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We consider estimation of the mean squared prediction error (MSPE) for observed best prediction (OBP) in small area estimation with count data. The OBP method has been previously developed in this context by Chen et al. (Journal of Survey Statistics and Methodology, 3, 136–161, 2015). However, estimation of the MSPE remains a challenging problem due to potential model misspecification that is considered in this setting. The latter authors proposed a bootstrap method for estimating the MSPE, whose theoretical justification is not clear. We propose to use a Prasad–Rao‐type linearization method to estimate the MSPE. Unlike the traditional linearization approaches, our method is computationally oriented and easier to implement in the same regard. Theoretical properties and empirical performance of the proposed method are studied. A real‐data application is considered. [ABSTRACT FROM AUTHOR]

Objectives: Persistent obstructive sleep apnea (OSA) after adenotonsillectomy (AT) has been reported in 20%–30% of children. The aim of this study was to determine the predictive value of drug‐induced sleep endoscopy (DISE) at the time of AT on subjective AT outcomes. Methods: This was a prospective cohort study of children aged 2–18 years being treated with AT for sleep disordered breathing (SDB) with one or more risk factors for AT failure: age >7 years, obesity, severe baseline OSA, Black race. All underwent DISE at the time of AT. Potential predictors of subjective AT outcome included age, sex, obesity, and DISE patterns. Multivariable linear regression was used to model predictors of post‐AT Pediatric Sleep Questionnaire (PSQ) and OSA‐18 outcomes. Results: Pre‐ and post‐AT PSQ/OSA‐18 responses were available from 194 children. Mean age was 9.3 ± 3.5 years, with 59% obese, 50% female, and 67% White. After AT, mean PSQ score decreased from 0.60 ± 0.19 to 0.28 ± 0.22, p < 0.001 and mean OSA‐18 score decreased from 66 ± 21 to 37 ± 18, p < 0.001. The most frequent sites of obstruction were the tonsils (92%), nasal airway (77%), adenoids (64%), and velopharynx (65%). Multivariable regression modeling demonstrated worse outcomes with obesity, male gender, and multilevel obstruction that included the nasal airway and tongue base in addition to adenotonsillar obstruction. Conclusions: Persistent OSA and symptom burden after AT was common in this population. Obesity, male gender, and multilevel obstruction during DISE were all associated with worse subjective outcomes. Level of Evidence: 3 Laryngoscope, 135:377–384, 2025 [ABSTRACT FROM AUTHOR]

Aim: To evaluate level of agreement of specialist trained retinopathy of prematurity (ROP) nurses compared with an experienced paediatric ophthalmologist in detection of referral‐warranted ROP (RWROP) using wide‐field digital retinal imaging. Methods: This is a prospective, observational, blinded study of neonates in a level III neonatal intensive care unit, from July 2020 to November 2022. Image capture using wide‐field digital retinal imaging followed by ROP grading and staging was completed by trained ROP nurses. This was then compared with findings by an experienced paediatric ophthalmologist. The primary outcome was presence of RWROP in either eye. Results: One hundred and ninety‐five neonates (55% male) with a total of 768 screening visits were included. At the initial screen, nurse and ophthalmologist agreed about presence of RWROP for 191 of 195 neonates (98%, kappa = 0.79, P < 0.0001), with 100% sensitivity for RWROP detection. Including all 768 screening episodes, agreement was 98% for RWROP. There was disagreement in 16 screenings (2%) for 11 (6%) neonates. Of the five screenings (0.7%) that the ophthalmologist thought were RWROP and the nurse did not, three were disagreements about whether the zone was posterior zone 2 or zone 1. Conclusions: We found excellent levels of agreement and add evidence that interpretations by specialist trained nurses could be safely integrated into a 'hybrid ROP screening system'. [ABSTRACT FROM AUTHOR]

