Time Research Articles

Memory in the Burst Occurrence of Repeating Fast Radio Bursts

Understanding the nature of repeating fast radio bursts (FRBs) is crucial for probing their underlying physics. In this work, we analyze the waiting time statistics between bursts of three repeating FRBs from four data sets. We find a universally pronounced dependency of the waiting times on the previous time interval (denoted as λ 0). We observe a temporal clustering, where short waiting times tend to be followed by short ones and long by long, comparative to their mean value. This memory dependency is manifested in the conditional mean waiting time as well as in the conditional mean residual time to the next burst, both of which increase in direct proportion to λ 0. Consequently, the likelihood of experiencing a subsequent FRB burst within a given time window after the preceding burst is generally influenced by the burst history. We reveal, for the first time, that these memory effects are present in the scale-invariant preconditioned waiting time distribution. We show that the memory effect provides a unified description of waiting times that may account for both the repeating FRBs and the apparently nonrepeating FRBs (i.e., those only observed one time). These results shed new light on the mechanism of FRBs.

Effect of Parental Involvement by the Headteachers in the Education of their Children on Students Retention in Masinga Sub-County, Kenya

The study focuses on the effect of parents’ involvement by head teachers in the education of their children and students’ retention in secondary school education in Masinga sub – county Kenya. It was guided by the following objective: to determine the extent to which parents’ involvement by the headteachers in the education of their children influences students’ retention in secondary school education. The study adopted a descriptive survey research design. The study was anchored on Epstein theory. The target population was 50 head teachers,50 deputy head teachers and 5022 form 3 and 4 students. Purposive, stratified proportionate sampling and simple random sampling were employed to sample 25 head teachers, 25 deputy head teachers and 370 students. Data collection instruments included questionnaires for headteachers and students, an interview guide for deputy headteachers and a document analysis guide. Validity of the research instruments was ascertained through expert judgement and piloting. Reliability was achieved through test – retest method where the instruments were piloted in a time interval of two weeks and the two results were correlated using Pearson’s product moment correlation method. Further, inferential analysis was employed that involved correlational analysis at a 0.05 level of significance. The hypothesis was accepted or rejected at 0.01 level of significance. The findings showed that there is a positive correction between parents’ involvement in the education of their children and students’ retention (r = 0.811; p = 0.00), hence the hypothesis was rejected and an alternative hypothesis accepted. The study concluded that the head teachers’ efforts to engage parents in the educational matters positively influence students’ retention. The study recommends that head teachers should use more communication strategies in order to involve all the parents in the education of their children.

Antimicrobial peptide LyeTx I mn∆K labeled with 68Ga is a potential PET radiopharmaceutical for molecular imaging of infections

