Theoretical evaluation of the impact of diverse treatment conditions by calculation of the tumor control probability (TCP) of simulated cervical cancer Hyperthermia-Radiotherapy (HT-RT) treatments in-silico.

INTRODUCTION: Hyperthermia (HT) induces various cellular biological processes, such as repair impairment and direct HT cell killing. In this context, in-silico biophysical models that translate deviations in the treatment conditions into clinical outcome variations may be used to study the extent of such processes and their influence on combined hyperthermia plus radiotherapy (HT + RT) treatments under varying conditions. METHODS: An extended linear-quadratic model calibrated for SiHa and HeLa cell lines (cervical cancer) was used to theoretically study the impact of varying HT treatment conditions on radiosensitization and direct HT cell killing effect. Simulated patients were generated to compute the Tumor Control Probability (TCP) under different HT conditions (number of HT sessions, temperature and time interval), which were randomly selected within margins based on reported patient data. RESULTS: Under the studied conditions, model-based simulations suggested a treatment improvement with a total CEM43 thermal dose of approximately 10 min. Additionally, for a given thermal dose, TCP increased with the number of HT sessions. Furthermore, in the simulations, we showed that the TCP dependence on the temperature/time interval is more correlated with the mean value than with the minimum/maximum value and that comparing the treatment outcome with the mean temperature can be an excellent strategy for studying the time interval effect. CONCLUSION: The use of thermoradiobiological models allows us to theoretically study the impact of varying thermal conditions on HT + RT treatment outcomes. This approach can be used to optimize HT treatments, design clinical trials, and interpret patient data.

An imprecise probability approach-based determination of over-represented southern African plant genera and families used in ethnopharmacology.

ETHNOPHARMACOLOGICAL RELEVANCE: The analyses of patterns of over-representation of southern African traditional medicinal plants at the genus and family level provide information about the differences in plant use among southern African countries and disease categories. 'Over-representation' refers to the phenomenon whereby the proportion of plants belonging to a taxonomic group is higher in ethnobotanical pharmacopoeia than in the total flora. AIM OF THE STUDY: This study aimed to use the Imprecise Dirichlet Model (IDM) to analyse data from ten southern African countries to establish how over-represented medicinal plant families compare with over-represented genera, how over-represented medicinal taxa differ among countries in this region of Africa, and how over-represented taxa differ among six major disease categories. MATERIALS AND METHODS: Floral data for the total species composition of each country were obtained from online databases. Medicinal plant species lists were generated from published surveys, inventories, and books. IDM calculations were executed using the inverse of the cumulative beta probability density function in Microsoft Excel™. Python programming language source code was used to calculate Pearson correlation (r) values and Jaccard coefficients (J). RESULTS: Nine of forty-two over-represented medicinal plant families in southern Africa (group 1) do not have over-represented genera. Seven of the forty genera with the highest margins of over-representation belong to under-represented families. Nineteen of the forty-two over-represented families have margins of over-representation smaller than the cumulative margins of their over-represented genera. Groups of countries with similar overall flora (J ≥ 0.333) are Botswana and Namibia (group 2), Malawi, Mozambique, Zambia and Zimbabwe (group 3). The families and genera with the highest margins of over-representation are Loganiaceae and Albizia in group 1, Combretaceae and Vachellia in group 2, Dioscoreaceae and Senna in group 3, and Sapotaceae and Solanum in group 4 (South Africa). The families and genera with the highest margins of over-representation across disease categories are Ebenaceae and Albizia, Canellaceae and Dicoma, Combretaceae and Pterocelastrus, Ebenaceae and Bersama, Francoaceae and Erythrina, and Aristolochiaceae and Strychnos for plants used in the treatment of STIs, febrile and mosquito-vector diseases, microbial infections, pain, skin conditions, and female sexual/reproductive problems, respectively. CONCLUSIONS: Genus-level calculations are more efficient in generating taxonomic lists that can be used for ethnopharmacological investigations due to the exclusion of under-represented genera. Limiting the size of geographical areas from which medicinal plant lists are sampled and targeting plants used to treat specific types of disease prevents the underestimation of niche over-represented taxa.

Development of a tool to calculate the probability of hypocalcemia after total thyroidectomy: a prospective study.