As human–machine teams are being considered for a variety of mixed‐initiative tasks, detecting and being responsive to human cognitive states, in particular systematic cognitive states, is among the most critical capabilities for artificial systems to ensure smooth interactions with humans and high overall team performance. Various human physiological parameters, such as heart rate, respiration rate, blood pressure, and skin conductance, as well as brain activity inferred from functional near‐infrared spectroscopy or electroencephalogram, have been linked to different systemic cognitive states, such as workload, distraction, or mind–wandering among others. Whether these multimodal signals are indeed sufficient to isolate such cognitive states across individuals performing tasks or whether additional contextual information (e.g., about the task state or the task environment) is required for making appropriate inferences remains an important open problem. In this paper, we introduce an experimental and machine learning framework for investigating these questions and focus specifically on using physiological and neurophysiological measurements to learn classifiers associated with systemic cognitive states like cognitive load, distraction, sense of urgency, mind wandering, and interference. Specifically, we describe a multitasking interactive experimental setting used to obtain a comprehensive multimodal data set which provided the foundation for a first evaluation of various standard state‐of‐the‐art machine learning techniques with respect to their effectiveness in inferring systemic cognitive states. While the classification success of these standard methods based on just the physiological and neurophysiological signals across subjects was modest, which is to be expected given the complexity of the classification problem and the possibility that higher accuracy rates might not in general be achievable, the results nevertheless can serve as a baseline for evaluating future efforts to improve classification, especially methods that take contextual aspects such as task and environmental states into account. As human‐machine teams are being considered for a variety of mixed‐initiative tasks, detecting and being responsive to human systematic cognitive states is among the most critical capabilities for artificial systems to ensure smooth interactions with humans and high overall team performance. We introduce an experimental and machine learning framework for investigating whether physiological and neurophysiological measurements are sufficient for learning classifiers associated with systemic cognitive states like cognitive load, distraction, sense of urgency, mind wandering, and interference. [ABSTRACT FROM AUTHOR]

This paper presents a two‐stage deep learning framework, RR‐HCL‐SVM, designed to aid in the assessment of residual thyroid tissues following thyroidectomy, utilizing single‐photon emission computed tomography (SPECT) images. Leveraging the power of deep learning, our model offers a comprehensive solution for the detection and assessment of remaining thyroid tissues. To enhance accuracy, we introduce a unique combination of features, incorporating the Radio Scan Index (RSI) and radiomics features. These features not only improve accuracy but also provide valuable insights into tissue characterization. Moreover, we employ efficient clustering techniques for feature dimension reduction, preserving model performance while reducing computational complexity. Experimental results demonstrate the effectiveness of our approach, achieving an impressive F1 score of 0.97, sensitivity of 0.96, and specificity of 0.98. The RR‐HCL SVM framework holds great promise in the clinical setting for the precise evaluation of residual thyroid tissues post‐thyroidectomy, offering potential benefits for patient care and treatment planning. [ABSTRACT FROM AUTHOR]

Key clinical message: In in vitro fertilization (IVF), laser offers several advantages. In this study, we employed laser to eliminate the zona pellucida of a contaminated embryo. This approach helps to rescue embryo with bacterial contamination, and improve embryo‐endometrium interaction. To present a case report on the removal of a contaminated zona pellucida from an embryo of patient with a history of recurrent implantation failure (RIF), which was followed by a successful live birth. We present the case of a 34‐year‐old patient with a history of 3 years of infertility who underwent in vitro fertilization. During the culture process, the embryos became contaminated, leading to three failed implantations. Despite the aneuploidy of the embryo and the implementation of a washing technique, the contamination persisted. In the final attempt, the contaminated zona pellucida was successfully removed using laser, followed by embryo transfer, resulting in a live birth. We provided detailed clinical information, including patient demographics, infertility history, ovarian response, evidence of bacterial contamination, embryo development, treatment protocols, and outcomes. Laser excision of the zona pellucida is a safe and effective method for addressing bacterial infection in embryos. [ABSTRACT FROM AUTHOR]

Fucoidanases (EC 3.2.1.–) catalyze the hydrolysis of glycosidic bonds between fucose residues in fucoidans. Fucoidans are a compositionally and structurally diverse class of fucose‐containing sulfated polysaccharides that are primarily found in brown seaweeds. Here, the structural characterization of a novel endo‐α(1,4)‐fucoidanase, Mef1, from the marine bacterium Muricauda eckloniae is presented, showing sequence similarity to members of glycoside hydrolase family 107. Using carbohydrate polyacrylamide gel electrophoresis and nuclear magnetic resonance analyses, it is shown that the fucoidanase Mef1 catalyzes the cleavage of α(1,4)‐linkages between fucose residues sulfated on C2 in the structure [‐3)‐α‐l‐Fucp2S‐(1,4)‐α‐l‐Fucp2S‐(1‐]n in fucoidan from Fucus evanescens. Kinetic analysis of Mef1 activity by Fourier transform infrared spectroscopy revealed that the specific Mef1 fucoidanase activity (Uf) on F. evanescens fucoidan was 0.1 × 10−3 Uf µM−1. By crystal structure determination of Mef1 at 1.8 Å resolution, a single‐domain organization comprising a (β/α)8‐barrel domain was determined. The active site was in an extended, positively charged groove that is likely to be designed to accommodate the binding of the negatively charged, sulfated fucoidan substrate. The active site of Mef1 comprises the amino acids His270 and Asp187, providing acid/base and nucleophile groups, respectively, for the hydrolysis of glycosidic bonds in the fucoidan backbone. Electron densities were identified for two possible Ca2+ ions in the enzyme, one of which is partially exposed to the active‐site groove, while the other is very tightly coordinated. A water wire was discovered leading from the exterior of the Mef1 enzyme into the active site, passing the tightly coordinated Ca2+ site. [ABSTRACT FROM AUTHOR]