BackgroundAntimicrobial peptides have been radiolabeled and investigated as molecular diagnostic probes due to their propensity to accumulate in infectious sites rather than aseptic inflammatory lesions. LyeTx I is a cationic peptide from the venom of Lycosa erythrognatha, exhibiting significant antimicrobial activity. LyeTx I mn∆K is a shortened derivative of LyeTx I, with an optimized balance between antimicrobial and hemolytic activities. This study reports the first 68Ga-radiolabeling of the DOTA-modified LyeTx I mn∆K and primarily preclinical evaluations of [68Ga]Ga-DOTA(K)-LyeTx I mn∆K as a PET radiopharmaceutical for infection imaging. MethodsDOTA(K)-LyeTx I mn∆K was radiolabeled with freshly eluted 68Ga. Radiochemical yield (RCY), radiochemical purity (RCP), and radiochemical stability (in saline and serum) were evaluated using ascending thin-layer chromatography (TLC) and reversed-phase high-performance liquid chromatography (RP-HPLC). The radiopeptide's lipophilicity was assessed by determining the logarithm of the partition coefficient (Log P). Serum protein binding (SBP) and binding to Staphylococcus aureus (S. aureus) cells were determined in vitro. Ex vivo biodistribution studies and PET/CT imaging were conducted in healthy mice (control) and mice with infection and aseptic inflammation to evaluate the potential of [68Ga]Ga-DOTA(K)-LyeTx I mn∆K as a specific PET radiopharmaceutical for infections. Results[68Ga]Ga-DOTA(K)-LyeTx I mn∆K was obtained with a high RCY (>90 %), and after purification through a Sep-Pak C18 cartridge, the RCP exceeded 99 %. Ascending TLC and RP-HPLC showed that the radiopeptide remained stable for up to 3.0 h in saline solution and up to 1.5 h in murine serum. [68Ga]Ga-DOTA(K)-LyeTx I mn∆K exhibited hydrophilic characteristics (Log P = −2.4 ± 0.1) and low SPB (ranging from 23.3 ± 0.4 % at 5 min of incubation to 10.5 ± 1.1 % at 60 min of incubation). The binding of [68Ga]Ga-DOTA(K)-LyeTx I mn∆K to S. aureus cells was proportional to bacterial concentration, with binding percentages of 8.8 ± 0.5 % (0.5 × 109 CFU.mL−1), 16.2 ± 1.4 % (1.0 × 109 CFU.mL−1), and 62.2 ± 0.6 % (5.0 × 109 CFU.mL−1). Ex vivo biodistribution studies and PET/CT images showed higher radiopeptide uptake at the infection site compared to the aseptic inflammation site; the latter was similar to the control group. Target-to-non-target (T/NT) ratios obtained by ex vivo biodistribution data were approximately 1.0, 1.3, and 3.0 at all investigated time intervals for the control, aseptic inflammation, and infection groups, respectively. Furthermore, T/NT ratios obtained from PET/CT images were 1.1 ± 0.1 for the control group and 1.4 ± 0.1 for the aseptic inflammation group. For the infection group, T/NT ratio was 5.0 ± 0.3, approximately 5 times greater compared to the former groups. ConclusionsThe results suggest the potential of [68Ga]Ga-DOTA(K)-LyeTx I mn∆K as a PET radiopharmaceutical for molecular imaging of infections.

Stereotactic radiotherapy for patients with bone metastases: a selected group with low rate of radiation treatment during the last month of life?

BackgroundComplex high-precision radiotherapy, such as stereotactic body radiotherapy (SBRT), should only be offered to patients with sufficiently long survival. In the context of bone metastases radiotherapy, low rates of treatment close to the end of life, e.g. last 30 days (RT30), may serve as a quality of care indicator. While traditional, pain-relieving short-course regimens have been studied comprehensively, real-world SBRT results are still limited.MethodsRetrospective analysis (2010–2023, n = 1117 episodes) of patients with bone metastases treated with traditional single-fraction (8 Gy × 1) or multi-fraction regimens (often 4 Gy × 5 or 3 Gy × 10) compared to stereotactic single-fraction (12–16 Gy × 1) or multi-fraction regimens.ResultsExcept for gender, almost all baseline variables were uneven distributed. Failure to complete fractionated radiotherapy was uncommon in the stereotactic (4%) and non-stereotactic group (3%), p = 1.0. With regard to RT30, relevant differences emerged (19% for 8-Gy single-fraction versus 0% for stereotactic single-fraction, p = 0.01). The corresponding figures were 11% for multi-fraction non-stereotactic and 2% for multi-fraction stereotactic, p = 0.08. Median overall survival was shortest after 8-Gy single-fraction irradiation (4.2 months) and longest after stereotactic multi-fraction treatment (13.9 months). Neither stereotactic radiotherapy nor multi-fraction treatment improved survival in multivariate Cox regression analysis. Factors significantly associated with longer survival included better performance status, lower LabBM score (5 standard blood test results), stable disease outside of irradiated area(s), metachronous distant metastases, longer time interval from metastatic disease to bone irradiation, and outpatient status.ConclusionThe implementation of SBRT for selected patients has resulted in low rates of non-completion and RT30. Optimal selection criteria remain to be determined, but in current clinical practice we exclude patients with poor performance status, unfavorable blood test results (high LabBM score) and progressive disease sites not amenable to SBRT. Established, guideline-endorsed short-course regimens, especially 8-Gy single-fraction treatment, continue to represent an important palliative approach.

