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Background: Photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumors (TURBT) has emerged as a promising complementary tool to white light (WL) cystoscopy, potentially improving cancer detection and replacing conventional mapping biopsies. This study aimed to investigate the diagnostic accuracy of PDD by anatomical locations in mapping biopsies through lesion-based analysis., Methods: PDD and WL findings were prospectively recorded in 102 patients undergoing mapping biopsies and PDD-assisted TURBT using oral 5-aminolevulinic acid. We evaluated 673 specimens collected from flat tumor or normal-looking lesions on WL cystoscopy, after excluding 98 specimens collected from papillary or nodular tumors., Results: Among the 673 lesions, cancer was detected in 110 (16%) by lesion-based analysis. PDD demonstrated significantly higher sensitivity (65.5% vs. 46.4%, p < 0.001) and negative predictive value (92.5% vs. 89.5%, p < 0.001) compared to WL. The sensitivity of PDD findings varied by location: posterior (100%), right (78.6%), dome (73.3%), left (70.6%), trigone (58.8%), bladder neck (41.7%), anterior (40.0%), and prostatic urethra (25.0%). Incorporating targeted biopsies of specific locations (bladder neck, anterior, and prostatic urethra) into the PDD-guided biopsies, regardless of PDD findings, significantly increased the overall sensitivity from 65.5% to 82.7% (p = 0.001)., Conclusions: This study first demonstrated the detection rate of location-specific mapping biopsies using PDD, revealing difficulties in accuracy assessment in areas susceptible to tangential fluorescence. While PDD-guided biopsy improves cancer detection compared to WL cystoscopy even for flat tumors or normal-looking lesions, more careful decisions, including mapping biopsies, may be beneficial for an assessment in these tangential areas., (© 2024 The Japanese Urological Association.)

Bacteria with streamlined genomes, that harbor full functional genes for essential metabolic networks, are able to synthesize the desired products more effectively and thus have advantages as production platforms in industrial applications. To obtain streamlined chassis genomes, a large amount of effort has been made to reduce existing bacterial genomes. This work falls into two categories: rational and random reduction. The identification of essential gene sets and the emergence of various genome-deletion techniques have greatly promoted genome reduction in many bacteria over the past few decades. Some of the constructed genomes possessed desirable properties for industrial applications, such as: increased genome stability, transformation capacity, cell growth, and biomaterial productivity. The decreased growth and perturbations in physiological phenotype of some genome-reduced strains may limit their applications as optimized cell factories. This review presents an assessment of the advancements made to date in bacterial genome reduction to construct optimal chassis for synthetic biology, including: the identification of essential gene sets, the genome-deletion techniques, the properties and industrial applications of artificially streamlined genomes, the obstacles encountered in constructing reduced genomes, and the future perspectives.

Introducing component-selective polymer chains onto the surface of a particle is an effective approach to improve the compatibilization efficiency of a particle-based compatibilizer. In this study, two particles with different kinds of component-selective polymer chains that have the same length and similar density but different graft locations were synthesized and their compatibilization effects were comparatively investigated. It was found that compared with the particle with homogeneous PMMA and PP grafts (R-P), the particle with a hemisphere of poly(methyl methacrylate) (PMMA) grafts and other hemisphere of polypropylene (PP) chains (J-P) showed a better compatibilization effect under equal loadings, although both particles exhibited high efficiency. The better compatibilization effect of particles with Janus grafts may be attributed to the stronger entanglements between grafted polymer chains and selective individual components. This work suggests that optimizing the graft location of a particle is an effective strategy for improving its compatibilization efficiency and helpful for the design of advanced particle compatibilizers.

More clinicians and researchers are exploring uses for large language model chatbots, such as ChatGPT, for research, dissemination, and educational purposes. Therefore, it becomes increasingly relevant to consider the full potential of this tool, including the special features that are currently available through the application programming interface. One of these features is a variable called temperature, which changes the degree to which randomness is involved in the model's generated output. This is of particular interest to clinicians and researchers. By lowering this variable, one can generate more consistent outputs; by increasing it, one can receive more creative responses. For clinicians and researchers who are exploring these tools for a variety of tasks, the ability to tailor outputs to be less creative may be beneficial for work that demands consistency. Additionally, access to more creative text generation may enable scientific authors to describe their research in more general language and potentially connect with a broader public through social media. In this viewpoint, we present the temperature feature, discuss potential uses, and provide some examples., (©Joshua Davis, Liesbet Van Bulck, Brigitte N Durieux, Charlotta Lindvall. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 08.03.2024.)

Background: The COVID-19 pandemic has had a significant impact on primary care service delivery with an increased use of remote consultations. With general practice delivering record numbers of appointments and rising concerns around access, funding, and staffing in the UK National Health Service, we assessed contemporary trends in consultation rate and modes (ie, face-to-face versus remote)., Objective: This paper describes trends in consultation rates in general practice in England for key demographics before and during the COVID-19 pandemic. We explore the use of remote and face-to-face consultations with regard to socioeconomic deprivation to understand the possible effect of changes in consultation modes on health inequalities., Methods: We did a retrospective analysis of 9,429,919 consultations by general practitioners, nurses, or other health care professionals between March 2018 and February 2022 for patients registered at 397 general practices in England. We used routine electronic health records from Clinical Practice Research Datalink Aurum with linkage to national data sets. Negative binomial models were used to predict consultation rates and modes (ie, remote versus face-to-face) by age, sex, and socioeconomic deprivation over time., Results: Overall consultation rates increased by 15% from 4.92 in 2018-2019 to 5.66 in 2021-2022 with some fluctuation during the start of the COVID-19 pandemic. The breakdown into face-to-face and remote consultations shows that the pandemic precipitated a rapid increase in remote consultations across all groups, but the extent varies by age. Consultation rates increased with increasing levels of deprivation. Socioeconomic differences in consultation rates, adjusted for sex and age, halved during the pandemic (from 0.36 to 0.18, indicating more consultations in the most deprived), effectively narrowing relative differences between deprivation quintiles. This trend remains when stratified by sex, but the difference across deprivation quintiles is smaller for men. The most deprived saw a relatively larger increase in remote and decrease in face-to-face consultation rates compared to the least deprived., Conclusions: The substantial increases in consultation rates observed in this study imply an increased pressure on general practice. The narrowing of consultation rates between deprivation quintiles is cause for concern, given ample evidence that health needs are greater in more deprived areas., (©Emma Maria Vestesson, Kaat Lieve An De Corte, Elizabeth Crellin, Jean Ledger, Minal Bakhai, Geraldine M Clarke. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 02.05.2023.)

Disorder and noise are inherent in biological systems. They are required to provide systems with the advantages required for proper functioning. Noise is a part of the flexibility and plasticity of biological systems. It provides systems with increased routes, improves information transfer, and assists in response triggers. This paper reviews recent studies on noise at the genome, cellular, and whole organ levels. We focus on the need to use noise in system engineering. We present some of the challenges faced in studying noise. Optimizing the efficiency of complex systems requires a degree of variability in their functions within certain limits. Constrained noise can be considered a method for improving system robustness by regulating noise levels in continuously dynamic settings. The digital pill-based artificial intelligence (AI)-based platform is the first to implement second-generation AI comprising variability-based signatures. This platform enhances the efficacy of the therapeutic regimens. Systems requiring variability and mechanisms regulating noise are mandatory for understanding biological functions., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This research investigates the use of a Binary Phase Shift Key (BPSK) sequence derived from the 192-bit key Advanced Encryption Standard (AES-192) algorithm for radar signal modulation to mitigate Doppler and range ambiguities. The AES-192 BPSK sequence has a non-periodic nature resulting in a single large and narrow main lobe in the matched filter response but also produces undesired periodic side lobes that can be mitigated through the use of a CLEAN algorithm. The performance of the AES-192 BPSK sequence is compared to an Ipatov-Barker Hybrid BPSK code, which effectively extends the maximum unambiguous range but has some limitations in terms of signal processing requirements. The AES-192 based BPSK sequence has the advantage of having no maximum unambiguous range limit, and when the pulse location within the Pulse Repetition Interval (PRI) is randomized, the upper limit on the maximum unambiguous Doppler frequency shift is greatly extended.

