Search

To compare and evaluate early and midterm outcomes of a novel no cross approach with short tip vs. standard tip introducer systems for all distal components to prevent target vessel bridging stent kink or collapse during fenestrated endovascular aortic repair (FEVAR). A retrospective analysis was conducted on all patients who underwent FEVAR at a tertiary referral centre between October 2016 and July 2022. The inclusion criterion was the use of renal artery fenestrations. Patients who had chronic dissections were included. Endpoints were analysed in two groups comprising the no cross group and the standard group, with all cases being consecutive in their respective groups. Cone beam computed tomography was used intra-operatively in all cases, and post-operative computed tomography angiograms and re-interventions were reviewed. Primary endpoints included technical success, intra-operative adjunctive procedures, adverse events related to the fenestration, and re-interventions, while secondary endpoints were secondary interventions and overall mortality rate. Seventy patients (35 in each group) were enrolled in the study, with 64 (91%) having juxtarenal aneurysms. There were no differences in demographics, cardiovascular risk factors, or aneurysm characteristics between the two groups. The no cross group demonstrated a significantly higher technical success rate (100% in all cases) compared with the standard group (29 cases, 83%; p =.010). Additionally, there were statistically significantly fewer intra-operative adjunctive procedures required in the no cross group (1.5% of fenestrations) compared with the standard group (8.2% of fenestrations) (p =.013). The overall median follow up was 32 months (interquartile range 22, 62 months). Implementation of a novel no cross concept during FEVAR, using a short dilator introducer tip on the distal bifurcated component and iliac extensions, significantly reduced intra-operative fenestration related adverse events and enhanced technical success. Further studies with larger patient populations and longer follow up are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

This study aimed to report the initial experience with a novel bidirectional double cuff inner branch design for incorporation of renal and mesenteric arteries in patients undergoing fenestrated and branched endovascular aortic repair (F/BEVAR). A retrospective review was undertaken of the experience of F/BEVAR with grafts integrating at least one bidirectional double cuffed inner branch implanted at three tertiary aortic centres between March 2022 and June 2023. All consecutive patients were included. Baseline characteristics, operative data, and follow up data were collected. Results were presented as number or median (interquartile range) unless otherwise stated. Thirteen patients (10 male; median age 72 [68, 77] years) had F/BEVAR using a total of 15 bidirectional double cuffed inner branches (30 cuffs). Indications for bidirectional doubled cuffed inner branches included cranial vessel orientation or double renal arteries in four patients each, common coeliomesenteric trunk in three patients, and early renal artery bifurcation, renal artery origin from a false lumen requiring a flexible route for catheterisation, and surplus configuration in one patient each. Twenty three of the 30 cuffs were used, whereas the remaining seven cuffs were intentionally occluded with vascular plugs. Target vessel incorporation was successful in all bidirectional branches. There was one technical failure related to unsuccessful catheterisation of a left renal artery targeted through a unidirectional caudal inner branch. During a median follow up of seven months there were no instances of target vessel instability or re-interventions and two patients died of causes unrelated to the bidirectional branches. The results of the use of bidirectional double cuff inner branches are promising, with high technical success and no short term branch related complications in this preliminary experience. This could potentially expand the applicability of branch endografting of complex endovascular aortic repairs, but long term results are still missing. [ABSTRACT FROM AUTHOR]

Surgeons face unique challenges in perioperative decision-making and communication with patients and families. In cardiothoracic surgery, the stakes are high, life and death decisions must be made quickly, and surgeons often lack a longstanding relationship with patients and families prior to intervention. This review considers specific challenges in the preoperative period followed by those faced postoperatively. While preoperative deliberation and informed consent focus on reaching a decision between 2 or more alternative approaches, the most vexing postoperative decisions often involve the patient's discontent with the best-case outcome or how to ensure goal-concordant care when complications arise. This review explores the preoperative ethical and legal requirement for informed consent by describing the contemporary preferred method, shared decision-making. We also present a framework to optimize surgeon communication and promote patient and family engagement in the setting of high-risk surgery for older patients with serious illness. In the postoperative period the family is often tasked with deciding what to do about major complications when the patient has lost decision-making capacity. We discuss several examples and offer strategies for surgeons to navigate these challenging situations. We also explore the concepts of clinical heroism and futility in relation to communicating with patients and families about the outcomes of surgery. Persistent ethical challenges in decision-making suggest that surgeons should improve their skills in communicating with patients to better engage with them, both before and after surgery. [ABSTRACT FROM AUTHOR]

This study examines the relationships between business analytics (BA) adoption, individual net benefits, and firm performance. A PLS-SEM approach was employed to analyze the data. The results reveal that BA adoption positively influences both individual net benefits and firm performance. Moreover, individual net benefits were found to have a positive effect on firm performance. These findings underscore the significance of BA in enhancing employee outcomes and organizational success. The study contributes to the growing body of literature on BA by providing empirical evidence of its impact on individual and organizational levels, highlighting the importance of data-driven decision-making in contemporary business environments. [ABSTRACT FROM AUTHOR]

