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This paper presents an experimental machining study of turning medium carbon alloy steel 4140 on Haas CNC turning center with TiC/TiCN/TiN-coated carbide inserts under different lubricating conditions. Cutting speed and feed rate were controlled at three different levels while a constant depth of cut is employed throughout the entire experimental study. The cutting fluid used in the study was produced from a genetically modified soybean oil and is hence biodegradable, renewable, less toxic, and sustainable to the environment. The three lubricating conditions tested in the study were dry, minimum quantity lubrication (MQL) (40 mL/min), and flood (1.3 L/min) conditions. With cutting speed and feed rate being control variables and cutting lubricate condition as noise factor, in total, 27 experimental runs were conducted according to Taguchi's L9 (34) orthogonal array. Statistical analysis using one-way ANOVA found that feed rate is a significant factor impacting surface roughness while cutting speed does not impact tool wear due to the range of speeds selected and use of coated insert. This study also concludes that dry condition generates the best result as the applications of cutting fluid in flood or MQL format did not generate significantly better surface roughness and lower tool wear. This implies that cutting fluids may be eliminated with careful selection of cutting parameters and tooling materials. [ABSTRACT FROM AUTHOR]

This paper presents an experimental study on abrasive waterjet (AWJ) milling circular pockets of the titanium alloy Ti6Al4V workpieces. A material removal model is firstly deduced to understand the erosion process of AWJ milling. Experiments are conducted to research the effects of the processing parameters (water pressure, abrasive flow rate, traverse speed, and stand-off distance) on the performance of the milled circular pockets of Ti6Al4V workpieces. Dominating parameters and their interactive effects on the milling depth and roughness of milled surfaces are presented based on Box-Behnken design method. A comparative analysis is taken for the average milling depth, which is dominated by several dimensionless variables that control the final performance involved in the milled circular pocket. Subsequently, through quantitative assessments by the experiments, predictions by the material removal model are in good agreement with experimental results with an average deviation of 3.5%. [ABSTRACT FROM AUTHOR]

This paper presents an experimental study on abrasive waterjet (AWJ) drilling of Inconel 718 and AISI 1040 steel, with an aim to understand the AWJ hole drilling performance and to investigate the process monitoring strategy by using acoustic emission (AE). In the experiments, pressure levels were set from 200 to 350 MPa at intervals of 50 MPa, and drilling time between 5 and 30 s at intervals of 5 s. It is found that the hole depth increases along with the drilling time at a slowing down penetration rate. A higher pressure results in a higher penetration rate. While there exists a direct influence of the material property on the drilling efficiency, it has limited significance with regard to the diameter of the hole produced. AE-RMS signal is demonstrated to be able to reflect the decreasing trend of the penetration rate and the influence of the pressure. A strong correlation between the penetration rate and AE-RMS values in AWJ hole drilling is shown through correlation analysis. The AE-RMS is also substantially affected by the material properties. A discrepancy of the AE-RMS under similar condition may suggest an anomaly in this cutting run. [ABSTRACT FROM AUTHOR]

In the construction of activity prediction models, the use of feature ranking methods is a useful mechanism for extracting information for ranking features in terms of their significance to develop predictive models. This paper studies the influence of feature rankers in the construction of molecular activity prediction models; for this purpose, a comparative study of fourteen rankings methods for feature selection was conducted. The activity prediction models were constructed using four well-known classifiers and a wide collection of datasets. The ranking algorithms were compared considering the performance of these classifiers using different metrics and the consistency of the ranked features. [ABSTRACT FROM AUTHOR]

The paper examines the design techniques of control charts intended for predicting critical time changes of lab-measured process indicators. A control chart design algorithm is offered for monitoring time changes of several product's properties with autocorrelations between consecutive observations. The algorithm is based on the filtration of observations by a specially designed filter without edge effect and on the Hotelling statistics. [ABSTRACT FROM AUTHOR]

This paper presents a comparative study on gas-sensing behavior of reduced graphene oxide (rGO) synthesized by chemical and green synthesis route. GO is synthesized by Hummers method and then reduced employing two reducing agents hydrazine hydrate [represented by (rGO)1] and l-citrulline [represented by (rGO)2]. Synthesized products were then obtained in the form of thin films, and tested for 10 ppm NO2 and CO at operating temperatures of 50, 100, and 150 °C. The green-synthesized reduced graphene oxide (rGO)2 exhibits higher relative response of 254.7% as compared to conventionally synthesized (rGO)1 (93.9%) and GO (22.7%) for 10 ppm NO2 at operating temperature of 150 °C. Furthermore, a switching of conductivity from usual p-type behavior to n-type on exposure of NO2 is observed at all operating temperatures (50, 100, and 150 °C) for GO, (rGO)1, and (rGO)2. The XRD, FTIR, and Raman confirm the oxidation and reduction process. (rGO)2 shows high thermal stability as observed through TGA. FESEM and TEM images show wrinkled sheet structure for GO as well (rGO)1 and (rGO)2. The data observed from the characterization of resultant products have made it possible to explain better reduction of GO through green-reducing agent and enhanced gas-sensing performance of green-synthesized reduced graphene oxide. [ABSTRACT FROM AUTHOR]

The ossicular joints of the middle ear can significantly affect middle-ear function, particularly under conditions such as high-intensity sound pressures or high quasi-static pressures. Experimental investigations of the mechanical behaviour of the human incudostapedial joint have shown strong non-linearity and asymmetry in tension and compression tests, but some previous finite-element models of the joint have had difficulty replicating such behaviour. In this paper, we present a finite-element model of the joint that can match the asymmetry and non-linearity well without using different model structures or parameters in tension and compression. The model includes some of the detailed structures of the joint seen in histological sections. The material properties are found from the literature when available, but some parameters are calculated by fitting the model to experimental data from tension, compression and relaxation tests. The model can predict the hysteresis loops of loading and unloading curves. A sensitivity analysis for various parameters shows that the geometrical parameters have substantial effects on the joint mechanical behaviour. While the joint capsule affects the tension curve more, the cartilage layers affect the compression curve more. [ABSTRACT FROM AUTHOR]

In this paper, a simplified yet efficient architecture of a deep convolutional neural network is presented for lung image classification. The images used for classification are computed tomography (CT) scan images obtained from two scientifically used databases available publicly. Six external shape-based features, viz. solidity, circularity, discrete Fourier transform of radial length (RL) function, histogram of oriented gradient (HOG), moment, and histogram of active contour image, have also been identified and embedded into the proposed convolutional neural network. The performance is measured in terms of average recall and average precision values and compared with six similar methods for biomedical image classification. The average precision obtained for the proposed system is found to be 95.26% and the average recall value is found to be 69.56% in average for the two databases. [ABSTRACT FROM AUTHOR]

