Evaluating the Effect of Financial Penalty on Hospital-Acquired Infections.

Purpose: This study explores the effects of CMS reimbursement financial penalties from the Hospital-Acquired Condition Reduction Program (HACRP) on hospital-acquired infections (HAI) in hospitals across the United States. Methods: Hospital-level data for 2896 hospitals in the United States were evaluated using multiple linear regression models with random effects analysis through a difference-in-differences study design to examine HAIs under the HACRP between hospitals that were financially penalized or not from calendar years 2013 to 2020. Results: This study showed significant differences from the pre-program Total HAC scores to the most recent reviewed year, validating the efficacy of the HACRP, and showing a reduction of overall HAIs over the years evaluated in the study. The multiple linear regression model with random effects analysis produced a significant (p < 0.001) interaction term between hospitals expected to be penalized in 2013 and each year evaluated in the study (-0.412 estimate) confirming decreases in HAI scores, and overall decreases in HAIs across the years of the study. Notably, 98% of hospitals in the worst-performing, expected to be financially penalized quartile from 2013, were found to have decreased their HAIs in their facilities, while only 38.8% of hospital in the performing, non-penalized quartiles showed decreases in HAIs across their facilities, by 2020. Conclusion: Our research indicates that implementing financial disincentives through reimbursement reductions could potentially decrease the incidence of HAIs. Our study further suggests that incorporating financial penalties and incentives for HAIs annually across all hospitals may lead to significant reductions in HAIs throughout the US healthcare system.

Chemical Derivatization and Paper Spray Ionization Mass Spectrometry for Fast Screening of Retinoic Acid in Cosmetics.

As a prescription drug, retinoic acid is listed as a banned cosmetic additive in the EU and China regulations. Currently, spectrophotometric methods, including thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), and HPLC-MS/MS, are commonly used for the determination of retinoic acid. As these conventional methods require complex pretreatment and are time-consuming, chemical derivatization combined with paper spray ionization mass spectrometry was developed for the fast detection of retinoic acid in cosmetics. N,N-dimethylpiperazine iodide (DMPI) was utilized as a derivatization reagent. Carboxylic acid in retinoic acid was derivatized to carry a positive charge and was subjected to mass spectrometry analysis. Results showed that compared with non-derivatized compounds, the detection limit was increased by about 50 times. The linearity in the range of 0.005-1 µg·mL-1 was good. The limit of detection (LOD) was 0.0013 µg·mL-1, and the limit of quantification (LOQ) was 0.0043 µg·mL-1. The recoveries of spiked samples were in the range of 95-105%, and the RSDs were below 5%. Derivatization and paper spray ionization MS render a quick, sensitive, and accurate method for the detection of retinoic acid in a complex matrix.

Psychometric properties of the Parenting Stress Index-Short Form in a Peruvian sample.

BACKGROUND: The stress experienced by parents in fulfilling their parental role has consequences for couple dynamics, parent-child interactions, and the mental health of parents. However, studies on the psychometric properties of the PSI-SF, particularly among Latin American parents, are scarce. Therefore, this study aims to evaluate the psychometric properties of the Spanish version of the Parenting Stress Index-Short Form (PSI-SF). METHODS: The participants were Peruvian mothers and fathers with children in early childhood and primary education, with a mean age of 34.4 years (SD = 6.8). The sample was obtained in two phases: 130 participants for the Exploratory Factor Analysis (EFA) and 791 participants for the Confirmatory Factor Analysis (CFA). RESULTS: The study results show a modified three-factor structure of the PSI-SF scale, with adequate fit indices (GFI = .99, AGFI = .99, SRMR = .024, CFI = .98, TLI = .98, RMSEA = .074) and loadings above 0.40. Additionally, the three factors of the scale demonstrated high reliability, with Cronbach's alpha and McDonald's omega values for Parental Distress (α = .94; ω = .95), Parent-Child Dysfunctional Interaction (α = .97; ω = .97), and Difficult Child (α = .94; ω = .94). The scale was also found to be invariant with respect to gender. CONCLUSION: In conclusion, the study results suggest that the modified PSI-SF has adequate psychometric properties and is invariant for assessing parental stress in Peruvian fathers and mothers with children in early childhood and primary education.

