Success Rate Research Articles

Maxwell’s Demon in MLP-Mixer: towards transferable adversarial attacks

Models based on MLP-Mixer architecture are becoming popular, but they still suffer from adversarial examples. Although it has been shown that MLP-Mixer is more robust to adversarial attacks compared to convolutional neural networks (CNNs), there has been no research on adversarial attacks tailored to its architecture. In this paper, we fill this gap. We propose a dedicated attack framework called Maxwell’s demon Attack (MA). Specifically, we break the channel-mixing and token-mixing mechanisms of the MLP-Mixer by perturbing inputs of each Mixer layer to achieve high transferability. We demonstrate that disrupting the MLP-Mixer’s capture of the main information of images by masking its inputs can generate adversarial examples with cross-architectural transferability. Extensive evaluations show the effectiveness and superior performance of MA. Perturbations generated based on masked inputs obtain a higher success rate of black-box attacks than existing transfer attacks. Moreover, our approach can be easily combined with existing methods to improve the transferability both within MLP-Mixer based models and to models with different architectures. We achieve up to 55.9% attack performance improvement. Our work exploits the true generalization potential of the MLP-Mixer adversarial space and helps make it more robust for future deployments.

An approach based on deep learning methods to detect the condition of solar panels in solar power plants

Solar panels are increasingly popular due to global energy shortages and rising costs. However, managing large or elevated panel systems requires regular oversight, leading to potential time and cost challenges. This study was focused on developing an AI-based drone for panel detection to address these issues and facilitate the control process. A low-cost system for AI-based identification of dusty, broken, and healthy solar panels was created using a Raspberry Pi 4B board and camera. The study proposed a Histogram Equalization (HE)-based preprocessing technique to improve the AI model. Firstly, the trainings were performed with YOLOv5 without the proposed method at epoch values of 100, 150, and 200 in order to see the effectiveness of the proposed method more clearly. As a result of these trainings, the highest F1 score was obtained as 80 %. In the second step, three deep learning algorithms - YOLOv5, YOLOv7, and YOLOv8 - with epochs of 100, 150, and 200 respectively, were used for training with the proposed method. A detailed comparative analysis of the developed models was carried out regarding their performance metrics. The YOLOv5l was obtained as the most successful panel detection model with an F1 score of 97 % at 150 epochs. The model with the best performance metrics was used in a real-time test application with an AI-based drone. F1 score results were obtained between 90 % and 97 %, mainly supporting the success rate obtained in real-time application. The results strongly support the effectiveness of this proposed method for panel detection tasks, showcasing its high efficacy and promising potential.

Effective and Imperceptible Adversarial Textual Attack via Multi-objectivization

The field of adversarial textual attack has significantly grown over the last few years, where the commonly considered objective is to craft adversarial examples (AEs) that can successfully fool the target model. However, the imperceptibility of attacks, which is also essential for practical attackers, is often left out by previous studies. In consequence, the crafted AEs tend to have obvious structural and semantic differences from the original human-written text, making them easily perceptible. In this work, we advocate leveraging multi-objectivization to address such issue. Specifically, we reformulate the problem of crafting AEs as a multi-objective optimization problem, where the attack imperceptibility is considered as an auxiliary objective. Then, we propose a simple yet effective evolutionary algorithm, dubbed HydraText, to solve this problem. HydraText can be effectively applied to both score-based and decision-based attack settings. Exhaustive experiments involving 44237 instances demonstrate that HydraText consistently achieves competitive attack success rates and better attack imperceptibility than the recently proposed attack approaches. A human evaluation study also shows that the AEs crafted by HydraText are more indistinguishable from human-written text. Finally, these AEs exhibit good transferability and can bring notable robustness improvement to the target model by adversarial training.

Single catheter approach for treatment of premature ventricular contractions.

