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Alignment in total ankle replacement is important for success and implant survival. Recently there has been the introduction and adoption of patient specific instrumentation for implantation in total ankle replacement. Current literature does not evaluate the effect of preoperative deformity on accuracy of patient specific instrumentation. A retrospective radiographic analysis was performed on 97 consecutive patients receiving total ankle replacement with patient specific instrumentation to assess the accuracy and reproducibility of the instrumentation. Subgroup analysis evaluated the effect of preoperative deformity. All surgeries were performed by fellowship trained foot and ankle surgeons without industry ties to the implants used. Preoperative and postoperative films were compared to plans based on computerized tomography scans to assess how closely the plan would be implemented in patients. Overall postoperative coronal plane alignment was within 2° of predicted in 87.6% (85 patients). Similarly, overall postoperative sagittal plane alignment was within 2° of predicted in 88.7% (86 patients). Tibial implant size was accurately predicted in 81.4% (79 patients), and talus implant size was correct in 75.3% (73 patients). Patients with preoperative varus deformity had a higher difference between predicted and actual postoperative alignment compared to valgus deformity (1.1° compared to 0.3°, p =.02). A higher average procedure time was found in varus patients, and more adjunctive procedures were needed in patients with varus or valgus deformity, but these were not significant, p >.5. Surgeons can expect a high degree of accuracy when using patient specific instrumentation overall, but less accurate in varus deformity. [ABSTRACT FROM AUTHOR]

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Background/Objectives: 3D patient-specific corrective osteotomies are optimized for use with oscillating saws, thereby rendering it incapable of executing curved osteotomies. The aim of this technical note is to introduce and evaluate the Panflute technique, which facilitates curved osteotomies with precise depth control for intra-articular corrective osteotomies in posttraumatic tibial plateau malunions. Methods: A 33-year-old male patient with an intra-articular malunion was treated one year after index surgery of a lateral split-depression tibial plateau fracture with the Panflute technique. The guide design allowed for multiple drill trajectories in a curved path, recreating the original fracture lines. Cylindrical drill tubes in the guide were tailored to match bone trajectory length. This resulted in a patient-specific Panflute-like design enabling precise depth control, safeguarding posterior neurovascular structures. Secondly, the recreated fragment was reduced with a reduction guide, applied to the plate in situ, to facilitate reposition using the plate as tool and reference. Results: The procedure went without technical drawbacks or surgical complications. Postoperative assessment showed that repositioning of the osteotomized articular fragment was performed accurately: pre- to postoperative translational corrections were 5.4 to 0.5 mm posterior displacement for AP deformity (x-axis); 2.9 to 1.0 mm lateral to medial reduction (y-axis); and 5.9 to 0.6 mm cranial-caudal correction (z-axis). Clinically, at 3 months, the fracture united, the patient regained full flexion, and valgus defect-laxity resolved. Conclusions: The presented Panflute-osteotomy guide allows for a pre-planned curved osteotomy. Additionally, for every drill trajectory, the depth could be controlled. The proposed method may expand our surgical armamentarium of patient-specific 3D techniques and solutions for complex intra-articular osteotomies. [ABSTRACT FROM AUTHOR]

During HIV-1 virus assembly, the genomic RNA (vRNA) is selected for packaging by the viral protein Gag because it contains a specific packaging signal, Psi. While there have been numerous studies of Gag–Psi interactions, there is almost no information on the kinetic aspects of this interaction. We investigated the kinetics of Gag binding to different RNAs using switchSENSE DRX2 technology. We measured the association rate of Gag binding to monomeric Psi, to a "Multiple Binding Site Mutant" Psi that is inactive for genome packaging in vivo, and to a scrambled Psi. We discovered that Gag binds more rapidly to Psi RNA than to the mutant or scrambled RNAs. Furthermore, rapid Gag association kinetics are retained within sub-regions of Psi: Gag associates more rapidly with RNA containing only the 3′ two of the three Psi stem-loops than with monomeric RNA containing the 5′ two stem-loops or a scrambled RNA. No differences were detectable with individual Psi stem-loops. Interestingly, the rate of binding of Gag molecules to Psi increases with increasing Gag concentration, suggesting cooperativity in binding. The results are consistent with the hypothesis that selectivity in packaging derives from kinetic differences in initiation of particle assembly. [ABSTRACT FROM AUTHOR]

Background: Identifying high-risk COVID-19 patients is critical for emergency department decision-making. Our study's primary objective was to identify new independent predictors of mortality and their predictive utility in combination with traditional pneumonia risk assessment scores and new risk scores for COVID-19 developed during the pandemic. Methods: A retrospective study was performed in two Italian University Hospitals. A multivariable logistic model was used to locate independent parameters associated with mortality. Results: Age, PaO2/FiO2, and SpO2/FiO2 ratios were found to be independent parameters associated with mortality. This study found that the Pneumonia Severity Index (PSI) was superior to many of the risk scores developed during the pandemic, for example, the International Severe Acute Respiratory Infection Consortium Coronavirus Clinical Characterisation Consortium (ISARIC 4C) (AUC 0.845 vs. 0.687, p < 0.001), and to many of the risk scores already in use, for example, the National Early Warning Score 2 (NEWS2) (AUC 0.845 vs. 0.589, p < 0.001). Furthermore, our study found that the Pneumonia Severity Index had a similar performance to other risk scores, such as CRB-65 (AUC 0.845 vs. 0.823, p = 0.294). Combining the PaO2/FiO2 or SpO2/FiO2 ratios with the risk scores analyzed improved the prognostic accuracy. Conclusions: Adding the SpO2/FiO2 ratio to the traditional, validated, and already internationally known pre-pandemic prognostic scores seems to be a valid and rapid alternative to the need for developing new prognostic scores. Future research should focus on integrating these markers into existing pneumonia scores to improve their prognostic accuracy. [ABSTRACT FROM AUTHOR]