In the ELISA format(s), the capture antibody is usually affixed to a solid phase, commonly referred to as the immunosorbent. How to tether the antibody most effectively will depend upon the physical properties of the support (plate well, latex bead, flow cell, etc.) as well as its chemical nature (hydrophobic, hydrophilic, the presence of reactive groups such as epoxide, etc.). Of course, it is ultimately the suitability of the antibody to withstand the linking process while preserving its antigen-binding efficiency that must be determined. In this chapter, the antibody immobilization processes and their consequences are described., (© 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Commonly used clinical treatments for intracranial hypertension include continuous lumbar cerebrospinal fluid drainage (CLCFD) and conventional lumbar puncture. However, lumbar puncture is more invasive, requires multiple punctures. CLCFD has less trauma, and drainage can be manipulated to avoid repeated lumbar puncture. However, CLCFD may also lead to complications such as intracranial hematoma and intracranial pneumothorax. Therefore, there is no agreement on which method is more effective. This study evaluated the efficacy of CLCFD and conventional lumbar puncture in the treatment of cerebrospinal fluid leakage after craniocerebral injury., Methods: The search terms 'brain injury' and 'CLCFD' were used to search CNKI, Wanfang, VIP, Longyuan, PubMed, Embase, Cochrane Library and other databases (from inception to November 1, 2022). Inclusion criteria: (I) randomized controlled trials (RCTs), CLCFD and conventional lumbar puncture drainage for patients with cerebrospinal fluid leakage after craniocerebral injury; (II) evaluation of indicators such as cerebrospinal fluid leakage stop time, clearance time, intracranial infection and complications. Cochrane systematic review was performed to assess the quality of the literature. RevMan 5.3 software was used for systematic analysis., Results: A total of 8 studies, involving 568 patients. There is some publication bias in the statistics. The cessation time of cerebrospinal fluid leakage (95% confidence interval (CI): -3.65 to -2.86, Z=16.21, P<0.00001), the time to return to normal pressure (95% CI: -3.13 to -2.09, Z=9.79, P<0.00001), cerebrospinal fluid clearing time (95% CI: -1.96 to -1.09, Z=6.91, P<0.00001), hospitalization time (95% CI: -1.99 to -0.91, Z=5.27, P<0.00001), incidence of intracranial infection (95% CI: 0.07-0.27, Z=5.84, P<0.00001) and complications (95% CI: 0.10-0.43, Z=4.22, P<0.0001) in the CLCFD group were lower than those in the conventional group. The cure rate of the CLCFD group was significantly higher than that of the conventional group (OR =3.75, 95% CI: 2.26-6.23, Z=5.11, P<0.00001); the difference in mortality between the two groups was not statistically significant (P>0.05)., Conclusions: Compared with conventional lumbar puncture, CLCFD can significantly increase the cure rate, shorten the recovery time of cerebrospinal fluid, and significantly reduce the incidence of intracranial infections, reduce complications, is conducive to the prognosis of patients.

The fundamental problem of energy-efficient reallocation of mobile random sensors to provide full coverage without interference is addressed in this paper. We consider n mobile sensors with the identical sensing range placed randomly on the unit interval and on the unit square. The sensors move from their initial random positions to the final locations so that: (a) every point on the unit interval or on the unit square is within the range of a sensor; (b) each pair of sensors is at a Euclidean distance greater than or equal to s; (c) the energy consumption for the movement of the sensors to the final positions is minimized. As a cost measure for the energy in the movement of sensors, we consider a-total movement defined as the sum ∑i=1ndia, for some constant a>0, provided that the i-th sensor is displaced the distance di. The main contribution is summarized as follows: (1) if the sensors are placed on the unit interval, we explain the sharp increase around the sensing radius equal to 12n and the interference distance equal to 1n for the expected minimal a-total displacement; (2) if the sensors are placed on the unit square, we explain the sharp increase around the square sensing radius equal to 12n and the interference distance equal to 1n for the expected minimal a-total displacement. We designed and analysed three algorithms. The probabilistic analysis of our protocols is based on a novel mathematical theory of the Beta distribution.

Helicobacter pylori ( H. pylori ) is the most prevalent etiology of gastritis worldwide. H. pylori management depends mainly on antibiotics, especially the triple therapy formed of clarithromycin, amoxicillin, and proton pump inhibitors. Lately, many antibiotic-resistant strains have emerged, leading to a decrease in the eradication rates of H. pylori. Polaprezinc (PZN), a mucosal protective zinc-L-carnosine complex, may be a non-antibiotic agent to treat H. pylori without the risk of resistance. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of a PZN-based regimen for the eradication of H. pylori. This study used a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from WOS, SCOPUS, EMBASE, PubMed, and Google Scholar until 25 July 2022. We used the odds ratio (OR) for dichotomous outcomes presented with the corresponding 95% confidence interval (CI). We registered our protocol in PROSPERO with ID: CRD42022349231. We included 3 trials with a total of 396 participants who were randomized to either PZN plus triple therapy ( n = 199) or triple therapy alone (control) ( n = 197). Pooled OR found a statistical difference favoring the PZN arm in the intention to treat and per protocol H. pylori eradication rates (OR: 2.01 with 95% CI [1.27, 3.21], p = 0.003) and (OR: 2.65 with 95% CI [1.55, 4.54], p = 0.0004), respectively. We found no statistical difference between the two groups regarding the total adverse events (OR: 1.06 with 95% CI [0.55, 2.06], p = 0.85). PZN, when added to the triple therapy, yielded a better effect concerning the eradication rates of H. pylori with no difference in adverse event rates, and thus can be considered a valuable adjuvant for the management of H. pylori. However, the evidence is still scarce, and larger trials are needed to confirm or refute our findings., Competing Interests: The authors declare no conflicts of interest.

The present study was undertaken to estimate the (co)variance components and genetic parameters of body weights recorded in Landlly piglets from birth to weaning at weekly intervals (w0 to w6). The data pertained to body weights of 2462 piglets, born to 91 sires and 159 dams across different generations during a 7-year period from 2014 to 2020. Five animal models (I-V), differentiated by inclusion or exclusion of maternal effects with or without covariance between maternal and direct genetic effects, were fitted on the data using the Bayesian algorithm. The analyses were implemented by Gibbs sampling in the BLUPF90 program and Markov chain Monte Carlo (MCMC) methodology was used to draw samples of posterior distribution pertaining to (co)variance components. Based on deviance information criteria (DIC), model V with inclusion of direct additive genetic, direct maternal genetic and permanent environmental effect of dam as random factors along with covariance between direct additive and maternal effects best fitted the data on pre-weaning traits (w0 to w5). Whereas, model I incorporating only the direct additive genetic effect best fitted the weaning weight (w6) data in Landlly piglets. The posterior mean estimates of direct heritability under the best models for W0 to W6 were 0.13, 0.19, 0.29, 0.13, 0.26, 0.32 and 0.46, respectively. Inclusion of the maternal component helped in better partitioning of variance for different body weights in Landlly piglets. The maternal heritability ranged from 0.06 to 0.14, while the litter heritability ranged from 0.11 to 0.15 for pre-weaning weights (W0 to W5) under the best-fit models. The influence of maternal environment was greater than maternal genetic effect from birth to 4th week of age. The results implied that variations in body weight of Landlly pigs were genetically controlled to moderate levels (especially w2 and w4) with contributions from direct additive and maternal genotype that can be exploited by designing efficient breeding programmes.