Reverse Total Shoulder Arthroplasty for Acute Proximal Humerus Fractures: Is Delay Associated With an Increased Rate of Reoperation?

To compare reoperation rates of acute versus delayed reverse total shoulder arthroplasty (RTSA) following a period of nonoperative treatment for proximal humerus fractures (PHFs). We also aimed to identify an optimal time interval from PHF to RTSA before the risk of reoperation significantly increased. . Database review. Ontario, Canada. Adults aged 50 years and older who sustained a PHF (OTA/AO 11A-C) between 2004 and 2019 were included. Exclusion criteria included polytrauma, open fractures, non-Ontario residents, invalid health insurance, and any operative treatment before RTSA. The primary outcome measure was reoperation within 2 years following RTSA. A risk-adjusted, restricted cubic spline was used to model the probability of reoperation according to the time elapsed between PHF and RTSA to identify a time point at which the risk of reoperation significantly increased. A multivariate logistics regression was used to identify predictors. In total, 891 patients (685 acute, 206 delayed) underwent RTSA for PHF. The acute cohort had a significantly lower reoperation rate (3.9%) compared with the delayed cohort (8.3%) (P = 0.02). The odds of reoperation increased with a delay to RTSA greater than 28 days and continued to rise until 100 days after fracture. Patients who underwent RTSA 28 days after PHF were found to have a significantly higher odds of reoperation by 2 years (P = 0.03). Among patients undergoing RTSA for acute PHFs, a delay to surgery greater than 28 days is associated with a greater odds of reoperation and may be useful when counseling patients. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Predicting Continuous Locomotion Modes via Multidimensional Feature Learning From sEMG.

Walking-assistive devices require adaptive control methods to ensure smooth transitions between various modes of locomotion. For this purpose, detecting human locomotion modes (e.g., level walking or stair ascent) in advance is crucial for improving the intelligence and transparency of such robotic systems. This study proposes Deep-STF, a unified end-to-end deep learning model designed for integrated feature extraction in spatial, temporal, and frequency dimensions from surface electromyography (sEMG) signals. Our model enables accurate and robust continuous prediction of nine locomotion modes and 15 transitions at varying prediction time intervals, ranging from 100 to 500 ms. Experimental results showcased Deep-STP's cutting-edge prediction performance across diverse locomotion modes and transitions, relying solely on sEMG data. When forecasting 100 ms ahead, Deep-STF achieved an improved average prediction accuracy of 96.60%, outperforming seven benchmark models. Even with an extended 500ms prediction horizon, the accuracy only marginally decreased to 93.22%. The averaged stable prediction times for detecting next upcoming transitions spanned from 31.47 to 371.58 ms across the 100-500 ms time advances. Although the prediction accuracy of the trained Deep-STF initially dropped to 71.12% when tested on four new terrains, it achieved a satisfactory accuracy of 92.51% after fine-tuning with just 5 trials and further improved to 96.27% with 15 calibration trials. These results demonstrate the remarkable prediction ability and adaptability of Deep-STF, showing great potential for integration with walking-assistive devices and leading to smoother, more intuitive user interactions.

Initial results of hard X-ray spectroscopy by LaBr[formula omitted](Ce) detector for runaway electron study in Thailand Tokamak-1