Catheter ablation has become one of the main treatment strategies in patients with premature ventricular complexes (PVC).The successful mapping and ablation can be performed with an ablation catheter without additional diagnostic catheters. We hypothesize that using a single catheter for PVC ablation may decrease complications, procedure time, and fluoroscopy exposure while maintaining comparable success rates. Sixty-nineconsecutive patients with PVC were treated with a single catheter approach compared to a historical cohort, in which a conventional setup was used. Propensity score matching was conducted with a 1:1 ratio. Outcome parameters included acute procedural success with elimination of all premature ventricular contractions after catheter ablation, procedural data as well as complication rates. Patients treated with a single catheter approach had shorter total procedure (60 minutes [IQR:47,5-69,0 minutes] vs. 90 minutes [IQR60-120 minutes]; p = 0.001) and fluoroscopy times (218 seconds[IQR:110,5-446 seconds] vs. 310 seconds[IQR190-640 seconds]; p = 0.012), which consecutively leads to a reduction of radiation exposure signified by a lower dose area product (155 cGycm² [IQR74.4-334.5 cGycm²] vs. 368.4 cGycm² [IQR:126-905.4 cGycm²]; p value 0.009). Acute procedural success rates were comparable in both groups (54 [84.3%] in the single catheter approach group and 58 [90.6%] in the conventional group; p: 0.287). A single catheter approach for the treatment of PVC is associated with a reduction of procedure- and fluoroscopy time, as well as a lesser radiation exposure, while maintaining equivalent acute success and complication rates compared with a conventionally used catheter setup.

Success Rates of Finger Revascularization and Replantation.

Revascularization surgery has been reported to have a higher success rate than replantation due to sufficient venous return. However, in complex cases, success depends on a wide range of indications. This study aimed to investigate success rates in cohorts that included severe cases. This single-center, noninterventional, retrospective cohort study included 292 patients (349 digits) who underwent revascularization or replantation at our institution between January 2000 and December 2022. Sex, age, smoking history, comorbidities, affected digit, amputation level, complete or incomplete amputation, type of fracture and mechanism, artery diameter, needle, vein anastomosis in the revascularization subgroup, vein grafting, warm ischemic time, and outcomes were investigated and compared between the revascularization and replantation subgroups of the distal and proximal amputation groups. In the distal amputation group, the arterial diameter in the revascularization subgroup was larger than that in the replantation subgroup (P < 0.05). In the proximal amputation group, the revascularization subgroup had a lower frequency of multiple amputations than the replantation subgroup (P < 0.05). Vein grafts were more frequently used in both revascularization subgroups than in the replantation subgroups (P < 0.05). However, the other injury severity indices were similar, and the success rates were not significantly different between the subgroups. The revascularization success rate was similar to that of replantation. Vein anastomosis or vein grafting to the veins should be advocated for revascularization in severe cases where skin bridges may not have sufficient venous return.

Safety and efficacy of pelvic arterial embolization for primary postpartum hemorrhage in hemodynamically stable and hemodynamically unstable patients: Is it “time” for a paradigm change?

BackgroundPelvic artery embolization (PAE) is an effective and safe technique for treating postpartum hemorrhage (PPH) with hemodynamic stability. However, its use in hemodynamically unstable patients remains controversial. PurposeTo determine the safety and efficacy of pelvic arterial embolization (PAE) according to the hemodynamic state of primary postpartum hemorrhage (PPH) patients. MethodsThis cohort study was conducted retrospectively, using data from January 2004 to December 2021, in a resource-rich setting at a tertiary Level 1 trauma academic center. A total of 437 patients were diagnosed with PPH during the study period. Of these 437 patients, 161 with primary PPH who underwent PAE were enrolled in the study. The outcomes assessed included the clinical success rate, mortality, the overall success rate, predictive factors for failed PAE, and time-dependent changes in hemodynamic parameters, such as systolic blood pressure (SBP), heart rate (HR), and shock index (SI). Propensity score (PS) matching analysis was performed to assess the influence of specific variables or conditions on the outcomes. ResultsOf the 161 patients who underwent PAE for primary PPH (mean age, 32.9 ± 4.3 [SD]), 85 were retrospectively categorized as having hemodynamic stability (mean age, 32.6 ± 4.1 [SD]), while 76 were categorized as having hemodynamic instability (mean age, 33.3 ± 4.4 [SD]). This study showed PAE for primary PPH had a success rate of 91.9 %, with no significant difference in mortality rates between the groups. The clinical success rate was 98.8 % for patients with hemodynamic stability and 84.2 % for those with hemodynamic instability (p < .001). The overall success rate was 98.8 % for hemodynamic stability and 89.5 % for hemodynamic instability (p = .014). After propensity score matching, the clinical success rate was higher in hemodynamically stable patients than in unstable ones (100 % vs. 86.3 %, p = .013). However, there was no significant difference in the overall success rate (100 % vs. 90.2 %, p = .056). Among the PS-matched population, predictive factors for the failed PAE in primary PPH were hemodynamic instability (adjusted odds ratio [aOR] 21.22, 95 % CI 1.27-355.76; p = .034) and emergency Cesarean delivery with accompanying hemorrhag (aOR 54.00, 95 % CI 11.93-244.56; p = .008). In three groups within a PS-matched population — hemodynamically stable, unstable with successful outcomes, and unstable with unsuccessful outcomes, a generalized linear mixed model (GLMM) analysis for time-dependent changes in hemodynamic parameters revealed a statistically significant difference in SBP, HR, and SI at various time points. ConclusionPelvic arterial embolization of primary postpartum bleeding in hemodynamic instability has been identified as an alternative, safe, and effective life-saving procedure for multidisciplinary treatment in resource-rich environments even after the baseline characteristics are balanced by the PS matching, suggesting it is a primary care option.