Over the years, there is a rapid increase in the prevalence of inadequate sleep and its detrimental consequences. Yet, the impact of prolonged nutritional interventions on sleep optimization remains unexplored. To examine the effect of carbohydrate manipulation combined with exercise training on sleep macro-structure. Forty-two healthy, trained male volunteers were recruited for this study. The 4-week intervention consisted of three groups: i) Sleep Low-No Carbohydrates (SL-NCHO): participants consumed all their carbohydrate intake at regular intervals prior to evening training, ii) Sleep High-Low Glycemic Index (SH-LGI) and iii) Sleep High–High Glycemic Index (SH-HGI): Carbohydrate intake was spread throughout the day, both prior (60% of total CHO intake) and after evening training (40% of total CHO intake). The SH-LGI and SH-HGI groups differentiated by consuming either LGI or HGI foods in the evening, respectively. Alongside, participants performed a standardized exercise program combining resistance exercise and high-intensity interval training. Participants' sleep macro-structure was assessed with polysomnography, actigraphy, sleep diary, and sleep-wake questionnaires. Objective assessments revealed a substantial time-effect on sleep initiation, duration, and continuity. After the intervention, sleep onset latency decreased (p < 0.001), sleep duration was prolonged (p = 0.006), sleep efficiency increased (p < 0.001), and wake after sleep onset decreased (p = 0.035). Sleep macroarchitecture did not significantly change, while the percentage of REM sleep stage to the total sleep time increased over time (p < 0.01). Consistent with the objective findings, subjects reported improved subjective sleep quality (p = 0.043) and reduced daytime sleepiness (p = 0.047). The combination of a personalized dietary plan with exercise training enhances sleep initiation, sleep continuity, sleep duration, REM and N1 sleep stages, independently of carbohydrate type or timing. Lifestyle interventions should be investigated further to promote sleep quality and recovery. The trial was registered at clinicaltrials.gov as NCT05464342. [ABSTRACT FROM AUTHOR]

As the usage of information and communication technology (ICT) solution have been exploded in the last decades, the research community exhibits a deficiency in terms of methodologies for accurately quantifying the energy consumption of individual ICT components. This paper presents a novel methodology aimed at addressing the existing research gap by offering a comprehensive analysis of energy consumption ranges for ICT components, measured in Watt. The methodology being proposed involves the classification of ICT components into distinct classes, namely sensors, gateways, servers-platforms, and databases, while these classes are further subdivided into sub-classes. The calculation of energy consumption places emphasis on particular components within each sub-class, encompassing CPUs, RAM, GPUs, hard drives, network switches, cooling systems, and communication units. Compared with existing green ICT standards where mainly focused on strategy-related recommendations, the methodology utilises manufacturers' specifications for standard operational procedures in order to compute energy consumption. The objective of the methodology is to extend the current research and provide countable energy consumption attributes of various component types, that are used in the ICT architecture, supporting the decision-making process of architects regarding environmentally sustainable and high-performance device selection. This study concludes with the development of a tree diagram for calculating the energy consumption of an ICT system. [ABSTRACT FROM AUTHOR]

The traditional treatment paradigm for patients with locally advanced rectal cancers has been neoadjuvant chemoradiation followed by curative intent surgery and adjuvant chemotherapy. This study aimed to assess surgery trends for locally advanced rectal cancers, factors associated with forgoing surgery, and overall survival outcomes. Adults with locally advanced rectal cancers were retrospectively analyzed using the National Cancer Database (2004–2019). Propensity score matching was performed. Factors associated with not undergoing surgery were identified using multivariable logistic regression. Kaplan–Meier and log-rank tests were used for 5-year overall survival analysis, stratified by stage and treatment type. A total of 72,653 patients were identified, with 64,396 (88.64%) patients undergoing neoadjuvant + surgery ± adjuvant therapy, 579 (0.80%) chemotherapy only, 916 (1.26%) radiation only, and 6,762 (9.31%) chemoradiation only. The proportion of patients who underwent surgery declined over the study period (95.61% in 2006 to 92.29% in 2019, P trend <.001), whereas the proportion of patients who refused surgery increased (1.45%–4.48%, P trend <.001). Factors associated with not undergoing surgery for locally advanced rectal cancers included older age, Black race (odds ratio 1.47, 95% CI 1.35–1.60, P <.001), higher Charlson–Deyo score (score ≥3: 1.79, 1.58–2.04, P <.001), stage II cancer (1.22, 1.17–1.28, P <.001), lower median household income, and non-private insurance. Neoadjuvant + surgery ± adjuvant therapy was associated with the best 5-year overall survival, regardless of stage, in unmatched and matched cohorts. Despite surgery remaining an integral component in the management of locally advanced rectal cancers, there is a concerning decline in guideline-concordant surgical care for rectal cancer in the United States, with evidence of persistent socioeconomic disparities. Providers should seek to understand patient perspectives/barriers and guide them toward surgery if appropriate candidates. Continued standardization, implementation, and evaluation of rectal cancer care through national accreditation programs are necessary to ensure that all patients receive optimal treatment. [ABSTRACT FROM AUTHOR]

Injuries to the extensor mechanism of the hand and forearm are common and cause significant functional disability. Complete tendon lacerations are managed with surgical repair, whereas selected partial tendon injuries may be managed without repair but with splinting and physiotherapy alone. There is limited evidence to support the management of partial lacerations, in particular the decision of whether to repair or not. We aimed to systematically review the literature to determine the optimal management of partial extensor tendon lacerations in the hand and forearm. A protocol for the systematic review was developed prospectively and registered with PROSPERO (CRD42021250431). PubMed, EMBASE, clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1990 to 27/05/2022. 4565 studies were screened, of which 88 underwent full text review. Five studies were included, one randomised control trial and four cohort studies. One study examined outcomes of partial lacerations treated without repair; the other four studies examined outcomes following repair. Pinch and grip strength and time to return to work were similar regardless of management. Adverse outcomes were reported for patients undergoing surgical repair; none were observed in those managed without repair. Meta-analysis was precluded by study heterogeneity and high risk of bias. There is limited evidence to support the management of partial extensor tendon lacerations, with some low-quality evidence that non-operative management of selected partial lacerations is safe. There is a pressing need for pragmatic, multicentre randomised trials to assess the cost-effectiveness of current treatments. [ABSTRACT FROM AUTHOR]