Background: The use of patient-specific instruments (PSIs) for osteotomies is becoming more popular in orthopaedic surgery for correcting mechanical axis and posttraumatic deformities. However, the PSI reduction guides have great potential for intraoperative deformation, which adversely affects the accuracy of the procedure. Purpose: To conduct a finite element analysis (FEA) to analyze different design parameters to improve the intraoperative stability of the reduction guides. Study Design: Descriptive laboratory study. Methods: A reduction guide with a rectangular cross section and four 4-mm K-wire slots was simplified, and the following parameters were modified: width, height, profile design, K-wire thickness, and positions. Bending and torsional moments were applied to the guide construct and guide deformation and equivalent stress were determined using FEA. Results: Increasing the profile height by 25% resulted in a 44% reduction in guide deformation for bending (37% for torsion). A 25% increase in profile width led to an 18% deformation reduction for bending (22% for torsion). Transverse K-wire slots resulted in 51% less deformation in torsion compared with longitudinally oriented slots. Placing the central K-wire slots 25% closer to the osteotomy reduced guide deformation by 20% for bending and 11% for torsion. Conclusion: The most effective methods to increase reduction guide stability are to increase the guide height and reduce the central K-wire distance to the osteotomy. Clinical Relevance: When performing opening or closing wedge osteotomies, which mainly involve bending of the guide, a high-profile guide and longitudinally oriented K-wire slots should be used. When torque is expected as in rotational osteotomies, the K-wire holes in guides should be oriented transversely to reduce intraoperative deformation. [ABSTRACT FROM AUTHOR]

Today, the rise of social media has profound effects on political communication activities. Political parties and political actors use social media platforms effectively in order to reach voters, disseminate their ideas and ideologies and gather support. The aim of this study is to identify the social media platforms actively used by political parties. The study aims to measure the usage and participation levels of political parties represented in the Turkish Grand National Assembly on social media platforms, which have a high number of users, with LBWA, WEDBA, PSI, LMAW, IRPA, CRADIS, one of the Multi-Criteria Decision-Making methods. In order to analyse the social media performance of political parties, the model includes an evaluation within the framework of the number of followers, number of followers, number of shares, number of likes and number of comments and aims to rank the most effective social media platforms used by political parties. According to the findings obtained as a result of the study, it is seen that the use of social media by political parties other than TİP and DEM party is carried out within the framework of similar strategies and this use is carried out within the framework of political communication opportunities offered to users within the framework of the basic features of the platform. [ABSTRACT FROM AUTHOR]

The Saurashtra region, located south of the Kachchh M7.7 (2001) epicentre, has seen a few M5.0 earthquakes with dispersed seismicity over the past two decades. In the Amreli area, a sudden triggering of earthquake activity was noticed in the month of October 2021 - March 2022, and 172 earthquakes of M ≤ 3.0 were recorded within a radius of 10 km. Persistent Scatterer Interferometry (PSI) time-series results of Sentinel 1 A dataset (2017–2022) show the seasonal variation in the displacement and indicate anomalous behaviour with a displacement amplitude, up-to 8 mm, before the earthquake activity. The coefficient correlation (R2) of 0.78 between precipitation and Land Water Storage (LWS) accomplish that the risen displacement amplitude is directly linked with the high LWS which change the pore pressure as well as the stress level of the existing faults in the subsurface and ultimately triggers the earthquake swarm activity in this part of the Indian plate. [ABSTRACT FROM AUTHOR]

The porous silicon (PSi) substrate was accurately synthesized using photoelectrochemical etching. A Nanofilm gallium nitride (GaN) was then precisely deposited on this PSi substrate using pulsed laser deposition (PLD). The x-ray diffraction (XRD) investigation revealed the GaN layer's distinct crystalline structure along the (002) plane, with a precise crystallite size of 21.57 nm. This precision in the deposition process enhanced both the surface morphology and film quality. In the atomic force microscope (AFM), oval particles were evenly distributed across the entire surface, and the RMS of the surface was 27 nm with a 20.63 nm surface roughness. A field emission scanning microscope (FESEM) image of the gallium nitride (GaN) films deposited at a wavelength of 532 nm showed that the GaN material had an evenly covered Psi surface. This reflected the presence of a smooth and even spread of round particles. The cross-sectional area of the GaN sheet had a thickness of 2.92 µm, demonstrating the precision of the deposition technique. The resulting GaN nanofilms demonstrate UV photoluminescence (P.L.), characterized by a wavelength peak of 363.7 nanometers, indicative of the GaN material. In addition, they display a red photoluminescence peak at 723 nanometers, corresponding to the PSi substrate. Under UV-visible light and photoluminescence (P.L.), the optical energy gaps of the GaN nanofilm and the PSi substrate were determined. The PSi substrate exhibited an optical energy gap of 2.1 electron volts, whereas the resulting gallium nitride nanofilms displayed multiple energy band gaps of 3.4 electron volts and 1.7 electron volts.

Abstract Percutaneous endoscopic lumbar discectomy (PELD) is increasingly used in patients with lumbar disc herniation due to its less invasive nature and faster recovery. In this study, we aimed to investigate the prognostic factors associated with patient satisfaction index (PSI) in PELD. A retrospective study of 337 patients who underwent PELD between November 2015 and October 2020 in our department was conducted. Preoperative data of the enrolled patients were recorded. A logistic regression model was developed to explore the preoperative factors associated with postoperative PSI. After a mean follow-up of 28.7 ± 3.6 months, 310 patients were satisfied (NASS score of 1 or 2) and 27 patients were dissatisfied (NASS score of 3 or 4), resulting in a patient satisfaction rate of 91.99%. Demographic data, clinical symptom characteristics, and neurological physical examinations (including lower limb hypesthesia, muscle strength, and tendon flex) did not show any significant differences between the four groups (NASS1,2,3,4). The satisfactory group showed a higher rate of positive Lasegue sign (P = 0.010) and higher preoperative VAS (P = 0.002). The dissatisfaction group showed a higher rate of contiguous double-level disc herniation (P = 0.003). Our findings indicated that positive Lasegue sign and high preoperative VAS were prognostic factors for patient-reported satisfaction and PELD might not be the first choice for contiguous double-level disc herniation.

Three-dimensional (3D) planning and Patient Specific Instrumentation (PSI) can help the surgeon to obtain more predictable results in Medial Opening Wedge High Tibial Osteotomy (mOW-HTO) than the conventional techniques. We compared the accuracy of the PSI and standard techniques and measured the learning curve for surgery time and number of fluoroscopic shots.