This paper presents the results of the first international comparative study of commonly applied analytical methods for microplastic analysis. Although it was shown that the comparability between previously published studies is highly limited, there are ambitious efforts regarding the standardization of microplastic analysis. This comparative study serves as a first step to assess the suitability of frequently used methods in microplastic research. Furthermore, it highlights obstacles when conducting a comparative study for microplastics. Results from 17 laboratories from eight different countries are compared. Samples comprised of five different types of microplastic reference particles with diameters ranging from 8 µm to 140 μm suspended in ultrapure water. Microscopy, Fourier-transform infrared microspectroscopy (μ-FTIR), Raman microspectroscopy (μ-Raman), thermo-extraction-and-desorption- or pyrolysis- combined with gas chromatography coupled to mass spectrometry (Σ-GC/MS), scanning electron microscopy and particle counter were compared regarding results on total particle number, polymer type, number of particles and/or particle mass for each polymer type. In the scope of this comparative study, for the identification of polymer type μ-Raman and Σ-GC/MS performed best. The quantification of polymer mass for identified polymer types was questionable for Σ-GC/MS, whereas other methods failed to determine the correct polymer mass. Quantification of particle number per identified polymer type was evaluated successful for μ-FTIR and the quantification of total particle numbers was best for microscopy and to a lesser extent for μ-FTIR. Remarkable was the large variance of results between the methods but also within the methods. The latter is likely due to individual interpretations of methods and preparation protocols, in particular in regard to the handling of blank values. Results strongly emphasize the need for standardization and validation of analytical methods in microplastic research both on a global scale as well as in the context of individual laboratories. [ABSTRACT FROM AUTHOR]

In the field of computational bioinformatics, identifying a set of genes which are responsible for a particular cellular mechanism, is very much essential for tasks such as medical diagnosis or disease gene identification. Accurately grouping (clustering) the genes is one of the important tasks in understanding the functionalities of the disease genes. In this regard, ensemble clustering becomes a promising approach to combine different clustering solutions to generate almost accurate gene partitioning. Recently, researchers have used generative model as a smart ensemble method to produce the right consensus solution. In the current paper, we develop a protein-protein interaction-based generative model that can efficiently perform a gene clustering. Utilizing protein interaction information as the generative model's latent variable enables enhance the generative model's efficiency in inferring final probabilistic labels. The proposed generative model utilizes different weak supervision sources rather utilizing any ground truth information. For weak supervision sources, we use a multi-objective optimization based clustering technique together with the world's largest gene ontology based knowledge-base named Gene Ontology Consortium(GOC). These weakly supervised labels are supplied to a generative model that eventually assigns all genes to probabilistic labels. The comparative study with respect to silhouette score, Biological Homogeneity Index (BHI) and Biological Stability Index (BSI) proves that the proposed generative model outperforms than other state-of-the-art techniques. [ABSTRACT FROM AUTHOR]

A novel design incorporating both reductive Bayer digestion and iron recovery into diasporic bauxite processing is proposed to remarkably reduce red mud discharge. This paper presents a comparative study on reductive versus typical Bayer digestion, after which an industrial validation test was carried out. During the test, relative alumina recovery of 98% and a reduction of 10.9% in the amount of red mud generated were achieved by substituting 2 wt.% iron powder for 10 wt.% lime of bauxite in the high-temperature digestion. Meanwhile, ~ 60% of the iron minerals were converted to magnetite by iron powder, meaning that processing the resulting red mud by magnetic separation could obtain iron concentrate with total iron concentration of 55.2% and iron recovery of 60.1%. The overall reduction of red mud discharge reached 50% for a ton of alumina. The proposed prototype is conducive to improve the Bayer process, aiming to achieve cleaner production of commercial alumina. [ABSTRACT FROM AUTHOR]

Conventional general-purpose distance-based similarity measures, such as Minkowski distance (also known as ℓ p -norm with p > 0 ), are data-independent and sensitive to units or scales of measurement. There are existing general-purpose data-dependent measures, such as rank difference, Lin's probabilistic measure and m p -dissimilarity ( p > 0 ), which are not sensitive to units or scales of measurement. Although they have been shown to be more effective than the traditional distance measures, their characteristics and relative performances have not been investigated. In this paper, we study the characteristics and relationships of different general-purpose data-dependent measures. We generalise m p -dissimilarity where p ≥ 0 by introducing m 0 -dissimilarity and show that it is a generic data-dependent measure with data-dependent self-similarity, of which rank difference and Lin's measure are special cases with data-independent self-similarity. We evaluate the effectiveness of a wide range of general-purpose data-dependent and data-independent measures in the content-based information retrieval and kNN classification tasks. Our findings show that the fully data-dependent measure of m p -dissimilarity is a more effective alternative to other data-dependent and commonly-used distance-based similarity measures as its task-specific performance is more consistent across a wide range of datasets. [ABSTRACT FROM AUTHOR]

Real-life decision-making problem has been demonstrated to cover the indeterminacy through single valued neutrosophic set. It is the extension of interval valued neutrosophic set. Most of the problems of real life involve some sort of uncertainty in it among which, one of the famous problem is finding a shortest path of the network. In this paper, a new score function is proposed for interval valued neutrosophic numbers and SPP is solved using interval valued neutrosophic numbers. Additionally, novel algorithms are proposed to find the neutrosophic shortest path by considering interval valued neutrosophic number, trapezoidal and triangular interval valued neutrosophic numbers for the length of the path in a network with illustrative example. Further, comparative analysis has been done for the proposed algorithm with the existing method with the shortcoming and advantage of the proposed method and it shows the effectiveness of the proposed algorithm. [ABSTRACT FROM AUTHOR]

The rapid development of population, economy and technology currently has led to the fast increase in electric consumption. Therefore, efficient energy management and load forecasting have been flagged as a very important need for electric networks planning and operation. Recently, different techniques have been developed to deal with load forecasting. However, the stochastic nature and uncertainty characteristics of the electric load make demand forecasting a challenging task for electric utilities where no technique can be identified as the most efficient one. It becomes therefore relevant to identify the technique that best fits a specific dataset. Thus, in this paper we propose a comparative study of four techniques for long-term load forecasting, namely Box–Jenkins, multiple linear regressions, MLR and nonlinear autoregressive neuronal networks with and without exogenous variables, NARX and NAR. The study is conducted on the Tunisian electric consumption, and the performance of different techniques is evaluated as a function of historical data and forecasting period's variations. Quantitative and qualitative assessments of results are reported in this study in order to pinpoint the strengths and weaknesses of the different assessed forecasting techniques. [ABSTRACT FROM AUTHOR]

