Technical Report Research Articles

Percutaneous Endoscopic Unilateral-Approach Bilateral Decompression for Lumbar Spinal Stenosis.

Lumbar spinal stenosis (LSS) involves the narrowing of the spinal canal due to degenerative changes in the vertebral joints, intervertebral discs, and ligaments. LSS encompasses central canal stenosis (CCS), lateral recess stenosis (LRS), and intervertebral foramen stenosis (IFS). The utilization of lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) has gained popularity in the treatment of CCS and LRS. This popularity is attributed to the rapid development of endoscopic instruments and the progress of endoscopic philosophy. In this technical report, a detailed introduction to the steps and key points of LE-ULBD is provided. Simultaneously, a retrospective review of 132 consecutive patients who underwent LE-ULBD for central canal and/or lateral recess stenosis was conducted. The outcomes after more than two years of follow-up were assessed using the visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, and the modified MacNab criteria to evaluate surgical efficacy. All 132 patients underwent LE-ULBD successfully. Among them, 119 patients were rated as "excellent," while 13 patients were rated as "good" based on the modified MacNab criteria during the last follow-up. Incidental dural tears occurred in four cases, but there were no post-operative epidural hematomas or infections. The experience demonstrates that LE-ULBD is a less invasive, effective, and safe approach. It can be considered as an alternative option for treating patients with lumbar central canal stenosis and/or lateral recess stenosis.

Understanding the influence of stakeholders on the implementation of front-of-pack nutrition labelling in the absence of public debate: the case of Portugal

In the context of the European Commission’s proposal for the harmonization of front-of-pack nutrition labels (FoPLs) across the European Union scheduled for 2023, Portugal’s position on the preferred format to be adopted remains unclear. Our study aims to (1) describe the context of the political decision regarding FoPL’s implementation in Portugal, (2) identify and characterize the actors involved in the debate and (3) evaluate their influence in the decision-making process and their position on the various formats of FoPLs considered. A document review complemented by a qualitative study with eight experts revealed the actors involved in the implementation of FoPLs in Portugal. The stakeholder theory was used to qualify their level of influence on the decision. To complement the experts’ analysis, the views of 1014 Portuguese consumers on stakeholders’ influence were collected via an online questionnaire. The results show a strong mobilization of the Portuguese Ministry of Health on the issue through the production of several technical and scientific reports. The background of the political decision related to FoPLs in Portugal highlights the commitment of some influential stakeholders in favour of the traffic light format, including one of the major Portuguese retailers, Continente. Nevertheless, in the face of public support for the Nutri-Score from a growing number of actors, Portugal has not yet adopted a specific format, partly due to some resistance from the agricultural sector. Portugal, by lack of consensus and agenda setting, is now awaiting formal harmonization of FoPLs by the European Commission. This study provides useful insights for public policy actors when promoting interventional measures.

Laparoscopic polyglycolic acid spacer placement for locally recurrent rectal cancer.

Carbon ion radiotherapy (CIRT) has received attention for the treatment of locally recurrent rectal cancer. When the surrounding primary organs are close to the irradiation site, a spacer is required to ensure safe irradiation. This work describes a novel technique using a bioabsorbable polyglycolic acid spacer placed laparoscopically and presents a technical report with five case studies. The short-term surgical outcomes were as follows: mean operating time 235 min with blood loss of 38 mL. CIRT was planned, and the patients underwent irradiation within 2 months of surgery. No pelvic infections occurred, and all procedures were performed safely. Herein, were present a technical report with reference to a video of the surgical procedure.

Technical report: The clinically useful selection of proteins protocol: An approach to identify clinically useful proteins for validation

Clinical proteomics studies aiming to develop markers of clinical outcome or disease typically involve distinct discovery and validation stages, neither of which focus on the clinical applicability of the candidate markers studied. Our clinically useful selection of proteins (CUSP) protocol proposes a rational approach, with statistical and non-statistical components, to identify proteins for the validation phase of studies that could be most effective markers of disease or clinical outcome. Additionally, this protocol considers commercially available analysis methods for each selected protein to ensure that use of this prospective marker is easily translated into clinical practice. SignificanceWhen developing proteomic markers of clinical outcomes, there is currently no consideration at the validation stage of how to implement such markers into a clinical setting. This has been identified by several studies as a limitation to the progression of research findings from proteomics studies. When integrated into a proteomic workflow, the CUSP protocol allows for a strategically designed validation study that improves researchers' abilities to translate research findings from discovery-based proteomics into clinical practice.