Chronic health conditions (CHCs) afflict millions of individuals worldwide. One promising intervention for CHC management is Acceptance and Commitment Therapy (ACT). Current literature is limited on examining ACTs' efficacy in CHCs without following a uniform definition of CHCs, even though such definitions exist (e.g., World Health Organization). This systematic review and meta-analysis aimed to: (a) collate evidence on the efficacy of ACT vs. comparison groups (active and inactive) in well-defined CHCs on symptoms and quality of life (QoL) outcomes, and (b) identify moderators of treatment efficacy. PubMed, PsycINFO, and Scopus databases were screened, and 57 studies included in the systematic review whereas 33 studies were included in QoL meta-analysis and 45 studies in symptom improvement meta-analysis. Study quality was mostly low, with some quality criteria lacking (e.g., attrition information). Random-effects meta-analyses showed that ACT was superior to comparison groups on both QoL and symptom improvement. Specifically, subgroup analyses showed that ACT was superior to inactive (i.e., waitlist, treatment- as -usual) and some active groups (i.e., yoga, expressive writing, standardized talking, supportive treatment) on improving overall and psychological health QoL domains, and on anxiety and depression symptoms. Significant moderators of treatment efficacy included CHC type (e.g., breast cancer), setting (e.g., outpatient) and treatment format (e.g., group). Findings suggest that ACT is an efficacious treatment compared to inactive groups and some active groups, leading to improved QoL and symptoms for various CHCs. Discussion proposes areas of ACTs' impact, suggestions for future research needs and recommendations for stakeholders. • ACT is efficacious for chronic conditions with improved quality of life and symptoms. • ACT is more efficacious than waitlist control and some active groups in both outcomes. • Significant moderators included treatment format, chronic condition type and setting. • Study quality was mostly low, associated with methodological problems. [ABSTRACT FROM AUTHOR]

Anaplastic thyroid carcinoma is a rare but aggressive neoplasm that often presents as advanced inoperable disease. Patients with B-Raf proto-oncogene (BRAF) v600e mutated anaplastic thyroid carcinoma who receive neoadjuvant dabrafenib/trametinib have improved rates of microscopically margin-negative resection and durable locoregional control. However this has not been evaluated in the setting of tracheal resection and primary reconstruction. Here we demonstrate the safety and efficacy of laryngotracheal resection and reconstruction after dabrafenib/trametinib for locoregionally advanced BRAF v600e mutated anaplastic thyroid carcinoma. [ABSTRACT FROM AUTHOR]

Digital marketing has been on the epicentre of many researches. However, there is the need to make clear which are the current trends of the Digital Marketing Strategies regarding luxurious hotels. Unfortunately, the COVID-19 pandemic has seriously "damaged" the hospitality industry and it has affected the digital marketing strategies of hotels. The aim of this paper is the evaluation of the most recent applications of digital marketing and especially the social media used by luxurious hotels and their guests (such as Facebook, Trip-advisor). The outcome of the research indicates that social media play a key role on the marketing of luxurious hotels. More specifically, a hotel should take into serious consideration the reviews made on social media by customers. A review can leverage a hotel but also it can doom its reputation. For this reason, the practitioners must give special attention on the reviews that the guests post on social media. The methodology of the paper is literature review. Hence, it will rely on publications. The authors have collected publications from various academic databases, such as SCOPUS, by using the appropriate keywords. The publications were selected based on how relative are with the purpose of this paper. To sum up, the hotel industry has to face a major challenge due to COVID-19 crisis. This crisis, which is an ongoing phenomenon, is expected to change the way that hotels are copying with. One of the changes that the hotel should take into consideration is which strategy will use on social media. This paper has relied on existing theories and speculations that have been made by several authors and they have not been cross-checked with primary researches. Therefore, there is the need for more primary data coming from upcoming publications. [ABSTRACT FROM AUTHOR]

• Biochar made by using as biomass a residue of anaerobic digestion. • Anaerobic digestion of waste was aiming at producing biogas. • Waste was a mixture of corn silage, malt and cattle manure. • Biochar was made by a single pyrolysis step of the residue. • Biochar was applied as bifunctional electrocatalyst in Zn-air batteries. Biochar, the product obtained by pyrolysis of biomass, is a new eco-friendly material with excellent properties and many promising applications. Among them it can be used as cathode in Zn-air batteries with very satisfactory results The residue was obtained by anaerobic digestion of a mixture of corn silage (10%), malt (10%), and cattle manure (80%), aiming to biogas production. It was first freeze–dried and then it was subjected to pyrolysis up to 800oC. The biochar was physicochemically characterized. It has moderate specific surface area, sufficient sp2/sp3 ratio and metal and non–metal surface chemical species. The biochar demonstrated satisfactory electrocatalytic performance, both as oxygen reduction and oxygen evolution catalyst. When applied as electrocatalyst in Zn–air batteries it reached an open–circuit potential of 1.45 V, a short–circuit current density of 200 mA cm–2 and maximum power density of around 62 mW cm–2. Its energy density was 927 Wh kg–1, (at 20 mA), and 518 Wh kg–1 (at 100 mA). In a charge–discharge mode at 10 mA, the potential varied between 1.35 and 1.90 V. These data, show that the waste biomass can be used as inexpensive material for Zn–air batteries and offers a useful approach to combine waste management with energy storage. For the manuscript "Biochar from residues of anaerobic digestion and its application as electrocatalyst in Zn-air batteries", by Pergamalis et al. [Display omitted] [ABSTRACT FROM AUTHOR]