El presente estudio se enfoca en analizar la calidad fisicoquímica de los efluentes generados por un grupo de Plantas de Tratamiento de Aguas Residuales (PTAR) situadas en el Valle Alto de Cochabamba para determinar su aptitud de reúso agrícola. Los principales parámetros analizados fueron (SO4)-2, (Cl)-1, (Na)+1, (Ca)+2, (Mg)+2, (HCO3)-1 y (NO3)-1. Además, se estimaron los índices relación de adsorción de sodio (RAS) y porcentaje de sodio intercambiable (PSI). En los efluentes evaluados se encontraron las siguientes concentraciones: 132,00 - 252,00 mg/L de (SO4)-2; 3,02 - 9,48 meq/L de (Cl)-1; 11,79 - 17,59 meq/L de (Na)+1; 40,00 - 100,00 mg/L de (Ca)+2; 75,39 - 92,42 mg/L de (Mg)+2; 153,72 - 473,36 mg/L de (HCO₃)-1; y 17,80 - 37,80 mg/L de (NO₃)-1. Las estimaciones del RAS de los efluentes presentaron valores comprendidos entre 5,41 y 8,01. Los resultados de PSI estuvieron comprendidos entre 6,29-9,55. Debido a sus concentraciones moderadas y en base a la clasificación de los efluentes como C3-S2 según la clasificación RIVERSIDE, los efluentes podrían emplearse para el riego de suelos que tengan un drenaje adecuado. Debido a que ninguna de las plantas de tratamiento realiza procesos de desinfección se recomienda limitar la aplicación de los efluentes a cultivos que no se consuman sin procesar, de tallo alto, forrajeros y de moderada tolerancia a la salinidad. Se recomienda además la aplicación de técnicas de riego que alternen el riego con aguas residuales y otras fuentes de suministro de agua para reducir los riesgos asociados a la salinidad.

In the current landscape of higher education, the quality of teaching plays a crucial role in supporting the comprehensive development of students. To ensure the effectiveness of the learning process, evaluating lecturers based on student opinions is an essential means of providing feedback and optimizing the learning experience. This paper focuses on constructing a lecturer ranking system, particularly in the context of a specific course through the evaluation process from students. Four different methods were employed to assess lecturers, including the PSI method, SRP method, RAM method, and PIV method. The evaluation results using these four methods were compared with each other and also with the traditional evaluation approach currently utilized in the educational institution. The achieved results demonstrate that the approach outlined in this paper is highly suitable for determining the rankings of lecturers when teaching individual courses. [ABSTRACT FROM AUTHOR]

Training competent behavior analysts is fundamentally crucial for the survival and prosperity of behavior analysis. The current article introduced the Comprehensive Application of Behavior Analysis to Schooling (CABAS) as a training model to train behavior analysts as strategic scientists. The CABAS training model is based on the philosophy of behavior selection and features a personalized system of instruction-based rank system. Each rank includes three areas of expertise: verbal behavior about science, contingency-shaped repertoire, and verbally mediated repertoire. The trainees work on these components with small-unit modules that shape and maintain their effective criterion-based performance. Advancement through these ranks demonstrates the trainees' increased proficiency and advanced expertise. We also discussed future research direction and the implications to graduate training programs in behavior analysis in general. [ABSTRACT FROM AUTHOR]

The STAR GATE archive included an experiment from China of psicho-physical claim reportedly conducted on aqueous object (Wu et al, 1991). Over a time-lapse of approximately 208 seconds, total 7 phases of significant temperature deviation from the baseline temperature of 25 °C may be identified, without an explainable source of thermal generation. Not questioning the genuineness of the experiment, this work analyzes the thermal-energy transfer on the test-object that could have caused the reported temperature changes. A non-adiabatic single-compartment produces first-order low-pass responses between a thermal-input and the object's temperature. Whereas the input determines the steady-state condition, the thermal dissipation dictates the dynamics. Under the assumption of ONLY first-order responses and adjusting the input parameters including DC and AC magnitudes and time-constant of the single-compartment responses, multi-phase temperature changes resembling the reported patterns could be reconstructed. One rising phase and three falling phases with apparent oscillation were reconstructed by considering the thermal input to contain modulatory patterns of 0.4-0.5 Hz in frequency. Such modeled modulation of the thermal inputs would correspond to a correlation coefficient of 0.95 between the DC and AC magnitudes at a varying AC/ DC modulation-depth of ≤94%. The low-frequency may suggest relevance to altered neuro-electro-physiology. [ABSTRACT FROM AUTHOR]

The author conducted weekly online group psychokinesis (PK) experiments between Aug. 9, 2019 and Feb. 25, 2023, with the goal of experiencing collective PK. Participant observation experiments were designed to uncover variables associated with group PK experiences rather than prove the existence of PK. Early experiments seemed to increase individual propensity for spontaneous anomalous experience. The group began attempting to influence pinwheel turning on June 12, 2020. Direct observation seemed to reduce pinwheel turning. Certain conversational elements, such as emotion and discussion of psychical research, seemed to enhance turning. A motionactivated Blink camera was incorporated into the protocol on November 8, 2021, allowing documentation of 44 pinwheel experiments. Experiences involved ostensible anomalous pinwheel turning, equipment failures, poltergeist-like events, and trickster effects. Quantitative results included: (1) Significantly more pinwheel turning, as measured by camera activations, during group meetings compared to equivalent nongroup periods; (2) Certain discussion topics were associated with rapid turning: occult traditions, psychic readings, psychical research; and (3) Other variables were associated with reduced turning: direct observation, relaxation exercise, miscellaneous discussion topics. Participants felt that the pinwheels exhibited a form of intelligence due to the pinwheel response to group discussion. Trickster effects included turning patterns that changed over time, unusual equipment failures, and 'hiding' behavior thwarting full verification. These features suggest that the replicability of findings may be limited, although a series of methodological guidelines are suggested to increase success. Grounded theory strategies allow theory development, and a new model is proposed to account for the phenomena in question. [ABSTRACT FROM AUTHOR]

This study examines a body of engaged "ritual magic practitioners" to understand their methods and techniques for facilitating putative parapsychological outcomes in everyday life, as well as outcomes on a computerized test of putative psi. We hypothesized that the combination of meditation, visualization, and related mental exercises at the core of magical practice relates to both invoked anomalous phenomena and spontaneouslyoccurring anomalous phenomena, and further that the perceptual-personality variable of transliminality (i.e., loose mental boundary functioning) is integral to this process. Likewise, we also anticipated that these associations would enable ritual magicians to score significantly above-chance on the psi test. A split-sample analysis found a positive and statistically significant series of relationships between transliminality and the majority of measured variables within the sample, and notably those involving questionnaire measures of subjective and objective anomalies as well as daily mental exercises. The ritual magicians also performed significantly below-chance (p < .01 for several conditions) on the psi test, as a function of open testing of ESP or using ritual to influence the test. We discuss these results in terms of significant predictions of trait and practice variables on ESP scoring, as well as the evidence that magical practice may represent techniques in which a transliminal dis-ease model might be better remediated. [ABSTRACT FROM AUTHOR]