Nipa is an abundant, underutilized palm whose major part is its fronds. Nipa fronds (NF) were, therefore, valorized as a renewable carbon resource for the preparation of advanced magnetic porous carbon (MPC) via simple one-step pyrolysis with FeCl3 addition as a magnetic precursor. Properties of the obtained material were determined by X-ray diffraction (XRD), nitrogen adsorption and desorption isotherms, vibrating sample magnetometer (VSM), scanning electron microscopy (SEM) images, energy-dispersive X-ray (EDX) spectroscopy, and Fourier-transform infrared (FTIR) spectroscopy. XRD results showed that Fe3O4 along with Fe0 particles were formed in the porous carbon base. FeCl3-activation of NF yielded MPC with a high specific surface area (SBET) of 330 m2/g, a large total pore volume (Vtotal) of 0.26 cm3/g, and a strong specific saturation magnetization of 7.65 emu/g. Subsequently, MPC was explored for the removal of acid yellow 23 (AY23) using H2O2 as an oxidation agent. Before H2O2 addition, MPC (0.80 g/L) at pH 3.0 partly eliminated AY23 (initial 100 ppm) with an adsorption capacity of 14.5 mg/g. In further catalytic oxidation with 200 ppm of H2O2, MPC removed 89.1% of AY23 within 120 min. Moreover, AY23 decolorization with different MPC samples obeyed pseudo-first-order kinetics, with the greatest rate constant being 0.0186 min−1. Interestingly, the utilized MPC samples could be easily removed from the treated media using a magnet. Altogether, the findings suggest that low-cost magnetic porous carbon produced from one-step pyrolysis of FeCl3-loaded nipa frond might be applied to the treatment of acid yellow 23 in wastewater due to its relative adsorption capacity, efficient catalytic performance, and powerful magnetic separability. [ABSTRACT FROM AUTHOR]

Methylammonium (MA)‐free perovskite solar cells have the potential for better thermal stability than their MA‐containing counterparts. However, the efficiency of MA‐free perovskite solar cells lags behind due to inferior bulk quality. In this work, 4‐methylphenethylammonium chloride (4M‐PEACl) is added into a MA‐free perovskite precursor, which results in greatly enhanced bulk quality. The perovskite crystal grains are significantly enlarged, and defects are suppressed by a factor of four upon the incorporation of an optimal concentration of 4M‐PEACl. Quasi‐2D perovskites are formed and passivate defects at the grain boundaries of the perovskite crystals. Furthermore, the perovskite surface chemistry is modified, resulting in surface energies more favorable for hole extraction. This facile approach leads to a steady state efficiency of 23.7% (24.2% in reverse scan, 23.0% in forward scan) for MA‐free perovskite solar cells. The devices also show excellent light stability, retaining more than 93% of the initial efficiency after 1000 h of constant illumination in a nitrogen environment. In addition, a four‐terminal mechanically stacked perovskite‐silicon tandem solar cell with champion efficiency of 30.3% is obtained using this MA‐free composition. The encapsulated tandem devices show excellent operational stability, retaining more than 98% of the initial performance after 42 day/night cycles in an ambient atmosphere. [ABSTRACT FROM AUTHOR]

The paper is proposed an improved equilibrium optimizer (IEO) algorithm to solve the optimal power flow (OPF) problem with the participation of a renewable energy source (RES). In the proposed IEO method, the "exponential term" is replaced by a function that does not dependent on the number of iterations. This modification of the IEO algorithm increases exploration ability compared to EO algorithm. In addition, the exploration of the proposed IEO algorithm will not decrease according to the number of iterations which avoids to get stuck at the local optimal solution. The IEO algorithm is tested on two IEEE 30-bus and IEEE 118-bus systems with three different objective functions. The performance of the proposed IEO method is compared with equilibrium optimizer (EO), artificial ecosystem optimization (AEO), cuckoo search algorithm (CSA), teaching-learning-based optimization (TLBO), artificial bee colony (ABC), and many other existing methods. Besides, a simple probabilistic formula for calculating RES output power based on the Monte-Carlo simulation model is proposed in this paper to reduce the computation time for the OPF problem with RES. The simulation results obtained show that the proposed IEO algorithm has better quality of the solution as well as stability level compared to the original EO algorithm and other algorithm. Thus, the proposed IEO algorithm is also one of effective and reliable algorithms for handling OPF problem with RES. [ABSTRACT FROM AUTHOR]

