Time Research Articles

Impact of Preoperative Time Intervals for Neoadjuvant Chemoradiotherapy on Short-term Postoperative Outcomes of Esophageal Cancer Surgery: A Population-Based Study Using the Dutch Upper Gastrointestinal Cancer Audit (DUCA) Data.

To clarify the impact of the preoperative time intervals on short-term postoperative and pathological outcomes in esophageal cancer patients who underwent neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy. The impact of preoperative intervals on esophageal cancer patients who received multimodality treatment remains unknown. Patients(cT1-4aN0-3M0) treated with nCRT plus esophagectomy were included using the Dutch national DUCA-database. Multivariate logistic regression was used to determine the effect of different time intervals upon short-term postoperative and pathological outcomes: diagnosis-to-nCRT intervals (≤5, 5-8 and 8-12wk), nCRT-to-surgery intervals (5-11, 11-17 and >17wk) and total preoperative intervals (≤16, 16-25 and >25wk). Between 2010-2021, a total of 5052 patients were included. Compared to diagnosis-to-nCRT interval ≤5 weeks, the interval 8-12 weeks was associated with higher risk of overall complications (P=0.049). Compared to nCRT-to-surgery interval 5-11 weeks, the longer intervals (11-17wk and >17wk) were associated with higher risk of overall complications (P-value=0.016; P-value<0.001) and anastomotic leakage (P-value=0.004; P-value=0.030), but the interval >17 weeks was associated with lower risk of ypN+ (P-value=0.021). The longer total preoperative intervals were not associated with the risk of 30-day mortality and complications compared to the interval ≤16 weeks, but the longer total preoperative interval (>25wk) was associated with higher ypT stage (P-value=0.010) and lower pCR rate (P-value=0.013). In patients with esophageal cancer undergoing nCRT and esophagectomy, prolonged preoperative time intervals may lead to higher morbidity and disease progression, and the causal relationship requires further confirmation.

Evaluation of the effect of dextrose prolotherapy versus deep dry needling therapy for the treatment of temporomandibular joint anterior disc displacement with reduction: (a randomized controlled trial).

to compare the combined effect of Prolotherapy and Deep Dry Needling (DDN) versus DDN effect on relieving the symptoms of Temporomandibular joint (TMJ) anterior disc displacement. The clinical trial randomly allocated forty patients. The (control group) patients received four intraarticular and masseteric DDN sessions, while the (study group) patients were subjected to the exact technique followed by Prolosolution injection. The baseline preoperative measurements included Maximal interincisal opening (MIO), auscultation of the presence of clicking, and Visual Analogue Scale (VAS), which were repeated for postoperative measurements after one, two, five, and eight months. By the end of the study, all patients expressed apparent improvement in pain MIO and clicking. The inter- and intragroup comparison revealed that the pain score values of the control group after five and eight months were significantly higher than those of the study group. The study group demonstrated more significant MIO calibration than the control group, with insignificant differences between both groups regarding the presence of clicking at any time interval. The associations between clicking and VAS values, between clicking and MIO, and between VAS values and increased MIO were positive in the test group and negative in the control group. Dextrose Prolotherapy and DDN were beneficial. However, Prolotherapy demonstrated more significant, sustained, and correlated long-term alleviation of symptoms and increased MIO. The study assesses the sole effect of dextrose prolotherapy on relieving the signs of TMJ anterior disc displacement apart from the impact of the penetrating needle. The study was registered on www. gov (#: NCT05821985) by Ahmed Nagi Alghandour.

Indigo (Indigo suffruticosa Mill.) seed germination to improve commercial viability