The recent subsidence at Joshimath in the Indian State of Uttarakhand led to the displacement of thousands of residents. Large cracks developed in the buildings and on the ground. No extensive and comprehensive deformation measurement of this event has been made. In this study, we use both PS and PSDS InSAR time series to investigate the magnitude, spatiotemporal as well as kinematic evolution of this slow-moving landslide. Eighty-seven ascending Sentinel-1 scenes with a temporal baseline of 1056 days from 2020 to 2023 were stacked for interferometric analysis. StaMPS is employed to identify PS points by their amplitude and phase information. TomoSAR is utilized to stipulate a coherence matrix to form a dense PSDS network of interferograms to surge point density for suitable phase unwrapping. PS and DS points are coupled to develop slope velocity maps revealing mean displacement rates of –84 mm for PS and –107 mm for PSDS, respectively. Cross-section profiles drawn on the slopes of subsidence show target scatterers on CS1, CS2 and CS4, yield a cumulative displacement of 400 mm in the last 3 years. CS3 and CS5 show a total displacement of about 350 mm. This study applies PSDS time-series InSAR to decipher ground movement in traditionally decohered environments. It also seeks to establish the boundaries and intensity of subsidence to aid in the mitigation of failure progression. [ABSTRACT FROM AUTHOR]

Abstract Solar power is a promising source of energy that is environmentally friendly, sustainable, and renewable. Solar photovoltaic (PV) panels are the most common and mature technology used to harness solar energy. Unfortunately, these panels are prone to dust accumulation, which can have a significant impact on their efficiency. To maintain their effectiveness, solar photovoltaics s must be cleaned regularly. Eight main techniques are used to clean solar panels: natural, manual, mechanical, robotic, drone, coating, electrical, and acoustic. This study aims to identify the best cleaning method using multiple criteria decision-making (MCDM) techniques. Using the Analytical Hierarchy Process (AHP), Quality Function Deployment (QFD), Fuzzy Technique for Order of Preference by Similarities to Ideal Solution (FTOPSIS), and Preference Selection Index (PSI), this research evaluates all eight cleaning methods based on several criteria that are categorized under cost, performance, resource requirement, and safety in Abu Dhabi. The data are collected from surveys completed by experts in solar and sustainable energy. The AHP, QFD, and PSI results identified natural, manual, and surface coating as the best and most effective cleaning methods. Natural cleaning involves using rainwater primarily to remove dirt and dust; manual cleaning requires cleaning agents and wiping clothes; and surface coatings involve applying a layer of hydrophobic material to the panels to repel dust. Identifying the most effective cleaning method for dust removal from solar panels can ensure optimal efficiency recovery at minimal costs and resources.

Abstract Background In traditional surgical procedures, significant discrepancies are often observed between the pre-planned templated implant sizes and the actual sizes used, particularly in patients with congenital hip dysplasia. These discrepancies arise not only in preoperative planning but also in the precision of implant placement, especially concerning the acetabular component. Our study aims to enhance the accuracy of implant placement during Total Hip Arthroplasty (THA) by integrating AI-enhanced preoperative planning with Patient-Specific Instrumentation (PSI). We also seek to assess the accuracy and clinical outcomes of the AI-PSI (AIPSI) group in comparison to a manual control group. Methods This study included 60 patients diagnosed with congenital hip dysplasia, randomly assigned to either the AIPSI or manual group, with 30 patients in each. No significant demographic differences between were noted the two groups. A direct anterior surgical approach was employed. Postoperative assessments included X-rays and CT scans to measure parameters such as the acetabular cup anteversion angle, acetabular cup inclination angle, femoral stem anteversion angle, femoral offset, and leg length discrepancy. Functional scores were recorded at 3 days, 1 week, 4 weeks, and 12 weeks post-surgery. Data analysis was conducted using SPSS version 22.0, with the significance level was set at α = 0.05. Results and conclusion The AIPSI group demonstrated greater prosthesis placement accuracy. With the aid of PSI, AI-planned THA surgery provides surgeons with enhanced precision in prosthesis positioning. This approach potentially offers greater insights and guidelines for managing more complex anatomical variations or cases.

Solar power is a promising source of energy that is environmentally friendly, sustainable, and renewable. Solar photovoltaic (PV) panels are the most common and mature technology used to harness solar energy. Unfortunately, these panels are prone to dust accumulation, which can have a significant impact on their efficiency. To maintain their effectiveness, solar photovoltaics s must be cleaned regularly. Eight main techniques are used to clean solar panels: natural, manual, mechanical, robotic, drone, coating, electrical, and acoustic. This study aims to identify the best cleaning method using multiple criteria decision-making (MCDM) techniques. Using the Analytical Hierarchy Process (AHP), Quality Function Deployment (QFD), Fuzzy Technique for Order of Preference by Similarities to Ideal Solution (FTOPSIS), and Preference Selection Index (PSI), this research evaluates all eight cleaning methods based on several criteria that are categorized under cost, performance, resource requirement, and safety in Abu Dhabi. The data are collected from surveys completed by experts in solar and sustainable energy. The AHP, QFD, and PSI results identified natural, manual, and surface coating as the best and most effective cleaning methods. Natural cleaning involves using rainwater primarily to remove dirt and dust; manual cleaning requires cleaning agents and wiping clothes; and surface coatings involve applying a layer of hydrophobic material to the panels to repel dust. Identifying the most effective cleaning method for dust removal from solar panels can ensure optimal efficiency recovery at minimal costs and resources. [ABSTRACT FROM AUTHOR]