PURPOSE: This study aimed to evaluate the ability of the percentage of decrease in serum PTH level in the first 8 h after total thyroidectomy (TT) to predict hypocalcemia requiring Ca supplementation and develop a tool to predict it. METHODS: 97 patients who underwent TT with measurement of preoperative parathyroid hormone (PTH) levels were prospectively evaluated 1 and 8 h after TT; postoperative magnesium (Mg2PO) and phosphorus levels were evaluated on the 2nd day after surgery. The percentage of decrease in PTH level 1 h (%dPTH1h) and 8 h (%dPTH8h) postoperatively and predictors of hypocalcemia requiring Ca supplementation were evaluated and an equation was developed to predict this outcome. RESULTS: %dPTH1h (p = 0.002), %dPTH8h (p = 0.001) and (Mg2PO) (p < 0.01) were isolated predictors of postoperative hypocalcemia requiring Ca supplementation. The data obtained led to the development of two tools to predict this complication. CONCLUSIONS: The percentage of decrease in PTH level 1 h and 8 h postoperatively and the magnesium level on the 2nd day after surgery were predictors of more severe hypocalcemia, and an auxiliary tool for predicting this complication was developed.

Fitting mathematical functions to extended lactation curves and forecasting late-lactation milk yields of dairy cows.

A 305-d lactation followed by a 60-d dry period has traditionally been considered economically optimal, yet dairy cows in modern intensive dairy systems are frequently dried off while still producing significant quantities of milk. Managing cows for an extended lactation has reported production, welfare, and economic benefits, but not all cows are suitable for an extended lactation. Implementation of an extended lactation strategy on-farm could benefit from use of a decision support system, based on a mathematical lactation model, that can identify suitable cows during early lactation that have a high likelihood of producing above a target milk yield (MY) at 305 d in milk (DIM). Therefore, our objectives were (1) to compare the suitability of 3 commonly used lactation models for modeling extended lactations (Dijkstra, Wood, and Wilmink) in primiparous and multiparous cows under a variety of lactation lengths, and (2) to determine the amount of early-lactation daily MY data needed to accurately forecast MY at d 305 by using the most suitable model and determine whether this is sufficient for identifying cows suitable for an extended lactation before the end of a typical voluntary waiting period (50-90 d). Daily MY data from 467 individual Holstein-Friesian lactations (DIM >305 d; 379 ± 65-d lactation length [mean ± SD]) were fitted by the 3 lactation models using a nonlinear regression procedure. The parameter estimates of these models, lactation characteristics (peak yield, time to peak yield, and persistency), and goodness-of-fit were compared between parity and different lactation lengths. The models had similar performance, and differences between parity groups were consistent with previous literature. Then, data from only the first i DIM for each individual lactation, where i was incremented by 30 d from 30 to 150 DIM and by 50 d from 150 to 300 DIM, were fitted by each model to forecast MY at d 305. The Dijkstra model was selected for further analysis, as it had superior goodness-of-fit statistics for i= 30 and 60. The data set was fit twice by the Dijkstra model, with parameter bounds either unconstrained or constrained. The quality of predictions of MY at d 305 improved with increasing data availability for both models and assisting the model fitting procedure with more biologically relevant constraints on parameters improved the predictions, but neither was reliable enough for practical use on-farm due to the high uncertainty of forecasted predictions. Using 90 d of data, the constrained model correctly classified 66% of lactations as being above or below a target MY at d 305 of 25 kg/d, with a probability threshold of 0.95. The proportion of correct classifications became smaller at lower targets of MY at d 305 and became greater when using more lactation days. Overall, further work is required to develop a model that can forecast late-lactation MY with sufficient accuracy for practical use. We envisage that a hybridized machine learning and mechanistic model that incorporates additional historical and genetic information with early-lactation MY could produce meaningful lactation curve forecasts.

Event Probabilities Have a Different Impact on Early and Late Electroencephalographic Measures Regarded as Metrics of Prediction.