Indigo suffruticosa Mill., commonly known as Guatemalan indigo or anil indigo, is being investigated as a regenerative rotational crop that is used to produce natural plant-based dyes in the USA. The fashion and textile industry currently rely on harmful synthetic dyes to color fabric. To improve the viability of Indigo and to minimize production costs, methods to improve Indigo seed germination rates will benefit the quality, crop yields, and enable large scale field plantings.This study was initiated to develop a methodology of treating seeds to increase seed germination rates of Guatemalan Indigo and decrease fungal seed pathogens. All studies were conducted on the currently available commercial Indigo varieties. Sterilization and germination methods included: ethanol and bleach sterilization, mechanical scarification (coffee grinder, belt sander), gibberellic acid, dry heat, freezing, distilled water soaking, and boiling water. Each treatment was replicated four times for each of the various times and temperatures tested. The dry heat method at 80°C for 30 min resulted in the highest average germination rate of 83 %. Trials demonstrated that the dry heat method was the only treatment that resulted in higher germination rates than control treatment with an average of only 64 % germination. Dry heat at 90°C across all time intervals (30 min, 1 h, and 2 h) showed no results higher than 34 % germination. Pre-treating seed with 10 min soak in 10 % bleach resulted in complete control of surface pathogens with no decrease in seed germination. The boiling water method for 30 sec also lead to higher germination rates but may prove too difficult in larger volumes. Other methods of sterilization, gibberellic acid, freezing, mechanical scarification, and long-term soaking resulted in average germination percentages equal to or less than the control of no treatment. The dry heat method should be applied 2 h before planting. Applying a 10 min bleach sterilization step and dry heat treatment will greatly improve germination of Indigo and will allow for a commercially viable protocol to be created. This will allow natural indigo to compete with inexpensive synthetic dyes, enabling producers to direct seed indigo rather than costly transplant production.

Outcomes of minimal residual disease at upfront debulking surgery compared with complete cytoreduction after neoadjuvant chemotherapy

ObjectiveThe aim of this study was to compare surgical complexity, post-operative complications, and survival outcomes between patients with minimal residual disease (completeness of cytoreduction (CC) score) CC-1 at the time...

A Machine Learning Model for Risk Stratification of Postdiagnosis Diabetic Ketoacidosis Hospitalization in Pediatric Type 1 Diabetes: Retrospective Study.

Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in pediatric type 1 diabetes (T1D), occurring in approximately 20% of patients, with an economic cost of $5.1 billion/year in the United States. Despite multiple risk factors for postdiagnosis DKA, there is still a need for explainable, clinic-ready models that accurately predict DKA hospitalization in established patients with pediatric T1D. We aimed to develop an interpretable machine learning model to predict the risk of postdiagnosis DKA hospitalization in children with T1D using routinely collected time-series of electronic health record (EHR) data. We conducted a retrospective case-control study using EHR data from 1787 patients from among 3794 patients with T1D treated at a large tertiary care US pediatric health system from January 2010 to June 2018. We trained a state-of-the-art; explainable, gradient-boosted ensemble (XGBoost) of decision trees with 44 regularly collected EHR features to predict postdiagnosis DKA. We measured the model's predictive performance using the area under the receiver operating characteristic curve-weighted F1-score, weighted precision, and recall, in a 5-fold cross-validation setting. We analyzed Shapley values to interpret the learned model and gain insight into its predictions. Our model distinguished the cohort that develops DKA postdiagnosis from the one that does not (P<.001). It predicted postdiagnosis DKA risk with an area under the receiver operating characteristic curve of 0.80 (SD 0.04), a weighted F1-score of 0.78 (SD 0.04), and a weighted precision and recall of 0.83 (SD 0.03) and 0.76 (SD 0.05) respectively, using a relatively short history of data from routine clinic follow-ups post diagnosis. On analyzing Shapley values of the model output, we identified key risk factors predicting postdiagnosis DKA both at the cohort and individual levels. We observed sharp changes in postdiagnosis DKA risk with respect to 2 key features (diabetes age and glycated hemoglobin at 12 months), yielding time intervals and glycated hemoglobin cutoffs for potential intervention. By clustering model-generated Shapley values, we automatically stratified the cohort into 3 groups with 5%, 20%, and 48% risk of postdiagnosis DKA. We have built an explainable, predictive, machine learning model with potential for integration into clinical workflow. The model risk-stratifies patients with pediatric T1D and identifies patients with the highest postdiagnosis DKA risk using limited follow-up data starting from the time of diagnosis. The model identifies key time points and risk factors to direct clinical interventions at both the individual and cohort levels. Further research with data from multiple hospital systems can help us assess how well our model generalizes to other populations. The clinical importance of our work is that the model can predict patients most at risk for postdiagnosis DKA and identify preventive interventions based on mitigation of individualized risk factors.