Bimodal functionality of highly conductive nanostructured silver film towards improved performance of photosystem I-based graphene photocathode.

We present the novel design of photosystem I (PSI)-based biosolar cell, whereby conductive transparent electrode materials, such as ITO or FTO, are replaced with glass covered with silver island film. This nanostructured metallic layer combines high electric conductance with enhancing the absorption efficiency of the PSI biocatalyst via the plasmonic effect. We demonstrate strong enhancement of the photocurrent generated in the biohybrid electrode composed of oriented layers of PSI reaction centers due to plasmonic interactions of the PSI fluorophores and redox centres with the conductive silver island film.

Parenting Stress Index in Caregivers of Individuals With Noonan Syndrome.

Medical professionals frequently underestimate stress level of parents/caregivers of patients with rare disorders as RASopathies, the latter might experience elevated stress levels, with their own health frequently overlooked despite significant responsibilities and hurdles encountered. The aim of this study is to assess the stress experienced by parents of individuals with Noonan syndrome and related conditions. Forty-eight parents (20 fathers; 28 mothers), among the 31 recruited families, completed the Italian version of the Parenting Stress Index-Short Form. Our study shows abnormally elevated scores (≥ 85° percentile) in 35.4% of parents. Data retrieved from subscales reveal a perception of a difficult child in 25% of cases, a dysfunctional parental-child interaction in 20.8%, a general parental distress in 10.4% of cases, and an elevated overall stress in 18.8% of parents. Questionnaires as the Parenting Stress Index-Short Form are valuable tools to evaluate stress in parents/caregivers of children with RASopathies. Evaluation by professionals is fundamental to support parents and caregivers in managing stressors and to enhance their quality of life and relationships. To prevent stress escalation and parents' burnout, an early assessment to tailor a timely treatment should be introduced as soon as possible as good clinical practice.

Prognostic factors for patient-reported satisfaction after percutaneous lumbar endoscopic discectomy at a minimum of two years' follow-Up.

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

An Unusual Case of Fibrous Dysplasia, Temporomandibular Joint Ankylosis, and Eagle's Syndrome.

Fibrous dysplasia is a benign bone disease in children and young adults. This is characterized by the replacement of normal bone with fibrous tissue along with immature woven bone. Fibrous dysplasia is a rare disorder and has variable presentations that pose challenges in diagnosis and treatment. Decisions are made on a case-by-case basis, depending on the symptoms, location, or possible complications. Symptomatic lesions are treated with surgical resection. cosmetic concerns of the patients are taken care of by surgical contouring. For any unresectable or recurrent lesion, bisphosphonate therapy can be used as a form of medical management.

Learning curves for high tibial osteotomy using patient-specific instrumentation: a case control study.

Objectives: Three-dimensional (3D) planning and Patient Specific Instrumentation (PSI) can help the surgeon to obtain more predictable results in Medial Opening Wedge High Tibial Osteotomy (mOW-HTO) than the conventional techniques. We compared the accuracy of the PSI and standard techniques and measured the learning curve for surgery time and number of fluoroscopic shots. Methods: We included the first 12 consecutive cases of mOW-HTO performed with 3D planning and PSI cutting guides and the first 12 non-supervised mOW-HTO performed with the standard technique. We recorded surgery time and fluoroscopic time. We calculated the variation (Δ delta) between the planned target and the postoperative result for Hip Knee Ankle Angle (HKA), mechanical medial Proximal Tibia Angle (MPTA), Joint Line Convergence Angle (JLCA) and tibial slope (TS) and compared it both groups. We also recorded the complication rate. We then calculated the learning curves for surgery time, number of fluoroscopic shots, Δ from target in both groups. CUSUM analysis charts for learning curves were applied between the two groups. Results: Mean surgical time and mean number of fluoroscopic shots were lower in PSI group (48.58±7.87 vs. 58.75±6.86 min; p=0.034 and 10.75±3.93 vs. 18.16±4.93 shots; p<0.001). The postoperative ΔHKA was 0.42±0.51° in PSI vs. 1.25±0.87° in conventional, p=0.005. ΔMPTA was 0.50±0.67° in PSI vs. 3.75±1.48° in conventional, p<0.001; ΔTS was 1.00±0.82° in PSI vs. 3.50±1.57° in conventional, p<0.001. ΔJLCA was 1.83±1.11° in PSI vs. 4±1.41° in conventional, p<0.001. The CUSUM analysis favoured PSI group regarding surgery time (p=0.034) and number of shots (p<0.001) with no learning curve effect for ΔHKA, ΔMPTA, ΔJLCA and ΔTS. Conclusions: PSI cutting guides and 3D planning for HTO are effective in reducing the learning curves for operation time and number of fluoroscopic shots. Accuracy of the procedure has been elevated since the first cases.