Historical aspects and challenges of teaching engineering geology to engineering students

This paper discusses some points of the evolution of Engineering Geology based on a survey of historical facts, books, and other types of publications and technical reports and analyzes the teaching in engineering schools, specifically in the São Carlos School of Engineering, at University of São Paulo (EESC/USP). The survey involved the main topics considered in the teaching of Engineering Geology and both successes and challenges of the teaching experience at undergraduate and graduate levels at EESC/USP over the past 50 years are presented. Engineering Geology teaching has undergone different phases and adaptations to the evolution of knowledge and research procedures. According to the survey, it focuses on four large groups of didactic activities for the current decade and, perhaps, for the next one in several countries. The first group refers to access to materials of each topic in the format of books, videos, and lectures available on websites and the second includes face-to-face activities on the solution of practical problems related to a specific topic. The third group focuses on field and laboratory works, whereas the fourth comprehends development and analyses of specific civil work projects, mineral exploration, and environmental problems according to both face-to-face and non-face-to-face methodologies.

Feasibility of Image Inversion for Ventral Hernia Repair Using the Versius System.

Background: The aim of our technical report is to demonstrate the image inversion technique in the new Versius Robotic System. Methods: We report a step-by-step surgical maneuver for robotic surgeons when performing robotic ventral hernia repair (VHR) with the Versius Robotic System. Technical Report: The image inversion artifice consists in rotating 180° with the scope using the surgeon's master control in a specific rotation command in the right-hand joystick. The assisting surgeon can do a manual inversion of the camera without the console being aware that the scope is inverted. In this scenario, the 30° Up configuration should be used while informing the console that the scope is looking down. The surgeon can reassign instruments to each joystick. This results in the right joystick controlling the left instrument and left control controlling the right instrument. Since the image is inverted, the movements will look natural on the surgeon console. Conclusions: The use of the image inversion technique with the Versius Robotic System is effective in aiding surgeons to perform the hernia defect closure during robotic VHRs.

Research and development of the high precision low field dipole magnet for CEPC Booster

In the Conceptual Design Report (CDR) stage of the Circular Electron and Positron Collider (CEPC), the injection energy of the Booster is 10 GeV and minimal working field of the dipole magnets is only 29 G, the magnets with iron cores could not meet the requirement of the field precision due to the remnant field. In the CEPC Technical Design Report (TDR) stage, the injection energy of the Booster is increased to 30 GeV and the minimal working field of the dipole magnets is raised to 95 G so that the influence of the remnant field becomes relatively small, the iron core dipole magnets can be used for the Booster. In this paper, the technical design of the CEPC Booster dipole magnets is described, the development and test of a full scale prototype pure dipole magnet are presented.

Alkylating agents are possible inducers of glioblastoma and other brain tumors.

Epidemiological evidence of an association between exposure to chemical carcinogens and an increased risk for development of glioblastoma (GBM) is limited to weak statistical associations in cohorts of firefighters, farmers, residents exposed to air pollution, and soldiers exposed to toxic chemicals (e.g., military burn pits, oil-well fire smoke). A history of ionizing radiation therapy to the head or neck is associated with an increased risk of GBM. Ionizing radiation induces point mutations, frameshift mutations, double-strand breaks, and chromosomal insertions or deletions. Mutational profiles associated with chemical exposures overlap with the broad mutational patterns seen with ionizing radiation. Data on 16 agents (15 chemicals and radio frequency radiation) that induced tumors in the rodent brain were extracted from 602 Technical Reports on 2-years cancer bioassays found in the National Toxicology Program database. Ten of the 15 chemical agents that induce brain tumors are alkylating agents. Three of the 15 chemical agents have idiosyncratic structures and might be alkylating agents. Only two of the 15 chemical agents are definitively not alkylating agents. The rat model is thought to be of possible relevance to humans suggesting that exposure to alkylating chemicals should be considered in epidemiology studies on GBM and other brain tumors.

Fabrication of a monorail-type diagnostic catheter for rescue retrieval technique of a distal embolic protection device.

In this technical report, we describe a challenging case concerning the retrieval of a distal embolic protection device (DEPD) post-carotid artery stenting. We propose a novel rescue retrieval technique for DEPD, employing a fabricated monorail-type HN5 diagnostic catheter. When integrated with existing strategies, this approach may optimize and streamline the process of DEPD removal.

