Surgical resection represents the standard of care in diffuse glioma, and more extensive tumour resection appears to be associated with favourable outcome. Up to now, terminology to describe extent ...of resection has been inconsistently applied across clinical trials which hampers comparative analysis of cohorts between different studies. Based on a comprehensive literature review, we developed evidence-based expert recommendations on categories for extent of resection. Recommendations are formulated for the categories ‘biopsy’, ‘partial resection’, ‘subtotal resection’, ‘near total resection’, ‘complete resection’ and ‘supramaximal resection’. Definitions rest on reduction of contrast- and non–contrast-enhancing tumour in glioblastoma, and on reduction of T2/FLAIR-hyperintense tumour in gliomas WHO grade 2 or 3. Both relative reduction of tumour volume (in percentage) as a measurement of surgical efficacy and absolute residual tumour volume (in cm3) as a measurement of remaining tumour burden are incorporated into the categories for extent of resection. Class of evidence for the proposed categories ranges from class IIB to IV. Limitations of the suggested categories are discussed. The proposed categories on extent of resection offer a framework to standardize nomenclature based on previous studies, and will need to be evaluated in prospective, molecularly well-defined cohorts. Our categories may eventually help as a stratification factor for future clinical trials.
•Nomenclature to describe extent of resection in diffuse glioma is inconsistent.•Categories are formulated based on an extensive literature review.•Definitions rest on relative reduction of tumour and absolute residual tumour.•Class of evidence for the proposed categories ranges from class IIB-IV.•Our categories offer a framework to standardize nomenclature in diffuse glioma.
Background: Wearable devices have tremendous potential for large-scale longitudinal measurement of sleep, but their accuracy needs to be validated. We compared the performance of the multisensor Oura ...ring (Oura Health Oy, Oulu, Finland) to polysomnography (PSG) and a research actigraph in healthy adolescents. Methods: Fifty-three adolescents (28 females; aged 15-19 years) underwent overnight PSG monitoring while wearing both an Oura ring and Actiwatch 2 (Philips Respironics, USA). Measurements were made over multiple nights and across three levels of sleep opportunity (5 nights with either 6.5 or 8h, and 3 nights with 9h). Actiwatch data at two sensitivity settings were analyzed. Discrepancies in estimated sleep measures as well as sleep-wake, and sleep stage agreements were evaluated using Bland-Altman plots and epoch-by-epoch (EBE) analyses. Results: Compared with PSG, Oura consistently underestimated TST by an average of 32.8 to 47.3 minutes (Ps < 0.001) across the different TIB conditions; Actiwatch 2 at its default setting underestimated TST by 25.8 to 33.9 minutes. Oura significantly overestimated WASO by an average of 30.7 to 46.3 minutes. It was comparable to Actiwatch 2 at default sensitivity in the 6.5, and 8h TIB conditions. Relative to PSG, Oura significantly underestimated REM sleep (12.8 to 19.5 minutes) and light sleep (51.1 to 81.2 minutes) but overestimated N3 by 31.5 to 46.8 minutes (Ps < 0.01). EBE analyses demonstrated excellent sleep-wake accuracies, specificities, and sensitivities - between 0.88 and 0.89 across all TIBs. Conclusion: The Oura ring yielded comparable sleep measurement to research grade actigraphy at the latter's default settings. Sleep staging needs improvement. However, the device appears adequate for characterizing the effect of sleep duration manipulation on adolescent sleep macro-architecture. Keywords: validation, adolescents, wearable, polysomnography, actigraphy
The EarthCARE satellite mission's objective is to retrieve profiles of aerosol and cloud physical and optical properties using the combination of cloud-profiling radar (CPR), high-spectral-resolution ...UV lidar (ATLID) and passive multi-spectral imager (MSI) data. Based on synergistic retrievals using data from these instruments, the 3D atmospheric cloud-aerosol state is estimated and then used to model the top-of-atmosphere (TOA) broadband radiances, which may then be compared to co-incident EarthCARE broadband radiometer (BBR) measurements. A high-spectral-resolution lidar enables the independent retrieval of extinction and backscatter but, being space based, suffers from relatively low signal-to-noise ratio (SNR) levels. The ATLID FeatureMask (A-FM) product provides a feature detection mask for the existence of atmospheric features within the lidar profiles based on a number of (statistical) image reconstruction techniques. Next to this, it also identifies those regions where the lidar beam has been fully attenuated and where the surface backscatter has impacted the measured lidar backscatter signals directly above the surface. From the pixels assigned as clear sky (with no features present above), the clear-sky-averaged profiles for the three ATLID channels, the co-polar Mie channel, the total cross channel and the co-polar Rayleigh channel are created. These feature-free or clear-sky profiles are useful for e.g., assessing the quality of the ATLID Level-1 (L1) attenuated backscatters. An important goal of the A-FM product is to guide smoothing strategies within downstream processors e.g., the ATLID profile retrieval (A-PRO) algorithm which directly follows A-FM within the EarthCARE Level-2 (L2) processing chain. Within the A-PRO algorithm, profiles of extinction, backscatter and linear depolarization ratio are retrieved. However, smoothing of the ATLID L1 attenuated backscatter is necessary since the SNR levels present at the ATLID native resolution are generally not sufficient for meaningful retrievals to be conducted. At the same time, to prevent biased retrievals, any smoothing procedure must respect the cloud-aerosol structure and avoid mixing strong features, e.g., clouds, and weak features, e.g., aerosol regions, together. The A-FM product provides the A-PRO algorithm with important information that is used to guide various smoothing procedures. To enable the processing of the large datasets from observation up to L2 retrievals, each EarthCARE orbit is separated into eight frames, divided at latitudes of 22.5.sup." N and 22.5.sup." S and 62.5.sup." N and 62.5.sup." S. As a secondary product, A-FM outputs can be used to conduct a frame-by-frame evaluation of the ATLID L1 cross-talk calibration, where an EarthCARE frame is one-eighth of a full orbit. This evaluation can be performed by comparing the retrieved clear-sky profiles to the expected channel profiles. The A-FM product has been applied to both synthetic data from the EarthCARE end-to-end simulator (ECSIM) and the L1 data from the Aeolus wind lidar mission. Comparisons against the ECSIM model truth indicate that A-FM has a percentage correctness 90 % and is capable of reliably detecting aerosol and cloud regions within extinctions ( 10.sup.-5 m.sup.-1).