Thailand Tokamak-1 (TT-1) successfully achieved its first plasma operation in early 2023. Understanding the behavior of high-energy runaway electrons (RE) during plasma discharges is crucial in TT-1 due to the potential risk of significant damage to in-vessel components. To study the RE behavior and analyze its characteristics, the LaBr3(Ce) detector was employed for measuring hard X-ray emissions in TT-1. In this study, we first characterized the LaBr3(Ce) detector in the laboratory and then performed hard X-ray spectroscopy in TT-1. Calibration sources, including 133Ba, 137Cs, 22Na, and 60Co, with energies up to 1.33 MeV, were used in the laboratory. The detector was calibrated using biased high voltage of -1000 V. It was found to have an energy resolution of approximately 6.2% at an energy of 0.662 MeV. After calibration, the detector was installed at TT-1 to measure hard X-ray. We analyze the hard X-ray emission from discharge #2183 during a selected time interval. It is found that the high-energy hard X-ray emissions reach up to approximately 500 keV. Assuming a simple Maxwellian distribution of the RE population, their temperature is estimated to be 224±5 keV. These findings confirm the presence of high-energy runaway electrons during TT-1’s plasma discharges. However, to accurately derive the runaway electron energy spectrum from the hard X-ray energy spectrum, the unfolding technique is required. In future work, we plan to apply the unfolding method, conduct numerical simulations on the physics of runaway electrons, and employ Monte Carlo simulations on the hard X-ray emissions.

Failed radial head arthroplasty treated by removal of the implant.

In patients with a failed radial head arthroplasty (RHA), simple removal of the implant is an option. However, there is little information in the literature about the outcome of this procedure. The aim of this study was to review the mid-term clinical and radiological results, and the rate of complications and removal of the implant, in patients whose initial RHA was undertaken acutely for trauma involving the elbow. A total of 11 patients in whom removal of a RHA without reimplantation was undertaken as a revision procedure were reviewed at a mean follow-up of 8.4 years (6 to 11). The range of motion (ROM) and stability of the elbow were recorded. Pain was assessed using a visual analogue scale (VAS). The functional outcome was assessed using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Radiological examination included the assessment of heterotopic ossification (HO), implant loosening, capitellar erosion, overlengthening, and osteoarthritis. Complications and the rate of further surgery were also recorded. The indications for removal of the implant were stiffness in five patients, aseptic loosening in five, and pain attributed to the RHA in three. The mean time interval between RHA for trauma to removal was ten months (7 to 21). Preoperatively, three patients had overlengthening of the implant, three had capitellar erosion, six had HO, and four had radiological evidence of loosening. At the final follow-up, the mean the flexion-extension arc improved significantly by 38.2° (95% CI 20 to 59; p = 0.002) and the mean arc of prono-supination improved significantly by 20° (95% CI 0 to 72.5; p = 0.035). The mean pain VAS score improved significantly by 3.5 (95% CI 2 to 5.5; p = 0.004). The mean MEPS improved significantly by 27.5 (95% CI 17.5 to 42.5; p = 0.002). The mean OES improved significantly by 9 (95% CI 2.5 to 14; p = 0.012), and the mean DASH score improved significantly by 23.5 (95% CI 7.5 to 31.6; p = 0.012). Ten patients (91%) had HO and osteoarthritis. Two patients underwent further surgery due to stiffness and pain, respectively. Simple removal of the implant at revision surgery following a failed RHA introduced following trauma provides satisfactory mid-term results with an acceptable risk of complications. Osteoarthritis, instability, and radioulnar impingement were not problems in this series.

Study on suppression of bituminous coal explosion by inert powder in cylindrical space

In order to understand how to control the spread of bituminous coal explosion, a cylindrical explosion tube is used for research. The results indicate that within 60 ms, the flame develops to the top of the tube. When 10 % inert powder is mixed in, the flame spreads to 1.2 cm at 10 ms, which is 0.4 cm shorter than the spread distance without adding inert powder. The time point for ending preheating and entering heating will be advanced with the increase of the mass of inert dust added. As the proportion of inert dust mixed decreases, the maximum impact airflow velocity of explosion gradually increases, the acceleration time interval gradually extends. When 10 % inert powder is mixed in, the maximum impact airflow velocity is 17 m/s, but it is delayed to 52 ms. The mixing of inert dust can reduce the mass fraction of CO inside the tube without changing the mass fraction of other gases, especially O2. As the mass of inert dust increases, the mass fraction of CO2 gradually increases and the range gradually expands.

Study on the effect of chlorogenic acid on the antimicrobial effect, physical properties and model accuracy of alginate impression materials.