Impact of mixed-infection rate of clarithromycin-susceptible and clarithromycin-resistant Helicobacter pylori strains on the success rate of clarithromycin-based eradication treatment.

Clarithromycin (CAM) resistance is a major contributor to the failure to eradicate Helicobacter pylori (H. pylori). The mixed-infection ratio of CAM-susceptible and CAM-resistant H. pylori strains differs among individuals. Pyrosequencing analysis can be used to quantify gene mutations at position each 2142 and 2143 of the H. pylori 23S rRNA gene in intragastric fluid samples. Herein, we aimed to clarify the impact of the rate of mixed infection with CAM-susceptible and CAM-resistant H. pylori strains on the success rate of CAM-containing eradication therapy. Sixty-four H. pylori-positive participants who received CAM-based eradication therapy, also comprising vonoprazan and amoxicillin, were enrolled in this prospective cohort study. Biopsy and intragastric fluid samples were collected during esophagogastroduodenoscopy. H. pylori culture and CAM-susceptibility tests were performed on the biopsy samples, and real-time PCR and pyrosequencing analyses were performed on the intragastric fluid samples. The mutation rates and eradication success rates were compared. The overall CAM-based eradication success rate was 84% (54/64): 62% (13/21) for CAM-resistant strains, and 95% (39/41) for CAM-sensitive strains. When the mutation rate of the 23S rRNA gene was 20% or lower for both positions (2142 and 2143), the eradication success rate was 90% or more. However, when the mutation rate was 20% or higher, the eradication success rate was lower (60%). The mutation rate of the CAM-resistance gene was related to the success of eradication therapy, as determined via pyrosequencing analysis.

Medium-Term Observation of Dalbo-Rotex Retention Elements: A Retrospective Cohort Study.

To investigate the medium-term survival of Dalbo-Rotex retention elements, identify potential risk factors for complication or loss, and to consider economic factors. Patients treated with Dalbo-Rotex retention elements in a university setting were retrospectively identified and examined. Clinical data comprised assessments of the dental, periodontal, endodontic, and prosthetic situation, including radiographic analysis. Patient satisfaction was quantified with visual analog scale questionnaires. Five-year Kaplan-Meier plots for relative survival and success rates were calculated. The 45 included patients had a total of 76 Dalbo-Rotex retention elements. Twelve Dalbo-Rotex elements failed and complications occurred in 42.1% of elements, equating to a survival rate of 84.2% and a success rate of 47.4% after a mean observation period of 49.2 months (SD 52.4, range 6-219 months). The 5-year cumulative survival and success rate was 62.4% (95% CI 44.0-88.4%) and 35.6% (95% CI 23.8-53.2%), respectively. Patients' self-assessment of prostheses retention was rated at 82 (IQR 40-92.2) with low pain perception at 4.5 (IQR 0-30). Probing pocket depth levels were significantly reduced in patients adhering to a regular recall interval compared with those with longer intervals. Chairside Dalbo-Rotex retention elements are a straightforward chairside method for prostheses retention that achieve good survival over medium-term follow up with high patient satisfaction. This technique is therefore a viable alternative to cast post copings that may be particularly valuable for patients with limited financial resources.