In this paper, we present a dataset to be used for the construction of the Voronoi diagram of 3D spherical balls (VD-B3). The dataset consists of sphere arrangements including general, anomaly, and extreme cases. The dataset also includes protein models downloaded from RCSB Protein Data Bank (PDB). The dataset can be used as a standard benchmark dataset to verify and validate the correctness, efficiency, and robustness of the construction algorithm. The dataset is simple and easy to understand. The details of the experiment and analysis based on this dataset are presented in the original research article: "Robust Construction of the Voronoi Diagram of Spherical Balls in the Three-Dimensional Space" which introduces the topology-oriented incremental algorithm for the construction that is thoroughly validated and compared with two implementations of the well known edge-tracing algorithm., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)

As compared with the computational fluid dynamics(CFD), the airfoil optimization based on deep learning significantly reduces the computational cost. In the airfoil optimization based on deep learning, due to the uncertainty in the neural network, the optimization results deviate from the true value. In this work, a multi-network collaborative lift-to-drag ratio prediction model is constructed based on ResNet and penalty functions. Latin supersampling is used to select four angles of attack in the range of 2°-10° with significant uncertainty to limit the prediction error. Moreover, the random drift particle swarm optimization (RDPSO) algorithm is used to control the prediction error. The experimental results show that multi-network collaboration significantly reduces the error in the optimization results. As compared with the optimization based on a single network, the maximum error of multi-network coordination in single angle of attack optimization reduces by 16.0%. Consequently, this improves the reliability of airfoil optimization based on deep learning., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhao, Wu, Chen, Lin and Ke.)

Irritable bowel syndrome (IBS), a gastrointestinal disorder affecting 7-12% of the population, is characterized by abdominal pain, bloating, and alternating bowel patterns. Data on risk and protective influences have yielded conflicting evidence on the effects of alternative interventions, such as vitamin D. This review focuses on the effects of vitamin D on IBS. A systematic review and meta-analysis considered all articles published until 4 April 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcomes, primary (Irritable Bowel Severity Scoring System (IBS-SSS)) and secondary (IBS quality of life (IBS-QoL) and serum level of calcifediol (25(OH)D)), was performed on six databases, Google Scholar, Web of Science, SCOPUS, EMBASE, PubMed (MEDLINE), and Cochrane Central Register of Controlled Trials. We included six trials with 616 patients. The pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS (MD: -45.82 with 95% CI [-93.62, 1.98], p = 0.06). However, the pooled analysis favored vitamin D over placebo in improving the IBS-Qol (MD: 6.19 with 95% CI [0.35, 12.03], p = 0.04) and serum 25(OH)D (MD: 25.2 with 95% CI [18.41, 31.98], p = 0.00001). Therefore, further clinical trials are required to reach clinically applicable and generalizable findings.

Background: Diabetes mellitus is a growing epidemic in Africa. Its diagnosis relies exclusively on laboratory evidence, which differs based on clinical circumstances., Objective: The study described the appropriateness of plasma glucose test requests per the American Diabetes Association criteria., Methods: We reviewed the plasma glucose test requests received by the chemical pathology laboratory of the University College Hospital, Ibadan, Nigeria between June 2018 and November 2018. The American Diabetes Association diabetes diagnostic criteria were used to define the appropriateness of test requests and determine the potential for ill-informed clinical decisions., Results: Four hundred and twenty-three requisition forms were included, with the majority from the medical wards/clinics (72.3%); the most frequent reason for a plasma glucose test was systemic hypertension (28.6%). Fasting plasma glucose was most requested (254; 60.0%). One hundred and sixteen (27.4%) requests were potentially inappropriate, with the 2-h postprandial plasma glucose (2hPPG) test requests (83; 71.6%) being the most inappropriate. The difference in the proportion of inappropriate requests was not statistically significantly between medical or surgical wards/clinics (Odds ratio 1.131, 95% confidence interval 0.709-1.803, p = 0.605). Inappropriate requests in six cases may have triggered inappropriate action., Conclusion: A third of the glucose tests requested for querying diabetes mellitus may have been inappropriate. Results of such testing may trigger inappropriate clinical action. To improve the quality of care and for economic reasons, laboratories should have programmes to improve the appropriate use of their services., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)

The origin of the genetic code has been attributed in part to an accidental assignment of codons to amino acids. Although several lines of evidence indicate the subsequent expansion and improvement of the genetic code, the hypothesis of Francis Crick concerning a frozen accident occurring at the early stage of genetic code evolution is still widely accepted. Considering Crick's hypothesis, mathematical descriptions of hypothetical scenarios involving a huge number of possible coexisting random genetic codes could be very important to explain the origin and evolution of a selected genetic code. This work aims to contribute in this regard, that is, it provides a theoretical framework in which statistical parameters of error functions are calculated. Given a genetic code and an amino acid property, the functional code robustness is estimated by means of a known error function. In this work, using analytical calculations, general expressions for the average and standard deviation of the error function distributions of completely random codes with standard stop codons were obtained. As a possible biological application of these results, any set of amino acids and any pure or mixed amino acid properties can be used in the calculations, such that, in case of having to select a set of amino acids to create a genetic code, possible advantages of natural selection of the genetic codes could be discussed., (© 2021. Springer Nature B.V.)