Digital platforms are arguably instrumental for the Circular Economy (CE), yet they frequently fail to deliver. An increasingly popular strategy for developing digital platforms is corporate incubation, where corporations invest in startups. Prior research has nonetheless paid scant attention to the role of corporate incubation in the evolution of digital platforms over time. To shed light on this, we conducted a qualitative case study of a digital platform incubated by one of the largest construction firms in Europe in the context of corporate incubation. Building on prior research suggesting that platform growth and platform scaling are distinct but often conflated phenomena, our analysis reveals four mechanisms through which corporate incubation enables platform growth and (ii) unpacks its role in transitioning to platform scaling. Drawing on boundary work theory, we offer a model explaining how the boundary work frames of organizational actors involved in corporate incubation influence the evolution of digital platforms over time. Our study contributes to the literature on digital platforms for CE by establishing corporate incubation as a promising yet challenging strategy for achieving platform growth, by deciphering the relational and temporal dynamics that condition platform scaling, and by conceptualizing digital platforms as entities performing boundary work. • Corporate incubation can be a fruitful strategy for achieving circular economy goals through digital platforms. • We distinguish between digital platform growth and scaling. • Platform growth and scaling via corporate incubation depend on boundary work frame alignment. • We uncover distinct relational mechanisms fostering platform growth and impeding platform scaling. [ABSTRACT FROM AUTHOR]

This systematic literature review examines Occupant Behaviour (OB) modelling in residential buildings, focusing on its role in narrowing the energy performance gap and enhancing occupant comfort. It provides an overview of methodologies from simple statistical models to advanced machine learning algorithms. We conducted a chronological literature review on OB modelling in residential buildings, identifying the algorithms and the main remarks and limitations of each study. We also present sample populations for each study, offering a comprehensive view of OB modelling's evolution. Our study shows a trend towards incorporating intelligent technologies like IoT and Artificial Intelligence, highlighting an evolution towards more advanced and precise techniques. The review evaluates studies utilizing monitoring, diary, or survey data to improve behavioural model accuracy, covering aspects such as occupant presence, window manipulation, lighting and shading regulation, thermostat adjustment, and usage patterns of domestic hot water and appliances. The review underscores the importance of standardized data collection and integrating OB into building standards. It advocates for adaptive OB models leveraging IoT data with privacy considerations and calls for comparative analysis of modelling techniques. Future research should develop adaptable occupancy profile repositories and integrated modelling frameworks to address OB complexities. • Explores comprehensive occupant behaviour modelling methods in residential settings. • Urges integration of realistic occupant behaviour models into building standards. • Highlights IoT's crucial role in enhancing occupant behaviour model accuracy. • Proposes extensive future research directions in occupant behaviour modelling. [ABSTRACT FROM AUTHOR]

The rising prevalence of obesity-related illnesses, such as metabolic steatotic liver disease (MASLD), represents a significant global public health concern. This disease affects approximately 30 % of the adult population and is the result of metabolic abnormalities rather than alcohol consumption. Additionally, MASLD is associated with an increased risk of cardiovascular disease (CVD), chronic liver disease, and a variety of cancers, particularly gastrointestinal cancers. Clonal hematopoiesis (CH) is a biological state characterized by the expansion of a population of blood cells derived from a single mutated hematopoietic stem cell. The presence of CH in the absence of a diagnosed blood disorder or cytopenia is known as clonal hematopoiesis of indeterminate potential (CHIP), which itself increases the risk of hematological malignancies and CVD. Steatotic liver disease may also complicate the clinical course of cancer patients receiving antineoplastic agents, a condition referred to as chemotherapy induced steatohepatitis (CASH). This review will present an outline of the various aspects of MASLD, including complications. Furthermore, it will summarize the existing knowledge on the emerging association between CHIP and MASLD and present the available data on patient cases with concurrent MASLD and hematological neoplasms. Finally, it will provide a brief overview of the chemotherapeutic drugs associated with CASH, the underlying pathophysiologic mechanisms and their clinical implications. • Cases of concurrent hematological neoplasms and MASH have been reported. • Large cohort studies indicate a higher risk of MASH in individuals with CHIP. • Inflammation may link CHIP and MASH, as well as hematological malignancies and MASH. • The impact of chemotherapy-induced liver steatosis is increasingly recognized. [ABSTRACT FROM AUTHOR]

Statin therapy has been shown to have a significant effect on lowering of low-density lipoprotien cholesterol (LDL-C) levels. This subsequently results in cardiovascular (CV) benefit through reduction in major adverse CV disease (CVD) events and overall mortality. Although there is well proven clinical benefit, statin therapy may be discontinued in some patients, and the most common cause for discontinuation is concern for statin-associated muscle symptoms. However, the data on the true prevalence of these symptoms is mixed and continued studies are showing that the symptoms may be less prevalent than previously believed. With statin-associated muscle symptoms being the most common reason for a patient to not be on statin therapy, it is important for physicians to understand how to evaluate for and manage these symptoms. This manuscript provides an overview of statin associated muscle symptoms so that physicians may be able to better manage patients on statin therapy and continue to use these medications when indicated to best reduce future risk of CVD for patients. [ABSTRACT FROM AUTHOR]