[Mechanism of Huachansu Injection against colorectal cancer based on network pharmacology and cellular experimental].

This study aimed to elucidate the mechanism of Huachansu Injection(HCSI) against colorectal cancer(CRC) using network pharmacology, molecular docking technology, and cellular experimental. This research group initially used LC-MS/MS to detect the content of 16 bufadienolides in HCSI. Ten bufadienolide components were selected based on a content threshold of greater than 10 ng·mL~(-1). Their potential targets were further predicted using the SwissTargetPrediction database. CRC-related targets were obtained through GeneCards, OMIM, TTD, and PharmGKB databases. The intersection targets of HCSI in the treatment of CRC were obtained through Venny. The "active component-target-disease" network and target protein-protein interaction(PPI) network were constructed via Cytoscape software. Core targets were screened based on the degree values. Gene Ontology(GO) function and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were performed on these key targets. Molecular docking was conducted using AutoDock software on major bufadienolide active components and key targets. Different concentrations of HCSI, psi-bufarenogin(BUF), and bufotalin(BFT) were tested for their effects on cell viability, migration, and apoptosis rates in CRC HCT116 cells. Western blot was conducted to detect the expression of proteins related to the PI3K/Akt/mTOR signaling pathway in HCT116 cells. Eight main active components of HCSI, including arenobufagin, BUF, and BFT, as well as 20 key targets of HCSI in combating CRC, such as EGFR, IL6, and mTOR, were identified. Based on KEGG pathway enrichment and molecular docking results, the PI3K/Akt/mTOR signaling pathway was selected for further verification. Cellular experimental demonstrated that HCSI, BUF, and BFT significantly inhibited the proliferation and migration abilities of HCT116 cells, induced apoptosis in these cells, and downregulated the expression of PI3K/Akt/mTOR pathway-related proteins. This result suggests that HCSI, BUF, and BFT may exert their anti-CRC effects by regulating the PI3K/Akt/mTOR signaling pathway through targets such as mTOR and PIK3CA. This study provides theoretical evidence for exploring the active ingredients and mechanism of HCSI against CRC.

Effect of Preoperative Coronal Plane Alignment on Actual Versus Predicted Alignment Using Patient Specific Instrumentation in Total Ankle Replacement.

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

Digitally Guided Advanced Prosthodontic Rehabilitation for Post-COVID-19 Mucormycosis Using Patient-Specific Implants: A Case Report.

This case report describes the prosthodontic rehabilitation of a middle-aged male patient who underwent bilateral low-level maxillectomy due to post-COVID-19 mucormycosis. The oronasal communication was closed using an anterior base tongue flap. Two patient-specific subperiosteal implants were placed to rehabilitate the patient's bony defect. Using a postsurgical CT scan, a virtually customized subperiosteal titanium framework was created from grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic bone bilaterally. Six months later, the right-sided patient-specific implant was infected and had to be surgically removed. After satisfactory healing, an open-tray impression was taken to create a computer-aided design/computer-aided manufacturing titanium Hader bar. An acrylic resin overdenture was then fabricated over this bar. A clasp assembly was fabricated by direct metal laser sintering of cobalt-chromium alloy for additional retention. The metal substructures were incorporated into the overdenture prosthesis to enhance the stability and retention.. This case report unveils an innovative approach to rehabilitating severely compromised maxillary bony defects and impaired oral functioning, offering a viable alternative when traditional reconstruction methods are inadequate. Prosthodontic treatment greatly affects the aesthetics, phonetics, and mastication of the patient, improving the overall quality of life of the patient.