This study aims to investigate the occurrence of surface displacements in the Canto do Amaro (CAM) onshore oil field, situated in Rio Grande do Norte, Brazil, using Sentinel-1 data. The persistent scatterer interferometry (PSI) technique was used to perform the analysis based on 42 Sentinel-1 images, acquired from 23 July 2020 to 21 December 2021. Moreover, information regarding the structural geology of the study area was collected by referencing existing literature datasets. Additionally, a study of the water, gas, and oil production dynamics in the research site was conducted, employing statistical analysis of publicly available well production data. The PSI points results were geospatially correlated with the closest oil well production data and the structural geology information. The PSI results indicate displacement rates from −20.93 mm/year up to 14.63 mm/year in the CAM region. However, approximately 90% of the deformation remained in the range of −5.50 mm/year to 4.95 mm/year, indicating low levels of ground displacement in the designated research area. No geospatial correlation was found between the oil production data and the zones of maximum deformation. In turn, ground displacement demonstrates geospatial correlation with geological structures such as strike-slip and rift faults, suggesting a tectonic movement processes. The PSI results provided a comprehensive overview of ground displacement in the Canto do Amaro field, with millimeter-level accuracy and highlighting its potential as a complementary tool to field investigations. [ABSTRACT FROM AUTHOR]

Background: In traditional surgical procedures, significant discrepancies are often observed between the pre-planned templated implant sizes and the actual sizes used, particularly in patients with congenital hip dysplasia. These discrepancies arise not only in preoperative planning but also in the precision of implant placement, especially concerning the acetabular component. Our study aims to enhance the accuracy of implant placement during Total Hip Arthroplasty (THA) by integrating AI-enhanced preoperative planning with Patient-Specific Instrumentation (PSI). We also seek to assess the accuracy and clinical outcomes of the AI-PSI (AIPSI) group in comparison to a manual control group. Methods: This study included 60 patients diagnosed with congenital hip dysplasia, randomly assigned to either the AIPSI or manual group, with 30 patients in each. No significant demographic differences between were noted the two groups. A direct anterior surgical approach was employed. Postoperative assessments included X-rays and CT scans to measure parameters such as the acetabular cup anteversion angle, acetabular cup inclination angle, femoral stem anteversion angle, femoral offset, and leg length discrepancy. Functional scores were recorded at 3 days, 1 week, 4 weeks, and 12 weeks post-surgery. Data analysis was conducted using SPSS version 22.0, with the significance level was set at α = 0.05. Results and conclusion: The AIPSI group demonstrated greater prosthesis placement accuracy. With the aid of PSI, AI-planned THA surgery provides surgeons with enhanced precision in prosthesis positioning. This approach potentially offers greater insights and guidelines for managing more complex anatomical variations or cases. [ABSTRACT FROM AUTHOR]

As a city undergoes large-scale construction and expansion, there is an urgent need to monitor the stability of the ground and infrastructure. The time-series InSAR technique is an effective tool for measuring surface displacements. However, interpreting these displacements in a built environment, where observed displacements consist of mixed signals, poses a challenge. This study uses principal component analysis (PCA) and the k-means clustering method for exploring deformation series within an unsupervised learning context. The PCA method extracts the dominant components in deformation series, whereas the clustering method identifies similar deformation series. This method was tested on Kunming City (KMC) using C-band Sentinel-1, X-band TerraSAR-X, and L-band ALOS-2 PALSAR-2 data acquired between 2017 to 2022. The experiment demonstrated that the suggested unsupervised learning approach can group PS points with similar kinematic characteristics. Five types of deformation kinematic characteristics were discovered in the three SAR datasets: upward, slight upward, stability, slight downward, and downward. According to the results, less than 20% of points exhibit significant motion trends, whereas 50% show small velocity values but still demonstrate movement trends. The remaining 30% are relatively stable. Similar clustering results were obtained from the three datasets using unsupervised methods, highlighting the effectiveness of identifying spatial–temporal patterns over the study area. Moreover, It was found that clustering based on kinematic characteristics enhances the interpretation of InSAR deformation, particularly for points with small deformation velocities. Finally, the significance of PCA decomposition in interpreting InSAR deformation was discussed, as it can better represent series with noise, enabling their accurate identification. [ABSTRACT FROM AUTHOR]

This work discusses landslide velocity mapping in the Swiss Alps using ALOS-2 PALSAR-2 ScanSAR differential interferometry and interferometric time series analyses based on small data stacks of about 10 images over eight years. A wide area coverage is possible due to the 350km swath width of the ScanSAR data. In our processing sequence we resampled the sub-swath SLCs to a common spatial grid. The co-registered sub-swath SLCs were mosaiced into large co-registered mosaic SLCs. We then applied normal procedures also used for stripmap mode data to generate differential interferograms and conduct a Persistent Scatterer Interferometry (PSI) processing. The results obtained over the Swiss Alps provide a good spatial coverage, with line-of-sight displacement velocities also extracted for some landslides in forested areas. The future applicability of the technique is very promising with upcoming L-band SAR missions (NISAR, ROSE-L and PALSAR-3) that provide data of even better suitability – higher spatial resolution, shorter revisit time intervals, and free and open data access. [ABSTRACT FROM AUTHOR]

This paper presents a comparative analysis of Multi-Temporal Interferometric Synthetic Aperture Radar (MT-InSAR) algorithms in a corner reflector located in Lisbon, Portugal. The reflector was monitored using daily observations from the Global Navigation Satellite System (GNSS) technique with submillimeter precision. The study focuses on comparing the performance and accuracy of different MT-InSAR approaches i) the Persistent Scatterer Interferometry (PSI) method using the open-source software StaMPS, ii) the PSI method using the commercial software SARPROZ, iii) the Quasi-PS method implemented with the SARPROZ software, as well as iv) a hybrid method Persistent scatterer – Distributed Scatterer (PS-DS) obtained from the European Ground Motion Service (EGMS) with SqueeSAR algorithm. The study period assumed was from October 2017 to January 2019, by considering the same initial information (ascending orbit Sentinel images). Statistical analysis of the time series was also performed, and the density of points in the vicinity was evaluated. To provide a comprehensive evaluation of accuracy, the uncertainties associated with both the GNSS and InSAR techniques were assessed. The findings of this comparative analysis offer valuable insights into the strengths and limitations of various MT-InSAR algorithms by using a more precise technique as a benchmark. The results improve the understanding of deformation monitoring in geodetic applications and highlight the potential for enhanced accuracy in such assessments. [ABSTRACT FROM AUTHOR]