The oddball protocol has been used to study the neural and perceptual consequences of implicit predictions in the human brain. The protocol involves presenting a sequence of identical repeated events that are eventually broken by a novel "oddball" presentation. Oddball presentations have been linked to increased neural responding and to an exaggeration of perceived duration relative to repeated events. Because the number of repeated events in such protocols is circumscribed, as more repeats are encountered, the conditional probability of a further repeat decreases-whereas the conditional probability of an oddball increases. These facts have not been appreciated in many analyses of oddballs; repeats and oddballs have rather been treated as binary event categories. Here, we show that the human brain is sensitive to conditional event probabilities in an active, visual oddball paradigm. P300 responses (a relatively late component of visually evoked potentials measured with EEG) tended to be greater for less likely oddballs and repeats. By contrast, P1 responses (an earlier component) increased for repeats as a goal-relevant target presentation neared, but this effect occurred even when repeat probabilities were held constant, and oddball P1 responses were invariant. We also found that later, more likely oddballs seemed to last longer, and this effect was largely independent of the number of preceding repeats. These findings speak against a repetition suppression account of the temporal oddball effect. Overall, our data highlight an impact of event probability on later, rather than earlier, electroencephalographic measures previously related to predictive processes-and the importance of considering conditional probabilities in sequential presentation paradigms.

Longitudinal Fluctuations in Treatment Response After OnabotulinumToxinA and Sacral Neuromodulation for Refractory Urgency Incontinence.

PURPOSE: We compared fluctuations in treatment response after onabotulinumtoxinA and sacral neuromodulation for urgency incontinence using Markov models. MATERIALS AND METHODS: We fit data from a randomized trial to Markov models to compare transitions of success/failure over 6 months between 200 U onabotulinumtoxinA and sacral neuromodulation. Objective failure was <50% reduction in urgency incontinence episodes from baseline; subjective failure "strongly disagree" to "neutral" to the Patient Global Symptom Control questionnaire. RESULTS: Of the 357 participants (median baseline daily urgency incontinence episodes 4.7 [IQR 3.7-6.0]) 61% vs 51% and 3.2% vs 6.1% reported persistent states of objective success and failure over 6 months after onabotulinumtoxinA vs sacral neuromodulation. Participants receiving onabotulinumtoxinA vs sacral neuromodulation had lower 30-day transition probabilities from objective and subjective success to failure (10% vs 14%, ratio 0.75 [95% CI 0.55-0.95]; 14% vs 21%, ratio 0.70 [95% CI 0.51-0.89]). The 30-day transition probability from objective and subjective failure to success did not differ between onabotulinumtoxinA and sacral neuromodulation (40% vs 36%, ratio 1.11 [95% CI 0.73-1.50]; 18% vs 17%, ratio 1.14 [95% CI 0.65-1.64]). CONCLUSIONS: Over 6 months after treatment, 2 in 5 women's symptoms fluctuate. Within these initial 6 months, women receiving onabotulinumtoxinA transitioned from success to failure over 30 days less often than sacral neuromodulation. For both treatments, there was an almost 20%-40% probability over 30 days that women returned to subjective and objective success after failure. Markov models add important information to longitudinal models on how symptoms fluctuate after urgency incontinence treatment.

Providing a comprehensive approach to oil well blowout risk assessment.

Drilling is one of the most dangerous activities in the oil and gas process industries. Therefore, a holistic approach was presented to prevent and control risks and reduce the uncertainty of blowouts, kick scenarios, and control layers based on the Fuzzy Bayesian Network (FBN). Four independent protection layers (IPLs) were used to evaluate the blowout outcome, and the failure probabilities of IPL1 and IPL2 were calculated with Fault Tree Analysis (FTA). Then, different events were transferred to the Bayesian Network (BN) in GeNIe software, and updated the probabilities. The Fuzzy Fault Tree (FFT) results reveal that the failure probabilities for IPL1 and IPL2 amount to 8.94×10-4 and 4.97×10-21, respectively. Also, the blowout probability results based on FFT were larger than FBN. According to FBN, the probability of the kick event was equal to 6.60×10-34. Sensitivity analysis showed that X1 (Mud volume/flow change) had the highest degree of importance in the blowout of oil wells. The results of this study can be used in both a preventive and reactive approach. Deductive and inductive reasoning, the dynamic nature and conditional dependencies, and causal relationships between events can make the model more realistic.

Specificity in the processing of a subject's own name.