The external validity of randomised controlled trials (RCTs) and their transferability to clinical practice is under investigated. This study aimed to analyse the exclusion criteria of recent carotid RCTs comparing carotid endarterectomy (CEA) and carotid artery stenting, and to assess the eligibility of consecutive clinical practice cohorts to those RCTs. An analysis of the clinical and anatomical exclusion criteria of RCTs for asymptomatic (SPACE-2, ACST-2, CREST-1, and CREST-2) and symptomatic carotid stenosis (SPACE-1, CREST-1, ICSS, and EVA-3S) was performed. Two hundred consecutive asymptomatic and 200 consecutive symptomatic patients, treated by CEA, or transfemoral or transcarotid artery stenting at a tertiary referral university centre were assessed for their potential eligibility for each corresponding RCT. RCT patient data were pooled and differences from the clinical practice cohort analysed. Statistics were descriptive and comparative using Fisher's exact and t tests. The number of clinical and anatomical exclusion criteria differed widely between RCTs. Potential eligibility rates of the clinical practice cohort for RCTs with regard to asymptomatic carotid stenosis were 80.5% (ACST-2), 79.5% (SPACE-2), 47% (CREST-1), and 20% (CREST-2). For RCTs on symptomatic carotid stenosis the eligibility rates were 89% (ICSS), 86.5% (EVA-3S), 64% (SPACE-1), and 39% (CREST-1). Both clinical practice cohorts were older by about three years and patients were more often male vs. the RCTs. Furthermore, a history of smoking (asymptomatic patients), hypertension (symptomatic patients), and atrial fibrillation was diagnosed more often, whereas hypercholesterolaemia and coronary heart disease (asymptomatic patients) were less prevalent. More clinical practice patients were on antiplatelets, anticoagulants, and lipid lowering drugs. Symptomatic clinical practice patients presented more often with retinal ischaemia and less often with minor hemispheric strokes than patients in the RCTs. The external validity of contemporary carotid RCTs varies considerably. Patients in routine clinical practice differ from RCT populations with respect to age, comorbidities, and medication. These data are of interest for clinicians and guideline authors and may be relevant for the design of future comparative trials. [ABSTRACT FROM AUTHOR]

The recent advance of flexible production systems requires fast and objective quality inspection of products. Computer vision based deep Convolutional Neural Networks (CNNs), are suitable for such applications since they provide automated, non-destructive, and cost-effective techniques to accomplish the requirements, hence eliminating the human operators or other inspections. In this paper a deep learning object detection framework is presented, able to detect correct, misaligned, and missing objects in complex scenes of the production line. Furthermore, the proposed architecture provides interfaces that allow the seamless integration of the model with varying manufacturing systems. [ABSTRACT FROM AUTHOR]

• Study of ultrashort laser irradiation of metals with Two Temperature Models (TTMs) • Boundary conditions and mesh independent benchmark Two Temperature Models (TTMs) • Inclusion of spallation and explosive boiling ablation regimes. • Inclusion of Kerr lens effect for accurate estimation of ablated widths. Ultrashort lasers are an evolving field in both the researching and industrial world, mainly due to their ability to give very small Heat Affected Zones (HAZ) during the irradiation of a material, making them efficient for micro- and nanostructuring. Two Temperature Models (TTMs) are widely used in literature to simulate the irradiation of a material by an ultrashort laser, however, still now, they have some significant limitations, such as boundary conditions and mesh size dependency and low accuracy in predicting ablation depth and crater diameter. The novelty of the current paper is that it proposes an advanced methodology for the development of heat transfer-only TTMs, with boundary conditions and mesh size independency, that are able to predict ablation depth and crater diameter with very high accuracy, as they take into consideration phenomena such as spallation, explosive boiling and Kerr effect. As an example, this methodology has been applied on the ultrashort laser irradiation of Au. [ABSTRACT FROM AUTHOR]

Augmented Reality (AR) applications have seen a rise in industry in the last few years, due to technological advancements in many of its fundamental areas, such as display and sensing technologies. AR has been used as a driver for supporting human operators in fully manual and semi-automated systems, proving its usefulness in areas such as operation and reconfiguration instructions, safety and resource status awareness. This paper presents an AR application that integrates a set of support features based on the latest advances in AR. The application covers all the aforementioned areas of interest, by including digital instructions, malfunction alerts and resource state visualization in one unified framework. An Asset Administration Shell (AAS) framework has been developed for integration and data exchange between the application and the overall industrial network. The developed application has been validated in an industrial-components-manufacturing case study. Nevertheless, its modularity allows for the adaption in other varying industrial sectors as well. [ABSTRACT FROM AUTHOR]

• Affiliation networks are integrated with molecular data to examine HIV transmission. • Core-peripheral structure in venue affiliation is associated with HIV transmission. • Popular social venues potentiate sexual affiliation network of minority young MSM. • Molecular and affiliation network approach informs effective network interventions. • A surveillance-research-community partnership is important to address ethical issues. This study investigates the two-mode core-periphery structures of venue affiliation networks of younger Black men who have sex with men (YBMSM). The study examined the association between these structures and HIV phylogenetic clusters, defined as members who share highly similar HIV strains that are regarded as a proxy for sexual affiliation networks. Using data from 114 YBMSM who are living with HIV in two large U.S. cities, our findings indicate that HIV phylogenetic clustering patterns were found to be associated with social clustering patterns whose members share affiliation with core venues that overlap with those of YBMSM. Distinct HIV transmission patterns were found in each city, a finding that can help to inform tailored venue-based and network intervention strategies. [ABSTRACT FROM AUTHOR]