Background: Whole-body vibration (WBV) could be an alternative training method for elderly with a high risk of falling., Research Question: What acute effects of sinus-like and random WBV intervention occur in this risk group and how do they differ?, Methods: This prospective pilot study was performed on two days separated by a one-week wash-out phase. Twelve subjects (10 women and 2 men, age 77.7 ± 5.3; 162.3 ± 7.4 cm; 82.4 ± 15.2 kg; BMI 31.2 ± 5.1 kg/m²) undertook sinus-like WBV intervention. One week later random WBV were performed. This consisted of six intervals each lasting 60 s, with heart and respiratory rates monitored. Feasibility outcomes involved safety and compliance. The primary endpoint was postural control, measured by a static posturography before and after the first interval and complete intervention. Secondary outcomes measured before and after the intervention were a Timed-Up-and-Go-Test (TUGT) and an instrumental gait analysis., Results: Random WBV intervention showed positive acute effect on postural control (Standard deviation (SD) Ellipse area p = 0.007; SD of the Center of force (CoF) independent from direction p = 0.017; SD of the CoF in the antero-posterior direction p = 0.011). There were no significant acute effects on TUGT or gait analysis (comparison between sinus-like and random WBV: Single Task: ΔVelocity p = 0.373, ΔStep time p = 0.077, ΔStep length p = 0.369, ΔStride length p = 0.408, ΔDouble-support-time p = 0.492; Dual task: ΔVelocity p = 0.580, ΔStep-time p = 0.559, ΔStep length p = 0.626, ΔStride length p = 0.584, ΔDouble-support-time p = 0.550). During sinus-like WBV, heart rate increased significantly from rest 69.7 ± 20.9bpm to max.146.0 ± 24.9bpm (p = 0.025). Respiratory rate increased significantly from 10.0 ± 1.0 to max.32.0 ± 6.0 (p = 0.011) during random WBV. No undesirable side effects were observed., Significance: Findings demonstrate that random WBV improves acute functional ability of postural control, but not gait for elderly people with a high risk of falling. Intervention with WBV seems safe and well accepted by participants. Monitoring of heart and respiratory rate offers protection for subjects with heart disease., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: In female cancer patients anticipating chemotherapy or radiation, oocyte retrieval for fertility should be performed as efficiently as possible to avoid postponing cancer treatments. Our objective was to compare clinical outcomes among female cancer patients who underwent a conventional early follicular phase-start ovarian stimulation cycle and those who underwent a random-start ovarian stimulation cycle., Evidence Review: A systematic review of the literature was performed in accordance with PRISMA guidelines. Medline, Embase.com, Scopus, Cochrane Library, and Clinicaltrials.gov databases were searched to identify all original research published in English through July 2020 on the topic of female cancer patients undergoing ovarian stimulation with a random or conventional start. Studies lacking a comparison group or including women who had already undergone chemotherapy at the time of ovarian stimulation were excluded. The primary author assessed all identified article titles and abstracts, and two independent reviewers assessed full-text articles and extracted data. A meta-analysis with a random-effects model was used to calculate weighted mean differences (WMDs) for outcomes of interest. The primary outcome was the number of mature (meiosis II) oocytes retrieved. Secondary outcomes included duration of stimulation, total dose of gonadotropins, total number of oocytes retrieved, fertilization rate, and number of embryos or zygotes cryopreserved., Results: A total of 446 articles were screened, and 9 full-text articles (all retrospective cohort or prospective observational) were included for review. Additionally, pooled primary retrospective data from two institutions were included. In total, data from 10 studies including 1653 women were reviewed. Five studies reported the number of embryos cryopreserved, and four reported fertilization rates. Random-start cycles were slightly longer (WMD 0.57 days, 95 % confidence interval [CI] 0.0-1.14 days) and used more total gonadotropins (WMD 248.8 international units, 95 % CI 57.24-440.40) than conventional-start cycles. However, there were no differences in number of mature oocytes retrieved (WMD 0.41 oocytes, 95 % CI -0.84-1.66), number of total oocytes retrieved (WMD 0.90 oocytes, 95 % CI -0.21-2.02), fertilization rates (WMD -0.12, 95 % CI -1.22-0.98), or number of embryos cryopreserved (WMD 0.12 embryos, 95 %CI -0.98-1.22) between random-start and conventional-start cycles. All outcomes except for the parameter "total oocytes retrieved" yielded an I 2 of over 50 %, indicating substantial heterogeneity between studies., Conclusion(s): Although random-start cycles may entail a longer duration of stimulation and use more total gonadotropins than conventional-start cycles, the absolute differences are small and likely do not significantly affect treatment costs. The similar numbers of mature oocytes retrieved, fertilization rates, and number of embryos cryopreserved in the two start-types suggest that they do not differ in any clinically important ways. Given that random-start cycles can be initiated quickly, they may help facilitate fertility preservation for cancer patients., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Double microlens arrays (MLAs) in series can be used to divide and superpose laser beam so as to achieve a homogenized spot. However, for laser beam homogenization with high coherence, the periodic lattice distribution in the homogenized spot will be generated due to the periodicity of the traditional MLA, which greatly reduces the uniformity of the homogenized spot. To solve this problem, a monolithic and highly integrated double-sided random microlens array (D-rMLA) is proposed for the purpose of achieving laser beam homogenization. The periodicity of the MLA is disturbed by the closely arranged microlens structures with random apertures. And the random speckle field is achieved to improve the uniformity of the homogenized spot by the superposition of the divided sub-beams. In addition, the double-sided exposure technique is proposed to prepare the rMLA on both sides of the same substrate with high precision alignment to form an integrated D-rMLA structure, which avoids the strict alignment problem in the installation process of traditional discrete MLAs. Then the laser beam homogenization experiments have been carried out by using the prepared D-rMLA structure. The laser beam homogenized spots of different wavelengths have been tested, including the wavelengths of 650 nm (R), 532 nm (G), and 405 nm (B). The experimental results show that the uniformity of the RGB homogenized spots is about 91%, 89%, and 90%. And the energy utilization rate is about 89%, 87%, 86%, respectively. Hence, the prepared structure has high laser beam homogenization ability and energy utilization rate, which is suitable for wide wavelength regime.

Background: There is limited information regarding the true frequency of nonmedical opioid use (NMOU) among patients receiving opioid therapy for cancer pain. Data to guide patient selection for urine drug testing (UDT) as well as the timing and frequency of ordering UDT are insufficient. This study examined the frequency of abnormal UDT among patients with cancer who underwent random UDT and their characteristics., Methods: Demographic and clinical information for patients with cancer who underwent random UDT were retrospectively reviewed and compared with a historical cohort that underwent targeted UDT. Random UDT was ordered regardless of a patient's risk potential for NMOU. Targeted UDT was ordered on the basis of a physician's estimation of a patient's risk for NMOU., Results: In all, 552 of 573 eligible patients (96%) underwent random UDT. Among these patients, 130 (24%) had 1 or more abnormal results; 38 of the 88 patients (43%) who underwent targeted UDT had 1 or more abnormal results. When marijuana was excluded, 15% of the random group and 37% of the targeted group had abnormal UDT findings (P < .001). It took a shorter time from the initial consultation to detect 1 or more abnormalities with the random test than the targeted test (median, 130 vs 274 days; P = .02). Abnormal random UDT was independently associated with younger age (P < .0001), male sex (P = .03), Cut Down, Annoyed, Guilty, and Eye Opener-Adapted to Include Drugs positivity (P = .001), and higher Edmonton Symptom Assessment System anxiety (P = .01)., Conclusions: Approximately 1 in 4 patients receiving opioids for cancer pain at a supportive care clinic who underwent random UDT had 1 or more abnormalities. Random UDT detected abnormalities earlier than the targeted test. These findings suggest that random UDT is justified among patients with cancer pain., (© 2020 American Cancer Society.)

Recently, the transformation from random to chaotic behavior in the statistics of Fano-Feshbach resonances was observed in thulium atoms with rising ensemble temperature. We performed random matrix theory simulations of such spectra and analyzed the resulting statistics in an attempt to understand the mechanism of the transformation. Our simulations show that, when evaluated in terms of the Brody parameter, resonance statistics do not change or change insignificantly when higher temperature resonances are appended to the statistics. In the experiments evaluated, temperature was changed simultaneously with optical dipole trap depth. Thus, simulations included the Stark shift based on the known polarizability of the free atoms and assuming their polarizability remains the same in the bound state. Somewhat surprisingly, we found that, while including the Stark shift does lead to minor statistical changes, it does not change the resonance statistics and, therefore, is not responsible for the experimentally observed statistic transformation. This observation suggests that either our assumption regarding the polarizability of Feshbach molecules is poor or that an additional mechanism changes the statistics and leads to more chaotic statistical behavior.

This work deals with an investigation of randomness effects on heart rhythm analysis. A mathematical model composed by three-coupled nonlinear oscillators coupled by time-delayed connections is employed for this aim. In this regard, heart rhythm is governed by delayed-differential equations. Nondeterministic aspects are incorporated considering random connections among oscillators. The main idea is to show that nonlinearities and randomness define together the great variety of possibilities in the heart dynamical system. In general, results corroborate that the model is able to capture the main behaviors of the cardiac system showing that pathological behaviors can evolve from normal rhythms due to random couplings. Experimental data corroborate this argues pointing that nonlinear dynamical analysis is useful for a proper physiological comprehension., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The construction of industrial projects involves fabricating and installing massive quantities of pipelines. The design data of pipelines is complex, usually unique for each project and not easily available to researchers and the public for confidentiality reasons. As a result, an industrial pipelines data generator able to realistically simulate pipelines structures will lessen the dependence on real-life data. This article describes an industrial pipelines data generator that was developed using topological and physical properties of pipelines from real industrial projects. This generator can simulate the properties (the type of component, length, diameter, running direction, and the connectivity relationships between components) of real industrial pipelines. Its application in construction engineering and management research, more specifically in the experimental analysis of an optimization algorithm, was described by the authors in previous work [1]. The data generator can be used to develop benchmark problem instances for optimization problems and for simulation studies of construction operations in industrial projects., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article., (© 2020 The Author(s).)