Subject's own name (SON) is widely used in both daily life and the clinic. Event-related potential (ERP)-based studies have previously detected several ERP components related to SON processing; however, as most of these studies used SON as a deviant stimulus, it was not possible to determine whether these components were SON-specific. To identify SON-specific ERP components, we adopted a passive listening task with EEG data recording involving 25 subjects. The auditory stimuli were a SON, a friend's name (FN), an unfamiliar name (UN) selected from other subjects' names and seven different unfamiliar names (DUNs). The experimental settings included Equal-probabilistic, Frequent-SON, Frequent-FN and Frequent-UN conditions. The results showed that SON consistently evoked a frontocentral SON-related negativity (SRN) within 210-350 ms under all conditions, which was not detected with the other names. Meanwhile, a late positive potential evoked by SON was found to be affected by stimulus probability, showing no significant difference between the SON and the other names in the Frequent-SON condition, or between the SON and a FN in the Frequent-UN condition. Taken together, our findings indicated that the SRN was a SON-specific ERP component, suggesting that distinct neural mechanism underly the processing of a SON.

Associations between thalamocortical functional connectivity and sensory over-responsivity in infants at high likelihood for ASD.

Despite growing evidence implicating thalamic functional connectivity atypicalities in autism spectrum disorder (ASD), it remains unclear how such alterations emerge early in human development. Because the thalamus plays a critical role in sensory processing and neocortical organization early in life, its connectivity with other cortical regions could be key for studying the early onset of core ASD symptoms. Here, we investigated emerging thalamocortical functional connectivity in infants at high (HL) and typical (TL) familial likelihood for ASD in early and late infancy. We report significant thalamo-limbic hyperconnectivity in 1.5-month-old HL infants, and thalamo-cortical hypoconnectivity in prefrontal and motor regions in 9-month-old HL infants. Importantly, early sensory over-responsivity (SOR) symptoms in HL infants predicted a direct trade-off in thalamic connectivity whereby stronger thalamic connectivity with primary sensory regions and basal ganglia was inversely related to connectivity with higher order cortices. This trade-off suggests that ASD may be characterized by early differences in thalamic gating. The patterns reported here could directly underlie atypical sensory processing and attention to social vs. nonsocial stimuli observed in ASD. These findings lend support to a theoretical framework of ASD whereby early disruptions in sensorimotor processing and attentional biases early in life may cascade into core ASD symptomatology.

Effect of rurality and travel distance on contralateral prophylactic mastectomy for unilateral breast cancer.

PURPOSE: Despite lack of survival benefit, demand for contralateral prophylactic mastectomy (CPM) to treat unilateral breast cancer remains high. High uptake of CPM has been demonstrated in Midwestern rural women. Greater travel distance for surgical treatment is associated with CPM. Our objective was to examine the relationship between rurality and travel distance to surgery with CPM. METHODS: Women diagnosed with stages I-III unilateral breast cancer between 2007 and 2017 were identified using the National Cancer Database. Logistic regression was used to model likelihood of CPM based on rurality, proximity to metropolitan centers, and travel distance. A multinomial logistic regression model compared factors associated with CPM with reconstruction versus other surgical options. RESULTS: Both rurality (OR 1.10, 95% CI 1.06-1.15 for non-metro/rural vs. metro) and travel distance (OR 1.37, 95% CI 1.33-1.41 for those who traveled 50 + miles vs. < 30 miles) were independently associated with CPM. For women who traveled 30 + miles, odds of receiving CPM were highest for non-metro/rural women (OR 1.33 for 30-49 miles, OR 1.57 for 50 + miles; reference: metro women traveling < 30 miles). Non-metro/rural women who received reconstruction were more likely to undergo CPM regardless of travel distance (ORs 1.11-1.21). Both metro and metro-adjacent women who received reconstruction were more likely to undergo CPM only if they traveled 30 + miles (ORs 1.24-1.30). CONCLUSION: The impact of travel distance on likelihood of CPM varies by patient rurality and receipt of reconstruction. Further research is needed to understand how patient residence, travel burden, and geographic access to comprehensive cancer care services, including reconstruction, influence patient decisions regarding surgery.

Simultaneous confidence intervals for quantile differences of several heterogeneous normal populations: With application to vitamin D supplement treatment on colorectal cancer patients.