To report the outcomes of redo fenestrated and/or branched endovascular aortic repair (F/BEVAR in FEVAR) to rescue previous failed FEVAR. Retrospective review of all consecutive patients undergoing F/BEVAR in FEVAR at eight aortic centres including pre-, intra-, and post-operative data according to a pre-established protocol. Follow up consisted of at least yearly computed tomography angiography. Values are presented as median and interquartile range, and survival as estimate ± standard error in percentage. 18 male patients (76 years old; range 69 – 78 years) receiving FEVAR involving two (two or three) target vessels between 2006 and 2016 underwent F/BEVAR in FEVAR between 2012 and 2019 (aneurysm diameter of 63 mm; range 56 – 69 mm). Median interval between the procedures was 53 (29 – 103) months. The indication for F/BEVAR in FEVAR was type Ia endoleak in 16 cases (eight isolated and eight combined with graft migration), one graft migration without endoleak and one migration with significant proximal aortic expansion. F/BEVAR in FEVAR involved all patent renovisceral arteries and had an operating time of 260 (204 – 344) minutes. Technical success was achieved in 15 (83%) cases. There was a failure to bridge one renal artery, one renal capsular bleed with the subsequent need for renal artery embolisation within 24 hours and one persistent type Ib endoleak despite iliac extension. There was no peri- or in hospital death. Two patients developed spinal cord ischaemia, one transient paraparesis and one permanent paraplegia. The latter occurred in a non-staged procedure where spinal drainage was used. During a follow up of 27 (7 – 39) months, three (17%) patients underwent late re-interventions. Overall survival at 24 months was 70 ± 11% with no aneurysm related death and a secondary clinical success at 24 months of 84 ± 11%. F/BEVAR in FEVAR is a technically challenging but feasible solution to rescue failed FEVAR. The outcomes are promising in many aortic centres but need to be confirmed by further studies with longer follow up. [ABSTRACT FROM AUTHOR]

The primary objective of this study is to contribute to the conservation and sustainable use of seas by promoting Ocean Literacy. It investigates the impact of an educational program on Greek primary and secondary public school students' knowledge about coastal lagoons and attitudes towards marine environment conservation. An educational resource titled "Exploring the Coastal Lagoons" was developed to facilitate the non-formal educational intervention. The program involved classroom, fieldwork/outdoor and laboratory activities, focusing on enhancing understanding of coastal lagoons' abiotic and biotic characteristics and human interconnection. Results showed improved knowledge and slightly more positive attitudes after the didactic intervention. The study underlines the effectiveness of targeted educational interventions in marine sciences, suggesting that non-formal educational settings influence student outcomes more than family or informal sources. Younger students appeared more adaptable and responsive to educational stimuli. The study advocates for refined educational strategies integrating cognitive and emotional elements, emphasizing real nature experience. [Display omitted] • An educational program aiming to enhance students' ocean literacy was implemented. • The educational program involved classroom, field and laboratory activities. • Knowledge about coastal lagoon ecosystem and human interconnection was enhanced. • An increase in positive attitudes towards marine environment protection was exerted. • Programs including nature experiences can improve students' ocean literacy. [ABSTRACT FROM AUTHOR]

• Several exercise- and sports-related parameters such as sex, age, athletic expertise, training season, and sports type are discussed. These factors may potentially influence sleep quantity and architecture. • Overall, sleep quantity and quality in athletes is reduced and potentially insufficient, in comparison to the general consensus of the American Academy of Sleep Medicine for non-athlete healthy adults. • Specifically, young athletes, mainly of Asian origin, showed poor sleep quality, with low efficiency and long wake after sleep onset. Sleep architecture data for specific athletic populations, such as female athletes, were lacking in the literature. • Further research on athletes according to sex and age is needed in order to establish sleep recommendations and promote sleep-optimizing interventions, especially for child and adolescent athletes. This systematic review aimed to describe objective sleep parameters for athletes under different conditions and address potential sleep issues in this specific population. PubMed and Scopus were searched from inception to April 2019. Included studies measured sleep only via objective evaluation tools such as polysomnography or actigraphy. The modified version of the Newcastle–Ottawa Scale was used for the quality assessment of the studies. Eighty-one studies were included, of which 56 were classified as medium quality, 5 studies as low quality, and 20 studies as high quality. A total of 1830 athletes were monitored over 18,958 nights. Average values for sleep-related parameters were calculated for all athletes according to sex, age, athletic expertise level, training season, and type of sport. Athletes slept on average 7.2 ± 1.1 h/night (mean ± SD), with 86.3% ± 6.8% sleep efficiency (SE). In all datasets, the athletes' mean total sleep time was <8 h. SE was low for young athletes (80.3% ± 8.8%). Reduced SE was attributed to high wake after sleep onset rather than sleep onset latency. During heavy training periods, sleep duration and SE were on average 36 min and 0.8% less compared to pre-season and 42 min and 3.0% less compared to in-season training periods, respectively. Athletes' sleep duration was found to be short with low SE, in comparison to the general consensus for non-athlete healthy adults. Notable sleep issues were revealed in young athletes. Sleep quality and architecture tend to change across different training periods. [Display omitted] [ABSTRACT FROM AUTHOR]