Introduction: N -acetylcysteine (NAC) has been extensively investigated for the use in acetaminophen and alcoholic hepatitis and is indicated in acetaminophen overdose. Studies assessing the effect of NAC on other forms of acute hepatitis in adult patients are limited and therefore here we aimed at evaluating the effect of NAC on survival in nonacetaminophen, nonalcoholic and nonviral hepatitis in adults., Methods: A comprehensive literature search up to September 2019 was completed for randomized controlled trials (RCTs) comparing NAC to placebo in the management of acute nonacetaminophen, nonalcoholic and nonviral hepatitis. Studies with insufficient data, non-RCT or nonprospective design, paediatric studies and studies with no comparator were excluded. Study selection, quality assessment and data extraction were independently performed by two co-authors. Primary outcome was survival. Secondary outcomes were an increase in infection rate. We used random model Mantel-Haenszel meta-analysis with Cochrane risk of bias to assess the quality of included studies. The recommendation was presented using the GRADE framework., Results: Seven out of 42 retrieved studies were included. Study population included patients with post-liver transplant, postsurgical, hypoxia-induced, ischemic and other nonalcoholic hepatitis. There was no difference in overall survival between NAC and placebo (odds ratio [OR] 0.95 [0.55 to 1.62]) in seven studies including 1033 patients. Furthermore, there was no difference in the rate of infection between NAC and placebo (OR 0.87 [0.43 to 1.79]). Random model analysis was used to adjust the effect of statistically significant heterogeneity in both analyses ( P = 0.02). Lack of blinding in one study was found as a possible source of heterogeneity., Conclusions: NAC does not improve overall survival or the rate of infection in patients with acute nonacetaminophen, nonalcoholic and nonviral hepatitis as compared to placebo and should not be recommended in such setting which may even delay a transplant evaluation (level of evidence: 2a, GRADE of recommendation: B)., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)

Despite multiple publications, molecular signatures predicting the course of hepatocellular carcinoma (HCC) have not yet been integrated into clinical routine decision-making. Given the diversity of published signatures, optimal number, best combinations, and benefit of functional associations of genes in prognostic signatures remain to be defined. We investigated a vast number of randomly chosen gene sets (varying between 1 and 10,000 genes) to encompass the full range of prognostic gene sets on 242 transcriptomic profiles of patients with HCC. Depending on the selected size, 4.7 to 23.5% of all random gene sets exhibit prognostic potential by separating patient subgroups with significantly diverse survival. This was further substantiated by investigating gene sets and signaling pathways also resulting in a comparable high number of significantly prognostic gene sets. However, combining multiple random gene sets using "swarm intelligence" resulted in a significantly improved predictability for approximately 63% of all patients. In these patients, approx. 70% of all random 50-gene containing gene sets resulted in equal and stable prediction of survival. For all other patients, a reliable prediction seems highly unlikely for any selected gene set. Using a machine learning and independent validation approach, we demonstrated a high reliability of random gene sets and swarm intelligence in HCC prognosis. Ultimately, these findings were validated in two independent patient cohorts and independent technical platforms (microarray, RNASeq). In conclusion, we demonstrate that using "swarm intelligence" of multiple gene sets for prognosis prediction may not only be superior but also more robust for predictive purposes. KEY MESSAGES: Molecular signatures predicting HCC have not yet been integrated into clinical routine Depending on the selected size, 4.7 to 23.5% of all random gene sets exhibit prognostic potential; independent of the technical platform (microarray, RNASeq) Using "swarm intelligence" resulted in a significantly improved predictability In these patients, approx. 70% of all random 50-gene containing gene sets resulted in equal and stable prediction of survival Overall, "swarm intelligence" is superior and more robust for predictive purposes in HCC.

Brain activity analysis is an important research area in the field of human neuroscience. Moreover, a subcategory in this field is the classification of brain activity in terms of different brain disorders. Since the Electroencephalography (EEG) signal is, in fact, a non-linear time series, employing techniques to investigate its non-linear structure is rather crucial. In this study, we evaluate the non-linear structure of the EEG signal between healthy and schizophrenic adolescents using fractal theory. The results of our analysis revealed that in terms of all recording channels, the EEG signal of healthy subjects is more complex compared to the ones suffering from schizophrenia. The statistical analysis also indicated that there is a significant difference in the complex structure of the EEG signal between these two groups of subjects. We also utilized approximate entropy in our analysis in order to verify the obtained results of the fractal analysis. The result of the entropy analysis suggested that EEG signal for healthy subjects is less random compared to the EEG signal in schizophrenic individuals. In addition, the employed methodology in this research can be further investigated in order to classify the brain activity in terms of other brain disorders, where one can explore how the complex structure of the EEG signal alters between them.

Objectives: To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice., Methods: We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2-4) and random cores (usually 10-14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables., Results: The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate-specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer., Conclusions: Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate-specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate., (© 2018 The Japanese Urological Association.)

Background: Point-of-care ultrasound (POCUS) has been used in various vascular access contexts; however, to date, it has not been widely adopted in haemodialysis clinics. People with end-stage kidney disease receiving haemodialysis require an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous access device (CVAD) in order to access their blood for therapy/treatment. Cannulation issues, such as haematoma and extravasation, related to AVFs and AVGs are common. This pilot and feasibility study will assess the feasibility of a randomised controlled trial aimed at evaluating whether POCUS-guided cannulation results in more successful and accurate AVF needle placement than the standard practice of blind cannulation., Methods: A controlled, random order crossover design will be used to evaluate two clinical conditions: (1) POCUS-guided cannulation and (2) standard practice of blind cannulation, when used by haemodialysis nurses. The feasibility of conducting this type of trial for these two clinical conditions will be assessed through recruitment, retention, and attrition rates; perceptions of acceptability; implementation measures; and assessment of methods of data collection. Clinical outcomes to be assessed are overall cannulation success on first attempt, accuracy of needle tip placement, number of extravasations, procedural time, and patient and nurse perceptions. The setting is a 16-chair dialysis unit in regional Australia. Participants will include adult haemodialysis patients with an AVF in situ for greater than 2 months and haemodialysis-trained registered nurses working full- or part-time. Clinical outcomes will be analysed using generalised linear mixed models. Feasibility data will be reported using descriptive statistics. Qualitative audio data will be digitally recorded, transcribed verbatim, and analysed using thematic analysis., Discussion: Point-of-care ultrasound for cannulation has the potential to promote high-quality, safe nursing care and decrease cannulation damage for patients on haemodialysis. Due to the lack of evidence for patient benefit and its innovative and niche use in haemodialysis centres, POCUS is currently only specified in one international guideline. This study will inform sample size calculations for a future multi-site trial., Trial Registration: Australian New Zealand Clinical Trials Registry, (21/11/2017) ACTRN12617001569392., Competing Interests: Ethics approval as detailed in manuscript.This publication is not under consideration in any other journal. All authors have consented to publication.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Runs test is a statistical procedure which determines whether a sequence of data within a given distribution have been derived with a random process or not. It may be applied to test the randomness of data in a survey that collect data from an ordered population. This article illustrates on method to perform a runs test and explains the rationale for performing it by providing some examples of how this test can be applied. The aim of this article was to describe on ways to use the runs test in a clinical survey from an ordered population to determine the degree of randomness in the sequence of subjects who are recruited within a sample obtained from the whole population. Clinical survey that involves an ordered population usually collects data from subjects who have been recruited by a consecutive sampling method. Therefore, this study recommends that the degree of randomness in the sequence of selected variable(s) obtained from consecutive sampling is necessary to be tested from a pilot study to ensure random data collection in the study.

Objective: To compare the safety and efficacy between a covered metallic ureteral stent (CMS) and a double-J ureteral stent (DJS) for the treatment of a malignant ureteral obstruction (MUO)., Materials and Methods: Nineteen patients (seven men and 12 women; mean age, 53.4 years) were randomly assigned to the CMS (n = 10) or DJS (n = 9) group. The following were compared between the two groups: technical success, i.e., successful stent placement into desired locations; stent malfunction; stent patency, i.e., no obstruction and no additional intervention; complications; and patient survival., Results: The technical success rate was 100% in all 10 and 12 ureteral units in the CMS and DJS groups, respectively. During the mean follow-up period of 253.9 days (range, 63-655 days), stent malfunction was observed in 40.0% (4/10) and 66.7% (8/12) in the CMS and DJS groups, respectively. In the per-ureteral analysis, the median patency time was 239.0 days and 80.0 days in the CMS and DJS groups, respectively. The CMS group yielded higher patency rates compared with the DJS group at three months (90% vs. 35%) and at six months (57% vs. 21%). The overall patency rates were significantly higher in the CMS group ( p = 0.041). Complications included the migration of two metallic stents in one patient in the CMS group, which were removed in a retrograde manner. The two patient groups did not differ significantly regarding their overall survival rates ( p = 0.286)., Conclusion: Covered metallic ureteral stent may be effective for MUO.