Dental impressions are essential for accurately capturing the detailed anatomy of teeth and surrounding oral structures. However, these impressions often become contaminated with saliva and blood, making proper disinfection necessary. The application of chemical disinfectants has been associated with negative side effects, leading to suboptimal disinfection practices in clinical settings. The purpose of this study was to evaluate the effectiveness of chlorogenic acid (CA) as a disinfectant for alginate impression materials, the impact of CA disinfection on the physical properties and dimensional accuracy of alginate impressions was also investigated. The physical properties of alginate impression materials, such as elastic recovery, strain-in-compression, initial setting time, and fluidity, were assessed after mixing the alginate impression materials with three different concentrations of CA solution (10 mg/mL, 15 mg/mL, 20 mg/mL). To evaluate the antimicrobial effect of CA, alginate impressions mixed with a 10 mg/mL CA solution and impressions mixed with distilled water (control group) were contaminated with four types of microorganism: Escherichia coli, Staphylococcus aureus, Candida albicans, and Streptococcus pneumoniae. Following a five-minute incubation period, a CA solution at a concentration of either 50mg/mL, 55 mg/mL, or 60 mg/mL was sprayed on the samples for disinfection. Samples were collected at different time intervals (10 min, 20 min, 30min) and cultured to determine the number of colony-forming units (CFU/mL), providing insight into the antimicrobial efficacy of these CA solutions. The dimensional accuracy of alginate impressions was assessed in three groups: one with alginate impressions mixed with distilled water, another with alginate impressions sterilized with available chlorine (2,000 mg/L) mixed with distilled water, and the last group consisting of alginate impressions mixed with 10 mg/mL CA solution and sprayed with 60 mg/mL CA solution. Both the standard model and the plaster model underwent 3D scanning, and the data were processed and compared by software. The root mean square (RMS) was used as a parameter to evaluate the deviation between models. All alginate impression materials mixed with either 10 mg/mL, 15 mg/mL, or 20 mg/mL concentrations of CA solution met the ISO 21563 standard for elastic recovery, strain-in-compression, and fluidity. However, only the material mixed with a concentration of 10 mg/mL CA had an initial setting time within the range specified by the T-6505 Japanese industrial standard. The application of CA solution by mixing or spraying showed significant antimicrobial effects on Staphylococcus aureus, Escherichia coli, Candida albicans, and Streptococcus pneumoniae. There was no significant difference in the dimensional accuracy of the alginate impressions between the group of the CA solution applied, the blank group, or the chlorine intervention group.

The Non-Perturbative Approach in Examining the Motion of a Simple Pendulum Associated with a Rolling Wheel with a Time-Delay

The present study aims to examine the movement of a simple pendulum (SP) that is connected by a lightweight spring and connected with a rotating wheel. The motivation behind this topic is to gain a comprehensive understanding of intricate dynamic systems that involve interconnected mechanical components and feedback with temporal delays. This system is not only theoretically attractive but also practically applicable in domains such as robotics, engineering, and control systems. As well known, all classical perturbation methods exploit Taylor expansion to simplify the reality of restoring forces. In contrast, the non-perturbative approach (NPA), as a novel methodology, transforms any nonlinear ordinary differential equation (ODE) into a linear one. It scrutinizes the restoring forces, away from employing Taylor expansion; hence it eliminates the previous weakness. The concept of the NPA is based mainly on the He’s frequency formula (HFF). The confidence of the NPA comes from the numerical compatibility between the nonlinear and linear ODEs via the Mathematica Software (MS). Therefore, instead of handling the nonlinear ODE, we investigate the linear one. The achieved response is plotted over time to show the impact of the acted parameters during a specified time interval. Moreover, the phase plane curves that correspond to the plotted solution are presented and examined. The stability criteria of the analogous linear ODE are provided and drawn to explore the stability/instability zones. The performance is applicable in engineering and other fields due to its ease of adaptation to different nonlinear systems. Therefore, the NPA can be regarded as substantial, successful, and interesting and can extended to be applied in further categories within the field of couples dynamical systems.