The skeleton is one of the most important organs in the human body in assisting our motion and activities; however, bone density attenuates gradually as we age. Among common bone diseases are osteoporosis and Paget's, two of the most frequently found diseases in the elderly. Nowadays, a combination of multiple drugs is the optimal therapy to decelerate osteoporosis and Paget's pathologic process, which comes with various underlying adverse effects due to drug‐drug interactions (DDIs). Artificial intelligence (AI) has the potential to evaluate the interaction, pharmacodynamics, and possible side effects between drugs. In this research, we created an AI‐based machine‐learning model to predict the outcomes of interactions between drugs used for osteoporosis and Paget's treatment, which helps mitigate the cost and time to implement the best combination of medications in clinical practice. In this study, a DDI dataset was collected from the DrugBank database within the osteoporosis and Paget diseases. We then extracted a variety of chemical features from the simplified molecular‐input line‐entry system (SMILES) of defined drug pairs that interact with each other. Finally, machine‐learning algorithms were implemented to learn the extracted features. Our stack ensemble model from Random Forest and XGBoost reached an average accuracy of 74 % in predicting DDIs. It was superior to individual models as well as previous methods in terms of most measurement metrics. This study showed the potential of AI models in predicting DDIs of Osteoporosis‐Paget's disease in particular, and other diseases in general. [ABSTRACT FROM AUTHOR]

A rate ratio (RR) is an important metric for comparing cancer risks among different subpopulations. Inference for RR becomes complicated when populations used for calculating age-standardized cancer rates involve sampling errors, a situation that arises increasingly often when sample surveys must be used to obtain the population data. We compare a few strategies of estimating the standardized RR and propose bias-corrected ratio estimators as well as the corresponding variance estimators and confidence intervals that simultaneously consider the sampling error in estimating populations and the traditional Poisson error in the occurrence of cancer case or death. Performance of the proposed methods is evaluated empirically based on simulation studies. An application to immigration disparities in cancer mortality among Hispanic Americans is discussed. Our simulation studies show that a bias-corrected RR estimator performs the best in reducing the bias without increasing the coefficient of variation; the proposed variance estimators for the RR estimators and associated confidence intervals are fairly accurate. Finding of our application study are both interesting and consistent with the common sense as well as the results of our simulation studies. [ABSTRACT FROM AUTHOR]

Summary: This article presents the problem of optimizing position and operating power of battery energy storage system (BESS) in the distribution system for the 24‐hour period. Wherein, the surveyed period is divided into small periods of peak, standard, and off‐peak hours. The goal is to find the optimal node for installation of BESS and its power in each interval to reduce the electricity purchasing cost and the cost of energy loss. The cuckoo search algorithm (CSA) is mapped to find the optimal parameters of BESS, and its efficiency is compared with that of genetic algorithm, sunflower optimization, and pathfinder algorithm. The efficiency of the proposed problem has been evaluated on two test systems. The obtained results show that the proposed problem and method have ability to reduce energy cost as well as contribute to reduce peak loads during peak hours in the 24‐hour period. The results also show that CSA is an effective tool for the problem of optimization position and power of BESS. [ABSTRACT FROM AUTHOR]

Network reconfiguration (NR) is one of the most effective methods to reduce line power loss in the distribution system, which causes higher losses than the other parts of the power system. This paper proposes a modified symbiotic organisms search (MSOS) algorithm to solve the NR problem. For the purpose of enhancing the effectiveness of MSOS, the mutualism and parasitism strategies of the original symbiotic organisms search (SOS) have been modified to create better new solutions. In the mutualism strategy, the so-far best solution is updated immediately as soon as new solutions are created. In the parasitism strategy, the update is only implemented for the first half of control variables, whereas another half still remains unchanged. The comparison results between MSOS and SOS on twenty-five benchmark functions and different scales of test distribution systems with 14, 33, 69, and 119 nodes show that the improvement level of MSOS over SOS is significant with higher success rates and better quality of gained solutions. Similarly, MSOS also reaches better results than other methods in the literature. Consequently, MSOS can be a favorable method for determining the most appropriate configurations for the distribution systems. [ABSTRACT FROM AUTHOR]