Missing data is an expected issue when large amounts of data is collected, and several imputation techniques have been proposed to tackle this problem. Beneath classical approaches such as MICE, the application of Machine Learning techniques is tempting. Here, the recently proposed missForest imputation method has shown high imputation accuracy under the Missing (Completely) at Random scheme with various missing rates. In its core, it is based on a random forest for classification and regression, respectively. In this paper we study whether this approach can even be enhanced by other methods such as the stochastic gradient tree boosting method, the C5.0 algorithm, BART or modified random forest procedures. In particular, other resampling strategies within the random forest protocol are suggested. In an extensive simulation study, we analyze their performances for continuous, categorical as well as mixed-type data. An empirical analysis focusing on credit information and Facebook data complements our investigations. [ABSTRACT FROM AUTHOR]

Square confined concrete arch is increasingly used in deep soft rock roadway support because of its advantages of high strength and construction convenience. However, the design of confined concrete arch in underground engineering still remains in experience-based method and lacks quantitative analysis. As a connecting component between arch sections, the connection joints have an important influence on the internal force distribution and failure mechanism of support arch. Therefore, a reasonable design of arch joints is the premise of rational support design. Taking Liangjia Coal Mine, a typical deep soft rock mine in China, as research background, this paper fully compared the most widely used joint types of confined concrete arch as analytical objects: flange joints and casing joints. The main failure modes of these two kinds of joints under bending moment are defined. Laboratory and numerical tests are carried out to study the mechanical characteristics of joints. Based on the M–θ curve, the influence law of different design parameters is analyzed, and the design principles of joints are proposed. The research results could provide a theoretical basis for the design and application of confined concrete arch in related projects. [ABSTRACT FROM AUTHOR]

This paper re-examines criticisms of cross-sectional methods used to test for supplier-induced demand (SID) and re-evaluates the empirical evidence using data from Australian medical services. Cross-sectional studies of SID have been criticised on two grounds. First, and most important, the inclusion of the doctor supply in the demand equation leads to an identification problem. This criticism is shown to be invalid, as the doctor supply variable is stochastic and depends upon a variety of other variables including the desirability of the location. Second, cross-sectional studies of SID fail diagnostic tests and produce artefactual findings due to model misspecification. Contrary to this, the re-evaluation of cross-sectional Australian data indicate that demand equations that do not include the doctor supply are misspecified. Empirical evidence from the re-evaluation of Australian medical services data supports the notion of SID. Demand and supply equations are well specified and have very good explanatory power. The demand equation is identified and the desirability of a location is an important predictor of the doctor supply. Results show an average price elasticity of demand of 0.22 and an average elasticity of demand with respect to the doctor supply of 0.46, with the impact of SID becoming stronger as the doctor supply rises. The conclusion we draw from this paper is that two of the main criticisms of the empirical evidence supporting the SID hypothesis have been inappropriately levelled at the methods used. More importantly, SID provides a satisfactory, and robust, explanation of the empirical data on the demand for medical services in Australia. [ABSTRACT FROM AUTHOR]

The mission of the Veterans Health Administration's (VHA) quality enhancement research initiative (QUERI) is to enhance the quality of VHA health care by implementing clinical research findings into routine care. This paper presents lessons that QUERI investigators have learned through their initial attempts to pursue the QUERI mission. The lessons in this paper represent those that were common across multiple QUERI projects and were mutually agreed on as having substantial impact on the success of implementation. While the lessons are consistent with commonly recognized ingredients of successful implementation efforts, the examples highlight the fact that, even with a thorough knowledge of the literature and thoughtful planning, unexpected circumstances arise during implementation efforts that require flexibility and adaptability. The findings stress the importance of utilizing formative evaluation techniques to identify barriers to successful implementation and strategies to address these barriers. [ABSTRACT FROM AUTHOR]

This paper addresses two seeming paradoxes in the realm of employer-provided health insurance: First, businesses consistently claim that they bear the burden of the insurance they provide for employees, despite theory and empirical evidence indicating that workers bear the full incidence. Second, benefit generosity and the percentage of premiums paid by employers have decreased in recent decades, despite the preferential tax treatment of employer-paid benefits relative to wages-trends unexplained by the standard incidence model. This paper offers a revised incidence model based on nominal wage rigidity, in an attempt to explain these paradoxes. The model predicts that when the nominal wage constraint binds, some of the burden of increasing insurance premiums will fall on firms, particularly small companies with low-wage employees. In response, firms will reduce employment, decrease benefit generosity, and require larger employee premium contributions. Using Current Population Survey data from 2000-2001, I find evidence for this kind of wage rigidity and its associated impact on the employment and premium contributions of low-wage insured workers during a period of rapid premium growth. [ABSTRACT FROM AUTHOR]

This paper examines the effects of conversions between For-Profit and Not-For-Profit forms on quality of medical care in California hospitals. The sample includes elderly patients treated in California's private hospitals from 1990 to 1998 for Acute Myocardial Infarction and Congestive Heart Failure. The results suggest that converted hospitals have experienced quality changes before conversion and that ignoring these changes may bias the estimates of conversion effects. Both conversions are found to have some adverse consequences: Hospitals that converted to FP form show an increase in AMI mortality rates, while those converted to NFP status indicate an increase in CHF mortality outcomes. [ABSTRACT FROM AUTHOR]

The discovery of mutations in cancer genes has advanced our understanding of cancer. These results are dispersed across the scientific literature and with the availability of the human genome sequence will continue to accrue. The COSMIC (Catalogue of Somatic Mutations in Cancer) database and website have been developed to store somatic mutation data in a single location and display the data and other information related to human cancer. To populate this resource, data has currently been extracted from reports in the scientific literature for somatic mutations in four genes, BRAF, HRAS, KRAS2 and NRAS. At present, the database holds information on 66 634 samples and reports a total of 10 647 mutations. Through the web pages, these data can be queried, displayed as figures or tables and exported in a number of formats. COSMIC is an ongoing project that will continue to curate somatic mutation data and release it through the website. [ABSTRACT FROM AUTHOR]

Purpose: There is a considerable body of literature relating to trabeculectomy, however there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we present the reported complications of first-time trabeculectomy from a nationally representative cohort of patients with chronic open angle glaucoma.Methods: Cross-sectional study of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases with chronic open angle glaucoma according to study eligibility criteria and data were collected by self-administered questionnaire.Follow-up: one year post-trabeculectomy.Main Outcome Measures: occurrence of early and late complications.Results: Clinical outcome data were available for 1240 (85.3%) of cases. Early complications were reported in 578 (46.6%) cases and late complications in 512 (42.3%) cases. Some cases had more than one complication. The most frequent early complications were hyphaema (n = 304, 24.6%), shallow anterior chamber (n = 296, 23.9%), hypotony (n = 296, 24.3%), wound leak (n = 216, 17.8%) and choroidal detachment (n = 175, 14.1%). The most frequent late complications were cataract (n = 251, 20.2%), visual loss (n = 230, 18.8%) and encapsulated bleb (n = 42, 3.4%). The occurrence of most complications was not associated with a consultant's specialist interest, level of activity, type of hospital or region. Encapsulated bleb was reported more frequently in a university hospital setting.Conclusions: The complication rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. These are similar to previous published studies and highlight in particular, the impact of trabeculectomy on visual acuity in the first year following surgery. This survey provides valid and clinically relevant data on the complications of trabeculectomy for the production of guidelines and standards for audit at regional, local and individual level. [ABSTRACT FROM AUTHOR]