In many applications, comparing the q-quantiles of several normal populations are more advantageous than comparing their means. In this paper, we consider the problem of constructing simultaneous confidence intervals (SCIs) for quantile differences of several heterogeneous normal distributions. To the best of our knowledge, this problem remains unsolved. We propose a novel method for constructing a set of SCI. We propose two new sets of SCI by using the proposed technique and discuss two classic and two simulation-based SCIs. We show that the proposed classic SCIs are conservative for all population parameters configuration. We also show that the simulation-based SCIs have correct coverage probability asymptotically. We then compare these six sets of SCI in terms of average volume and coverage probability via an extensive simulation study. Results show that one of the proposed classic SCI can be recommended. Finally, the proposed methods are illustrated by a real example that is a vitamin D study on colorectal cancer patients.

Socio-Organizational Dimensions: The Key to Advancing the Shared Care Record Agenda in Health and Social Care.

Integrating health and social care delivery with the help of digital technologies is a grand challenge. We argue that previous attempts have largely failed to achieve their objectives because implementers and decision makers disregard the complex socio-organizational dimensions of change associated with initiatives. These include structural and organizational complexity inhibiting the development of shared care pathways; professional jurisdictions, interests, and expertise; and existing data and governance structures. We provide an overview of those dimensions that can inform strategic decisions going forward, thereby contributing to the chances of success of shared care initiatives.

Rethinking the focus on forest fires in federal wildland fire management: Landscape patterns and trends of non-forest and forest burned area.

For most of the 20th century and beyond, national wildland fire policies concerning fire suppression and fuels management have primarily focused on forested lands. Using summary statistics and landscape metrics, wildfire spatial patterns and trends for non-forest and forest burned area over the past two decades were examined across the U.S, and federal agency jurisdictions. This study found that wildfires burned more area of non-forest lands than forest lands at the scale of the conterminous and western U.S. and the Department of Interior (DOI). In an agency comparison, 74% of DOI burned area occurred on non-forest lands and 78% of U.S. Forest Service burned area occurred on forested lands. Landscape metrics revealed key differences between forest and non-forest fire patterns and trends in total burned area, burned patch size, distribution, and aggregation over time across the western U.S. Opposite fire patterns emerged between non-forest and forest burns when analyzed at the scale of federal agency jurisdictions. In addition, a fire regime departure analysis comparing current large fire probability with historic fire trends identified certain vegetation types and locations experiencing more fire than historically. These patterns were especially pronounced for cold desert shrublands, such as sagebrush where increases in annual area burned, and fire frequency, size, and juxtaposition have resulted in substantial losses over a twenty-year period. The emerging non-forest fire patterns are primarily due to the rapid expansion of non-native invasive grasses that increase fuel connectivity and fire spread. These invasions promote uncharacteristic frequent fire and loss of native ecosystems at large-scales, accelerating the need to place greater focus on managing invasive species in wildland fire management. Results can be used to inform wildfire management and policy aimed at reducing uncharacteristic wildfire processes and patterns for both non-forest and forest ecosystems as well as identify differing management strategies needed to address the unique wildfire issues each federal agency faces.

Atuação da psicologia em unidade neonatal no contexto da pandemia da covid-19 / The work of psychology in a neonatal unit in the covid-19 pandemic / Actuación de la psicología en una unidad neonatal en el contexto de la pandemia de la covid-19

A pandemia de covid-19 provocou intensas mudanças no contexto do cuidado neonatal, exigindo dos profissionais de saúde a reformulação de práticas e o desenvolvimento de novas estratégias para a manutenção da atenção integral e humanizada ao recém-nascido. O objetivo deste artigo é relatar a atuação da Psicologia nas Unidades Neonatais de um hospital público de Fortaleza (CE), Brasil, durante o período de distanciamento físico da pandemia de covid-19. Trata-se de estudo descritivo, do tipo relato de experiência, que ocorreu no período de março a agosto de 2020. No contexto pandêmico, o serviço de Psicologia desenvolveu novas condutas assistenciais para atender às demandas emergentes do momento, como: atendimento remoto; registro e envio on-line de imagens do recém-nascido a seus familiares; visitas virtuais; e reprodução de mensagens de áudio da família para o neonato. Apesar dos desafios encontrados, as ações contribuíram para a manutenção do cuidado centrado no recém-nascido e sua família, o que demonstra a potencialidade do fazer psicológico.(AU)