In this paper, a proposed modified stochastic fractal search algorithm (MSFS) is applied to find the most appropriate site and size of capacitor banks for distribution systems with 33, 69, and 85 buses. Two single-objective functions are considered to be reduction of power loss and reduction of total cost of energy loss and capacitor investment while satisfying limit of capacitors, limit of conductor, and power balance of the systems. MSFS was developed by performing three new mechanisms including new diffusion mechanism and two new update mechanisms on the conventional stochastic fractal search algorithm (SFS). As a result, MSFS can reduce 0.002%, 0.003%, and 0.18% of the total power loss from SFS for the three study systems. As compared to other methods, MSFS can reduce power loss from 0.07% to 3.98% for the first system, from 3.7% to 7.3% for the second system, and from 0.92% to 6.98% for the third system. For the reduction of total cost, the improvement level of the proposed method over SFS and two other methods is more significant. It is 0.03%, 1.22%, and 5.76% for the second system and 2.31%, 0.87%, and 3.77% for the third system. It is emphasized that the proposed method can find the global optimal solutions for all study cases while SFS was still implementing search process nearby or far away from the solutions. Furthermore, MSFS can converge to the best solutions much faster than these compared methods. Consequently, it can be concluded that the proposed method is very effective for finding the best location and size of added capacitors in distribution power systems. [ABSTRACT FROM AUTHOR]

Introduction: The phytochemical composition of plant material governs the bioactivity and potential health benefits as well as the outcomes and reproducibility of laboratory studies and clinical trials. Objective: The objective of this work was to develop an efficient method for the in‐depth characterisation of plant extracts and quantification of marker compounds that can be potentially used for subsequent product integrity studies. Centella asiatica (L.) Urb., an Ayurvedic herb with potential applications in enhancing mental health and cognitive function, was used as a case study. Methods: A quadrupole time‐of‐flight analyser in conjunction with an optimised high‐performance liquid chromatography (HPLC) separation was used for in‐depth untargeted fingerprinting and post‐acquisition precursor ion quantification to determine levels of distinct phytochemicals in various C. asiatica extracts. Results: We demonstrate the utility of this workflow for the characterisation of extracts of C. asiatica. This integrated workflow allowed the identification or tentative identification of 117 compounds, chemically interconnected based on Tanimoto chemical similarity, and the accurate quantification of 24 phytochemicals commonly found in C. asiatica extracts. Conclusion: We report a phytochemical analysis method combining liquid chromatography, high resolution mass spectral data acquisition, and post‐acquisition interrogation that allows chemical fingerprints of botanicals to be obtained in conjunction with accurate quantification of distinct phytochemicals. The variability in the composition of specialised metabolites across different C. asiatica accessions was substantial, demonstrating that detailed characterisation of plant extracts is a prerequisite for reproducible use in laboratory studies, clinical trials and safe consumption. The methodological approach is generally applicable to other botanical products. Botanical products are popular for promoting resilience, maintaining health and preventing or treating disease. Challenges in defining effects of botanical products reside in achieving batch‐to‐batch reproducibility regarding their composition and product stability, i.e. providing consistent products for clinical trials and consumers. In this work, using Centella asiatica (L.) Urb. as a case study, we demonstrate the efficacy of integrating untargeted high‐resolution mass spectrometry with post acquisition precursor ion extraction for determining chemical profiles and quantifying selected marker compounds. [ABSTRACT FROM AUTHOR]

In this paper, an effective method to determine an initial searching point (ISP) of the network reconfiguration (NR) problem for power loss reduction is proposed for improving the efficiency of the continuous genetic algorithm (CGA) to the NR problem. The idea of the method is to close each initial open switch in turn and solve power flow for the distribution system with the presence of a closed loop to choose a switch with the smallest current in the closed loop for opening. If the radial topology constraint of the distribution system is satisfied, the switch opened is considered as a control variable of the ISP. Then, ISP is attached to the initial population of CGA. The calculated results from the different distribution systems show that the proposed CGA using ISP could reach the optimal radial topology with better successful rate and obtained solution quality than the method based on CGA using the initial population generated randomly and the method based on CGA using the initial radial configuration attached to the initial population. As a result, CGA using ISP can be a favorable method for finding a more effective radial topology in operating distribution systems. [ABSTRACT FROM AUTHOR]

Ethyl 2-((4-oxo-3-phenyl-3,4-dihydroquinazolin-2-yl)thio)acetate (3) which was synthesized starting from anthranilic acid (1) via 2-thioxo-3-phenylquinazolin-4(3H)-one (2) reacted with hydrazine hydrate to afford 2-((4-oxo-3-phenyl-3,4-dihydroquinazolin-2-yl)thio)acetohydrazide (4). Reaction of (4) with thiocarbonyl-bis-thioglycolic acid gave a new compound name N-(4-oxo-2-thioxothiazolidin-3-yl)-2-((4-oxo-3-phenyl-3,4-dihydroquinazolin-2-yl)thio)acetamide (5). Knoevenagel condensation of (5) with appropriate aldehydes gave fourteen (Z)-N-(5-arylidene-4-oxo-2-thioxothiazolidin-3-yl)-2-((4-oxo-3-phenyl-3,4-dihydroquinazolin-2-yl)thio)acetamide compounds (6a–o) with moderate yield. The chemical structure of the compounds was elucidated on the basis of IR, 1H-NMR, 13C-NMR, and HR-MS spectral data. The 5-arylidene-2-thioxothiazolidinone compounds exhibited mild-to-moderate cytotoxic activity against both K562 (chronic myelogenous leukemia) cells and MCF7 (breast cancer) cells. [ABSTRACT FROM AUTHOR]