This paper considers a stochastic volatility version of the Heath, Jarrow and and Morton (1992) term structure model. Market completeness is obtained by adapting the Hobson and Rogers (1998) complete stochastic volatility stock market model to the interest rate setting. Numerical simulation for a special case is used to compare the stochastic volatility model against the traditional Vasicek (1977) model. [ABSTRACT FROM AUTHOR]

The toolpath for a sharp corner is important in pocket machining during high-speed machining with numerical control. When milling a sharp corner, a longer tool engagement length generates larger engagement angle and milling force, which reduces the machining precision. To reduce the milling force at a sharp corner and clear up uncut materials, the toolpath at corners must be optimized. In this paper, a new method of generating the toolpath with circular cycle transition at a sharp corner is put forward to provide a new numerically controlled toolpath pattern for pocket milling. On the basis of a common contour-parallel toolpath, minimum radius arcs and circular cycles are added in sequence at a sharp corner. When the cutter comes to the sharp corner, the corner material is removed step by step with a sequence of circular cycles. The validity of the proposed method is confirmed through simulation and tests. The proposed toolpath method is realized by employing the Institute of Manufacturing Technology (IMT) computer-aided manufacturing (CAM) system. The toolpaths at sharp corners generated through commercial software and IMT-CAM software are tested by comparing the corresponding milling forces. It is illustrated in the results that the proposed method reduces the milling force effectively and is of great significance when it is applied in high-speed machining. [ABSTRACT FROM AUTHOR]

Among the many kinds of networking technologies, the wireless ad hoc network is an important one for creating high-performance ubiquitous computing systems. The availability of a wireless ad hoc network (WANET) depends highly upon the level of node reliability. System-level fault diagnosis has long been a subject for the purpose of maintaining system reliability. This paper addresses the comparison-based approach to fault detection, and accordingly, we developed a localized algorithm for detecting faulty nodes in strongly one-step t-diagnosable WANETs. The contributions of this paper are highlighted as follows: (i) A localized fault detection algorithm is proposed for strongly one-step t-diagnosable WANETs under the comparison model, (ii) the proposed algorithm is formally proved, and it incurs only linear time complexity, which is relatively efficient compared to some others in literature, and (iii) some examples are presented for clarifying how to accomplish the comparison-based fault detection process. [ABSTRACT FROM AUTHOR]

As an effective alternative approach to provide goods and services for public infrastructure, the Public Private Partnership (PPP) has been studied extensively over the past few decades. On a global scale, China and the United States have developed cooperation on PPP projects in various areas. To perform a comparative study, this paper analyzes how PPP projects work in both countries for public transportation. The basic features, types, and phases of PPPs in public transportation are introduced first, followed by a thorough discussion on their advantages and challenges. This paper adopts a case study method to analyze the achievements and problems of PPP projects in both countries and then proposes important findings and suggestions for future research. [ABSTRACT FROM AUTHOR]

Secure data transfer against the malicious attacks is an important issue in an infrastructure-less independent network called mobile ad-hoc network (MANET). Trust assurance between MANET nodes is the key parameter in the high-security provision under dynamic topology variations and open wireless constraints. But, the malicious behavior of nodes reduces the trust level of the nodes that leads to an insecure data delivery. The increase in malicious attacks causes the excessive energy consumption that leads to a reduction of network lifetime. The lack of positional information update of the nodes in ad-hoc on-demand vector (AODV) protocol during the connection establishment offers less trust level between the nodes. Hence, the trust rate computation using energy and mobility models and its update are the essential tasks for secure data delivery. This paper proposes a trust-aware ad-hoc routing (T2AR) protocol to improve the trust level between the nodes in MANET. The proposed method modifies the traditional AODV routing protocol with the constraints of trust rate, energy, mobility based malicious behavior prediction. The packet sequence ID matching from the log reports of neighbor nodes determine the trust rate that avoids the malicious report generation. Besides, the direct and indirect trust observation schemes utilization increases the trust level. Besides, the received signal strength indicator utilization determines the trusted node is within the communication range or not. The comparative analysis between the proposed T2AR with the existing methods such as TRUNCMAN, RBT, GR, FBR and DICOTIDS regarding the average end-to-end delay, throughput, false positives, packet delivery ratio shows the effectiveness of T2AR in the secure MANET environment design. [ABSTRACT FROM AUTHOR]

Over the past three decades, a variety of meta-reasoning systems which support reasoning about higher-order abstract specifications have been designed and developed. In this paper, we survey and compare four meta-reasoning systems, Twelf, Beluga, Abella and Hybrid, using several benchmarks from the open repository ORBI that describes challenge problems for reasoning with higher-order abstract syntax representations. In particular, we investigate how these systems mechanize and support reasoning using a context of assumptions. This highlights commonalities and differences in these systems and is a first step towards translating between them. [ABSTRACT FROM AUTHOR]

When to stop testing is an important aspect in software test management. This paper discusses a new approach to this problem. There are two major improvements in this approach in comparison to the earlier studies. It uses failure size proportional model to estimate the number of failures and the corresponding cost of repair. Instead of reliability it uses a new measure called attained failure size. Failure size is the probability of finding a failure causing input in the input domain. Attained failure size is the failure size at the termination of testing. The advantages of these improvements are also discussed. [ABSTRACT FROM AUTHOR]

Case studies are largely used for investigating software engineering practices. They are characterized by their flexible nature, multiple forms of data collection, and are mostly informed by qualitative data. Synthesis of case studies is necessary to build a body of knowledge from individual cases. There are many methods for such synthesis, but they are yet not well explored in software engineering. The objective of this research is to demonstrate the similarities and differences of the results and conclusions when applying three different methods of synthesis, and to discuss the challenges of synthesizing evidence from reported case studies in SE. We describe a worked example of three such methods where three independent teams synthesized two studies that investigated critical factors of trust in outsourced projects through thematic synthesis and cross-case analysis, and compared these to each other and also to an already published narrative synthesis. In addition, despite that the primary studies were well presented for synthesis, we identified challenges in the use of case studies synthesis methods related to the goals and research questions of the synthesis, the types and number of case studies, variations in context, limited access to raw data, and quality of the case studies. Thus, we recommend that the analysts should be aware of these challenges and try to account for them during the execution of the synthesis. We also recommend that analysts consider using more than one method of synthesis for sake of reliability of the results and conclusions. [ABSTRACT FROM AUTHOR]