The COVID-19 pandemic brought intense changes to neonatal care and required health professionals to reformulate practices and develop new strategies to ensure comprehensive and humanized care for newborn. This study aims to report the experience of the Psychology Service in the Neonatal Units of a public hospital in Fortaleza, in the state of Ceará, Brazil, during the social distancing period of the COVID-19 pandemic. This descriptive experience report study was conducted from March to August 2020. During the pandemic, the Psychology Service developed new care practices to meet the emerging demands of that moment, such as remote care, recordings and online submission of newborns' pictures and video images for their family, virtual tours, and reproduction of family audio messages for the newborns. Despite the challenges, the actions contributed to the maintenance of a care that is centered on the newborns and their families, which shows the potential of psychological practices.(AU)

La pandemia de la COVID-19 ha traído cambios intensos en el contexto de la atención neonatal, que requieren de los profesionales de la salud una reformulación de sus prácticas y el desarrollo de nuevas estrategias para asegurar una atención integral y humanizada al recién nacido. El objetivo de este artículo es reportar la experiencia del Servicio de Psicología en las Unidades Neonatales de un hospital público de Fortaleza, en Ceará, Brasil, durante el periodo de distanciamiento físico en la pandemia de la COVID-19. Se trata de un estudio descriptivo, un reporte de experiencia, que se llevó a cabo de marzo a agosto de 2020. En el contexto pandémico, el servicio de Psicología desarrolló nuevas conductas asistenciales para atender a las demandas emergentes del momento, tales como: atención remota; grabación y envío em línea de imágenes del recién nacido; visitas virtuales; y reproducción de mensajes de audio de la familia para el recién nacido. A pesar de los desafíos encontrados, las acciones contribuyeron al mantenimiento de la atención centrada en el recién nacido y su familia, lo que demuestra el potencial de la práctica psicológica.(AU)

Circadian light therapy and light dose for depressed young people: a systematic review and meta-analysis.

Background: Empirical evidence has shown that light therapy (LT) can reduce depression symptoms by stimulating circadian rhythms. However, there is skepticism and inconclusive results, along with confusion regarding dosing. The purpose of this study is to quantify light as a stimulus for the circadian system and create a dose-response relationship that can help reduce maladies among adolescents and young adults (AYAs). This will provide a reference for light exposure and neural response, which are crucial in the neuropsychological mechanism of light intervention. The study also aims to provide guidance for clinical application. Methods: The latest quantitative model of CLA (circadian light) and CSt,f (circadian stimulus) was adopted to quantify light dose for circadian phototransduction in youth depression-related light therapy. Articles published up to 2023 through Web of Science, Cochrane Library, Medline (OVID), CINAHL, APA PsycINFO, Embase, and Scholars were retrieved. A meta-analysis of 31 articles (1,031 subjects) was performed using Stata17.0, CMA3.0 (comprehensive meta-analysis version 3.0) software, and Python 3.9 platform for light therapy efficacy comparison and dose-response quantification. Results: Under various circadian stimulus conditions (0.1 < CSt,f < 0.7) of light therapy (LT), malady reductions among AYAs were observed (pooled SMD = -1.59, 95%CI = -1.86 to -1.32; z = -11.654, p = 0.000; I2 = 92.8%), with temporal pattern (p = 0.044) and co-medication (p = 0.000) suggested as main heterogeneity sources. For the efficacy advantage of LT with a higher circadian stimulus that is assumed to be influenced by visualization, co-medication, disease severity, and time pattern, sets of meta-analysis among random-controlled trials (RCTs) found evidence for significant efficacy of circadian-active bright light therapy (BLT) over circadian-inactive dim red light (SMD = -0.65, 95% CI = -0.96 to -0.34; z = -4.101, p = 0.000; I2 = 84.9%) or circadian-active dimmer white light (SMD = -0.37, 95% CI = -0.68 to -0.06; z = -2.318, p = 0.02; I2 = 33.8%), whereas green-blue, circadian-active BLT showed no significant superiority over circadian-inactive red/amber light controls (SMD = -0.21, 95% CI = -0.45 to 0.04; z = -2.318, p = 0.099; I2 = 0%). Overall, circadian-active BLT showed a greater likelihood of clinical response than dim light controls, with increased superiority observed with co-medication. For pre-to-post-treatment amelioration and corresponding dose-response relationship, cumulative duration was found more influential than other categorical (co-medication, severity, study design) or continuous (CSt,f) variables. Dose-response fitting indicated that the therapeutic effect would reach saturation among co-medicated patients at 32-42 days (900-1,000 min) and 58-59 days (1,100-1,500 min) among non-medicated AYAs. When exerting high circadian stimulus of light therapy (0.6 < CSt,f < 0.7), there was a significantly greater effect size in 1,000-1,500 min of accumulative duration than <1,000 or >1,500 min of duration, indicating a threshold for practical guidance. Limitations: The results have been based on limited samples and influenced by a small sample effect. The placebo effect could not be ignored. Conclusions: Although the superiority of LT with higher circadian stimulus over dimmer light controls remains unproven, greater response potentials of circadian-active BLT have been noticed among AYAs, taking co-medication, disease severity, time pattern, and visual characteristics into consideration. The dose-response relationship with quantified circadian stimulus and temporal pattern had been elaborated under various conditions to support clinical depression treatment and LT device application in the post-pandemic era.