Retroperitoneal fibrosis (RPF) is a condition characterized by chronic inflammatory and fibrotic changes in the retroperitoneum that can lead to serious complications including kidney failure, mesenteric and limb ischemia, and deep venous thrombosis among others. Affected individuals may present with nonspecific symptomology that would require a high clinical index of suspicion for prompt diagnosis. We herein discuss a case of a young African-American man with recurrent deep venous thrombosis who presents with a 4-week history of constant aching pain of abdomen and back and kidney failure. Initial noncontrast computed tomogram (CT) only revealed mild bilateral hydroureteronephrosis with inflammatory changes but without obvious mass or lymphadenopathy. At the insistence of the renal consulting team to rule out RPF, a CT-urogram was performed which revealed an infiltrative mass encasing the aorta, inferior vena cava, and common iliac vessels. Laparoscopic biopsy revealed dense fibroadipose tissue, lymphocytic aggregates, focal scattered IgG4-positive plasma cells, and fibrin deposition. Patient underwent bilateral nephrostomy placement and empirical corticosteroid therapy with resolution of kidney failure. Our case illustrates a classic presentation of RPF with relatively benign findings on noncontrast CT that could have been missed if clinicians did not keep a high index of suspicion for the condition. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Assess the reliability of a Sleep Endoscopy Rating Scale (SERS) and its relationship with pediatric obstructive sleep apnea (OSA) severity.Study Design: Retrospective case series of pediatric patients who underwent drug-induced sleep endoscopy (DISE) at the time of surgery for OSA from January 1, 2013 to May 1, 2014.Methods: Three blinded otolaryngologists scored obstruction on DISE recordings as absent (0), partial (+1), or complete (+2) at six anatomic levels: nasal airway, nasopharynx, velopharynx, oropharynx, hypopharynx, and arytenoids. Ratings were summed for a SERS total score (range, 0-12). Reliability was calculated using a κ statistic with linear weighting. SERS ratings and obstructive apnea-hypopnea index (OAHI) were compared using Spearman correlation. A receiver operating characteristic (ROC) analysis determined the ability of the SERS total score to predict severe OSA (OAHI >10).Results: Thirty-nine patients were included (mean age, 8.3 ± 5.1 years; 36% obese; mean OAHI, 19.1 ± 23.7). Intrarater and inter-rater reliability was substantial-to-excellent (κ = 0.61-0.83) and fair-to-substantial (κ = 0.33-0.76), respectively. Ratings correlated best with OAHI for the oropharynx (r = 0.54, P = .02), hypopharynx (r = 0.48, P = .04), and SERS total score (r = 0.75, P = .002). In ROC analysis, a SERS total score ≥6 demonstrated sensitivity/specificity of 81.8%/87.5%, respectively, and correctly classified 84% of patients.Conclusions: The SERS can be applied reliably in children undergoing DISE for OSA. Ratings of the oropharynx, hypopharynx, and SERS total score demonstrated significant correlation with OSA severity. A SERS total score ≥6 was an accurate predictor of severe OSA.Level Of Evidence: 4. Laryngoscope, 126:1492-1498, 2016. [ABSTRACT FROM AUTHOR]

Background and Aim Suboptimal viral suppression with adefovir ( ADV) poses a challenge in managing chronic hepatitis B. Few studies have evaluated the efficacy of entecavir ( ETV) in ADV-experienced patients. Our aim is to assess treatment effectiveness of ETV in ADV-experienced patients. Methods ADV-experienced patients switched to ETV were enrolled from six US clinics. Patients completed a median of 24 months of ETV after switch. Patients were categorized into partial responders (detectable HBV- DNA at switch) or complete responders (undetectable HBV- DNA at switch) to ADV. Primary and secondary outcome measurements were complete viral suppression ( CVS, HBV- DNA < 60 IU/mL) and biochemical response ( BR, alanine aminotransferase [ ALT] < 40 U/L), respectively. Results A total of 120 patients were included in the analysis (80 ADV partial responders; 40 ADV complete responders). In partial responders, CVS rate was 84% after 24 months of ETV. BR rate was 58% at switch to ETV and increased to 90% after 24 months. All complete responders continued to experience CVS after switch. On multivariate analysis inclusive of age, male gender, ALT level at switch, and history of lamivudine ( LAM) exposure, we identified positive, hepatitis B e antigen status before ADV and higher HBV- DNA level at time of switch as significant independent negative predictors of CVS. In eight patients with ADV resistance, seven achieved CVS after 24 months of ETV, and all achieved BR. Conclusion In ADV-experienced patients, high rates of CVS and BR can be achieved/sustained after switching to ETV, including those with ADV resistance or with prior exposure to LAM. [ABSTRACT FROM AUTHOR]