Occlusion of the internal jugular vein (IJV) can be observed in thyroid cancer either on preoperative imaging with ultrasound or cross-sectional imaging, particularly contrast-enhanced CT-scan, and can be detected during follow-up when using these same imaging modalities. For thyroid cancer, four different causes of occlusion of the IJV can be identified: venous thrombosis associated with a hypercoagulable state, tumor thrombus in the vein, compression or invasion of the IJV by thyroid disease or lymph node metastases, and fibrotic collapse of the IJV following lateral neck dissection. Clinicians managing patients with thyroid cancer need to be aware of and able to diagnose each of these conditions. The overall patient impact and appropriate management of each will be discussed. [ABSTRACT FROM AUTHOR]

• Degenerative cervical myelopathy is a major cause of disability. • Surgery is the mainstay of treatment, but there is significant variation in approach. • This was an international survey of spine surgeons. • We found that approach is decided on a case by case basis. • However, posterior approaches are favoured. • Further study required to assess need for fusion in addition to laminectomy. Degenerative cervical myelopathy (DCM) results from compression of the cervical spine cord as a result of age related changes in the cervical spine, and affects up to 2% of adults, leading to progressive disability. Surgical decompression is the mainstay of treatment, but there remains significant variation in surgical approaches used. This survey was conducted in order to define current practice amongst spine surgeons worldwide, as a possible prelude to further studies comparing surgical approaches. Methods: An electronic survey was developed and piloted by the investigators using SurveyMonkey. Collected data was categorical and is presented using summary statistics. Where applicable, statistical comparisons were made using a Chi-Squared test. The level of significance for all statistical analyses was defined as p < 0.05. All analysis, including graphs was performed using R (R Studio). Results: 127 surgeons, from 30 countries completed the survey; principally UK (66, 52%) and North America (15, 12%). Respondents were predominantly Neurosurgeons by training (108, 85%) of whom 84 (75%) reported Spinal Surgery as the principal part of their practice. The majority indicated they selected their surgical procedure for multi-level DCM on a case by case basis (62, 49%). Overall, a posterior approach was more popular for multi-level DCM (74, 58%). Region, speciality or annual multi-level case load did not influence this significantly. However, there was a trend for North American surgeons to be more likely to favour a posterior approach. Conclusions: A posterior approach was favoured and more commonly used to treat multi-level DCM, in an international cohort of surgeons. Posterior techniques including laminectomy, laminectomy and fusion or laminoplasty appeared to be equally popular. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical, functional, and radiological midterm outcomes of the all-arthroscopic modified Eden-Hybinette procedure in patients with recurrent anterior shoulder instability.Methods: A retrospective, single-center case series with prospectively collected data was conducted. The inclusion criterion was traumatic recurrent anterior shoulder instability with significant glenoid bone loss; patients with atraumatic or multidirectional instability were excluded. An all-arthroscopic modified Eden-Hybinette procedure using iliac crest autograft and double-pair button fixation was carried out. All patients were postoperatively assessed for recurrence and apprehension. Shoulder range of motion values and functional scores, including American Shoulder and Elbow Surgeons Score, Oxford instability, Rowe instability, and Walch-Dupplay, were recorded. Graft positions, healing, and absorption were evaluated with computed tomography. Comparisons of values were performed with paired t tests for normally distributed differences and with nonparametric Wilcoxon's signed rank test otherwise.Results: The final study cohort included 28 patients, mean age 36 ± 10 years, and mean follow-up period 43 ± 6 months (range 36 to 53). Median glenoid bone loss was 12.4% (range 8% to 33%). No recurrence occurred, no subjective shoulder instability was reported, and no major complications were documented through the last follow-up. Postoperative shoulder range of motion had no significant differences compared with the healthy side. All final postoperative functional scores significantly increased to show excellent results compared with preoperative values. All grafts were positioned and healed optimally, and none was completely reabsorbed.Conclusions: The all-arthroscopic modified Eden-Hybinette procedure is safe, leading to excellent clinical and radiological midterm outcomes in patients with recurrent anterior shoulder instability. This technique restores glenoid bone defects and preserves the normal shoulder anatomy.Level Of Evidence: IV, therapeutic, retrospective case series. [ABSTRACT FROM AUTHOR]