Objective: Random peer review programs are not optimized to discover cases with diagnostic error and thus have inherent limitations with respect to educational and quality improvement value. Nonrandom peer review offers an alternative approach in which diagnostic error cases are targeted for collection during routine clinical practice. The objective of this study was to compare error cases identified through random and nonrandom peer review approaches at an academic center., Methods: During the 1-year study period, the number of discrepancy cases and score of discrepancy were determined from each approach., Results: The nonrandom peer review process collected 190 cases, of which 60 were scored as 2 (minor discrepancy), 94 as 3 (significant discrepancy), and 36 as 4 (major discrepancy). In the random peer review process, 1,690 cases were reviewed, of which 1,646 were scored as 1 (no discrepancy), 44 were scored as 2 (minor discrepancy), and none were scored as 3 or 4. Several teaching lessons and quality improvement measures were developed as a result of analysis of error cases collected through the nonrandom peer review process., Conclusions: Our experience supports the implementation of nonrandom peer review as a replacement to random peer review, with nonrandom peer review serving as a more effective method for collecting diagnostic error cases with educational and quality improvement value., (Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

Background: Tendon/ligament injuries are common sports injuries. Clinically, the repair of a ruptured tendon or ligament to its bony insertion is needed, but the enthesis structure is not well reestablished following surgical repair. Herein, we fabricated dual-layer aligned-random scaffold (ARS) by electrospinning and aimed to investigate the effect of the scaffold on tendon-to-bone healing in vivo., Materials and Methods: The random and dual-layer aligned-random silk fbroin poly(L-lactic acid-co-e-caprolactone) (P(LLA-CL)) nanofibrous scaffolds were successfully fabricated by electrospinning methods. Ninety New Zealand white rabbits were randomly divided into three groups (random scaffold [RS], ARS, and control groups), and they were subjected to surgery to establish an extra-articular tendon-to-bone healing model with autologous Achilles tendon., Results: Histological assessment showed that the ARS significantly increased the area of metachromasia, decreased the interface width, and improved collagen maturation and organization at the tendon-bone interface compared with the RS and control groups. Microcomputed tomography analysis showed that the bone tunnel area of RS and ARS groups was significantly smaller than those of the control group. Real-time polymerase chain reaction showed that BMP-2 and osteopontin expression levels of the tissue at the interface between the bone and graft in the RS and ARS groups were higher than those of the control group at 6 weeks. Collagen I expression level of the ARS group was significantly higher than those of the RS and control groups at 6 and 12 weeks. Moreover, the ARS groups had a better ultimate load-to-failure and stiffness than the RS and control groups., Conclusion: ARS could effectively augment the tendon-to-bone integration and improve gradient microstructure in a rabbit extra-articular model by inducing the new bone formation, increasing the area of fibrocartilage, and improving collagen organization and maturation. The dual-layer aligned-random silk fibroin/P(LLA-CL) nanofibrous scaffold is proved to be a promising biomaterial for tendon-to-bone healing., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: To determine whether prebiopsy multiparametric magnetic resonance imaging (mpMRI) with subsequent systematic plus targeted biopsies for suspicious lesions improve prostate cancer detection compared with standard non-targeting systematic biopsies without mpMRI in biopsy-naïve patients., Methods: Patients who underwent their first prostate biopsy due to suspicion of prostate cancer were analyzed retrospectively to compare the biopsy outcomes between patients who received prebiopsy mpMRI (215 patients) and those who did not (281 patients). mpMRI was performed to determine pre-biopsy likelihood of the presence of prostate cancer using a three-point scale (1 = low level of suspicion, 2 = equivocal, and 3 = high level of suspicion). Systematic biopsies were performed in both groups. Targeted biopsies were added for a high level of suspicious lesions on mpMRI. All biopsies were performed by transperineal biopsy technique. After biopsy, Prostate Imaging Reporting and Data System ver. 2 (PIRADS-2) scoring was performed to describe the mpMRI findings and predictive value of PIRADS-2 was evaluated., Results: The detection rate of total and clinically significant prostate cancer was significantly higher in patients who received prebiopsy mpMRI than in those who did not (55.3 and 46.0% vs. 42.0 and 35.2%, respectively; p = 0.004 and p = 0.016). The clinically insignificant prostate cancer detection rate was similar between the two groups (9.3% vs. 6.8%; p = 0.32). Of 86 patients who underwent systematic plus targeted biopsy in the MRI cohort and were diagnosed with prostate cancer, seven patients were detected by addition of targeted biopsy whereas 29 patients were missed by targeted biopsy but detected by systematic biopsy. There was a correlation between the PIRADS-2 and prostate cancer detection rate, and a receiver-operator curve analysis yielded an area under the curve of 0.801 (p <  0.0001)., Conclusions: Prebiopsy mpMRI with subsequent systematic plus targeted biopsies for suspicious lesions can yield a higher cancer detection rate than non-targeting systematic biopsies. PIRADS-2 scoring is useful for predicting the biopsy outcome.

Objectives: Our aim was to examine correlation between Post-void residual urine (PVR) after uroflowmetry and random PVR., Methods: Male patients reporting to the Urology outpatient clinic with LUTS were selected. Patients' age, prostate volume, bladder capacity, voided volume, maximum flow rate, average flow rate, random PVR and PVR after uroflowmetry were recorded. We evaluated the correlations between these parameters. Also we assessed if there was a difference between random PVR and PVR after uroflowmetry. We divided PVR after uroflowmetry and random PVR into three groups: Group 1: 0-50 mL, Group 2: 51-100 mL and Group 3: >100 mL. Also we divided the patients into two groups according to bladder capacity as Group 1: ≤400 mL and Group 2: >400 mL. We compared these groups to determine whether a significant difference., Results: Seventy-seven patients applying to the urology outpatient clinic were assessed between 2013 and 2014. PVR after uroflowmetry was significantly higher than random PVR (P < 0.001). When we divided PVR after uroflowmetry and random PVR into three groups there was a significant difference between the groups (P = 0.02). When we divided the patients into two groups according to bladder capacity as Group 1: ≤400 mL and Group 2: >400 mL, PVR after uroflowmetry was different, but random PVR was similar (P < 0.001, P = 0.72)., Conclusions: PVR after uroflowmetry seems to be incorrectly high in patients whose bladder capacity is above 400 mL., (© 2017 John Wiley & Sons Australia, Ltd.)

This research extends the work of Hoffman et al. to provide both sectioning and super-resolution using random patterns within thick specimens. Two methods of processing structured illumination in reflectance have been developed without the need for a priori knowledge of either the optical system or the modulation patterns. We explore the use of two deconvolution algorithms that assume either Gaussian or sparse priors. This paper will show that while both methods accomplish their intended objective, the sparse priors method provides superior resolution and contrast against all tested targets, providing anywhere from ∼1.6× to ∼2× resolution enhancement. The methods developed here can reasonably be implemented to work without a priori knowledge about the patterns or point spread function. Further, all experiments are run using an incoherent light source, unknown random modulation patterns, and without the use of fluorescent tagging. These additional modifications are challenging, but the generalization of these methods makes them prime candidates for clinical application, providing super-resolved noninvasive sectioning in vivo., ((2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).)