The GREENWATER study: patients' green sensitivity and potential recovery of injected contrast agents.

The environmental footprint of iodinated contrast agents (ICAs) and gadolinium-based contrast agents (GBCAs) is noteworthy. This study assesses: (1) patients' "green sensitivity" as measured by their acceptance in a sustainability study and (2) the resulting potential reduction of contrast residuals in wastewater. After ethical approval, participants scheduled for administration of ICAs or GBCAs for diagnostic purposes were enrolled in this prospective observational study from July 2022 to October 2023. They were asked to prolong their hospital stay by up to 60 min to collect their first urine in dedicated canisters, thereby measuring the recovery rates of ICAs and GBCAs as found/theoretical ratio of concentrations. Mann-Whitney U, χ2 tests, and multivariable regression analysis were used. Patients scheduled for contrast-enhanced CT or MRI (n = 455) were screened; 422 (92.7%) accepted to participate. We enrolled 212 patients administered with ICAs and 210 administered with GBCAs. The median recovery rate was 51.2% (interquartile range 29.2-77.9%) for ICAs and 12.9% (9.0-19.3%) for GBCAs. At multivariable analysis, a significant effect of patient age (ICAs, p = 0.001; GBCAs, p = 0.014), urine volume (p < 0.001 for both), and time interval from contrast administration to urine collection (p < 0.001 for both) on recovery rates was found for both contrast agents; injected contrast volume (p = 0.046) and saline flushing usage (p = 0.008) showed asignificant effect only for ICAs. The high patient enrollment compliance (93%) and potential recovery rates of 51% (ICAs) and 13% (GBCAs) play in favor of sustainable practices in reducing the environmental footprint of contrast agents. Question How many patients are willing to extend their stay in radiology by up to 60 min to help reduce the environmental impact of contrast agents? Findings Over 90% of screened patients agreed to extend their stay by up to 60 min and collect their urine in dedicated containers. Clinical relevance Patients demonstrated a high willingness to cooperate in reducing the environmental impact of contrast agents, allowing for a potential recovery of approximately 51% for iodinated and 13% for gadolinium-based contrast agents.

Modeling of natural first stroke stepped leader characteristics

The paper constitutes a novel physical approach to the different stages of negative leader stepping in cloud-to-ground lightning, starting with determination of the length of the negative streamer zone below the leader tip. The positive space leader, belonging to a pre-existing space leader, propagates towards the main leader tip, bridging the streamer zone. Such propagation time however is too short for leader thermalization. The thermalization, with associated substantial drop in the internal voltage gradient, occurs over a much longer time, through corona current injected at the tip of the moving negative space leader. The latter stage constitutes the determining factor for the time interval between steps. The model has then been applied to leaders with prospective return stroke current of 3–228 kA, leader tip height of 23–2000 m, leader charge linearly decaying to practically vanish at heights of either 2500 m or 4500 m. For the conditions investigated, the step length varies in the range 3.5 m to 39 m, the bridging time of the streamer zone by positive space leader in the range 0.8 - 3 μs, time interval between steps in the range 8.5–92 μs, yielding mean stepped leader speed in the range 1.0 - 11.6 × 105 m/s. Whenever possible the model predictions were satisfactorily compared to field measurements. Interaction between the negative downward leader and an upward connecting leader during the attachment process is out of scope of this work.