Peptide receptor radionuclide therapy is a targeted therapy used to treat unresectable somatostatin receptor-positive neuroendocrine tumors. The objective of this study was to evaluate response rates among neuroendocrine tumors of different primaries and identify factors relevant to future treatment strategies. We retrospectively reviewed patients who received peptide receptor radionuclide therapy for neuroendocrine tumors from 2018 to 2019 at our institution. Patients were assessed with computed tomography/magnetic resonance imaging and 68Ga-DOTATATE-positron emission tomography before and after 2 or 4 cycles of peptide receptor radionuclide therapy. Tumor response was evaluated by RECIST 1.1. Statistics included multinomial logistic regression models and Fisher exact test. Twenty-seven patients underwent 92 cycles of peptide receptor radionuclide therapy: pancreas (n = 11), small bowel (n = 7), and other (n = 9) neuroendocrine tumors. Overall, 30% (8 of 27) had partial response, 59% (16 of 27) stable disease, and 11% (3 of 27) progressed. Pancreatic neuroendocrine tumors responded differently from small bowel neuroendocrine tumors regardless of cycle number (P =.01). The majority of pancreatic neuroendocrine tumors (6 of 11) had partial response to peptide receptor radionuclide therapy, while all small bowel neuroendocrine tumors had stable disease. Pancreatic neuroendocrine tumors stable after 2 cycles were more likely to respond to additional cycles versus other neuroendocrine tumors (probability: 60% vs 11%). Patients with unresectable advanced or metastatic pancreatic neuroendocrine tumors may benefit from a full course of peptide receptor radionuclide therapy, whereas other neuroendocrine tumors appear less likely to respond. Large prospective studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Despite thyroid hormone replacement, some euthyroid patients with Hashimoto thyroiditis will continue to experience persistent symptoms that reduce their quality of life. Recent studies indicate that total thyroidectomy is superior to medical therapy alone in improving these symptoms. However, there is a high complication rate after total thyroidectomy in patients with Hashimoto thyroiditis. This study evaluates the cost-effectiveness of total thyroidectomy for euthyroid patients who have Hashimoto thyroiditis with persistent symptoms. We utilized a Markov model to compare total thyroidectomy and medical therapy alone over the lifetime of the cohort. Costs, probabilities, and utility parameters were derived from literature and Medicare cost data. A willingness-to-pay threshold of $100,000/quality-adjusted life years was used. We performed sensitivity analyses to ascertain model uncertainty. On average, medical therapy alone costs $12,845, produced 16.9 quality-adjusted life years, and was dominated. Total thyroidectomy costs $1,490 less and produced 1.4 more quality-adjusted life years. Probabilistic sensitivity analysis confirmed total thyroidectomy as the optimal strategy in 89% of cases. Medical therapy alone will become cost-effective if the cost of uncomplicated thyroidectomy increases by 25%, if the probability of permanent complication after total thyroidectomy increases 12-fold, or if there is no gain in quality of life after thyroidectomy. Total thyroidectomy is more cost-effective than medical therapy alone for the management of euthyroid patients who have Hashimoto thyroiditis with persistent symptoms. [ABSTRACT FROM AUTHOR]

About half of patients with acute ST-segment elevation myocardial infarction (STEMI) present with multivessel coronary artery disease (MVD). Recent evidence supports complete revascularization in these patients. However, optimal timing of non-culprit lesion revascularization in STEMI patients is unknown because dedicated randomized trials on this topic are lacking. STUDY DESIGN: The MULTISTARS AMI trial is a prospective, international, multicenter, randomized, two-arm, open-label study planning to enroll at least 840 patients. It is designed to investigate whether immediate complete revascularization is non-inferior to staged (within 19-45 days) complete revascularization in patients in stable hemodynamic conditions presenting with STEMI and MVD and undergoing primary percutaneous coronary intervention (PCI). After successful primary PCI of the culprit artery, patients are randomized in a 1:1 ratio to immediate or staged complete revascularization. The primary endpoint is a composite of all-cause death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and stroke at 1 year. CONCLUSIONS: The MULTISTARS AMI trial tests the hypothesis that immediate complete revascularization is non-inferior to staged complete revascularization in stable patients with STEMI and MVD. [ABSTRACT FROM AUTHOR]

This volume presents selected papers of young scientists – participants of International Young Scientists Conference in Computational Science (YSC'2020). This annual event has been annually organized by ITMO University since 2012 and aims to develop a dialogue about the present and the future of computational science with a focus on applications of modeling and simulation to solve a wide range of problems in science, industry, and business. In this editorial we present retrospective analysis of scientific topics, which were presented during the YSC editions, and determine key trends of the conference, related to the interaction of computational and intelligent technologies. [ABSTRACT FROM AUTHOR]

Study Objective: Because postmenopausal bleeding (PMB) is associated with up to 10% of endometrial neoplasia and office endometrial sampling fails in approximately 10% and is inadequate in 30% of cases, the objective was to determine the role of hysteroscopic endometrial resection (HER) for the diagnosis and treatment of women with PMB.Design: A retrospective cohort.Setting: A university-affiliated teaching hospital.Patients: One hundred fifty-one women with PMB (September 1990-December 2010).Intervention: HER in the operating room.Measurements and Main Results: The median (range) age and body mass index were 58 (50-87) years and 29 (21-52) kg/m2, respectively. Office endometrial biopsy failed in 30 (19.8%), was inadequate in 20 (13.2%), identified nonatypical endometrial hyperplasia (NAH) in 21 (14%), atypical hyperplasia (AH) in 4 (2.6%), and endometrial cancer (EC) in 2 (1.3%) women. HER in 151 women identified 7 new cases of AH (3 from failed/inadequate office biopsy and 4 from NAH) and 9 EC (5 from failed/inadequate office biopsy, 1 from proliferative endometrium, 2 from NAH, and 1 from AH). All 27 women with NAH were treated by HER alone. Of 8 women with AH, 6 were treated with HER and 2 with hysterectomy; no residual endometrium was found in hysterectomy specimens. Of the 11 women with EC, 2 refused hysterectomy and are well 10 and 15 years after HER. Hysterectomy was performed for 9 of 11 EC cases, 2 of 8 AH cases, and 1 for abnormal uterine bleeding. Six women had repeat HER for persistent abnormal uterine bleeding, and 10 were lost to follow-up. At a median follow-up of 11.5 years (range, 7-20 years), 132 (12 hysterectomies + 10 lost) of 151 (87.4%) women were satisfied with no further bleeding.Conclusion: In women with PMB, hysteroscopic endometrial resection concomitantly with resection of intrauterine pathology by experienced surgeons is feasible, safe, and effective for diagnosis in all cases and treatment of the majority of intrauterine pathology including NAH and selected cases of AH and EC. [ABSTRACT FROM AUTHOR]