Social Norms and Concussion Disclosure Behavior: Clarification of Terms and Measurement Recommendations.

Non-disclosed sport-related concussion symptoms pose a significant risk to athletes' health and well-being. Many research investigations have focused on understanding the factors impacting athletes' concussion disclosure behaviors. One of the most robust predictors of the likelihood that an athlete will disclose concussion symptoms to their coaches, athletic trainers, parents, or peers is what researchers term "social norms." The extant literature regarding social norms influencing concussion disclosure behaviors is inconsistent on how the construct should be defined, conceptualized, or measured, often failing to distinguish between descriptive and injunctive social norms and their sources (direct and indirect). In this Technical Report, we provide an overview of these critical distinctions, their importance in assessments, and examples from the literature where scholars have correctly operationalized these constructs in athletic populations. We conclude with a brief set of suggestions for researchers seeking to measure social norms in future research.

Peer review of GPT-4 technical report and systems card.

The study provides a comprehensive review of OpenAI's Generative Pre-trained Transformer 4 (GPT-4) technical report, with an emphasis on applications in high-risk settings like healthcare. A diverse team, including experts in artificial intelligence (AI), natural language processing, public health, law, policy, social science, healthcare research, and bioethics, analyzed the report against established peer review guidelines. The GPT-4 report shows a significant commitment to transparent AI research, particularly in creating a systems card for risk assessment and mitigation. However, it reveals limitations such as restricted access to training data, inadequate confidence and uncertainty estimations, and concerns over privacy and intellectual property rights. Key strengths identified include the considerable time and economic investment in transparent AI research and the creation of a comprehensive systems card. On the other hand, the lack of clarity in training processes and data raises concerns about encoded biases and interests in GPT-4. The report also lacks confidence and uncertainty estimations, crucial in high-risk areas like healthcare, and fails to address potential privacy and intellectual property issues. Furthermore, this study emphasizes the need for diverse, global involvement in developing and evaluating large language models (LLMs) to ensure broad societal benefits and mitigate risks. The paper presents recommendations such as improving data transparency, developing accountability frameworks, establishing confidence standards for LLM outputs in high-risk settings, and enhancing industry research review processes. It concludes that while GPT-4's report is a step towards open discussions on LLMs, more extensive interdisciplinary reviews are essential for addressing bias, harm, and risk concerns, especially in high-risk domains. The review aims to expand the understanding of LLMs in general and highlights the need for new reflection forms on how LLMs are reviewed, the data required for effective evaluation, and addressing critical issues like bias and risk.

A brief guide to measurement uncertainty (IUPAC Technical Report)

Abstract This Brief Guide reintroduces readers to the main concepts and technical tools used for the evaluation and expression of measurement uncertainty, including both classical and Bayesian statistical methods. The general approach is the same that was adopted by the Guide to the Expression of Uncertainty in Measurement (GUM): quantities whose values are surrounded by uncertainty are modeled as random variables, which enables the application of a wide range of techniques from probability and statistics to the evaluation of measurement uncertainty. All the methods presented are illustrated with examples involving real measurement results from a wide range of fields of chemistry and related sciences, ranging from classical analytical chemistry as practiced at the beginning to the 20th century, to contemporary studies of isotopic compositions of the elements and clinical trials. The supplementary material offers profusely annotated computer codes that allow the readers to reproduce all the calculations underlying the results presented in the examples.

Validation of numerical results of complex seismic analysis through simple analytics

AbstractThe paper analyzes the application of the numerical findings of the program, which is becoming increasingly difficult for civil and structural design. Since, as in many other countries, the verification of design using a software model is now required by current Italian codes as well. Given this, the structural engineer must provide a technical report using a licensed software tool, attached to other project documents to get the Seismic Authorization at the local Civil Engineering Department offices. Following a brief explanation of structural analysis methodologies, this study presents a criterion for assessing the applicability of numerical findings obtained using any structural software. Three case studies of this criterion are shown to demonstrate how to check them using simple manual calculations: (i) the normal stress in RC columns subjected to gravity loads; (ii) the periods of vibration, participating masses, and seismic base shear derived from dynamic modal analysis; and (iii) the main parameters characterizing the pushover curves of existing buildings. Finally, this work underlines the significance of confirming the application of numerical results obtained by software in civil and structural design. The offered criteria and scenarios exhibit realistic techniques to ensure accuracy and reliability in structural performance assessment, according to the structural requirements imposed by current codes in Italy and similar countries.