Spaceborne SAR Interferometry techniques namely Differential SAR Interferometry (DInSAR) and Persistent Scatterer Interferometry (PSI) are remote sensing-based techniques used to measure and monitor terrain deformations. In the present study, advances in PSI since its inception, considering three important parameters (pixel selection criteria, baseline configuration, and deformation model) is discussed in detail. Further, in view of the research heading towards the pixel selection criteria and phase optimization of Distributed Scatterers (DSs) pixels, detailed discussion is made over its advancement also. In addition, the statistical homogenous pixel (SHP) and the similar time-series interferometric phase (STIP) pixel-based PSCs selection are the latest development. In view of this, the connection and difference of major and latest SHP and STIP pixel-based PSCs selection methods in term of the mathematic model of phase optimization for conventional DS and DS with multiple scattering mechanism (DS-MSM), types of pixel selection capability, computational efficiency are characterized. Further, in this study, a novel Bayesian methodology and its details are proposed for the phase optimization of DS pixels, which will provide a much better idea of the characteristics of the parameter of interest than latest one based on complex least square mathematic model for phase optimization of DS pixels. [ABSTRACT FROM AUTHOR]

Surface movements pose a critical issue requiring prompt detection and monitoring to ensure safety. To address this concern, the detection and continuous monitoring of surface deformations have gained importance. While numerous point-based surveying methods exist, multi-temporal interferometric synthetic aperture radar (InSAR) analysis has emerged as a powerful technique capable of detecting deformations across large areas with freely available SAR images and software. However, the significance of surface movement forecasting must be addressed, as it plays a significant role in preventing accidents and implementing precautionary measures. In light of this, a comprehensive study was conducted at the new Istanbul Airport in Türkiye, employing the Persistent Scatterer InSAR (PSI) method with a collection of 211 Sentinel-1 SAR images. The results obtained were investigated, and six test case regions were determined for the forecasting analysis in terms of time series movement type (subsidence, uplift, and stable) and structure type (runway and building) using various machine learning (ML) algorithms. To accomplish this, regression-based and sequential-based ML algorithms were employed and compared, showing the potential of cutting-edge techniques. The Stacked LSTM algorithm was the most effective in generating accurate forecasts. Furthermore, by incorporating exogenous variables into the forecasting analysis, the study improved the accuracy of the results. To gain deeper insights into the impact of these exogenous variables, feature importance analysis was conducted using the permutation feature importance method. The results obtained were examined, considering both the structure type and the characteristics of the time series data. [ABSTRACT FROM AUTHOR]

To compare the reconstruction of orbital fractures using patient-specific implants (PSI) and conventional pre-formed titanium mesh; to develop a method of three-dimensional (3D) superimposition and analysis of the reconstructed orbits; and to present the pitfalls in 3D planning of orbital PSI and how to avoid them. This was a retrospective study of patients with orbital fractures who were treated in our institution between the years 2022 and 2023 using PSI or conservative prefabricated titanium mesh. Three different methods for virtual reconstruction of orbital fractures were used and are detailed with advantages, disadvantages and indications. Data acquired included age, gender, method of reconstruction, functional outcomes and aesthetic outcomes. 3D analysis for accuracy of reconstruction was performed. A total of 23 patients were included; 12 were treated using PSI and 11 using prefabricated titanium meshes. There were 8 male and 4 female patients in the PSI group comparted to 5 and 6 in the prefabricated group. All three virtual methods for reconstruction were used successfully, each with the proper indications. When comparing PSI reconstruction to conventional mesh, a significant difference in accuracy was observed; PSI cases showed an inaccuracy of 0.58 mm compared to 1.54 mm with the conventional method. Complications are presented, and tips for avoiding them are detailed. Three different methods for virtual reconstruction were used successfully; automated computerized reconstruction is used for small defects, repositioning is the superior method for non-comminuted cases while mirroring is the method of choice in comminuted fractures. 3D analysis can be performed using a novel method detailed in this report. PSI reconstruction showed superior results, indicating it should be the method of choice when possible. Pitfalls are presented and approaches to prevent them are discussed. Orbital reconstruction is a very important entity in maxillofacial surgery with crucial functional and esthetical implications, and one should use virtual planning and PSI implants, as they significantly improve outcomes. [ABSTRACT FROM AUTHOR]

Remote sensing techniques, such as Interferometric Synthetic Aperture Radar (InSAR), have the potential to document and monitor surface deformation up to a millimetre scale especially in areas where ground monitoring is not feasible. The InSAR technique has been used to isolate and map some current and potential landslide areas in Kinnaur region of the Satluj Valley in Himachal Pradesh. The fragile ecosystem of Kinnaur has been challenged by the shifting climatic pattern and immense anthropogenic pressure associated with burgeoning hydroelectric projects, leading to destructive landslides of epic proportions. Three recent landslides that occurred at Ribba and Pangi villages of the Satluj River Valley and the Batseri landslide in the Sangla Valley were studied and potential landslide areas along the Satluj Valley were mapped with Sentinel-1 multi-baseline interferograms using data acquired between 2016 and 2021. The analysis suggests significant changes in velocities (±11 mm/y) where the subsidence rate ranges from −6 to −11 mm/y with a cumulative displacement of ±45 mm/y. Our study highlights the potential locations for future landslides and provides an early warning landslide map to support future disaster prevention in highly deformed regions. [ABSTRACT FROM AUTHOR]

The trickster concept has been proposed as a useful description of paranormal phenomena in response to nine decades of inconsistent experimental results and the inability to develop sustained practical applications of psi. However, the trickster of mythology is too diverse and ambiguous for scientific research. The term 'psi-trickster' is used here to refer to an active factor that makes psi effects inconsistent and unsustainable but can be investigated scientifically. My transition from optimism about psi experiments to reluctantly accepting the psi-trickster is described. The primary purpose of this essay is to describe strategies and options for research given the apparent psi-trickster. Strategies for dealing with the psi-trickster include: (a) hope that continued experimental research will overcome it; (b) accept the far-reaching implications of the usual assumptions for psi experiments and develop models of unconscious conflicting psi influences by many different people; (c) investigate the possibility that reliable psi effects occur in rare conditions, such as after many years of intense meditation practice; (d) propose physics-based models; and (e) consider that factors other than the motivations of living persons may be involved. Experimental psi research has the ultimate goal of converting psi to technology. Like other technologies, the most advanced development will be for military uses and for corporate profits. Spontaneous psi experiences tend to inspire a sense of meaning in life and a belief that the person's life is watched over, similar to mystical and near-death experiences. The psi-trickster characteristics prevent psi from being converted to technology and preserve its mysterious, mystical aspects. An indepth investigation is needed to understand how paranormal beliefs and experiences affect a person's life and society as a whole. This is the first step in investigating the psitrickster characteristics and should include the distribution of beliefs in the population for the full spectrum from skeptics to proponents. [ABSTRACT FROM AUTHOR]