Visual imagery skills and risk attitude.

Several of Kahneman and Tversky's seminal works in the 1970s found evidence of the importance of framing in decision making under risk. They hypothesized that imaginability (visual imagery ability) may play an important role in the evaluation of subjective probabilities. However, the impact of visual imagery ability on choice under risk has not yet been explored. This is the main purpose of our study. In an online experiment, we collected participants' visual imagery ability using the Vividness of Visual Imagery Questionnaire and their risk attitude using two choice-based risk elicitation tasks. Participants made their risk decisions either in an environment where risk was visualized (visual frame) or not (non-visual frame), and were randomly assigned to one of the two decision frames. Our results suggest that neither visual imagery ability nor decision frame has a substantial impact on risk attitude.

Simultaneous multiple-stimulus auditory brain-computer interface with semi-supervised learning and prior probability distribution tuning.

Objective.Auditory brain-computer interfaces (BCIs) enable users to select commands based on the brain activity elicited by auditory stimuli. However, existing auditory BCI paradigms cannot increase the number of available commands without decreasing the selection speed, because each stimulus needs to be presented independently and sequentially under the standard oddball paradigm. To solve this problem, we propose a double-stimulus paradigm that simultaneously presents multiple auditory stimuli.Approach.For addition to an existing auditory BCI paradigm, the best discriminable sound was chosen following a subjective assessment. The new sound was located on the right-hand side and presented simultaneously with an existing sound from the left-hand side. A total of six sounds were used for implementing the auditory BCI with a 6 × 6 letter matrix. We employ semi-supervised learning (SSL) and prior probability distribution tuning to improve the accuracy of the paradigm. The SSL method involved updating of the classifier weights, and their prior probability distributions were adjusted using the following three types of distributions: uniform, empirical, and extended empirical (e-empirical). The performance was evaluated based on the BCI accuracy and information transfer rate (ITR).Main results.The double-stimulus paradigm resulted in a BCI accuracy of 67.89 ± 11.46% and an ITR of 2.67 ± 1.09 bits min-1, in the absence of SSL and with uniform distribution. The proposed combination of SSL with e-empirical distribution improved the BCI accuracy and ITR to 74.59 ± 12.12% and 3.37 ± 1.27 bits min-1, respectively. The event-related potential analysis revealed that contralateral and right-hemispheric dominances contributed to the BCI performance improvement.Significance.Our study demonstrated that a BCI based on multiple simultaneous auditory stimuli, incorporating SSL and e-empirical prior distribution, can increase the number of commands without sacrificing typing speed beyond the acceptable level of accuracy.

Probability of cultivating Se-rich maize in Se-poor farmland based on intensive field sampling and artificial neural network modelling.