Background and Objectives: Attentional biases (AB) for trauma-related stimuli have been examined in many studies assessing different trauma samples. In emotional Stroop tasks (EST), blocked and single-trial formats are used almost interchangeably in clinical research. There is reason to believe that different designs yield different results and assess different processes, which, however, has been hardly examined in studies. Furthermore, there is a dearth of information about AB in older trauma survivors with posttraumatic stress symptoms., Methods: Older adults with (n = 20) and without PTSD symptoms (n = 26) as well as non-traumatized controls (n = 21) completed an EST, in which words were presented both blocked and randomized., Results: Analyses revealed that individuals with PTSD symptoms showed AB for trauma- and depression-related words; however, mode of administration did not significantly influence reaction times., Limitations: The emotional Stroop task cannot disentangle the underlying cognitive mechanism (i.e., facilitation, interference, avoidance)., Conclusions: PTSD symptoms in older trauma survivors are associated with AB. Overall, participants with PTSD symptoms did not show greater impairment of cognitive control in comparison to both control groups. Results also illustrate that methodological differences between task versions need to be considered more thoroughly., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Dropwise condensation is a phenomenon of common occurrence in everyday life, the understanding and controlling of which is of great interest to applications ranging from technology to nature. Scalable superhydrophobic textures on metals are of direct relevance in improving phase change heat transport in realistic industrial applications. Here we reveal important facets of individual droplet growth rate and droplet departure during dropwise condensation on randomly structured hierarchical superhydrophobic aluminum textures, that is, surfaces with a microstructure consisting of irregular re-entrant microcavities and an overlaying nanostructure. We demonstrate that precoalescence droplet growth on such a surface can span a broad range of rates even when the condensation conditions are held constant. The fastest growth rates are observed to be more than 4 times faster as compared to the slowest growing droplets. We show that this variation in droplet growth on the hierarchical texture is primarily controlled by droplet growth dynamics on the nanostructure overlaying the microstructure and is caused by condensation-induced localized wetting nonuniformity on the nanostructure. We also show that the droplets nucleating and growing within the microcavities are able to spontaneously navigate the irregular microcavity geometry, climb the microtexture, and finally depart from the surface by coalescence-induced jumping. This self-navigation is realized by a synergistic combination of self-orienting Laplace pressure gradients induced within the droplet as it dislodges itself and moves through the texture, as well as multidroplet coalescence.

Objectives: Psoriasis is a chronic inflammatory skin disorder and the efficacy and safety of Chinese herbal medicine (CHM) treatments is unclear. This review evaluates oral CHM for psoriasis vulgaris clinical trial evidence., Design: The Cochrane Library, PubMed, EMBASE, CINAHL, AMED, CBM, CNKI, CQVIP and Wanfang databases were searched from inception to June 2015. Randomised controlled trials (RCTs) of oral CHM compared to placebo data were included and analysed using Review Manager 5.2., Results: Seven studies were included, no study utilised identical CHM intervention. Four studies data were subgrouped (decoction or capsule/pill) and pooled in meta-analysis to evaluate treatment effective rate for PASI60 or above (RR: 2.74 [0.92, 8.21] I 2  =   65%). Another five studies were subgrouped and evaluated for PASI score change, (MD -7.00 [-10.74, -3.27] I 2  =   98%). Only one study presented Dermatology Life Quality Index data, which favoured CHM (MD: -4.08 [-7.56, -0.60]). Two studies presented data on psoriasis-related inflammatory cell-signalling protein tumour necrosis factor-a (TNF-a) (MD: -4.92 [-5.31, -4.53]). No serious adverse events were reported., Conclusion: While CHMs appear to be safe and may have benefit for psoriasis, variation between CHM interventions, outcome measures and the quality of included studies limit the conclusions of this review. Further rigorous RCTs utilising reliable, validated symptom and QoL outcome measures are recommended.

Experts' remarkable ability to recall meaningful domain-specific material is a classic result in cognitive psychology. Influential explanations for this ability have focused on the acquisition of high-level structures (e.g., schemata) or experts' capability to process information holistically. However, research on chess players suggests that experts maintain some reliable memory advantage over novices when random stimuli (e.g., shuffled chess positions) are presented. This skill effect cannot be explained by theories emphasizing high-level memory structures or holistic processing of stimuli, because random material does not contain large structures nor wholes. By contrast, theories hypothesizing the presence of small memory structures-such as chunks-predict this outcome, because some chunks still occur by chance in the stimuli, even after randomization. The current meta-analysis assessed the correlation between level of expertise and recall of random material in diverse domains. The overall correlation was moderate but statistically significant ([Formula: see text]), and the effect was observed in nearly every study. This outcome suggests that experts partly base their superiority on a vaster amount of small memory structures, in addition to high-level structures or holistic processing.

Coincidences accompany our lives. This paper shows to which extent serendipity plays a role in important discoveries and developments in medicine. These include, among others, Mendel's laws, the determination of the human chromosome number, the discovery of DNA by Watson and Crick, the PAP test, or the discovery of X-rays and radioactivity. But also and especially in pharmacology, there are many examples of serendipity. Some go closely with serendipities in the discovery of bacteriology.

Background: The copper intrauterine device (IUD) is under-utilised in South Africa, where injectable progestin contraception (IPC) dominates contraception usage. There is a lack of robust comparative data on these contraceptive options to inform policy, programs, clinical counseling, and women's choices., Methods: Within the context of a South African program to increase women's access to the IUD, we conducted a pragmatic, open-label, parallel-arm, randomised controlled trial of the IUD versus IPC at two South African hospitals. The target sample size was 7,000 women and the randomisation ratio was 1:1. The random sequence was computer-generated and group allocation was concealed in sealed, opaque, consecutively-numbered envelopes. Counselled, consenting women attending termination of pregnancy services were randomly assigned to IUD or IPC immediately post-termination. Condoms were promoted for the prevention of sexually-transmitted infections. The primary outcome was pregnancy; secondary outcomes were discontinuation, side-effects, and HIV acquisition and disease progression. Pregnancy and discontinuation outcomes are reported here., Results: The trial closed early with 2,493 participants randomised (IUD = 1,247, IPC = 1,246), due to international concerns regarding a possible association between IPC and HIV acquisition. Median follow-up was 20 months; 982 and 1000 participants were followed up in the IUD and IPC groups, respectively. Baseline group characteristics were comparable. Pregnancy occurred significantly less frequently among women allocated to the IUD than IPC: 56/971 (5.8%) versus 83/992 (8.4%), respectively; risk ratio (RR) 0.69, 95% confidence interval (CI) 0.50 to 0.96; P = 0.025. There were more protocol violations in the IUD group; however, discontinuation rates were similar between IUD and IPC groups (141/855 [16.5%] and 143/974 [14.7%], respectively). Women in the IUD group were more likely to discontinue contraceptive use due to abdominal pain or backache and non-specific symptoms, and those in the IPC group due to oligo- or amenorhoea and lack of sexual activity., Conclusions: The IUD was significantly more effective in preventing pregnancy than IPC. Efforts to expand contraception options and improve access to the IUD in settings where it is under-utilised are worthwhile. This trial shows that randomising long-acting, reversible contraceptives is feasible., Trial Registration: Pan African Clinical Trials Registry number PACTR201409000880157 (04-09-2014).

The mean of the solute flux through membrane pores depends on the random distribution and permeability of the pores. Mathematical models including such randomness factors make it possible to obtain statistical parameters for pore characterization. Here, assuming that pores follow a Poisson distribution in the lipid phase and that their permeabilities follow a Gaussian distribution, a mathematical model for solute dynamics is obtained by applying a general result from a previous work regarding any number of different kinds of randomly distributed pores. The new proposed theory is studied using experimental parameters obtained elsewhere, and a method for finding the mean single pore flux rate from liposome flux assays is suggested. This method is useful for pores without requiring studies by patch-clamp in single cells or single-channel recordings. However, it does not apply in the case of ion-selective channels, in which a more complex flux law combining the concentration and electrical gradient is required.