The synchrophasor estimation offers reliable, economical, and efficient wide-area monitoring, control and protection applications for the power system. The evaluation of the performance of phasor estimation ensures the requirements of power system monitoring, control, and protection applications. This paper presents the comprehensive integrated compliance test for evaluating the performance of phasor estimation. The integrated compliance tests model the real-time operating scenario of the power system considering all steady-state and dynamic-state test conditions together. Firstly, M-class phasor estimation using the enhanced band-pass FIR filter with various window functions Rife-Vincent-class 2, Hamming, Hanning, and Blackman is presented. In addition, the frequency and rate of change of frequency (ROCOF) are calculated from the estimated phasor. Further, the comparative performance analysis for the phasor, frequency, and ROCOF estimation using an enhanced band-pass FIR filter with various window functions under standard compliance tests and integrated compliance tests is presented to demonstrate the necessity of the integrated compliance tests. [ABSTRACT FROM AUTHOR]

The converse flexoelectric effect can be applied to control thin-shell structures. In this paper, the vibration control of a conical shell with multiple flexoelectric actuators is studied. In order to investigate the actuation performance of the flexoelectric patch, this study analyzes the electric field gradient, modal forces, and displacement of a conical shell driven by the flexoelectric patch and their relationships with the design parameters. In the physical model, the AFM probe is positioned on the upper surface of the flexoelectric patch to create a high-intensity non-uniform electric field within the flexoelectric actuator. In turn, generates internal stress in the flexoelectric actuator patch through the converse flexoelectric effect. The case study shows that the high-intensity non-uniform electric field generated by the AFM probe has nearly zero contribution to the electric field in areas far from the contact point. As a result, the stress generated by the converse flexoelectric effect primarily concentrates near the AFM probe, with the size and shape of the flexoelectric patches having minimal influence on the actuation. Based on the assumption of small deformation and linear displacement, considering the vibration control of multiple flexoelectric actuators on the truncated conical shell, the lateral displacement results controlled by multiple flexoelectric actuators can be calculated by the superposition principle. When multiple flexoelectric actuators work together, the same flexoelectric actuator in different positions may induce opposite lateral displacements at a specific point on the surface of the truncated conical shell. This can result in the cancellation of vibrational displacements produced by the flexoelectric actuators. Approximate optimal distribution positions for the multi-channel flexoelectric actuators were determined through experimental simulations. In this study, the superior vibration suppression capabilities of multi-channel flexoelectric actuators are highlighted through a comparative analysis with single-channel configurations, demonstrating their effectiveness in controlling complex vibration modes in conical shell structures. [ABSTRACT FROM AUTHOR]

In this paper, two step-down converters with a high reduction ratio based on the concept of switched inductors and switched capacitors are analyzed, modeled, and controlled. These topologies can achieve a high-voltage step-down ratio compared to a conventional buck converter. The proposed topologies have the same conversion ratio in terms of the duty cycle, however, they have different operating principles, and thus, different design, modeling, and control strategies must be followed. Therefore, the guidelines for the design of these types of converters are proposed here. Furthermore, to show the benefits of selected topologies, a comparison between them and other topologies with similar voltage ratios is presented. The comparison is made regarding the number of semiconductors, number of passive elements, and switch electrical stress. Besides, model-based control strategies are proposed for both converters. The modeling process yields a second-order system for the switched inductor-based converter structure and a fourth-order system for the switched capacitor-based converter. Based on these models, control laws are designed resulting in multi-loop controllers, formed by inner and outer control loops. These control schemes are aimed to guarantee output voltage regulation and, therefore, zero steady-state error of the states in each system. Finally, the performance of the proposed control strategies and converters is evaluated on an experimental setup. [ABSTRACT FROM AUTHOR]

The consensus reaching process (CRP) is often utilized to mitigate conflicts among decision makers and help them reach an agreement. Almost all existing CRP models focused on obtaining a consensual complete ranking of alternatives. However, in many situations, it may be sufficient to classify alternatives into a number of ordinal classes rather than a complete ranking. To this end, this study proposes an ordinal classification-based CRP (OCCRP) with the aim to generate consensual ordinal classes of alternatives. Further, this study investigates the OCCRP in the large-scale multi-attribute group decision making context, in which flexible linguistic expression is used to model uncertain opinions of decision makers. In the OCCRP, an approach is proposed to manage flexible linguistic expression by transforming it into linguistic distribution assessment. Then, an opinion clustering and aggregation approach is used to deal with the assessment information of the large group. Next, an approach-based technique for order performance by similarity to ideal solution is used to obtain the ordinal classification of alternatives. Following this, a feedback adjustment mechanism is presented to help decision makers improve their consensus level on the ordinal classification of alternatives. Finally, a numerical example about grape wine grading problem and a comparative analysis are presented to demonstrate the validity of the proposal. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting one in five women of reproductive age. Polycystic appearance of the ovaries in ultrasonography is associated with oligomenorrhea, and clinical and or biochemical hyperandrogenism. PCOS has been associated with voice alterations for many years. However, there is insufficient research on voice analysis in PCOS patients. Objectives: This research aimed to examine the voice characteristics among women with PCOS. Patients and methods: Our study included 25 women confirmed with PCOS and 25 control. A complete voice assessment was performed for all participants using primary demographic data, vocal symptoms, auditory perceptual evaluation of the voice, Arabic version of the Voice Handicap Index, acoustic analysis, and video laryngoscopic examination of the larynx. Results: Our study revealed statistically significant differences between PCOS and control groups in phonasthenic symptoms, auditory perceptual assessment of the voice, acoustic parameters, and laryngoscopic examination. Conclusion: PCOS women with hirsutism are complaining of vocal symptoms, changes in vocal characters, and deterioration of the acoustic parameters of the voice. High serum levels of androgen can cause the deepening of the voice, which is essential for the early detection of vocal symptoms in PCOS patients to prevent virilization of their voice. Trial registration: NCT06085170. Registered 20 August 2023—retrospectively registered, https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://classic.clinicaltrials.gov/ct2/show/NCT06085170&ved=2ahUKEwjEyLqUq6KGAxWxRPEDHb57DIQQFnoECBQQAQ&usg=AOvVaw1xTurnA6mJEZ9PK0vQS8VL. [ABSTRACT FROM AUTHOR]

