groups: PTX, CIN (cinacalcet use), and observation (OBS). In CKD 5D we found a significant parathormone (PTH) decrease in all groups. Despite all groups had a higher PTH at baseline, we identified a more pronounced reduction in the PTX group. Regarding severe SHPT, the difference among groups was evidently wider: 31%, 14% and 80% of STD, STD + CIN, and PTX groups reached adequate PTH levels, respectively (p<0.0001). Concerning the Ktx population, although the difference was not so impressive, a higher rate of success in the PTX group was also observed. PTX still seems to be the best treatment choice for SHPT, especially in patients with prolonged diseases in unresourceful scenarios.

A retrospective comparison of endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in the treatment of acute cholangitis

Endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) can rapidly alleviate obstruction, facilitate bile drainage, and reduce pressure in the bile duct. In this study, to evaluate the effect of plastic biliary stent on the recurrence rate of choledocholithiasis in patients with actual cholangitis after endoscopic retrograde cholangioangiography (ERCP), we a comparative analysis of the efficacy and safety between ENBD and ERBD in inflammatory remission rate, complication rate, and success rate of secondary or multiple endoscopic lithotomy. A total of 347 patients undergoing ENBD and ERBD were enrolled in this retrospective study. Preoperative assessments including blood tests, electrocardiography, abdominal ultrasonography, CT scans, MRI, or MRCP were conducted on all participants. Additionally, serum CRP and amylase levels were measured using a magnetic nanobead-based immunoassay. We found that The success rate of stone removal in the ENBD group was higher than that in the ERBD group (90.8% vs. 72.7%) (P &lt;0.0001). The remission rate of inflammation in the ERBD group (100.0%) was higher than that in the ENBD group (98.7%) (P &gt;0.05). No significant difference was observed between the ERBD group and the ENBD group in preoperative and postoperative inflammatory indexes (total bilirubin, direct bilirubin, white blood cells, neutrophils, CRP, and serum amylase). Moreover, there were significant differences in post-ERCP pancreatitis between the ERBD group and ENBD group. These results suggest that both ENBD and ERBD can effectively improve clinical efficacy. Moreover, magnetic nanobeads have good application in serum index detection to increase detection efficiency.

Efficacy and safety of a neurointerventional operation robotic assistance system in cerebral angiography

BackgroundAt present, neurointerventional surgery requires angiographers to perform operations in the digital subtraction angiography (DSA) room. Ionising radiation and chronic joint damage are still unavoidable for angiographers. Therefore, we researched...

3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials.

3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth. MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10. Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs. The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.

Laser lead extraction of very old leads. Insights from the GermAn Laser Lead Extraction RegistrY (GALLERY)

Abstract Background Transvenous lead extraction (TLE) has become one of the most crucial therapeutic pillars in modern CIED management. Very old pacemaker and defibrillator leads are known to be risk factors for procedural complications in patients undergoing TLE. Aim &amp; Methods Aim of this study was to analyze patients with very old leads undergoing TLE. We conducted a retrospective analysis of all patients in the GALLERY with at least one lead aged ≥10 years and compared them to a cohort of patients with leads aged &amp;lt;10 years, in terms of baseline- and lead characteristics, as well as procedural outcomes and potential predictors of adverse events. Results We identified 858 patients with at least one lead aged ≥10 years (Group A) and 1666 patients with leads aged &amp;lt;10 years (Group B). Patients in Group A were older (70.4±13.7 vs. 66.7±13.7; p&amp;lt;0.001) and were less likely to exhibit highly reduced LVEF (18.5 vs. 30.0%, p&amp;lt;0.001) or coronary artery disease (36.1 vs. 46.4%, p&amp;lt;0.001), compared to Group B. The mean numbers of leads per patient were 2.5±1.1 and 2.4±1.0, respectively (p&amp;lt;0.001) with median ages of the oldest indwelling lead of 161.5 [137-206.75] and 72.0 [48-94] months (p&amp;lt;0.001). Patients in Group A had higher proportions of right-sided (47.7 vs. 25.8%, p&amp;lt;0.001) and abandoned leads (41.3 vs. 23.4%, p&amp;lt;0.001). Median procedural time was longer in Group A with 93.5 [63-145] vs. 75 [52-116] minutes (p&amp;lt;0.001) with an increased necessity for additional tools for extraction (12.6 vs. 3.4%, p&amp;lt;0.001). Overall (5.5 vs. 3.6%, p=0.03) and major complication rates (3.2 vs. 1.4%, p=0.005) were both higher in Group A. Patients in Group A were less likely to achieve complete procedural success rate (84.3 vs. 95.1%, p&amp;lt;0.001) and had a higher rate for procedural failure (3.5 vs. 1.5%, p=0.002). There was no difference in procedure-related &amp;lt;(0.7 vs. 0.5%, p=0.592) or all-cause mortality (3.5 vs. 3.2%, p=0.711) between groups. Multivariate analysis in Group A revealed the presence of abandoned leads (OR: 1.83, 95% CI: 1.0-3.4, p=0.049), female sex (OR: 2.15, 95% CI: 1.2-3.9, p=0.013) and systemic infection (OR:1.89, 95%CI: 1.0-3.5, p=0.039) as predictors for procedural complications. The use of additional extraction tools (OR:4.4, 95%CI:2.0-9.7, p&amp;lt;0.001) and a BMI≥35 kg/m2 (OR:4.4, 95%CI:1.4-14.0, p=0.012) were identified as risk factors for procedural failure. Procedural complications (OR:5.2, 95%CI:2.0-13.7, p&amp;lt;0.001) and systemic infection (OR:18.7, 95%CI: 5.6-62.9, p&amp;gt;0.001) were highly predictive for all-cause mortality. Conclusion Patients with leads aged ≥10 years undergoing TLE suffer from more procedural complications, more often require additional extraction tools and have lower rates for complete procedural success, but do not show any differences in mortality, when compared to patients with leads aged &amp;lt;10 years. The necessity of additional tools for extraction and a BMI≥35 kg/m2 were identified as predictors for procedural failure.