Geological evidence reveals a staircase pattern in Earth’s rotational deceleration evolution

The Earth’s rotation has been decelerating throughout its history due to tidal dissipation, but the variation of the rate of this deceleration through time has not been established. We present a detailed analysis of eight geological datasets to constrain the Earth’s rotational history from 650 to 240 Mya. The results allow us to test physical tidal models and point to a staircase pattern in the Earth’s deceleration from 650 to 280 Mya. During this time interval, the Earth–Moon distance increased by approximately 20,000 km and the length of day increased by approximately 2.2 h. Specifically, there are two intervals with high Earth rotation deceleration, 650 to 500 Mya and 350 to 280 Mya, separated by an interval of stalled deceleration from 500 to 350 Mya. The interval with stalled deceleration is attributed mainly to reduced tidal dissipation due to the continent-ocean configuration at the time, not to changes in Earth’s dynamical ellipticity from continental assembly or glaciation. Modeling indicates that, except for the very recent time, tidal dissipation is the main driver for decelerating Earth rotation. One potential implication of our findings is that the Earth’s tidal dissipation, along with Earth’s rotation deceleration, may play a role in the evolving Earth.

Laws of macroevolutionary expansion

Van Valen’s law of constant extinction postulates that in comparable ecological contexts, the probability for a taxon to survive to the next time interval is independent of how long it has already existed. The law implies that species do not age, that is, the survival probability from one time step to the next does not decrease with species’ age. While the original law describes survivorship over time, here we show that there is a counterpart to the law describing species dynamics in space. Indeed, the probability for a taxon to expand a step further in its range size does not depend on how large of a range the taxon already occupies. We show that such patterns of stochastically constant expansion are common in the global mammalian fossil record throughout the Cenozoic and are consistent with the mammalian species distribution in the present-day world. Intriguing is that the law in space holds best for the linear dimension of the range rather than for the range area. We interpret this as suggesting that species primarily expand via the frontier of their range; this process is known as leading-edge expansion in ecology. And while the difficulty of expanding in linear steps remains constant, the area gains diminish. In line with evolutionary theory collectively known as the Red Queen’s hypothesis, this suggests that the effectiveness of expansion saturates, even if species longevity does not. When interpreted in reverse, this explains from the macroevolutionary perspective why larger species ranges are associated with lower extinction risks.

Evaluation of the usefulness of non-weight-bearing tunnel view using X-ray in the short term after medial meniscus posterior root tear onset: a retrospective study

BackgroundThis study aimed to examine whether the non-weight-bearing tunnel view X-ray is effective for short-term evaluation of medial meniscus posterior root tear (MMPRT) by assessing the X-ray characteristics at the initial and follow-up visits.MethodsThis was a retrospective longitudinal study of 26 enrolled knees diagnosed with MMPRT on magnetic resonance imaging. The distance between the medial tibial eminence and medial femoral condyle (MTE–MFC distance) and medial tibiofemoral joint (MTFJ) width were measured by obtaining non-weight-bearing tunnel view and frontal view X-ray radiographs. The initial and follow-up values at a median interval of 17 days were compared. Additionally, the correlations between the MTE–MFC distance increase rate and body mass index (BMI), age, femorotibial angle (FTA), and posterior tibial slope (PTS) were evaluated using linear regression analysis.ResultsThe tunnel view images of the initial and follow-up X-rays showed a significant increase in the MTE–MFC distance and a significant decrease in the MTFJ width. Furthermore, a moderate correlation was observed between the change in the MTE–MFC distance and the time interval between X-rays. However, no substantial correlation was observed for the change in the MTFJ width over time. Moreover, no significant correlation was observed between the change in the MTE–MFC distance in the non-weight-bearing tunnel view and BMI, age, FTA, and PTS.ConclusionsThe non-weight-bearing tunnel view is highly beneficial for evaluating MMPRT progression in the short term.