Background: Previous research has suggested that alternative (respiratory) care providers (ACP) may provide affordable, accessible care for sleep-disordered breathing (SDB) that decreases wait-times and improves clinical outcomes. The objective of this study was to compare ACP-led and sleep physician-led care for SDB on patient reported outcome and experiences, with a focus on general and health-related quality of life, sleepiness, and patient satisfaction. Methods: We conducted a secondary analysis of a randomized trial in which participants with severe SDB were assigned to either ACP-led or physician-led management. We created longitudinal linear mixed models to assess the impacts of treatment arm and timepoint on total and domain-level scores of multiple patient-reported outcome measures and patient-reported experience measures. Results: Patients in both treatment arms (ACP-led n = 81; sleep-physician = 75) reported improved outcomes on the Sleep Apnea Quality of Life Index, Health Utilities Index, and Epworth Sleepiness Scale. Patients in each group had similar and clinically meaningful improvements on domains assessing cognition, emotion, and social functioning. The linear mixed models suggested no significant difference between treatment arms on the patient-reported outcomes. However, scores significantly improved over time. Conclusions: Management of SDB using ACPs was comparable to physician-led care, as measured bypatient-reported outcome and experience measures. While loss to follow-up limits our findings, these results provide some support for the use of this novel health service delivery model to improve access to high quality SDB care. Clinical trial registration: This is analysis of data from the study registered Clinicaltrials.gov (NCT02191085). [ABSTRACT FROM AUTHOR]

Detection and Dissection of Anomalous Tissue Domains (DDATD) from multi-sample spatial transcriptomics (ST) data provides unprecedented opportunities to characterize anomalous tissue domains (ATDs), revealing both population-level and individual-specific pathogenic factors for understanding pathogenic heterogeneities behind diseases. However, no current methods can perform de novo DDATD from ST data, especially in the multi-sample context. Here, we introduce STANDS, an innovative framework based on Generative Adversarial Networks which integrates three core tasks in multi-sample DDATD: detecting, aligning, and subtyping ATDs. STANDS incorporates multimodal-learning, transfer-learning, and style-transfer techniques to effectively address major challenges in multi-sample DDATD, including complications caused by unalignable ATDs, under-utilization of multimodal information, and scarcity of normal ST datasets necessary for comparative analysis. Extensive benchmarks from diverse datasets demonstrate STAND's superiority in identifying both common and individual-specific ATDs and further dissecting them into biologically distinct subdomains. STANDS also provides clues to developing ATDs visually indistinguishable from surrounding normal tissues. The authors introduce STANDS, a GAN-based framework that integrates three core tasks for the multi-sample detection and dissection of anomalous tissue domains from spatial transcriptomics data, revealing pathogenic heterogeneity behind diseases. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of auditory neuropathy spectrum disorder (ANSD) is based on the existence of cochlear microphonics or otoacoustic emissions, as well as aberrant or nonexistent-evoked auditory brainstem responses. The outcomes of cochlear implantation (CI) are thought to be significantly influenced by genetic reasons in ANSD. Objective: The purpose of this systematic review was to gather more information regarding the relationship between various genetic variants and the outcomes of cochlear implantation in adult and pediatric patients with ANSD (both syndromic and non-syndromic). Methods: Electronic databases "Medline/PubMed, Google Scholar, ScienceDirect, Europe PMC, and Cochrane Library" were searched for this systematic review. For cohort studies, the Newcastle–Ottawa scale (NOS score) was used to assess the quality of the retrieved research. The standardized mean difference produced by the Cohen's d or Hedges' g tests was used to assess the effect size measure. Results: This comprehensive study showed that OTOF, GJB2, ATPA3, and OPA1 were among the genetic variants with improved CI outcomes. On the other hand, other genetic mutations displayed variable results (TMPRSS3) or worse CI outcomes (PJVK). For OTOF mutations, CI had a moderate effect (Hedges' g = 0.7), which led to good cochlear implant outcomes. The results of the GJB2 cochlear implant showed a significant effect size when pre- and post-implant assessments were compared. The results of CI for TMPRSS3 mutations were inconsistent, with one study demonstrating a negligible effect (Hedges' g = 0.2), and another study found a negative impact (Hedges' g = − 2.17). Poor CI results were indicated by PJVK mutations impacting CI outcomes. A significant impact was observed when comparing pre- and postimplantation outcomes (Cohen's d > 1) in cases of ATP1A3 mutations (CAPOS syndrome) and OPA1 mutations. In addition, early implantation produced better results than late implantation in certain genetic variations. Conclusion: Some genetic variants, such as OTOF, GJB2, ATPA3, and OPA1, had improved CI outcomes, according to data extraction and synthesis of the systematic review's findings. Conversely, PJVK displayed worse CI results and inconsistent results for TMPRSS3 genetic mutations. [ABSTRACT FROM AUTHOR]

Chemokine receptor CXCR4 is involved in diverse diseases. A comparative study was conducted on CXCR4 embedded in a POPC lipid bilayer binding with CXCL12 in full and truncated forms, hBD-3 in wildtype, analog, and mutant forms based on in total 63 µs all-atom MD simulations. The initial binding structures of CXCR4 with ligands were predicted using HADDOCK docking or random-seed method, then μs-long simulations were performed to refine the structures. CXCR4&ligand binding structures predicted agree with available literature data. Both kinds of ligands bind stably to the N-terminus, extracellular loop 2 (ECL2), and ECL3 regions of CXCR4; the C2-C3 (K32-R38) region and occasionally the head of hBD-3 bind stably with CXCR4. hBD-3 analogs with Cys11-Cys40 disulfide bond can activate CXCR4 based on the Helix3-Helix6 distance calculation, but not other analogs or mutant. The results provide insight into understanding the dynamics and activation mechanism of CXCR4 receptor binding with different ligands. The chemokine receptor CXCR4 is involved in cancers and diverse diseases, however, molecular details surrounding the binding of different ligands to this receptor remain incomplete. Here, the authors study the binding and interaction between CXCR4 with CXCL12 and hBD-3 in different forms, and find that both ligands can bind with CXCR4 at the same site, and analogs of hBD-3 with a Cys11-Cys40 disulfide bond can activate CXCR4. [ABSTRACT FROM AUTHOR]

Simarouba, a neotropical genus in the family Simaroubaceae, currently lacks comprehensive genomic data in existing databases. This study aims to fill this gap by providing genomic resources for three Simarouba species, S. amara, S. versicolor, and S. glauca. It also aims to perform comparative molecular evolutionary analyses in relation to other species within the order Sapindales. The analysis of these three Simarouba species revealed the presence of the typical quadripartite structure expected in plastomes. However, some pseudogenization events were identified in the psbC, infA, rpl22, and ycf1 genes. In particular, the CDS of the psbC gene in S. amara was reduced from 1422 bp to 584 bp due to a premature stop codon. Nucleotide diversity data pointed to gene and intergenic regions as promising candidates for species and family discrimination within the group, specifically matK, ycf1, ndhF, rpl32, petA-psbJ, and trnS-trnG. Selection signal analyses showed strong evidence for positive selection on the rpl23 gene. Phylogenetic analyses indicated that S. versicolor and S. glauca have a closer phylogenetic relationship than S. amara. We provide chloroplast genomes of three Simaruba species and use them to elucidate plastome evolution, highlight the presence of pseudogenization, and identify potential DNA barcode regions. [ABSTRACT FROM AUTHOR]