The prevalence of antiphospholipid antibodies and effects on the outcomes of in vitro fertilization

Introduction: The problem of infertility is common worldwide. IVF remains the most widely used technique of assisted reproductive technology. Embryo implantation failure is a common cause of unexplained infertility and recurrent miscarriages, thus the relationship between antiphospholipid antibodies and embryo implantation failure after IVF and embryo transfer is an important problem in fertility medicine that must be studied. Patients and methods: A retrospective and prospective (bidirectional) cohort study were conducted at the Laboratory Department of the Faculty of Medicine, and Hospital from June 2017 to June 2021. The sample size was 1000 participants, 900 of them were retrospective (2017–2020), and 100 were prospective (2020–2021). Data was collected, including patients’ demographics, type and duration of fertility, and antiphospholipid antibody values. Inclusion criteria-Women &lt;40 years old, undergoing IVF, and in the retrospective study, patients who undergo IVF and who have antibody data, positivity of phospholipids, and/or anticardiolipin, and/or B2 glycoprotein I, and the presence of the gestational sac on ultrasound as a criterion for pregnancy. We performed a PTT LA for the control group in a cohort study (20 healthy women), then a PTT LA test, and the blending test were performed, and the values were considered positive if the correction was not made. The PTT LA test is a screening test. Results: The average age of the women was 31.91, the success rate of assisted fertilization in inducing pregnancy in the last trial was 52.8%, the prevalence was 4.4% of anticardiolipin IgG, 2.6% of anticardiolipin IgM, and 4% of Lupus anticoagulant. No relation was found between the antiphospholipid value and the age of the women, the number of times the experiment was conducted, the rate of success and failure, the type of infertility, and the number of oocytes induction, while the duration of sterility was affected by positive values of IgG and lupus coagulant antibodies. Conclusion: There is no need for a routine antiphospholipid assay for female candidates for IVF, and when it is confirmed, treatment is required by Anticoagulants.

Effects of Drugs and Chemotherapeutic Agents on Dental Implant Osseointegration: Narrative Review.

Dental implants have been one of the most popular treatments for rehabilitating individuals with single missing teeth or fully edentulous jaws since their introduction. As more implant patients are well-aged and take several medications due to various systemic conditions, clinicians should be mindful of possible drug implications on bone remodeling and osseointegration. The present study aims to study and review some desirable and some unwelcomed implications of medicine on osseointegration. A broad search for proper relevant studies were conducted in four databases, including Web of Science, Pubmed, Scopus, and Google Scholar. Some commonly prescribed medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), anticoagulants, metformin, and chemotherapeutic agents may jeopardize osseointegration. On the contrary, some therapeutic agents such as anabolic, anti-catabolic, or dual anabolic and anti-catabolic agents may enhance osseointegration and increase the treatment's success rate. Systemic medications that enhance osseointegration include mineralization promoters and bone resorption inhibitors. On the other hand, medications often given to the elderly with systemic problems might interfere with osseointegration, leading to implant failure. However, to validate the provided research, more human studies with a higher level of evidence are required.

Research on product design of FAHP bone marrow aspiration needle

Bone marrow aspiration is a crucial medical procedure to obtain bone marrow samples for diagnosis and treatment. However, traditional bone marrow aspiration needles face several challenges such as operational difficulties, inadequate sample acquisition, and patient discomfort. To address these issues, we aimed to design a bone marrow aspiration needle product by using fuzzy analytic hierarchical process (FAHP). The FAHP method was used to identify key factors in the design of the bone marrow aspiration needle, including technicality, usage, and application characteristics. The importance weights and priorities of each factor were determined through questionnaires and interviews with experts. A new bone marrow aspiration needle product was developed based on the results of the FAHP. The new product design considers the weights and priorities assigned to key factors, resulting in improved convenience during operation and a higher success rate of sample acquisition. This was achieved by optimising the structure and material selection of the needle. This study presents a novel bone marrow puncture needle product that effectively integrates the importance and priority of the key factors. It successfully enhances operational performance and patient experience, thereby offering an innovative solution to improve the success rate and therapeutic effect of bone marrow punctures.

The Viability of Topic Modeling to Identify Participant Motivations for Enrolling in Online Professional Development

Identifying motivation for enrollment in MOOCs has been an important way to predict participant success rates. But themes for motivation have largely centered around themes for enrolling in any MOOC, and not ones specific to the course being studied. In this study, qualitatively coding discussion forums was combined with topic modeling to identify participants’ motivation for enrolling in two successive statistics education professional development online courses. Computational text mining, such as topic modeling, is a learning analytics field that has proven effective in analyzing large volumes of text to automatically identify topics or themes. This contrasts with traditional qualitative approaches, in which researchers manually apply labels (or codes) to parts of text to identify common themes. Combining topic modeling and qualitative research may prove useful to education researchers and practitioners in better understanding and improving online learning contexts that feature asynchronous discussion. Three topic modeling approaches were used in this study, including both unsupervised and semi-supervised modeling techniques. The three topic modeling approaches were validated and compared to determine which participants were assigned motivation themes that most closely aligned to their posts made in an introductory discussion forum. A discussion of how each technique can be useful for identifying topical themes within discussion forum data is included. Though the three techniques have varying success rates in identifying motivation for enrolling in the MOOCs, they do all identify similar themes for motivation that are specific to statistics education.