Short-term effects of an unprecedented heatwave on intertidal bivalve populations: fisheries management surveys provide an incomplete picture

IntroductionCoastal marine ecosystems, are particularly susceptible to climate change. One such threat is atmospheric heatwaves, which are predicted to increase in frequency, duration, and intensity. Many intertidal organisms already live at the edge of their thermal tolerance limits and heatwaves can outstretch an organism’s ability to compensate in the short term. In June 2021 the Pacific Northwest region of North America, including the Salish Sea, experienced a significant atmospheric heatwave during some of the lowest tides of the year. This was followed by numerous reports of dead and dying intertidal marine organisms region-wide. A semi-quantitative rapid assessment found a range of both species- and location-specific effects but generally recorded widespread negative impacts to intertidal shellfish species across the Salish Sea. MethodsFollowing these results, we opportunistically analyzed data collected by intertidal bivalve resource managers from the region. These datasets allowed us to examine regional density and size data for clam and oyster populations before and after the heatwave to increase our quantitative understanding of heatwave effects. ResultsWe found a range of responses including positive and negative effects of the heatwave on clam and oyster density. While we generally found small changes in bivalve size, some site-species combinations displayed large shifts in size frequency. Many of our analyses did not indicate even moderate statistical support, even with large changes in the mean, driven in part by high variability in the data. Time intervals between surveys, ranging from 2 to over 25 months, had little effect on observed variability indicating that any heatwave-induced effects may be masked by variability inherent to the population ecology and/or survey methodology. DiscussionThis analysis has highlighted the need for intertidal resource managers, and the greater research community, to consider alternative survey approaches designed to constrain variability in order to detect the effects of acute or extreme events. With the effects of climate change predicted to become more intense, targeted survey approaches may be needed to detect the effects and implications of such events and to continue effective management of intertidal bivalves in the Salish Sea and worldwide.

Clinical and neuroimaging precursors in cerebral amyloid angiopathy: impact of the Boston criteria version 2.0.

Although the Boston criteria version 2.0 facilitates the sensitivity of cerebral amyloid angiopathy (CAA) diagnosis, there are only limited data about precursor symptoms. This study aimed to determine the impact of neurological and imaging features in relation to the time of CAA diagnosis. Patients diagnosed with probable CAA according to the Boston criteria version 1.5, treated between 2010 and 2020 in our neurocentre, were identified through a keyword search in our medical database. Neuroimaging was assessed using Boston criteria versions 1.5 and 2.0. Medical records with primary focus on the clinical course and the occurrence of transient focal neurological episodes were prospectively evaluated. Thirty-eight out of 81 patients (46.9%) exhibited transient focal neurological episodes, most often sensory (13.2%) or aphasic disorders (13.2%), or permanent deficits at a mean time interval of 31.1 months (SD ±26.3; range 1-108 months) before diagnosis of probable CAA (Boston criteria version 1.5). If using Boston criteria version 2.0, all patients receiving magnetic resonance imaging (MRI) met the criteria for probable CAA, and diagnosis could have been made on average 44 months earlier. Four patients were younger than 50 years, three of them with supporting pathology. Cognitive deficits were most common (34.6%) at the time of diagnosis. Non-haemorrhagic MRI markers enhance the sensitivity of diagnosing probable CAA; however, further prospective studies are proposed to establish a minimum age for inclusion. As the neurological overture of CAA may occur several years before clinical diagnosis, early clarification by MRI including haemosensitive sequences are suggested.

Impact of the interval between neoadjuvant immunotherapy and surgery on prognosis in esophageal squamous cell carcinoma (ESCC): a real-world study

BackgroundThe time interval between neoadjuvant immunotherapy and surgery is 6 weeks for esophageal squamous cell carcinoma (ESCC), but whether delayed surgery affects prognosis remains unclear.MethodsClinical data of locally advanced ESCC who underwent neoadjuvant immunotherapy followed by esophagectomy from November 2019 to December 2022 were collected. The surgery outcomes and prognosis were compared between short-interval (time to surgery ≤ 6 weeks) and long-interval groups (time to surgery > 6 weeks).Results152 patients were enrolled totally, with a ratio of 91:61 between short-interval and long-interval groups. The rate of pathological complete response in the short-interval and long-interval groups were 34.1% and 24.6% (P = 0.257). Delayed surgery did not have a significantly impact on the number of lymph node dissections (P = 0.133), operative duration (P = 0.689), blood loss (P = 0.837), hospitalization duration (P = 0.293), chest drainage duration (P = 0.886) and postoperative complications (P > 0.050). The 3-year Overall survival (OS) rates were 85.10% in the short-interval group, and 82.07% in the long-interval group (P = 0.435). The 3-year disease-free survival (DFS) rates were 83.41% and 70.86% in the two groups (P = 0.037). Subgroup analysis revealed that patients with a favorable response to immunotherapy (tumor regression grade 0) exhibited inferior 3-year OS (long-interval vs. short-interval: 51.85% vs. 91.08%, P = 0.035) and DFS (long-interval vs. short-interval: 47.40% vs. 91.08%, P = 0.014) in the long-interval group.ConclusionsDelayed surgery after neoadjuvant immunotherapy does not further improve pathological response; instead, it resulted in a poorer DFS. Especially for patients with a favorable response to immunotherapy, delayed surgery increases the risk of mortality and recurrence.