Application of unilateral biportal endoscopy technique to resect a thoracic spinal intradural extramedullary meningioma: technical report and review of the literature

BackgroundMeningiomas are common intradural extramedullary spinal tumors, which arise from arachnoid cap cells in the leptomeninges surrounding the brain or spinal cord. Sensory and motor dysfunction as well as pain were the most common presenting symptoms. Surgical resection remains the primary treatment for spinal intradural extramedullary meningiomas. Traditionally, spinal meningiomas excision requires longer skin incision, bilateral subperiosteal muscle stripping, and total laminectomy. We report a new technique for the treatment of thoracic spinal intradural extramedullary meningioma, which involves the use of unilateral biportal endoscopy (UBE) technique to resect the tumor, and reviewed and analyzed relevant literature.Case presentationA 69-year-old female patient presented with back pain accompanied by slowly progressive lower limb paresis, and severe pain in the right lower limb. Magnetic resonance imaging suggests a thoracic spinal intradural extramedullary meningioma. She underwent meningioma resection using UBE technique with complete recovery at the follow-up examination 3 months after surgery.ConclusionThis case confirmed the UBE technique can be a good choice for resection of spinal intradural extramedullary meningioma.

The Hegemony of South Africa and the Free Movement of Persons in SADC: Challenges and Perspectives

The free movement of persons faces many challenges in the SADC region. Currently, there is no solid regional framework that governs it. As a result, it is managed by several varying bilateral agreements between the member states. This study aims to evaluate the impact the hegemony of South Africa has on the free movement of persons in the SADC region. The specific objectives of the study were to examine the effect the hegemony of South Africa has on visa openness in the SADC region, to describe the hegemony of South Africa in relation to ratification of the protocol on the facilitation of movement of persons in the SADC region, and finally to evaluate the influence the hegemony of South Africa has on border procedures in the SADC region. The qualitative research method was undertaken in pursuit of fulfilling the study objectives. The data for this study was collected from a selection of official statistics, technical reports, and scholarly journals. The findings of the study suggest that the hegemony of South Africa has greatly contributed and shaped the status of the free movement of persons in the region. South Africa has negotiated itself into favourable positions with its fellow SADC member states that have placed them at an advantage. South Africa benefits from favourable visa openness and border procedures. It’s contribution in influencing the Protocol on the Facilitation of Movement of Persons has resulted in it being among the countries that have ratified the protocol which has more relaxed provisions. The study recommends harmonised free movement agreements that have a more regional outlook and an approach to the free movement of persons that has a bearing that is not centred around security and negative perceptions.

The role of territorial governance as an instrument for biological diversity conservation in the Atlantic Forest: Social learning from the Paraná River Biodiversity Corridor, Brazil

In Latin America, in the non-coastal portion of the Brazilian Atlantic Forest, there is the territory of Paraná River Biodiversity Corridor, which shares decision-making processes since 2010 and based on the performance of its Managing Network. In this context, the aim of this study was to evaluate the role of the Paraná River Biodiversity Corridor Managing Network as an instrument of territorial governance for biological diversity conservation actions. Methodologically, the method of participant observation of the Network's meetings was used, in association with the semi-structured questionnaire and content analysis of its technical reports. The results showed that the Network expands institutional action for biodiversity conservation in the territory, enhancing personal learning and the possibility of building shared agendas, for example, the elaboration of a Bioregional Management Plan for the Corridor. Out of every 10 planned actions, seven were completed, which demonstrates confidence in the Network in mediating inter-institutional actions. One of these actions was the approval of an ecological restoration project carried out in partnership by 16 Network members from 2017 to 2022, expanding results and optimizing financial costs. However, there are limitations related to the institutional structure of the Network members, who lack dialogic and administrative prerogatives that end up not favoring territorial integration. Finally, develop actions for the conservation of biological diversity must be planned in a dialogical and participatory way, on a regional scale and mediated, unconditionally, by robust governance arrangements.