Clinical Characteristics And Success Of Ptosis Surgery At Indonesia National Eye Center Cicendo Eye Hospital During January 2016 – December 2020

ABSTRACT Ptosis is defined as drooping of the upper eyelid. Unilateral or bilateral ptosis can affect appearance and visual function, both of which can negatively impact quality of life. It may be congenital or acquired, determined by the timing of onset. To describe clinical characteristics and surgical outcomse in ptosis correction surgery at Indonesia National Eye Centre, Cicendo Eye Hospital. This is a descriptive-retrospective study, medical records of patients who was admitted to Indonesia National Eye Centre, Cicendo Eye Hospital, from January 2016 to December 2020 with diagnosis of eyelid ptosis were included in this study. From total of 189 patients (209 eyes) in this study, there were 41,8% male and 58,2% female patients with median age 22 years at the first time of visit. Most of the patients had unilateral ptosis (89,5%), and 10,5% had unilateral ptosis. According to the etiology of ptosis, 34,2% eyes were neurogenic ptosis. Degree of ptosis were severe in 70,9% eyes and most patients had fair levator function. Success rate were more than 95% in ptosis patient who underwent surgery. Majority of ptosis patient in Indonesia National Eye Centre, Cicendo Eye Hospital were caused by neurogenic followed by mechanical, traumatic, aponeurotic, myogenic, and pseudoptosis. Female patients were more common than male patients and median age at the first time visit were during second decade of life. Surgical outcome in ptosis tend to have high clinical success rates. Keywords: Characteristic, Outcome, Ptosis, Surgery

Determination of the pubertal growth spurt by artificial intelligence analysis of cervical vertebrae maturation in lateral cephalometric radiographs

ObjectiveThis study aimed to assess the performance of a convolutional neural network (CNN) model in detecting the pubertal growth spurt by analyzing cervical vertebrae maturation (CVM) in lateral cephalometric radiographs (LCRs). Study designIn total, LCRs of patients from 6 to 17 years old were selected. Three radiologists independently and blindly classified the maturation stages on the LCRs and defined the difficulty of each classification. Subsequently, the stage and level of difficulty were determined by consensus. LCRs were distributed between training, validation, and test sets across four CNN-based models. The models’ responses were compared with the radiologists’ reference standard, and the architecture with the highest success rate was selected for evaluation. Models were developed using full and cropped LCRs with original and simplified maturation classifications. ResultsIn the simplified classification, the Inception-v3 CNN yielded accuracy of 74% and 75%, with recall and precision values of 61% and 62%, for full and cropped LCRs, respectively. It achieved 61% and 62% success rates with full and cropped LCRs, respectively, reaching 72.7% for easy-to-classify cropped cases. ConclusionOverall, the CNN model demonstrated potential for determining whether the patient's maturation status regarding the pubertal growth spurt through images of the cervical vertebrae. It may be useful as an initial assessment tool or as an aid for optimizing the assessment and treatment decisions of the clinician.

Abstract B014: Patient-derived organoid models for drug screening in molecular subtypes of endometrial cancer