Optimizing tracking and completion of follow-up colonoscopy after abnormal stool tests at health systems participating in the Centers for Disease Control and Prevention's Colorectal Cancer Control Program.

We present findings from an assessment of award recipients' partners from the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP). We describe partners' processes of identifying and tracking patients undergoing stool-based screening. We analyzed data from eight CRCCP award recipients purposively sampled and their partner health systems from 2019 to 2023. The data included number of stool-based tests distributed and returned; abnormal findings; referrals and completion of follow-up colonoscopies; and colonoscopy findings. We also report on strategies to improve tracking of stool-based tests and facilitation of follow-up colonoscopies. Five of eight CRCCP award recipients reported that all or some partner health systems were able to report stool test return rates. Six had health systems that were able to report abnormal stool test findings. Two reported that health systems could track time to follow-up colonoscopy completion from date of referral, while four could report colonoscopy completion but not the timeframe. Follow-up colonoscopy completion varied substantially from 24.2 to 75.5% (average of 47.9%). Strategies to improve identifying and tracking screening focused mainly on the use of electronic medical records; strategies to facilitate follow-up colonoscopy were multi-level. Health systems vary in their ability to track steps in the stool-based screening process and few health systems can track time to completion of follow-up colonoscopy. Longer time intervals can result in more advanced disease. CRCCP-associated health systems participating in this study could support the implementation of multicomponent strategies at the individual, provider, and health system levels to improve tracking and completion of follow-up colonoscopy.

Inertial flow-induced fluid pressurization enhances the reactivation of rate-and-state faults

We reveal that inertial flow can introduce additional pressure perturbations which accelerate the instability of critically stressed faults. We integrate a poroelastic spring-slider model with rate-and-state friction (RSF), a nonlinear flow model characterized by the improved Izbash equation, and a universal visco-inertial permeability model. The effect of inertial flow depends on the fracture network properties, proximity to faults, and injection parameters. Significant inertial flow results in higher pressure magnitudes and pressurization rates, causing notable differences in predictions between linear and nonlinear flow models, as well as aging and slip laws. The impact of inertial flow is particularly pronounced within a specific permeability range and is enhanced by high-rate injections. The fault reactivation is delayed due to fault strengthening with RSF in response to increased pressurization rates. Conversely, the presence of inertial flow enhances fault reactivation and promotes unstable slip behaviors. Furthermore, the results demonstrate that cyclic injection increases the critical stiffness of faults without an adequate release of pore pressure in each cycle. The time interval of the cyclic injection is prolonged as inertial flow generates higher pressure levels. This study highlights the importance of inertial flow in the stability analysis of critically stressed faults.

Energy drinks: is there anything to be concerned about? A review of the literature with attention to the value of drinks among athletes

Introduction: Popular energy drinks containing caffeine, taurine or guarana are currently generating a lot of interest. Their supply is an increasingly popular method of boosting the body. Therefore, it is important to know the effects of such drinks on health. Objective: A review of the literature on the health effects of energy drinks with a focus on the value of their consumption in athletes. Current Knowledge: Many studies have been made and numerous medical cases have been analyzed to assess the health effects of energy drinks. The most commonly described complications are those involving the cardiovascular and neurological systems, but there are also cases of gastrointestinal, kidney, gynecological or skin diseases. The severity of these complications depends on the amount of energy drinks consumed and the time interval in which they were drunk. Nowadays, athletes are increasingly turning to energy drinks to boost their performance. It is also noticeable that children and adolescents who should not consume caffeine or sugar in excess consume this type of drink. Conclusions: The growing popularity of energy drinks, including among professional athletes as well as children and adolescents, is leading to an increasing number of complications due to their excessive consumption. Therefore, further research on their health effects and harmfulness is needed to determine their safe use.