We show that the maximum likelihood estimators (MLEs) of the fixed effects and within-cluster correlation are consistent in a heteroscedastic nested-error regression (HNER) model with completely unknown within-cluster variances under mild conditions. The result implies that the empirical best linear unbiased prediction (EBLUP) method for small area estimation is valid in such a case. We also show that ignoring the heteroscedasticity can lead to inconsistent estimation of the within-cluster correlation and inferior predictive performance. A jackknife measure of uncertainty for the EBLUP is developed under the HNER model. Simulation studies are carried out to investigate the finite-sample performance of the EBLUP and MLE under the HNER model, with comparisons to those under the nested-error regression model in various situations, as well as that of the jackknife measure of uncertainty. The well-known Iowa crops data is used for illustration. The Canadian Journal of Statistics 40: 588-603; 2012 © 2012 Statistical Society of Canada [ABSTRACT FROM AUTHOR]

Introduction: Cystic fibrosis (CF) pulmonary disease is characterized by intermittent episodes of acute lung symptoms known as 'pulmonary exacerbations'. While exacerbations are classically treated with parenteral antimicrobials, oral antibiotics are often used in 'mild' cases. Objectives: We determined how often management progressed to intravenous (IV) therapy. We also examined multiple courses of oral antimicrobials within one exacerbation, and identified patient factors associated with unsuccessful treatment. Methods: We performed a retrospective chart audit of oral antibiotic use in CF patients, from March 2009 through March 2010, for 'mild' CF exacerbations. Results: Administration of a single vs multiple courses of oral antibiotics for treatment of 'mild' CF exacerbation avoided progression to IV therapy 79.8% and 50.0% of the time, respectively. Overall, oral antibiotics circumvented the need for IV therapy 73.8% of the time. Using multi-variant analysis, we found multiple patient characteristics to be independent risk factors for oral antibiotic failure including a history of pseudomonas infection [odds ratio (OR) 2.13, confidence interval (CI) 1.29-3.54], CF-related diabetes (OR 1.85, CI 1.00-3.41), allergic Bronchopulmonary aspergillosis (OR 3.81, CI 1.38-10.56), low socioeconomic status (OR 1.67, CI 1.04-2.67), and calculated baseline forced expiratory volume in 1 s (FEV1) <75% of predicted prior to an acute exacerbation (OR 1.93, CI 1.20-3.08). Decline in FEV1 > 10%, weight for age, body mass index, distance from the CF center and gender were not significant. Conclusion: Our observations suggest that one course of oral antimicrobials is frequently effective in outpatient CF pulmonary exacerbations but exacerbations requiring more than one course of oral antibiotics are likely to require IV therapy. Please cite this paper as: Briggs EC, Nguyen T, Wall MC and MacDonald KD. Oral antimicrobial use in outpatient cystic fibrosis pulmonary exacerbation management: a single-center experience. Clin Respir J 2012; 6: 56-64. [ABSTRACT FROM AUTHOR]

Objective: The major form of magnetic resonance imaging-defined white matter injury (WMI) comprises diffuse lesions where the burden of small necrotic foci (microscopic necrosis) is poorly defined. We hypothesized that myelination failure associated with diffuse WMI involves an aberrant injury response linked to arrested preoligodendrocyte (preOL) maturation in reactive astrocyte-rich lesions. Methods: A retrospective autopsy series (1983-2000) was selected for cases with diffuse WMI and analyzed relative to prospectively collected contemporary cases (2003-2010). Controls were age- and region-matched to address regional variation in preOL maturation. Successive oligodendrocyte stages were analyzed with lineage-specific markers. Microscopic necrosis was quantified with microglial markers. Axon injury markers defined the burden of axonopathy. Extracellular matrix remodeling was defined by detection of hyaluronic acid (HA), an inhibitor of preOL maturation, and the HA receptor, CD44. Results: In the contemporary case series, diffuse WMI was accompanied by a significant reduction in the burden of microscopic necrosis and axonopathy. Diffuse astrogliosis extended into the lesion surround with elevated HA and astrocyte-expressed CD44. The total population of OL lineage stages was significantly increased in lesions. This increase coincided with significant expansion of the preOL pool. Interpretation: Although these data confirm that microscopic necrosis occurs in contemporary cases, the markedly decreased burden supports that it does not contribute substantially to myelination failure. The primary mechanism of myelination failure involves a disrupted cellular response whereby preOLs fail to differentiate in diffuse astrogliotic lesions. PreOL maturation arrest converts chronic WMI to a more immature state related to the burden of astrogliosis. ANN NEUROL 2012;71:93-109 [ABSTRACT FROM AUTHOR]