Purpose: To investigate an effective time-resolved variable-density random undersampling scheme combined with an efficient parallel image reconstruction method for highly accelerated aortic 4D flow MR imaging with high reconstruction accuracy., Materials and Methods: Variable-density Poisson-disk sampling (vPDS) was applied in both the phase-slice encoding plane and the temporal domain to accelerate the time-resolved 3D Cartesian acquisition of flow imaging. In order to generate an improved initial solution for the iterative self-consistent parallel imaging method (SPIRiT), a sample-selective view sharing reconstruction for time-resolved random undersampling (STIRRUP) was introduced. The performance of different undersampling and image reconstruction schemes were evaluated by retrospectively applying those to fully sampled data sets obtained from three healthy subjects and a flow phantom., Results: Undersampling pattern based on the combination of time-resolved vPDS, the temporal sharing scheme STIRRUP, and parallel imaging SPIRiT, were able to achieve 6-fold accelerated 4D flow MRI with high accuracy using a small number of coils (N=5). The normalized root mean square error between aorta flow waveforms obtained with the acceleration method and the fully sampled data in three healthy subjects was 0.04±0.02, and the difference in peak-systolic mean velocity was -0.29±2.56cm/s., Conclusion: Qualitative and quantitative evaluation of our preliminary results demonstrate that time-resolved variable-density random sampling is efficient for highly accelerating 4D flow imaging while maintaining image reconstruction accuracy., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: A new strategy of adoptive and passive immunotherapy involves combining dendritic cells (DCs) with a subset of natural killer T lymphocytes termed cytokine-induced killer (CIK) cells. The objective of this systematic review and meta-analysis was to evaluate the safety and efficacy of DC-CIK therapy vs. placebo, no intervention, conventional treatments, or other complementary and alternative medicines for malignant tumors., Method: We searched PubMed, Medline, Embase, Cochrane, Wangfang, Weipu, CNKI databases and reference lists of articles. We selected randomized controlled trials of DC-CIK therapy vs. placebo, no intervention, conventional treatments, or other complementary and alternative medicines in patients with all types and stages of malignant tumor. Primary outcome measures were overall survival and treatment response. Secondary outcome measures were health-related quality of life (HRQoL) assessment, progression free survival (PFS), and adverse events., Results: Six trials met our inclusion criteria. There was evidence that chemotherapy+DC-CIK increased the 2-year (RR 2.88, 95% CI 1.38 to 5.99, P=0.005) and 3-year (RR 11.67, 95% CI 2.28 to 59.69, P=0.003) survival rates and progression free survival (RR 0.64, 95% CI 0.34 to 0.94, P<0.0001) in patients with non-small cell lung cancer compared to those treated with chemotherapy alone. DC-CIK therapy appears to be well-tolerated by cancer patients and to improve post-treatment patient health related quality of life., Conclusion: DC-CIK immunotherapy is a safe and effective treatment for patients with malignant tumors. Further clinical trials to provide supportive evidence for the routine use of DC-CIK therapy in clinical practice are warranted., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Thermoplastic biodegradable polymers displaying an elastomeric behavior are greatly valued for the regeneration of soft tissues and for various medical devices. In this work, terpolymers composed of ε-caprolactone (CL), D-lactide (D-LA), and L-lactide (L-LA) were synthesized. These poly(lactide-ε-caprolactone) (PLCLs) presented an elevated randomness character (R∼1), glass transition temperatures (Tg ) higher than 20°C and adjusted L-LA content. In this way, the L-LA average sequence length (/L-LA ) was reduced to below 3.62 and showed little or no crystallization capability during in vitro degradation. As a result, the obtained materials underwent homogenous degradation exhibiting KMw ranging from 0.030 to 0.066 d(-1) and without generation of crystalline remnants in advanced stages of degradation. Mechanical performance was maintained over a period of 21 days for a rac-lactide-ε-caprolactone copolymer composed of ∼85% D,L-LA and ∼15% CL and also for a terpolymer composed of ∼72% L-LA, ∼12% D-LA and ∼16% CL. Terpolymers having L-LA content from ∼60 to 70% and CL content from ∼10 to 27% were also studied. In view of the results, those materials having CL and D-LA units disrupting the microstructural arrangement of the L-LA crystallizable chains, an L-LA content <72% and a random distribution of sequences, may display proper and tunable mechanical behavior and degradation performance for a large number of medical applications. Those with a CL content from 15 to 30% will fulfill the demand of elastomeric materials of Tg higher than 20°C whereas those with a CL content from 5 to 15% might be applied as ductile stiff materials., (© 2013 Wiley Periodicals, Inc.)

Reflection symmetry is an important property of human designs and biological organisms, and it is often judged to be beautiful. Previous reaction-time based studies have shown a congruency effect, where reflection symmetry facilitates processing of positive words, and random patterns facilitate negative words. But what is the neural basis of affective responses to symmetry? In Experiment 1 we recorded ERPs from posterior electrode clusters while participants viewed reflection or random patterns with either a positive or negative word superimposed. In the Discriminate Regularity task, participants categorized the patterns (reflection or random). In the Discriminate Word task, they categorized the words as positive or negative. In Experiment 2, participants classified words and patterns on each trial. We found a difference between ERP waves from congruent (reflection with positive word, random with negative word) and incongruent trials (reflection with negative, random with positive). This congruency effect began around 200 ms, and persisted up to 1,000 ms post stimulus, and was only present in the Discriminate Word task. We suggest that when evaluating words, participants automatically evaluate the background pattern as well, and this alters early visual processing., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The conventional interpretation of spikes is from the perspective of an external observer with knowledge of a neuron's inputs and outputs who is ignorant of the contents of the "black box" that is the neuron. Here we consider a neuron to be an observer and we interpret spikes from the neuron's perspective. We propose both a descriptive hypothesis based on physics and logic, and a prescriptive hypothesis based on biological optimality. Our descriptive hypothesis is that a neuron's membrane excitability is "known" and the amplitude of a future excitatory postsynaptic conductance (EPSG) is "unknown". Therefore excitability is an expectation of EPSG amplitude and a spike is generated only when EPSG amplitude exceeds its expectation ("prediction error"). Our prescriptive hypothesis is that a diversity of synaptic inputs and voltage-regulated ion channels implement "predictive homeostasis", working to insure that the expectation is accurate. The homeostatic ideal and optimal expectation would be achieved when an EPSP reaches precisely to spike threshold, so that spike output is exquisitely sensitive to small variations in EPSG input. To an external observer who knows neither EPSG amplitude nor membrane excitability, spikes would appear random if the neuron is making accurate predictions. We review experimental evidence that spike probabilities are indeed maintained near an average of 0.5 under natural conditions, and we suggest that the same principles may also explain why synaptic vesicle release appears to be "stochastic". Whereas the present hypothesis accords with principles of efficient coding dating back to Barlow (1961), it contradicts decades of assertions that neural activity is substantially "random" or "noisy". The apparent randomness is by design, and like many other examples of apparent randomness, it corresponds to the ignorance of external macroscopic observers about the detailed inner workings of a microscopic system.

Purpose: This study proposes and evaluates a novel method for generating efficient undersampling patterns for 3D Cartesian acquisition with compressed sensing (CS) and parallel imaging (PI)., Methods: Image quality achieved with schemes that accelerate data acquisition, including CS and PI, are sensitive to the design of the specific undersampling scheme used. Ideally random sampling is required to recover MR images from undersampled data with CS. In practice, pseudo-random sampling schemes are usually applied. Radial or spiral sampling either for Cartesian or non-Cartesian acquisitions has been using because of its favorable features such as interleaving flexibility. In this study, we propose to undersample data on the ky-kz plane of the 3D Cartesian acquisition by circularly selecting sampling points in a way that maintains the features of both random and radial or spiral sampling., Results: The proposed sampling scheme is shown to outperform conventional random and radial or spiral samplings for 3D Cartesian acquisition and is found to be comparable to advanced variable-density Poisson-Disk sampling (vPDS) while retaining interleaving flexibility for dynamic imaging, based on the results with retrospective undersampling. Our preliminary results with the prospective implementation of the proposed undersampling strategy demonstrated its favorable features., Conclusions: The proposed undersampling patterns for 3D Cartesian acquisition possess the desirable properties of randomization and radial or spiral trajectories. It provides easy implementation, flexible sampling, and high accuracy of image reconstruction with CS and PI.