Can critical care transport be safely reduced in children intubated during emergency management of status epilepticus in the United Kingdom: a national audit with case–control analysis

ObjectiveThis study describes the baseline clinical characteristics, predictors of successful extubation at referring hospitals and short-term outcomes of children intubated for status epilepticus and referred to United Kingdom (UK) paediatric...

TomFi: Small Object Tracking Using Commodity WiFi

Rodent infestation has always been one of the most severe threats to humans, which to solve consumes massive manpower and resources. People usually use traps or poisons to treat rat infestation. Such passive countermeasures are inefficient. Damage often occurs when the rats are finally trapped or killed, not to mention the potential risk to injure humans or cause pollution. In this article, we propose a WiFi-based active small object tracking system named TomFi . The core components of TomFi include several deep learning techniques that bridge rat locations/motions and WiFi signal variations (represented by the channel state information). TomFi first employs a detection model to detect the appearance of the rat and then localize it based on a two-branch localization model. Through the design of the two-branch localization model, to our best knowledge, we are the first to solve the information loss and distortion problem. We conducted extensive experiments in both the laboratory environment and real-world kitchen scenarios. The results show that TomFi can achieve a detection success rate of 99%+ and a centimeter-level localization accuracy in real time.

Point Cloud Attacks in Graph Spectral Domain: When 3D Geometry Meets Graph Signal Processing.

With the increasing attention in various 3D safety-critical applications, point cloud learning models have been shown to be vulnerable to adversarial attacks. Although existing 3D attack methods achieve high success rates, they delve into the data space with point-wise perturbation, which may neglect the geometric characteristics. Instead, we propose point cloud attacks from a new perspective-the graph spectral domain attack, aiming to perturb graph transform coefficients in the spectral domain that correspond to varying certain geometric structures. Specifically, leveraging on graph signal processing, we first adaptively transform the coordinates of points onto the spectral domain via graph Fourier transform (GFT) for compact representation. Then, we analyze the influence of different spectral bands on the geometric structure, based on which we propose to perturb the GFT coefficients via a learnable graph spectral filter. Considering the low-frequency components mainly contribute to the rough shape of the 3D object, we further introduce a low-frequency constraint to limit perturbations within imperceptible high-frequency components. Finally, the adversarial point cloud is generated by transforming the perturbed spectral representation back to the data domain via the inverse GFT. Experimental results demonstrate the effectiveness of the proposed attack in terms of both the imperceptibility and attack success rates.

Intravitreal bevacizumab improves trabeculectomy survival at 12 months: the bevacizumab in trabeculectomy study—a randomised clinical trial

AimsTo evaluate the effect of an intraoperative dose of intravitreal bevacizumab (Avastin) on surgical success following trabeculectomy with mitomycin-C (MMC) over 12 months.MethodsA single centre, parallel, double-blinded randomised, placebo-controlled trial...