Selenium (Se) is a necessary micronutrient for humans, and its supplementation from crop grains is important to address the ubiquitous Se deficiency in people worldwide. Se uptake by crops largely depend on soil bioavailable Se rather than soil total Se content, which provides possibilities to explore the Se-rich crops in Se-poor area. Here, the possibility of cultivating Se-rich maize grains in Se-poor farmland was tested based on intensive field sampling and mathematical modelling. Sampling was conducted at county scale, and a total of 7779 topsoil samples and 109 maize samples with paired rhizosphere soils samples were collected. Results showed that although the soil Se content in the study county from southwestern China was at a low level (0.01-2.75 mg kg-1), 54.1% of the maize grain samples satisfied the standard for Se-rich products (0.02-0.30 mg kg-1). Soil organic matter, iron oxide, and phosphorus levels were correlated negatively with Se bioconcentration factor (BCF) of maize grain. Compared with the multivariate linear regression model, the artificial neural network (ANN) model was more accurate and reliable in predicting maize Se BCF. Prediction using the ANN model showed that 22.7% of the county's farmland was suitable for cultivating naturally Se-rich maize, which increased 21.3% growing areas than that from cultivation based on simply soil total Se. This study provided a new methodological framework for natural Se-rich maize production and verified the probability of cultivating naturally Se-rich maize in Se-poor farmland.

Integrated graph measures reveal survival likelihood for buildings in wildfire events.

Wildfire events have resulted in unprecedented social and economic losses worldwide in the last few years. Most studies on reducing wildfire risk to communities focused on modeling wildfire behavior in the wildland to aid in developing fuel reduction and fire suppression strategies. However, minimizing losses in communities and managing risk requires a holistic approach to understanding wildfire behavior that fully integrates the wildland's characteristics and the built environment's features. This complete integration is particularly critical for intermixed communities where the wildland and the built environment coalesce. Community-level wildfire behavior that captures the interaction between the wildland and the built environment, which is necessary for predicting structural damage, has not received sufficient attention. Predicting damage to the built environment is essential in understanding and developing fire mitigation strategies to make communities more resilient to wildfire events. In this study, we use integrated concepts from graph theory to establish a relative vulnerability metric capable of quantifying the survival likelihood of individual buildings within a wildfire-affected region. We test the framework by emulating the damage observed in the historic 2018 Camp Fire and the 2020 Glass Fire. We propose two formulations based on graph centralities to evaluate the vulnerability of buildings relative to each other. We then utilize the relative vulnerability values to determine the damage state of individual buildings. Based on a one-to-one comparison of the calculated and observed damages, the maximum predicted building survival accuracy for the two formulations ranged from [Formula: see text] for the historical wildfires tested. From the results, we observe that the modified random walk formulation can better identify nodes that lie at the extremes on the vulnerability scale. In contrast, the modified degree formulation provides better predictions for nodes with mid-range vulnerability values.

Fleischner Society Guideline Recommendations for Incidentally Detected Pulmonary Nodules and the Probability of Lung Cancer.

PURPOSE: The Fleischner Society aims to limit further evaluations of incidentally detected pulmonary nodules when the probability of lung cancer is <1% and to pursue further evaluations when the probability of lung cancer is ≥1%. To evaluate the internal consistency of guideline goals and recommendations, the authors evaluated stratum-specific recommendations and 2-year probabilities of lung cancer. METHODS: A retrospective cohort study (2005-2015) was conducted of individuals enrolled in one of two integrated health systems with solid nodules incidentally detected on CT. The 2017 Fleischner Society guidelines were used to define strata on the basis of smoking status and nodule size and number. Lung cancer diagnoses within 2 years of nodule detection were ascertained using cancer registry data. Confidence interval (CI) inspection was used to determine if stratum-specific probabilities of lung cancer were different than 1%. RESULTS: Among 5,444 individuals with incidentally detected lung nodules (median age, 66 years; 54% women; 57% smoked; median nodule size, 5.5 mm; 55% with multiple nodules), 214 (3.9%; 95% CI, 3.4%-4.5%) were diagnosed with lung cancer within 2 years. For 7 of 12 strata (58%), 2,765 patients (51%), and 194 lung cancer cases (91%), there was alignment between Fleischner Society goals and recommendations. Alignment was indeterminate for 5 strata (42%), 2,679 patients (49%), and 20 lung cancer cases (9%) because CIs for the probability of lung cancer spanned 1%. CONCLUSIONS: Fleischner Society guideline goals and recommendations align at least half the time. It is uncertain whether alignment of guideline goals and recommendations occurs more often.