In medical and social studies, it is often desirable to assess the correlation between characteristics of interest that are not directly observable. In such cases, repeated measures are often available, but the correlation between the repeated measures is not the same as that between the true characteristics that are confounded with the measurement errors. The latter is called the hidden correlation. Previously, the problem has been treated by assuming prior knowledge about the measurement errors or by using relatively complex statistical models, such as the mixed-effects models, with no closed-form expression for the estimated hidden correlation. We propose a simple estimator of the hidden correlation that is very much like the Pearson correlation coefficient, with a closed-form expression, under assumptions much weaker than the mixed-effects model. Simulation results show that the proposed simple estimator performs similarly as the restricted maximum likelihood (REML) estimator in mixed models but is computationally much more efficient than REML. We also made simulation comparison with the Pearson correlation. We considered a real data example. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: We characterized and compared the fluorescence properties of various well-defined G-quadruplex structures. The increase of intrinsic fluorescence of G-rich DNA sequences when they form G-quadruplexes can be used to monitor the folding and unfolding of G-quadruplexes as a function of cations and temperature. The temperature-dependent fluorescence spectra of different G-quadruplexes also exhibit characteristic patterns. Thus, the stability and possibly also the structure of G-quadruplexes can be characterized and distinguished by their intrinsic fluorescence spectra. [Copyright &y& Elsevier]

Objective: Although magnetic resonance imaging (MRI) is the optimal imaging modality to define cerebral white-matter injury (WMI) in preterm survivors, the histopathological features of MRI-defined chronic lesions are poorly defined. We hypothesized that chronic WMI is related to a combination of delayed oligodendrocyte (OL) lineage cell death and arrested maturation of preoligodendrocytes (preOLs). We determined whether ex vivo MRI can distinguish distinct microglial and astroglial responses related to WMI progression and arrested preOL differentiation. Methods: We employed a preterm fetal sheep model of global cerebral ischemia in which acute WMI results in selective preOL degeneration. We developed novel algorithms to register histopathologically-defined lesions with contrast-weighted and diffusion-weighted high-field ex vivo MRI data. Results: Despite mild delayed preOL degeneration, preOL density recovered to control levels by 7 days after ischemia and was ∼2 fold greater at 14 days. However, premyelinating OLs were significantly diminished at 7 and 14 days. WMI evolved to mostly gliotic lesions where arrested preOL differentiation was directly proportional to the magnitude of astrogliosis. A reduction in cerebral WM volume was accompanied by four classes of MRI-defined lesions. Each lesion type displayed unique astroglial and microglial responses that corresponded to distinct forms of necrotic or non-necrotic injury. High-field MRI defined 2 novel hypointense signal abnormalities on T2-weighted images that coincided with microscopic necrosis or identified astrogliosis with high sensitivity and specificity. Interpretation: These studies support the potential of high-field MRI for early identification of microscopic necrosis and gliosis with preOL maturation arrest, a common form of WMI in preterm survivors. ANN NEUROL 2011 [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Cancers around the eye are often treated using orthovoltage machines or by plastic surgery, neither of which are widely available in regional Australia. External beam radiation therapy (EBRT) using electrons and an internal eye shield is an alternative, relatively underreported technique which can provide similar cosmetic and functional outcomes. This report aimed to describe the process for the use of internal eye shields at GenesisCare Fraser Coast Radiation Oncology (GCFCRO) and the associated clinical outcomes and patient perceptions of the delivery and results of this procedure.This project was conducted in two phases. Phase I was an audit of the departmental technique and short‐term clinical outcomes of 17 patients who received EBRT for skin cancer near the eyes at GCFCRO in partnership with Wide Bay Hospital and Health Service (WBHHS). Phase II was a survey of nine of those patients to elicit the patient perspective of the delivery and long‐term outcomes of the treatment.Phase I revealed the departmental procedures for simulation, planning and treatment at GCFCRO are consistent with other departments published protocols. Phase II results detailed positive patient perspectives regarding cosmetic outcomes and receipt of EBRT for skin cancer near their eyes.EBRT with an internal eye shield is an acceptable alternative modality to surgery for squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) around the eye in the definitive and adjuvant setting. This is particularly important in regional locations to facilitate patients receiving high‐quality care and outcomes locally. [ABSTRACT FROM AUTHOR]