Use of half red blood cell units in oncology patients during severe shortages to extend hospital supply.

The COVID-19 pandemic exerted an unprecedented impact on the blood supply from 2020 through 2022. As a result, throughout 2021 there were months our hospital had less than one-day supply of type O RBCs. To meet transfusion needs, whole RBC units were split into half units and issued to stable, non-bleeding patients. This single-institution, retrospective study examines time intervals to subsequent transfusion and total numbers of RBC units subsequently transfused after the first half or whole RBC unit. Patients who were transfused RBC between May 21, 2021 and November 1, 2021 were divided into in- and outpatient groups, then based on whether they received at least 1 half RBC unit or only whole RBC units during the study period. The time interval between this first half unit transfusion, or first whole unit transfusion in those who did not receive half units, and the subsequent RBC transfusion within 90 days was calculated and compared, as well as the total number of RBC units transfused 30 days after the first unit. In general, patients transfused with half units received a subsequent transfusion significantly earlier than those transfused with whole units. Additionally, receiving an index half unit was associated with more RBC transfusions in the following 30 days (p = .001). Transfusion of half RBC units during a severe RBC blood shortage can temporarily decrease RBC usage but will result in a shorter interval to the next transfusion and greater total number of RBC units transfused in subsequent days.

Urinary excretion of gluten immunoreactive peptides as an indicator of gastrointestinal function after fasting and dietary provocation in healthy volunteers

IntroductionUnderstanding intestinal permeability is paramount for elucidating gastrointestinal health and pathology. The size and nature of the molecule traversing the intestinal barrier offer crucial insights into various acute and chronic diseases, as well as the evolution of some conditions. This study aims to assess the urinary excretion kinetics of gluten immunogenic peptides (u-GIP), a unique class of dietary peptides detectable in urine, in volunteers under controlled dietary conditions. This evaluation should be compared to established probes like lactulose, a non-digestible disaccharide indicative of paracellular permeability, and mannitol, reflecting transcellular permeability.MethodsFifteen participants underwent simultaneous ingestion of standardized doses of gluten (10 g), lactulose (10 g), and mannitol (1 g) under fasting conditions for at least 8 hours pre-ingestion and during 6 hours post-ingestion period. Urine samples were collected over specified time intervals. Excretion patterns were analyzed, and correlations between the lactulose-to-mannitol ratio (LMR) and u-GIP parameters were assessed.ResultsThe majority of u-GIP were detected within the first 12 hours post-ingestion. Analysis of the variability in cumulative excretion across two sample collection ranges demonstrated that lactulose and u-GIP exhibited similar onset and excretion dynamics, although GIP reached its maximum peak earlier than either lactulose or mannitol. Additionally, a moderate correlation was observed between the LMR and u-GIP parameters within the longest urine collection interval, indicating potential shared characteristics among permeability pathways. These findings suggest that extending urine collection beyond 6 hours may enhance data reliability.DiscussionThis study sheds light on the temporal dynamics of u-GIP in comparison to lactulose and mannitol, established probes for assessing intestinal permeability. The resemblance between u-GIP and lactulose excretion patterns aligns with the anticipated paracellular permeability pathway. The capacity to detect antigenic food protein fragments in urine opens novel avenues for studying protein metabolism and monitoring pathologies related to the digestive and intestinal systems.

Effect of radiofrequency ablation of genicular nerves on the isokinetic muscle strength of knee joint in patients with osteoarthritis knee: A randomized double-blind sham controlled clinical trial.