Relationship of Dyspeptic Symptoms with Dinner to Breakfast Time Interval

Objective: To ascertain the relationship of dyspeptic symptoms with dinner to breakfast time interval. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Liaquat National Hospital, Karachi Pakistan, from Aug 2021 to Apr 2022. Methodology: We enrolled patients of either gender, between 18 to 50 years of age, with persistent symptoms of dyspepsia for at least two months and/or confirmed cases of dyspepsia. Written, informed consent was taken from all patients prior to recruiting them. Patients visiting outpatient department with symptoms of dyspepsia and/or confirmed cases of dyspepsia were interviewed to fill out Short-form Leeds Dyspepsia Questionnaire (SF-LDQ). Results: Total 400 patients were studied with nearly half of the participants being female 188 (47%) with 72(18%), 87(21.8%), 113(28.2%) and 128(32%) patients had dinner to breakfast duration of ≤8 hours, 8.1-10 hours, 10.1-12 hours and &gt;12 hours, respectively. There was moderate positive correlation between fasting duration and SF-LDQ (r=0.46, p&lt;0.001). Nightly fasting duration of more than 10 hours had increased risk of indigestion, heartburn and regurgitation. Conclusion: Longer duration between dinner and breakfast was found to be associated with increased likelihood of dyspeptic symptoms including indigestion, heartburn and regurgitation.

Risk Factor Analysis and Algorithmic Approach for Managing Deep Brain Stimulation Device-Related Wound Complications

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management.Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed.Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; growth (P = 0.044), and history of multiple previous revisions (P &lt; 0.001) were associated with device removal.Conclusion: To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

Applying Fractal Theory: Solving the Geometric Challenge of Price Change and Scaling in Economics

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Price changes in economics present significant geometric challenges due to sharp discontinuities, which cannot be efficiently described by continuous processes like Brownian motion. Traditional models often rely on linear assumptions, yet financial data frequently exhibit irregular, complex patterns. Fractal theory, a mathematical framework, offers a more accurate way to describe these fluctuations by revealing the underlying self-similar structures in price changes and scaling phenomena. This study explores the use of fractal geometry to gain deeper insights into market behavior. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: The objective is to demonstrate that an alternative model, constructed based on geometric scaling assumptions, offers a more accurate description of price changes in competitive markets. &amp;lt;i&amp;gt;Method&amp;lt;/i&amp;gt;: The study combined the scaling principle from fractal geometry with a stable Levy model to formulate an integrated model. The logarithmic transformation of the model was applied over successive price changes to observe the behavior of market prices. &amp;lt;i&amp;gt;Result&amp;lt;/i&amp;gt;: The scaling principle asserts that no specific time interval (such as a day or a week) holds inherent significance in competitive markets. Instead, these time features are compensated or arbitrated away, supporting the idea that market behavior is self-similar across different time scales. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The scaling principle provides a more reliable framework for modeling price changes and is recommended for consideration in economic analyses.

To Determine the Risk-Based Screening Interval for Diabetic Retinopathy: Development and Validation of Risk Algorithm from a Retrospective Cohort Study.

The optimal screening interval for diabetic retinopathy (DR) remains controversial. This study aimed to develop a risk algorithm to predict the individual risk of referable sight-threatening diabetic retinopathy (STDR) in a mainly Chinese population and to provide evidence for risk-based screening intervals. The retrospective cohort data from 117,418 subjects who received systematic DR screening in Hong Kong between 2010 and 2016 were included to develop and validate the risk algorithm using a parametric survival model. The risk algorithm can be used to predict the individual risk of STDR within a specific time interval, or the time to reach a specific risk margin and thus to allocate a screening interval. The calibration performance was assessed by comparing the cumulative STDR events versus predicted risk over 2 years, and discrimination by using receiver operative characteristics (ROC) curve. Duration of diabetes, glycosylated hemoglobin, systolic blood pressure, presence of chronic kidney disease, diabetes medication, and age were included in the risk algorithm. The validation of prediction performance showed that there was no significant difference between predicted and observed STDR risks in males (5.6% vs. 5.1%, P=0.724) or females (4.8% vs. 4.6%, P=0.099). The area under the receiver operating characteristic curve was 0.80 (95% confidence interval [CI], 0.78 to 0.81) for males and 0.81 (95% CI, 0.79 to 0.83) for females. The risk algorithm has good prediction performance for referable STDR. Using a risk-based screening interval allows us to allocate screening visits disproportionally more to those at higher risk, while reducing the frequency of screening of lower risk people.