Abstract Background The use of 3D-printed Patient-Specific Instruments (PSI) has been investigated to enhance the postoperative functional results in total hip arthroplasty (THA) and has been recognized as an innovative approach for the optimal alignment of hip implant components. Point-of-care production is gradually becoming the norm for PSI manufacturing. The purpose of this article is to assess the accuracy and safety of PSI for total hip arthroplasty performed at the point-of-care in Vietnam. Methods 34 THA cases were assessed in this prospective study. A template for the size and orientation of the implant and the design of the PSI was generated using data from preoperative 3D computed tomography (CT) scanning of the lower limb. The principal surgeon determined the implants’ position and PSI design directly using the software. The PSI is then produced using a 3D-compatible resin printer in our manufacturing hospital. The PSI, consisting of an acetabulum and a femoral component placed press-fit on the bony surface, guided surgeons to precisely ream the acetabulum and cut the femoral neck according to the pre-planned plane. Postoperative CT scanning was obtained and superimposed onto the 3D model of the implant to evaluate the accuracy of the procedure by comparing the orientation values of the cup and the alignment of the stem between the planned and the actual results. Intra- and postoperative clinical parameters of surgery, including surgical time, intra-operative blood loss, complications, and the first ambulation, were also recorded to evaluate the safety of the surgery. Results The preparation for PSI required an average of 3 days. 94% of cup size and 91% of stem size were correctly selected. The mean values of postoperative inclination and anteversion were 44.2° ± 4.1° and 19.2° ± 5.6°, respectively. 64.7% of cases deviated from planned within the ± 50 range and 94.1% within the ± 10° range. There was no significant statistical difference between the planned and the achieved values of stem anteversion, osteotomy height, and leg length discrepancy (p > 0.05). The average surgical time was 82.5° ± 10.8 min, and the intraoperative blood loss was estimated at 317.7° ± 57.6 ml. 64.7% of patients could walk on the day of surgery. There were no complications reported. Conclusions The point-of-care manufactured PSI is a useful solution for improving the accuracy of total hip arthroplasty surgery, especially in restoring implant orientation and reducing leg length discrepancy. However, long-term clinical follow-up evaluation is needed to confirm the efficacy and safety of this approach.

In this study, Differential Interferometric Synthetic Aperture Radar Interferometry (DInSAR) of artificial Corner Reflectors (CRs) were validated in the area of fast and nonlinear deformation gradient caused by active coal longwall exploitation. Three Sentinel-1 datasets were processed using conventional DInSAR, Persistent Scatterer Interferometry (PSI), and Small BAseline Subset methods implemented in ENVI SARscape™. For evaluation, leveling and Global Navigation Satellite System (GNSS) measurements were used. Considering the challenge of snow cover, the removal of all winter images was not a successful strategy due to the long temporal baseline and strong movement, which cause phase unwrapping problems and underestimate the real deformation. The results indicate that only conventional DInSAR and SBAS with low network redundancy allow us to capture maximal deformation gradient and the root mean square error calculated between the CRs and the ground truth is on the level of 2–3 cm for the vertical and easting deformation component, respectively. For the small deformation gradient represented by the permanent GNSS station (4 cm/year), all SBAS techniques appeared to be more accurate than DInSAR, which corresponds to higher redundancy and better removal of the atmospheric signal. In contrast, DInSAR results allowed to capture information about two subsidence basins, which was not possible with SBAS and PSI approaches.

During HIV-1 virus assembly, the genomic RNA (vRNA) is selected for packaging by the viral protein Gag because it contains a specific packaging signal, Psi. While there have been numerous studies of Gag–Psi interactions, there is almost no information on the kinetic aspects of this interaction. We investigated the kinetics of Gag binding to different RNAs using switchSENSE DRX2 technology. We measured the association rate of Gag binding to monomeric Psi, to a “Multiple Binding Site Mutant” Psi that is inactive for genome packaging in vivo, and to a scrambled Psi. We discovered that Gag binds more rapidly to Psi RNA than to the mutant or scrambled RNAs. Furthermore, rapid Gag association kinetics are retained within sub-regions of Psi: Gag associates more rapidly with RNA containing only the 3′ two of the three Psi stem-loops than with monomeric RNA containing the 5′ two stem-loops or a scrambled RNA. No differences were detectable with individual Psi stem-loops. Interestingly, the rate of binding of Gag molecules to Psi increases with increasing Gag concentration, suggesting cooperativity in binding. The results are consistent with the hypothesis that selectivity in packaging derives from kinetic differences in initiation of particle assembly.

The study's aim was to explore the associations between meditation, extended human capacities, and synchronistic experiences. 725 participants completed questionnaires and online tasks assessing these variables before and after engaging in personal growth workshops. The results showed that 1) meditators scored higher than non-meditators on noetic experiences and beliefs, and pre-workshop synchronistic experiences; 2) meditation frequency was associated with higher noetic experiences and beliefs, and pre-workshop synchronistic experiences; 3) meditation-based workshop participants reported more synchronistic experiences during their workshop than non-meditation-based workshop participants; and 4) noetic experiences mediated the association between meditation frequency and pre-workshop synchronistic experiences. [ABSTRACT FROM AUTHOR]

Purpose: Three-dimensional (3D) printed patient-specific instruments (PSI) have been introduced to increase precision and simplify surgical procedures. Initial results in femoral and tibial osteotomies are promising, but validation studies on 3D planning, manufacturing of patient-specific cutting blocks and 3D evaluation of the attained results are lacking. Methods: In this study, patient-specific cutting blocks and spacers were designed, fabricated, and used to perform a high tibial osteotomy (HTO). After segmentation of CT data sets from 13 human tibiae, 3D digital planning of the HTO was performed with a medial opening of 8 mm. These 3D models were used to fabricate patient-specific cutting blocks and spacers. After the surgical procedure, accuracy was evaluated measuring 3D joint angles and surface deviations. Results: The lowest mean deviation was found to be 0.57° (SD ± 0.27) for the MPTA. Medial and lateral tibial slope deviated from the 3D planning by an average of 0.98° (SD ± 0.53) and 1.26° (SD ± 0.79), respectively, while tibial torsion deviated by an average of 5.74° (SD ± 3.24). Color analysis of surface deviations showed excellent and good agreement in 7 tibiae. Conclusion: With 3D cutting blocks and spacers, the 3D planning of the HTO can be translated into reality with small deviations of the resulting joint angles. Within this study, the results of the individual steps are examined for errors and thus a critical evaluation of this new and promising method for performing patient-specific HTOs is presented. [ABSTRACT FROM AUTHOR]