Leveraging the Application of IoT based Deep Learning Prediction Model in Smart Healthcare

The standard IoT sensors and tools are to learn data construction techniques for creating a predictive model.The use of time series evaluation tools to identify thyroid tumors in their early stages is examined in this research. The records of thyroid ultrasound scans from 475 individuals are examined. The analysis is utilized to evaluate the predictor model's accuracy and the Time Series evaluation methodologies' suitability for correctly identifying thyroid cancer in its early stages. The results demonstrate the effectiveness of time-collection analytic techniques in the early detection of thyroid cancer. The results also highlight the potential for utilizing time series analytic techniques in various cancer-related early detection initiatives. The majority of thyroid tumors were found at an early stage using time series analysis, a finding that is the focus of this technical report. The program developed the ability to distinguish between benign and malignant tumors. The results of the observation demonstrated that the set of guidelines was effective in increasing the precision degree measurement using various wearable IoT Sensors. Additionally, the set of guidelines can identify the presence of a tumor before any scientific symptoms are apparent. The observer concluded that time-collecting analysis might be utilized to identify early cancer symptoms, which would undoubtedly lead to improved outcomes and more advanced treatments.

Anterior transcorporeal approach combined with posterior translaminar approach in percutaneous endoscopic cervical discectomy for two-segment cervical disc herniation treatment: a technical report and early follow-up

ObjectiveFull endoscopic techniques are being gradually introduced from single-segment cervical disc herniation surgery to two-segment cervical disc herniation surgery. However, there is no suitable full endoscopic treatment for mixed-type two-segment cervical disc herniation (MTCDH) in which one segment herniates in front of the spinal cord and the other segment herniates behind the spinal cord. Therefore, we introduce a new full endoscopic technique by combining an anterior transcorporeal approach and a posterior translaminar approach. In addition, we provide a brief description of its safety, efficacy, feasibility, and surgical points.MethodsThirty patients with MTCDH were given full endoscopic surgical treatment by a combined transcorporeal and transforaminal approach and were followed up for at least 12 months.ResultsClinical assessment scales showed that the patient’s symptoms and pain were significantly reduced postoperatively. Imaging results showed bony repair of the surgically induced bone defect and the cervical Cobb angle was increased. No serious complications occurred.ConclusionThis technique enables minimally invasive surgery to relieve the compression of the spinal cord by MTCDH. It avoids the fusion of the vertebral body for internal fixation, preserves the vertebral motion segments, avoids medical destruction of the cervical disc to the greatest extent possible, and expands the scope of adaptation of full endoscopic technology in cervical surgery.

Assessing ChatGPT's orthopedic in-service training exam performance and applicability in the field.

ChatGPT has gained widespread attention for its ability to understand and provide human-like responses to inputs. However, few works have focused on its use in Orthopedics. This study assessed ChatGPT's performance on the Orthopedic In-Service Training Exam (OITE) and evaluated its decision-making process to determine whether adoption as a resource in the field is practical. ChatGPT's performance on three OITE exams was evaluated through inputting multiple choice questions. Questions were classified by their orthopedic subject area. Yearly, OITE technical reports were used to gauge scores against resident physicians. ChatGPT's rationales were compared with testmaker explanations using six different groups denoting answer accuracy and logic consistency. Variables were analyzed using contingency table construction and Chi-squared analyses. Of 635 questions, 360 were useable as inputs (56.7%). ChatGPT-3.5 scored 55.8%, 47.7%, and 54% for the years 2020, 2021, and 2022, respectively. Of 190 correct outputs, 179 provided a consistent logic (94.2%). Of 170 incorrect outputs, 133 provided an inconsistent logic (78.2%). Significant associations were found between test topic and correct answer (p = 0.011), and type of logic used and tested topic (p = < 0.001). Basic Science and Sports had adjusted residuals greater than 1.96. Basic Science and correct, no logic; Basic Science and incorrect, inconsistent logic; Sports and correct, no logic; and Sports and incorrect, inconsistent logic; had adjusted residuals greater than 1.96. Based on annual OITE technical reports for resident physicians, ChatGPT-3.5 performed around the PGY-1 level. When answering correctly, it displayed congruent reasoning with testmakers. When answering incorrectly, it exhibited some understanding of the correct answer. It outperformed in Basic Science and Sports, likely due to its ability to output rote facts. These findings suggest that it lacks the fundamental capabilities to be a comprehensive tool in Orthopedic Surgery in its current form. II.

Qualitative analysis of the reflection of the mathematical dimension of gambling in gaming online content - Technical report no. 1

Qualitative analysis of the reflection of the mathematical dimension of gambling in gaming online content - Technical report no. 1