Abstract Introduction: The lack of reliable pre-clinical models has significantly impeded the progress of drug discovery for specific molecular subtypes of endometrial cancer. This study aimed to develop patient-derived organoid models for use in preclinical screening of novel and repurposed therapies in endometrial cancer molecular subtypes. Method: Endometrial cancer tissue (n=27) and ascites fluid (n=1) were collected for this study (ethics approval SESLHD HREC 2021_ETH11975 and 19/001) from patients of various subtypes (17 endometrioid, 3 high grade serous, 2 carcinosarcoma, 2 clear cell, 3 mixed) undergoing treatment at the Royal Hospital for Women and Prince of Wales Private Hospital in Sydney, Australia. Tumor cells were isolated, embedded in 70% Matrigel and cultured in defined culture medium to form organoids. Molecular subtyping of organoids and matched parental tissue was undertaken by mismatch repair (MMR) and p53 immunohistochemistry (IHC), and sequencing of POLE exonuclease domain mutations (EDMs). A unique matched two-dimensional (2D) cell line and three-dimensional (3D) organoid culture derived from ascites isolated from a high grade serous endometrial cancer patient was established. These molecularly stratified pre-clinical models were then used to test drug activity. As a proof of principle, response to paclitaxel and carboplatin was undertaken. Result: 20 organoids representing all major molecular subtypes were established (71% success rate), including one derived from ascites fluid. Organoids are presented with either a cystic or solid structure that highly resembles the morphology of the original tissue. Organoid culture can faithfully retain key features including MMR, p53 status as well as POLE EDMs of the parental tissue. The drug screening results identified contrasting responses of 2D and 3D models obtained from the same patient tissue, highlighting the importance of selecting appropriate pre-clinical models for drug development and testing. Conclusion: This study demonstrated that patient-derived organoids can successfully recapitulate the molecular characterization of endometrial cancer. Molecularly defined organoids represent a promising preclinical resource for drug screening in endometrial cancer. In addition, the model structure should be taken into account while conducting drug screening. Citation Format: Dongli Liu, Elyse Powell, King Man Wan, Ramanand Athavale, Christine Loo, Caroline E. Ford. Patient-derived organoid models for drug screening in molecular subtypes of endometrial cancer [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr B014.

Research on the Winning Factors of 3x3 Basketball Techniques

Background and Aim: China's three-player basketball sport developed rapidly after being approved by the International Olympic Committee as an Olympic event, but there are obvious shortcomings in theoretical research, technical training, tactical strategies, and international experience. The lack of in-depth theoretical research and technical training models makes it difficult for players and coaches to fully understand the characteristics and winning factors of three-player basketball, resulting in insufficient international competitiveness. In contrast, other countries such as Serbia and Latvia have performed outstandingly in this field. If China can attach importance to the theoretical research and technical training of three-player basketball, and establish an effective training model, it is expected to rapidly improve the level of three-player basketball. Materials and Methods: This article aims to deeply explore the winning factors of 3x3 basketball technology. By comprehensively using literature review, mathematical statistics, and video analysis methods, the 3x3 basketball tournament of the 32nd Tokyo Olympics is taken as the research object to conduct in-depth research on 3x3 basketball technology. Results: Latvia, the champion team of the 3x3 basketball tournament at the 32nd Tokyo Olympics, emphasizes teamwork. They have a higher three-point shooting percentage than their opponents, have more crucial close-range shots, and have a clear advantage in free throw shooting percentage. The proportion of team cooperation scores is high, mainly achieved through pick and roll assists, with high breakthrough times and success rates. They perform well in rebounding and have good error protection, but need to balance pressing and fouls. These factors together helped them achieve victory. Conclusion: In terms of scoring, the team should focus on diversified three-point training, strengthen pick and roll coordination, improve breakthrough and layup abilities, as well as free throw techniques. Cultivate team collaboration awareness and cooperation skills to ensure excellent overall performance of the team. In terms of assists, focus on practicing pick and roll and direct pass techniques, while strengthening breakthrough and finishing abilities. In breakthrough training, emphasis is placed on improving the ability to break through cover and position perception. In terms of rebounding, mistakes, and fouls, emphasis is placed on teamwork in attacking, cultivating rebounding skills, intelligent pressing, and quick counterattacks to improve the team's performance in these key areas. These training strategies help teams gain more scoring opportunities in matches and improve their overall competitive level.

Outcomes of paediatric fundoplication stratified by subtype of neurological impairment

AimsJejunal feeding is increasingly seen as an alternative to fundoplication in neurologically impaired children. However, fundoplication may offer important advantages. This study aimed to determine: (i) contemporary outcomes of fundoplication from a sub-specialised service; and (ii) whether outcomes were influenced by neurological characteristics. MethodsSingle-centre retrospective review of consecutive children undergoing fundoplication by three surgeons over five years (2017–2022) using a standardised technique. Children were stratified as neurologically unimpaired, static brain injury, neuromuscular condition or neurodegenerative impairment. Failure was defined as a requirement for subsequent jejunal feeding or further surgery. Data are presented as median (IQR) unless stated. Comparisons used Fisher's test. Results144 children underwent fundoplication at 1.9 years (1–5 years): 97/144 (67 %) had neurological impairment. Surgery was completed laparoscopically 128/144 (89 %) and converted in 9/137 (7 %). 84/144 (60 %) underwent concomitant gastrostomy formation. At 35 months (22–47), absolute failure was 16 % (23/144). Failure was higher in those with neurodegenerative conditions (not significant). Persistence of symptoms was noted in 23/144 (16 %). Two (1.4 %) required reoperation (<30 days). Nine (6.4 %) required admission to critical care. One death within 30 days was unrelated. ConclusionsGiven fundoplication may provide significant benefits (avoiding pump feeds, frequent tube failure/changes and risk of jejunal perforation), success rates are high and morbidity low, fundoplication should be offered to families as an alternative to jejunal feeding as part of comprehensive counselling. There was no significant difference in outcome between neurological impairment subtypes in this sample size.