Comparison of NEWS2 and PSI as mortality predictors in patients with community acquired pneumonia.

In the West, National Early Warning Score 2 (NEWS2) is commonly applied to predict the severity of illness using only bedside variables unlike the extensive Pneumonia Severity Index (PSI). The objective of this study was to compare these scores as mortality predictors in patients admitted with community acquired pneumonia (CAP). This cross-sectional study was conducted in Jinnah Postgraduate Medical Centre, Karachi, Pakistan, for six months in 2020 on 116 patients presenting with CAP. Cases of aspiration pneumonia, hospital acquired pneumonia, pulmonary tuberculosis, pulmonary embolism, and pulmonary oedema were excluded. In-hospital mortality was taken as the outcome of this study. The mean age of the participants was 46.9±20.5 years. The in-hospital mortalities were 45(38.8%). NEWS2 was 97.8% sensitive but only 15.5% specific in predicting the outcome, whereas PSI was less sensitive (68.9%) but more specific (50.7%), which showed that in comparison with PSI, NEWS2 is a more sensitive mortality predicting score among hospitalised CAP patients.

Intrinsic disruption of white matter microarchitecture in major depressive disorder: A voxel-based meta analysis of diffusion tensor imaging.

BACKGROUND: Major depressive disorder (MDD) is a prevalent and disabling mood disorder, thought to be linked with brain white matter (WM) alterations. Prior diffusion tensor imaging (DTI) studies have reported inconsistent changes in fractional anisotropy (FA) across different brain regions in MDD patients. However, none of these studies utilized raw t-map data for WM meta-analysis in MDD. Our study aims to address this gap by conducting a whole-brain-based meta-analysis of FA in MDD using Seed-based d mapping via permutation of subject images (SDM-PSI), combining reported peak coordinates and raw statistical parametric maps. OBJECTIVES: Following PRISMA guidelines, we performed a systematic search and meta-analysis to compare FA in MDD patients with healthy controls (HC). Our goal was to identify WM abnormalities in MDD, using SDM, which could shed light on the disorder's pathogenesis. RESULTS: The meta-analysis included 39 studies with 3696 participants (2094 with MDD, 1602HC). It revealed that MDD patients, in comparison to HC, have lower FA in the corpus callosum (CC) and anterior thalamic projections (ATP). Subgroup analyses indicated that the CC is a more stable pathogenic factor in MDD. Meta-regression analyses showed no linear correlation between the mean age, percentage of female patients, duration of depression, and FA abnormalities. This suggests that WM impairments in interhemispheric connections and anterior thalamocortical circuits are significant in the pathogenesis of MDD.

Site matters: site-specific factors control phosphorus retention in buffer strip soils under concentrated field runoff.

Soil erosion from agricultural fields is a persistent ecological problem, potentially leading to eutrophication of aquatic habitats in the catchment area. Often used and recommended mitigation measures are vegetated filter strips (VFS) as buffer zones between arable land and water bodies. However, if they are designed and managed poorly, nutrients - especially phosphorus (P) - may accumulate in the soil. Ultimately, VFS can switch from being a nutrient sink to a source. This problem is further aggravated if the field runoff does not occur as uniform sheet flow, but rather in concentrated form, as is usually the case. To assess the impact of concentrated flow on VFS performance, we have taken soil core samples from field-VFS transition zones at six sites in Lower Austria. We determined a multitude of physical and chemical soil parameters, focusing on P fractions and indices. Our results revealed that concentrated flow can lead to an accumulation of P in the VFS. P levels in the VFS inside the area of concentrated runoff can be equal to or higher than in the field, even though they receive no direct fertilization. However, the concentration and distribution of nutrients in the fields and VFSs were also site-specific and affected by local factors such as the age of the VFS, cropping, and fertilization. Accordingly, there is a need for more sophisticated, bespoke VFS designs that can cope with site-specific runoff volumes and movements of nutrients that occur.