This randomised controlled trial evaluated the effect of radiofrequency ablation (RFA) of genicular nerve on muscle strength in osteoarthritis knee patients with chronic pain. Fifty-four patients with chronic knee osteoarthritis, experiencing significant pain (VNRS > 50) and moderate to severe disease (KL grade ≥ 2) were enrolled. Group 1 received RFA of genicular nerves of the affected knee while Group 2 received a sham procedure. The primary outcome was change in knee muscle strength evaluated using isokinetic peak torque(IPT) using IsoforceTM isokinetic dynamometer at 3 months. Secondary outcomes included changes in pain scores, function, perceived effect of the treatment and compliance to physiotherapy. At 3 months, significant difference was observed between IPT of flexor muscle at 60 and 180 degrees between the treatment and the Sham control (p-value = 0.01). No significant difference was observed in the extensor muscle strength. Within-group analysis revealed a significant increase in the IPT values for both extension and flexion at 60 and 180 degrees/sec evident across various time intervals. Group1 consistently reported lower VNRS scores at all time points. WOMAC scores of both groups were significantly different at all timepoints, with higher scores indicating reduced functionality in Group2. The GPE and compliance to physiotherapy were higher in Group1 patients at all times of follow up albeit decreasing trend in later periods. Application of RFA to genicular nerves in chronic OA knee patients resulted in better pain relief, improved functionality and increased muscle strength at extension and flexion at 3 months follow-up.

Estimation of Levels of Salivary Pyridinoline Cross-Linked Carboxyterminal Telopeptide of Type I Collagen (ICTP) in Periodontally Healthy and Diseased Patients at Various Time Intervals Before and After Periodontal Therapy

Estimation of Levels of Salivary Pyridinoline Cross-Linked Carboxyterminal Telopeptide of Type I Collagen (ICTP) in Periodontally Healthy and Diseased Patients at Various Time Intervals Before and After Periodontal Therapy

Neural network analysis in time series forecasting

Objectives. To build neural network models of time series (LSTM, GRU, RNN) and compare the results of forecasting with their mutual help and the results of standard models (ARIMA, ETS), in order to ascertain in which cases a certain group of models should be used.Methods. The paper provides a review of neural network models and considers the structure of RNN, LSTM, and GRU models. They are used for modeling time series in Russian macroeconomic statistics. The quality of model adjustment to the data and the quality of forecasts are compared experimentally. Neural network and standard models can be used both for the entire series and for its parts (trend and seasonality). When building a forecast for several time intervals in the future, two approaches are considered: building a forecast for the entire interval at once, and step-by-step forecasting. In this way there are several combinations of models that can be used for forecasting. These approaches are analyzed in the computational experiment.Results. Several experiments have been conducted in which standard (ARIMA, ETS, LOESS) and neural network models (LSTM, GRU, RNN) are built and compared in terms of proximity of the forecast to the series data in the test period.Conclusions. In the case of seasonal time series, models based on neural networks surpassed the standard ARIMA and ETS models in terms of forecast accuracy for the test period. The single-step forecast is computationally less efficient than the integral forecast for the entire target period. However, it is not possible to accurately indicate which approach is the best in terms of quality for a given series. Combined models (neural networks for trend, ARIMA for seasonality) almost always give good results. When forecasting a non-seasonal heteroskedastic series of share price, the standard approaches (LOESS method and ETS model) showed the best results.

Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea.

The real-world effectiveness of computer-aided detection (CADe) systems during colonoscopies remains uncertain. We assessed the effectiveness of the novel CADe system, ENdoscopy as AI-powered Device (ENAD), in enhancing the adenoma detection rate (ADR) and other quality indicators in real-world clinical practice. We enrolled patients who underwent elective colonoscopies between May 2022 and October 2022 at a tertiary healthcare center. Standard colonoscopy (SC) was compared to ENAD-assisted colonoscopy. Eight experienced endoscopists performed the procedures in randomly assigned CADe- and non-CADe-assisted rooms. The primary outcome was a comparison of ADR between the ENAD and SC groups. A total of 1,758 sex- and age-matched patients were included and evenly distributed into two groups. The ENAD group had a significantly higher ADR (45.1% vs. 38.8%, p=0.010), higher sessile serrated lesion detection rate (SSLDR) (5.7% vs. 2.5%, p=0.001), higher mean number of adenomas per colonoscopy (APC) (0.78±1.17 vs. 0.61±0.99; incidence risk ratio, 1.27; 95% confidence interval, 1.13-1.42), and longer withdrawal time (9.0±3.4 vs. 8.3±3.1, p<0.001) than the SC group. However, the mean withdrawal times were not significantly different between the two groups in cases where no polyps were detected (6.9±1.7 vs. 6.7±1.7, p=0.058). ENAD-assisted colonoscopy significantly improved the ADR, APC, and SSLDR in real-world clinical practice, particularly for smaller and nonpolypoid adenomas.