Prediction of water-conducting fractured zone (WCFZ) of mine overburden is the premise for reducing or eliminating water inrush hazards in undersea mining. To obtain a more robust and precise prediction of WCFZ in undersea mining, a WCFZ prediction dataset with 122 cases of fractured zones was constructed. Five machine learning algorithms (linear regression, XGBRegressor, RandomForestRegressor, LineareSVR, and KNeighborsRegressor) were employed to develop five corresponding predictive models, taking multiple factors into account.The optimal parameters for each model are obtained through ten-fold cross-validation (10CV). The model's predictive performance was validated and assessed using two metrics, namely the coefficient of determination (R2) and mean squared error (MSE). A comparison was made with the regression performance of commonly used empirical formulas. The results indicate that the constructed model outperforms reliance solely on theoretical criteria, showing a high R2 value of up to 0.925 and a low MSE value of 3.61. The proposed model was validated in a recently established mining area on Sanshan Island, China. It shows low absolute and relative errors of 0.71 m and 2.01%, respectively, between the predicted value from the model and observation result from the field, demonstrating a high level of consistency with on-site conditions. This paves a path to leveraging machine learning algorithms for predicting the height of WCFZ. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to the proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance. Utilizing a benchmark dataset, MedReview, consisting of 8161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the performance of open-source models was all improved after fine-tuning. The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were manifested in both a human evaluation and a larger-scale GPT4-simulated evaluation. [ABSTRACT FROM AUTHOR]

Background: Data regarding rural youths' experience with firearms, including safety training, is highly limited despite their frequent presence in homes. Our objective was to investigate rural adolescents' use of firearms and whether they had received formal firearm training. Methods: A convenience sample of 2021 National FFA (formerly Future Farmers of America) Convention & Expo attendees were given an anonymous survey at the University of Iowa Stead Family Children's Hospital injury prevention booth. The survey explored their use of rifles/shotguns and handguns and whether they had completed a certified firearm safety course. Descriptive and comparative analyses, including multivariable logistic regression analyses, were performed on compiled data. Results: 3206 adolescents ages 13–18 years participated with 45% reporting they lived on a farm or ranch. The vast majority of participants (85%) had fired a rifle/shotgun; 43% reported firing them > 100 times. Of those that had fired rifles/shotguns, 41% had done so before 9 years old. Most had also fired a handgun (69%), with 23% having fired handguns > 100 times. Of those that had fired handguns, 44% had done so before 11 years. Average age for first firing rifles/shotguns was 9.5 (SD 3.1) years, and 11.1 (SD 3.0) years for handguns. Males, non-Hispanic Whites, and those living on farms or in the country had significantly greater percentages who had fired a rifle/shotgun or a handgun. Significant differences were also seen by U.S. census region. Over half (64%) reported having gone hunting. Of those that had used a firearm, 67% had completed a firearm safety training course. Overall, 23% were/had been members of a school or club shooting team and of these, 87% had taken a safety course. Conclusions: Most FFA member participants had fired both rifles/shotguns and handguns, many at very young ages. Significant differences in firearm use were noted by demographic factors including the home setting (i.e., farms and ranches) and their U.S. census region. Nearly one-third of adolescent firearm users had not received formal safety training. Promoting firearm safety should include advising families on when it is developmentally appropriate to introduce youth to firearms and on the importance of firearm safety training. [ABSTRACT FROM AUTHOR]

Introduction: A dynamic molecular biomarker that can identify early efficacy of immune checkpoint inhibitor (ICI) therapy remains an unmet clinical need. Here we evaluate if a novel circulating tumor DNA (ctDNA) assay, xM, used for treatment response monitoring (TRM), that quantifies changes in ctDNA tumor fraction (TF), can predict outcome benefits in patients treated with ICI alone or in combination with chemotherapy in a real-world (RW) cohort. Methods: This retrospective study consisted of patients with advanced cancer from the Tempus de-identified clinical genomic database who received longitudinal liquid-based next-generation sequencing. Eligible patients had a blood sample ≤ 40 days prior to the start of ICI initiation and an on-treatment blood sample 15–180 days post ICI initiation. TF was calculated via an ensemble algorithm that utilizes TF estimates derived from variants and copy number information. Patients with molecular response (MR) were defined as patients with a ≥ 50% decrease in TF between tests. In the subset of patients with rw-imaging data between 2 and 18 weeks of ICI initiation, the predictive value of MR in addition to rw-imaging was compared to a model of rw-imaging alone. Results: The evaluable cohort (N = 86) was composed of 14 solid cancer types. Patients received either ICI monotherapy (38.4%, N = 33) or ICI in combination with chemotherapy (61.6%, N = 53). Patients with MR had significantly longer rw-overall survival (rwOS) (hazard ratio (HR) 0.4, P = 0.004) and rw-progression free survival (rwPFS) (HR 0.4, P = 0.005) than patients with molecular non-response (nMR). Similar results were seen in the ICI monotherapy subcohort; HR 0.2, P = 0.02 for rwOS and HR 0.2, P = 0.01 for rwPFS. In the subset of patients with matched rw-imaging data (N = 51), a model incorporating both MR and rw-imaging was superior in predicting rwOS than rw-imaging alone (P = 0.02). Conclusions: xM used for TRM is a novel serial quantitative TF algorithm that can be used clinically to evaluate ICI therapy efficacy. [ABSTRACT FROM AUTHOR]

The study probes comparative and additional value relevance of total comprehensive income and other comprehensive income, respectively, in the Indian context after adopting IFRS-converged accounting standards. The study sample comprises of 367 Indian non-financial companies. The period of study is F.Y. 2016–2017 to F.Y. 2019–2020. Results reveal both net profit and total comprehensive are value relevant, but the supremacy of neither of the two could be established based on our findings. Furthermore, other comprehensive income comes out to be additionally value relevant. The study's findings determine the decision usefulness of OCI and thus, provide useful insights to standard setting bodies. [ABSTRACT FROM AUTHOR]