Purpose: A substantial proportion of conventional tibial plateau plates have a poor fit, which may result in suboptimal fracture reduction due to applied -uncontrolled- compression on the bone. This study aimed to assess whether patient-specific osteosyntheses could facilitate proper fracture reduction in medial tibial plateau fractures. Methods: In three Thiel embalmed human cadavers, a total of six tibial plateau fractures (three Schatzker 4, and three Schatzker 6) were created and CT scans were made. A 3D surgical plan was created and a patient-specific implant was designed and fabricated for each fracture. Drilling guides that fitted on top of the customized plates were designed and 3D printed in order to assist the surgeon in positioning the plate and steering the screws in the preplanned direction. After surgery, a postoperative CT scan was obtained and outcome was compared with the preoperative planning in terms of articular reduction, plate positioning, and screw direction. Results: A total of six patient-specific implants including 41 screws were used to operate six tibial plateau fractures. Three fractures were treated with single plating, and three fractures with dual plating. The median intra-articular gap was reduced from 6.0 (IQR 4.5–9.5) to 0.9 mm (IQR 0.2–1.4), whereas the median step-off was reduced from 4.8 (IQR 4.1–5.3) to 1.3 mm (IQR 0.9–1.5). The median Euclidean distance between the centre of gravity of the planned and actual implant was 3.0 mm (IQR: 2.8–3.7). The lengths of the screws were according to the predetermined plan. None of the screws led to screw penetration. The median difference between the planned and actual screw direction was 3.3° (IQR: 2.5–5.1). Conclusion: This feasibility study described the development and implementation of a patient-specific workflow for medial tibial plateau fracture surgery that facilitates proper fracture reduction, tibial alignment and accurately placed screws by using custom-made osteosynthesis plates with drilling guides. [ABSTRACT FROM AUTHOR]

This study investigated the potential for energy savings and reduction in CO2 emissions in hospital buildings in Bosnia and Herzegovina (B&H), through the implementation of energy renovation measures. The building sector in B&H is characterized by significant energy consumption, and hospitals account for a substantial portion of the total energy consumption in public buildings. This study analyzes certain energy renovation measures for selected hospital buildings, including the installation of thermal insulation on exterior walls and flat roofs, and the installation of a photovoltaic plant on the flat roof. The Preference Selection Index (PSI) multicriteria decision-making method was employed to evaluate and rank renovation scenarios based on energy, environmental, and financial criteria. The results indicate that the most preferred measure is the installation of a photovoltaic plant on a flat roof, resulting in significant primary energy and CO2 savings, with an acceptable discounted payback period. The findings emphasize the effectiveness of energy renovation measures in enhancing energy efficiency and reducing the environmental impact of hospital buildings in B&H. [ABSTRACT FROM AUTHOR]

Introduction: Interest in 3D printing for orthopedic surgery has been increasing since its progressive adoption in most of the hospitals around the world. The aim of the study is to describe all the current applications of 3D printing in patients undergoing hip surgery of any type at the present time. Materials and Methods: We conducted a systematic narrative review of publications indexed in MedLine through the search engine PubMed, with the following parameters: 3D printing AND (orthopedics OR traumatology) NOT tissue engineering NOT scaffold NOT in vitro and deadline 31 July 2023. After reading the abstracts of the articles, papers were selected according to the following criteria: full text in English or Spanish and content related to hip surgery. Those publications involving experimental studies (in vitro or with anatomical specimens) or 3D printing outside of hospital facilities as well as 3D-printed commercial implants were excluded. Results are presented as a reference guide classified by disease, including the used software and the steps required for the development of the idea. Results: We found a total of 27 indications for in-house 3D printing for hip surgery, which are described in the article. Conclusions: There are many surgical applications of 3D printing in hip surgery, most of them based on CT images. Most of the publications lack evidence, and further randomized studies should be encouraged to assess the advantages of these indications. [ABSTRACT FROM AUTHOR]

Private Set Intersection Cardinality (PSI-CA) and Private Set Union Cardinality (PSU-CA) are two cryptographic primitives whereby two or more parties are able to obtain the cardinalities of the intersection and the union of their respective private sets, and the privacy of their sets is preserved. In this paper, we propose a new privacy protection intersection cardinality protocol, which can quickly deal with set inequality and asymmetry problems and can obtain 100% correct results, and, in terms of efficiency, we are much faster than using the polynomial method. Our protocol adopts the Paillier addition homomorphic encryption scheme and applies the identifier guidance technology, using identifier determination, to the semi-homomorphic encryption ciphertext environment, excluding a large number of different options and quickly finding the base of the intersection of two sides. [ABSTRACT FROM AUTHOR]

Objective: Response of pyogenic spine infection to antibiotic therapy is usually based on nonspecific symptoms and inflammation markers. Abnormalities on MRI persist too long to influence therapy. Is FDG-PET/CT a timely and robust predictor of successful therapy? Materials and Methods: Retrospective study. Sequential FDG-PET/CTs done to assess treatment response over a 4-year period. Recurrence of infection after stopping treatment was the endpoint. Results: One hundred seven patients enrolled. First treatment response scan showed no signs of infection in 69 patients (low risk). Twenty-four additional patients underwent additional treatment after an initial positive scan with low-risk pattern on follow-up imaging. After stopping antibiotics, none had clinical recurrence of infection. One had positive cultures at surgery for negative predictive value of 0.99. Thirty-eight patients had evidence of residual infection. Abnormalities in 28 were comparable to what is seen with untreated infection (high-risk). Twenty-seven received additional treatment until resolution. Antibiotics were stopped in 1 who suffered recurrence. Ten had low-grade/localized abnormalities consistent with infection (intermediate-risk). Signs of infection resolved in 3 after additional treatment. Of the remaining 7 patients who had minor residual abnormalities when antibiotics were stopped, 1 had recurrent infection for a positive predictive value of 0.14. Conclusion: Risk stratification proposed: A low-risk scan with only inflammation at a destroyed joint indicates negligible risk of recurrence. Unexplained activity in bone, soft tissue or spinal canal indicates high risk with further antibiotics recommended. Most patients with subtle or localized findings (intermediate risk) did not experience recurrence. Stopping therapy could be considered under careful observation. [ABSTRACT FROM AUTHOR]

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