Chlorophyll fluorescence characteristics and H2O2 contents of Chinese tallow tree are dependent on population origin, nutrients and salinity.

Plants from invasive populations often have higher growth rates than conspecifics from native populations due to better environmental adaptability. However, the roles of improved chlorophyll fluorescence or antioxidant defenses in helping them to grow better under adverse situations are insufficient, even though this is a key physiological question for elucidating mechanisms of plant invasion. Here, we conducted experiments with eight native (China) and eight introduced (USA) populations of Chinese tallow tree (Triadica sebifera). We tested how salinity, nutrients (overall amount or N:P in two separate experiments) and their interaction affected T. sebifera aboveground biomass, leaf area, chlorophyll fluorescence and antioxidant defenses. Plants from introduced populations were larger than those from native populations, but salinity and nutrient shortage (low nutrients or high N:P) reduced this advantage, possibly reflecting differences in chlorophyll fluorescence based on their higher PSII maximum photochemical efficiency (F v/F m) and PSI maximum photo-oxidizable P700 in higher nutrient conditions. Native population plants had lower F v/F m with saline. Except in high nutrients/N:P with salinity, introduced population plants had lower electron transfer rate and photochemical quantum yield. There were no differences in antioxidant defenses between introduced and native populations except accumulation of hydrogen peroxide (H2O2), which was lower for introduced populations. Low nutrients and higher N:P or salinity increased total antioxidant capacity and H2O2. Our results indicate that nutrients and salinity induce differences in H2O2 contents and chlorophyll fluorescence characteristics between introduced and native populations of an invasive plant, illuminating adaptive mechanisms using photosynthetic physiological descriptors in order to predict invasions.

Common and separable neural alterations in adult and adolescent depression - Evidence from neuroimaging meta-analyses.

Depression is a highly prevalent and debilitating mental disorder that often begins in adolescence. However, it remains unclear whether adults and adolescents with depression exhibit common or distinct brain dysfunctions during reward processing. We aimed to identify common and separable neurofunctional alterations during receipt of rewards and brain structure in adolescents and adults with depression. A coordinate-based meta-analysis was employed using Seed-based d mapping with permutation of subject images (SDM-PSI). Compared with healthy controls, both age groups exhibited common activity decreases in the right striatum (putamen, caudate) and subgenual ACC. Adults with depression showed decreased reactivity in the right putamen and subgenual ACC, while adolescents with depression showed decreased activity in the left mid cingulate, right caudate but increased reactivity in the right postcentral gyrus. This meta-analysis revealed shared (caudate) and separable (putamen and mid cingulate cortex) reward-related alterations in adults and adolescents with depression. The findings suggest age-specific neurofunctional alterations and stress the importance of adolescent-specific interventions that target social functions.

Drought Has a Greater Negative Effect on the Growth of the C3Chenopodium quinoa Crop Halophyte than Elevated CO2 and/or High Temperature.

Plant growth and productivity are predicted to be affected by rising CO2 concentrations, drought and temperature stress. The C3 crop model in a changing climate is Chenopodium quinoa Willd-a protein-rich pseudohalphyte (Amaranthaceae). Morphophysiological, biochemical and molecular genetic studies were performed on quinoa grown at ambient (400 ppm, aCO2) and elevated (800 ppm, eCO2) CO2 concentrations, drought (D) and/or high temperature (eT) treatments. Among the single factors, drought caused the greatest stress response, inducing disturbances in the light and dark photosynthesis reactions (PSII, apparent photosynthesis) and increasing oxidative stress (MDA). Futhermore, compensation mechanisms played an important protective role against eT or eCO2. The disruption of the PSII function was accompanied by the activation of the expression of PGR5, a gene of PSI cyclic electron transport (CET). Wherein under these conditions, the constant Rubisco content was maintained due to an increase in its biosynthesis, which was confirmed by the activation of rbcL gene expression. In addition, the combined stress treatments D+eT and eCO2+D+eT caused the greatest negative effect, as measured by increased oxidative stress, decreased water use efficiency, and the functioning of protective mechanisms, such as photorespiration and the activity of antioxidant enzymes. Furthermore, decreased PSII efficiency and increased non-photochemical quenching (NPQ) were not accompanied by the activation of protective mechanisms involving PSI CET. In summary, results show that the greatest stress experienced by C. quinoa plants was caused by drought and the combined stresses D+eT and eCO2+D+eT. Thus, drought consistently played a decisive role, leading to increased oxidative stress and a decrease in defense mechanism effectiveness.