Quasiperiodic γ-Ray Modulations in the Blazars PKS 2155-83 and PKS 2255-282

While there has been an increase in interest in the possibility of quasiperiodic oscillations (QPOs) in blazars, the search has hitherto been restricted to sources with well-sampled light curves. Objects with light curves that include gaps have been, to our knowledge, overlooked. Here, we study two such curves, which have the interesting feature of pertaining to relatively high-redshift blazars—FSRQs, PKS 2155-83, and PKS 2255-282—observed by the Fermi Large Area Telescope. Their redshifts border the “cosmic noon” era of galaxy formation and merging, and their light curves exhibit a distinctive pattern of repetitive high and low (gap dominant) states for 15.6 yr. To accommodate for the gaps in the curves, data are integrated over extended time intervals of 1 month and 2 months. The resulting curves were also examined using methods suitable for sparsely sampled data. This investigation of PKS 2155-83 and PKS 2255-282 suggests QPOs with periods of 4.69 ± 0.79 yr (3σ) and 6.82 ± 2.25 yr (2.8σ), respectively. The probability density functions of the blazars’ fluxes, along with the correlation between their flux and spectral index, were also analyzed. Given the epochs in which the objects are observed, the plausibility of a binary black hole scenario as an origin of the apparent periodicity was examined. We estimated the prospective parameters of such a system using a simple geometric model. The total masses were estimated and found to be consistent, in principle, with independent (dynamical) measurements of the central black hole masses in the two host galaxies.

Basic self-disturbance in adolescents at risk of psychosis: temporal stability investigated by the experience sampling method in a mixed method study.

Basic self-disturbance (BSD), also called anomalous self-experiences (ASEs), are core phenotypic markers for schizophrenia spectrum disorders and a prepsychotic vulnerability marker considered to be temporally stable (trait-phenomenon). Studies of BSD in children and adolescents are lacking. To be clinically useful, we need to know more about the characteristics and temporal development of BSD in prepsychotic phases. This study used a smartphone application measuring the occurrence and subjective intensity of ASEs in the daily life of 27 help-seeking adolescents (12-18 years) repeatedly over a period of 6 months. A total of 5223 unique application-reports based on individually selected and verbatim descriptions of personal core ASEs were analysed by mixed methods. The intensity of ASEs, within subjects and between subjects and irrespective of time intervals or baseline scores obtained by the Examination of Anomalous Self-Experience (EASE) were relatively stable with a mean variability of 1.25 (0.4) SD. Participants with low EASE total scores at baseline had a significantly lower score on ASE intensity than those with high baseline EASE total scores at baseline (mean 2.42 vs 3.42, p=0.046). In this study, ASEs were not reported as essentially fluctuating experiences but as almost constantly present, demonstrating BSD as a mainly trait phenomenon in prepsychotic phases in persons under the age of 18. Considering the continuous experience of BSD and its predictive value for psychosis development, ASEs should be targeted and monitored to the same extent as other prepsychotic features.

Treatment of gingival enlargement caused by orthodontic treatment

The aim of this study was to assess the healing process of gingival enlargement in adolescents with and without fixed orthodontic appliances using conventional scalpel treatments over a 3-month follow-up period. 20 patients with gingival enlargement were divided into two groups. The control group, without fixed orthodontic appliances, received mechanical treatment through conventional scalpel. Test group, comprising patients with fixed orthodontic appliances, was treated using conventional scalpel. Follow-up visits were conducted on days 1 and 90. Clinical periodontal parameters, including plaque index, gingival index, bleeding on probing, probing pocket depth, and gingival overgrowth index, were compared across groups at different time intervals from baseline. All groups exhibited statistically significant reductions in clinical periodontal parameters during the study period (P &lt; 0.05). Test group, treated with conventional scalpel, showed the fastest and most consistent improvements in the healing process compared to baseline. Conventional scalpel therapy proved to be an effective method for treating gingival enlargement, with no reported discomfort or pain during or after the procedure. Given the challenges patients with fixed orthodontic appliances face in maintaining oral hygiene, they should be scheduled for more frequent follow-ups and given thorough home-care instructions.