Diabetic macular edema (DME) has emerged as the foremost cause of vision loss in the population with diabetes. Early detection of DME is paramount, yet the prevailing screening, relying on two-dimensional and labor-intensive fundus photography (FP), results in frequent unwarranted referrals and overlooked diagnoses. Self-imaging optical coherence tomography (SI-OCT), offering fully automated, three-dimensional macular imaging, holds the potential to enhance DR screening. We conducted an observational study within a cohort of 1822 participants with diabetes, who received comprehensive assessments, including visual acuity testing, FP, and SI-OCT examinations. We compared the performance of three screening strategies: the conventional FP-based strategy, a combination strategy of FP and SI-OCT, and a simulated combination strategy of FP and manual SD-OCT. Additionally, we undertook a cost-effectiveness analysis utilizing Markov models to evaluate the costs and benefits of the three strategies for referable DR. We found that the FP + SI-OCT strategy demonstrated superior sensitivity (87.69% vs 61.53%) and specificity (98.29% vs 92.47%) in detecting DME when compared to the FP-based strategy. Importantly, the FP + SI-OCT strategy outperformed the FP-based strategy, with an incremental cost-effectiveness ratio (ICER) of $8016 per quality-adjusted life year (QALY), while the FP + SD-OCT strategy was less cost-effective, with an ICER of $45,754/QALY. Our results were robust to extensive sensitivity analyses, with the FP + SI-OCT strategy standing as the dominant choice in 69.36% of simulations conducted at the current willingness-to-pay threshold. In summary, incorporating SI-OCT into FP-based screening offers substantial enhancements in sensitivity, specificity for detecting DME, and most notably, cost-effectiveness for DR screening. [ABSTRACT FROM AUTHOR]

Dementia represents a significant global health challenge, with early screening during the preclinical stage being crucial for effective management. Traditional diagnostic biomarkers for Alzheimer's Disease, the most common form of dementia, are limited by cost and invasiveness. Mild cognitive impairment (MCI), a precursor to dementia, is currently identified through neuropsychological tests like the Montreal Cognitive Assessment (MoCA), which are not suitable for large-scale screening. Eye-tracking technology, capturing and quantifying eye movements related to cognitive behavior, has emerged as a promising tool for cognitive assessment. Subtle changes in eye movements could serve as early indicators of MCI. However, the interpretation of eye-tracking data is challenging. This study introduced a dementia screening tool, VR Eye-tracking Cognitive Assessment (VECA), using eye-tracking technology, machine learning, and virtual reality (VR) to offer a non-invasive, efficient alternative capable of large-scale deployment. VECA was conducted with 201 participants from Shenzhen Baoan Chronic Hospital, utilizing eye-tracking data captured via VR headsets to predict MoCA scores and classify cognitive impairment across different educational backgrounds. The support vector regression model employed demonstrated a high correlation (0.9) with MoCA scores, significantly outperforming baseline models. Furthermore, it established optimal cut-off scores for identifying cognitive impairment with notable sensitivity (88.5%) and specificity (83%). This study underscores VECA's potential as a portable, efficient tool for early dementia screening, highlighting the benefits of integrating eye-tracking technology, machine learning, and VR in cognitive health assessments. [ABSTRACT FROM AUTHOR]

Background: Fluid administration is the first line treatment in intensive care unit (ICU) patients with sepsis and septic shock. While fluid boluses administration can be titrated by predicting preload dependency, the amount of other forms of fluids may be more complex to be evaluated. We conducted a retrospective analysis in a tertiary hospital, to assess the ratio between fluids given as boluses and total administered fluid intake during early phases of ICU stay, and to evaluate the impact of fluid strategy on ICU mortality. Data related to fluid administration during the first four days of ICU stay were exported from an electronic health records system (ICCA®, Philips Healthcare). Demographic data, severity score, norepinephrine dose at ICU admission, overall fluid balance and the percentage of different fluid components of the overall volume administered were included in a multivariable logistic regression model, evaluating the association with ICU survival. Results: We analyzed 220 patients admitted with septic shock and sepsis-induced hypotension from 1st July 2021 to 31st December 2023. Fluid boluses and maintenance represented 49.3% ± 22.8 of the overall fluid intake, being balanced solution the most represented (40.4% ± 22.0). The fluid volume for drug infusion represented 34.0% ± 2.9 of the total fluid intake, while oral or via nasogastric tube fluid intake represented 18.0% ± 15.7 of the total fluid intake. Fluid volume given as boluses represented 8.6% of the total fluid intake over the four days, with a reduction from 25.1% ± 24.0 on Day 1 to 4.8% ± 8.7 on Day 4. A positive fluid balance [OR 1.167 (1.029–1.341); p = 0.021] was the most important factor associated with ICU mortality. Non-survivors (n = 66; 30%) received a higher amount of overall inputs than survivors only on Day 1 [2493 mL vs. 1855 mL; p = 0.022]. Conclusions: This retrospective analysis of fluids given over the early phases of septic shock and sepsis-induced hypotension showed that the overall volume given by boluses ranges from about 25% on Day 1 to about 5% on Day 4 from ICU admission. Our data confirms that a positive fluid balance over the first 4 days of ICU is associated with mortality. [ABSTRACT FROM AUTHOR]

Background: Many individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis. Methods: The traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7). Results: A total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score (r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score (p < 0.001), bother/concern domain score (p < 0.001), and total score (p < 0.001), each demonstrating a moderate Cohen's d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach's alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen's d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males. Conclusions: The ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL. [ABSTRACT FROM AUTHOR]

Septoplasty is one of the most frequently performed surgical procedures in otorhinolaryngology to overcome nasal obstruction. Following septal surgery, nasal packs are commonly inserted by surgeons to support and appose septal flaps the types of which depend on the preference and experience of the surgeon. Background We conducted a study to compare the Merocel sponge with that of a newly developed septal clip with the splint in patients who underwent septoplasty or submucosal resection to find out which one is better. A total of 50 patients were included in the study over a period of 3 years. Patients were divided into 2 groups of 25 each where group M is for patients receiving Merocel after surgery and group C is for patients receiving septal clips with splints. Aim The aim of this study was to assess and compare the effects of a Merocel pack on nasal functions with that of the septal clip and their eventual complications and outcome in the post-operative period. Results The main observations that were found in both groups in the immediate postoperative period were (1) pain (2) nasal obstruction (3) sleep disturbance (4) headache (5) epiphora (6) dryness of mouth and (7) postnasal drip. Pain was mild to moderate in the case of group M (MPS was 2.4) and moderate to severe degree in the case of group C (MPS was 5.7). Nasal obstruction was more common in Merocel group patients. Sleep disturbance, headache, epiphora, post-nasal drip, and dryness of mouth were also more in the Merocel group. After pack removal in both groups, the nasal examination was done to see crusts, vestibulitis, and septal ulcers. All these findings were more in the septal clip with the splint group. Conclusions It was observed that Merocel nasal packing causes significant morbidity and discomfort in the immediate post-operative period as compared to septal clips. It is also expensive. The new septal clips with splints can be used as an effective alternative to Merocel for approximation of flaps after septal surgery. [ABSTRACT FROM AUTHOR]