Non-invasive detection of systemic lupus erythematosus using SERS serum detection technology and deep learning algorithms.

Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple symptoms, and its rapid screening is the research focus of surface-enhanced Raman scattering (SERS) technology. In this study, gold@silver-porous silicon (Au@Ag-PSi) composite substrates were synthesized by electrochemical etching and in-situ reduction methods, which showed excellent sensitivity and accuracy in the detection of rhodamine 6G (R6G) and serum from SLE patients. SERS technology was combined with deep learning algorithms to model serum features using selected CNN, AlexNet, and RF models. 92 % accuracy was achieved in classifying SLE patients by CNN models, and the reliability of these models in accurately identifying sera was verified by ROC curve analysis. This study highlights the great potential of Au@Ag-PSi substrate in SERS detection and introduces a novel deep learning approach for SERS for accurate screening of SLE. The proposed method and composite substrate provide significant value for rapid, accurate, and noninvasive SLE screening and provide insights into SERS-based diagnostic techniques.

Comparison of 3D computer-assisted planning with and without patient-specific instrumentation for severe bone defects in reverse total shoulder arthroplasty.

BACKGROUND: Preoperative planning is an integral aspect of managing complex deformity in reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the success of patient-specific instrumentation (PSI) and 3D computer-assisted planning with standard instrumentation (non-PSI) in achieving planned corrections of the glenoid among patients undergoing RSA with severe bony deformity requiring glenoid bone grafts. METHODS: A retrospective case-control study was performed, including all patients that underwent RSA with combined bone grafting procedures (BIO-RSA or structural bone grafting) for severe glenoid deformity by a single study between June 2016 and July 2023. Patients were required to have preoperative and postoperative CT scans as well as preoperative 3D planning performed for inclusion. Patients were divided into two groups based on the use of 3D computer-assisted planning with or without PSI (PSI vs. non-PSI). The corrected inclination and version were measured by two separate reviewers on preoperative and postoperative 2D CT scans and compared to their corresponding preoperative planning goals utilizing bivariate analyses. RESULTS: We identified 45 patients that met our inclusion criteria (22 PSI and 23 non-PSI). Preoperative inclination (mean ± SD) (PSI 10.12° ± 15.86°, non-PSI 9.43° ± 10.64°; P = .864) and version (PSI -18.78° ± 18.3°, non-PSI -17.82° ± 11.49°; P = .835) measurements were similar between groups. No significant differences in the mean deviation (error) between the postoperative and planned inclination (PSI 5.49° ± 3.72; non-PSI 6.91° ± 5.05; P = .437) and version (PSI 8.37° ± 5.7; non-PSI 5.37° ± 4.43; P = .054) were found between groups. No difference in the rate of outliers (>10° error) was noted in inclination (P = .135) or version (P = .445) between groups. Greater planned version correction was correlated with greater error when PSI was utilized (PSI r = 0.519, P = .013; non-PSI r = 0.362, P = .089). CONCLUSION: Both PSI and 3D computer-assisted planning without PSI (non-PSI) appear to be useful techniques to achieve version and inclination correction among patients undergoing RSA with severe glenoid deformity required glenoid bone grafting with no clear superiority of one method over the other. Surgeons should be aware that when utilizing PSI, slightly greater error in achieving version goals may occur as version correction is increased.

Selection of optimal strategy for managing decentralized solar PV systems considering uncertain weather conditions.

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