Learning Hybrid Policies for MPC with Application to Drone Flight in Unknown Dynamic Environments

In recent years, drones have found increased applications in a wide array of real-world tasks. Model predictive control (MPC) has emerged as a practical method for drone flight control, owing to its robustness against modeling errors/uncertainties and external disturbances. However, MPC’s sensitivity to manually tuned parameters can lead to rapid performance degradation when faced with unknown environmental dynamics. This paper addresses the challenge of controlling a drone as it traverses a swinging gate characterized by unknown dynamics. This paper introduces a parameterized MPC approach named hyMPC that leverages high-level decision variables to adapt to uncertain environmental conditions. To derive these decision variables, a novel policy search framework aimed at training a high-level Gaussian policy is presented. Subsequently, we harness the power of neural network policies, trained on data gathered through the repeated execution of the Gaussian policy, to provide real-time decision variables. The effectiveness of hyMPC is validated through numerical simulations, achieving a 100% success rate in 20 drone flight tests traversing a swinging gate, demonstrating its capability to achieve safe and precise flight with limited prior knowledge of environmental dynamics.

Outcomes of Humerus Nonunion Surgery in Patients With Initial Operative Fracture Fixation.

To describe outcomes following humerus aseptic nonunion surgery in patients whose initial fracture was treated operatively and to identify risk factors for nonunion surgery failure in the same population. Retrospective case series. Eight, academic, level 1 trauma centers. Patients with aseptic humerus nonunion (OTA/AO 11 and 12) after the initial operative management between 1998 and 2019. Success rate of nonunion surgery. Ninety patients were included (56% female; median age 50 years; mean follow-up 21.2 months). Of 90 aseptic humerus nonunions, 71 (78.9%) united following nonunion surgery. Thirty patients (33.3%) experienced 1 or more postoperative complications, including infection, failure of fixation, and readmission. Multivariate analysis found that not performing revision internal fixation during nonunion surgery (n = 8; P = 0.002) and postoperative de novo infection (n = 9; P = 0.005) were associated with an increased risk of recalcitrant nonunion. Patient smoking status and the use of bone graft were not associated with differences in the nonunion repair success rate. This series of previously operated aseptic humerus nonunions found that more than 1 in 5 patients failed nonunion repair. De novo postoperative infection and failure to perform revision internal fixation during nonunion surgery were associated with recalcitrant nonunion. Smoking and use of bone graft did not influence the success rate of nonunion surgery. These findings can be used to give patients a realistic expectation of results and complications following humerus nonunion surgery. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Efficacy and safety of caspofungin for the treatment of invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease.

We assessed the efficacy of a 3-week primary or salvage caspofungin regimen in patients with chronic obstructive pulmonary disease (COPD) and concomitant proven or suspected invasive pulmonary aspergillosis (IPA). Forty-four patients were treated with an initial loading caspofungin dose of 70 mg, followed by a daily dose of 50 mg for 20 days. The main efficacy endpoint was clinical effectiveness. Secondary endpoints included the clinical efficacy of caspofungin after 1 week, therapeutic efficacy based on the European Organization for Research and Treatment of Cancer and Mycoses Study Group Education and Research Consortium (EORTC/MSG) criteria, the sensitivity of different Aspergillus strains to caspofungin in vitro, and the safety of caspofungin. An assessment of 42 patients in the intention-to-treat group revealed efficacy rates of 33.33% within 1 week and 38.10% within 3 weeks. According to the EORTC/MSG criteria, the treatment success rate was 38.10%. The success rate of first-line treatment was 54.76%, whereas salvage treatment had a success rate of 45.24%. No adverse events were reported among the participants. Caspofungin is effective and safe as an initial or salvage treatment for patients with IPA and COPD.