Owing to their entropy stabilization and multi-principal effect, transition-metal-based high-entropy oxides are attracting extensive attention as an effective family of anode materials for lithium ...ion batteries (LIBs). Herein, spinel-type (Al.sub.0.2CoCrFeMnNi).sub.0.58O.sub.4-delta HEO nanocrystalline powder with high concentration of oxygen vacancies is successfully prepared by the method of solution combustion synthesis (SCS), and explored as a novel anode active material for LIBs. As compared to (CoCrFeMnNi).sub.0.6O.sub.4-delta, the inactive Al.sup.3+-doped (Al.sub.0.2CoCrFeMnNi).sub.0.58O.sub.4-delta anode provides more than twice the reversible specific capacity of 554 mAh g.sup.-1 after 500 cycles at a specific current of 200 mA g.sup.-1, accompanied with good rate capability (634 mAh g.sup.-1 even at 3 A g.sup.-1) and cycling performance. The enhanced electrochemical properties can be attributed to that inactive Al.sup.3+-doping resulted into the more space for Li.sup.+ intercalation and deintercalation, enhanced structural stability, and the improved electronic conductivity and Li.sup.+ diffusivity. Graphical abstract
In this letter, we report on the optical and structural properties of supported and suspended MoS.sub.2 /Graphene/MoS.sub.2 vertical heterostructures using Raman and photoluminescence (PL) ...spectroscopies. Vertical heterostructures (VH) are formed by multiple wet transfers on micro-sized holes in SiO.sub.2 /Si substrates, resulting in VH with different configurations. The strong interlayer coupling is confirmed by Raman spectroscopy. Additionally, we observe an enhancement of the PL emission in the three-layer VH (either support or suspended) compared with bare MoS.sub.2 or MoS.sub.2 /Graphene. This suggests the formation of a spatial type-II band alignment assisted by the graphene layer and thus, the operation of the VH as a n++/metal/n junction.
The primary aim of this investigation was to leverage radiomics features derived from contrast-enhanced abdominal computed tomography (CT) scans to devise a predictive model to discern the benign and ...malignant nature of intraductal papillary mucinous neoplasms (IPMNs). Radiomic signatures were meticulously crafted to delineate benign from malignant IPMNs by extracting pertinent features from contrast-enhanced CT images within a designated training cohort (n = 84). Subsequent validation was conducted with data from an independent test cohort (n = 37). The discriminative ability of the model was quantitatively evaluated through receiver operating characteristic (ROC) curve analysis, with the integration of carefully selected clinical features to improve the comparative analysis. Arterial-phase images were utilized to construct a model comprising 8 features for distinguishing between benign and malignant cases. The model achieved an accuracy of 0.891 95% confidence interval (95% CI), 0.816–0.996 in the cross-validation set and 0.553 (95% CI 0.360–0.745) in the test set. Conversely, employing 9 features from the venous-phase resulted in a model with a cross-validation accuracy of 0.862 (95%CI 0.777–0.946) and a test set accuracy of 0.801 (95% CI 0.653–0.950).Integrating the identified clinical features with imaging features yielded a model with a cross-validation accuracy of 0.934 (95% CI 0.879–0.990) and a test set accuracy of 0.904 (95% CI 0.808–0.999), thereby further improving its discriminatory ability. Our findings distinctly illustrate that venous-phase radiomics features eclipse arterial-phase radiomic features in terms of predictive accuracy regarding the nature of IPMNs. Furthermore, the synthesis and meticulous screening of clinical features with radiomic data significantly increased the diagnostic efficacy of our model, underscoring the pivotal importance of a comprehensive and integrated approach for accurate risk stratification in IPMN management.
The optimal intermittent time for post-activation potentiation (PAP) training remains uncertain and contentious. This study employed a meta-analysis to systematically evaluate the effect of different ...intermittent times on PAP in relation to explosive vertical jump height. Relevant literature was sourced from CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, and Google Scholar databases using keywords such as “postactivation potentiation,” “activation enhancement effect,” “PAP,” “explosive vertical jump,” “explosive vertical high jump,” and “intermittent time.” The search covered publications from the inception of each database until June 2024. Studies involving athletes (regardless of sport type) undergoing PAP training were included, with no restrictions on the methods used to induce PAP. Comparative analysis focused on the heights of countermovement jumps (CMJ) and peak ground reaction force (GRF) before and after interventions. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool, and data were analyzed using RevMan5.3. The study included a total of 21 papers with 327 subjects, primarily using the squat as the method of PAP induction. The meta-analysis revealed that intermittent times of 4 min MD = − 0.03, 95% CI: − 0.04 ~ − 0.01; Z = 2.71, P = 0.007 and 5–8 min MD = − 0.03, 95% CI: − 0.04 ~ – 0.01; Z = 3.07, P = 0.002 significantly increased the height of explosive vertical CMJs. However, intermittent times of 1–3 min MD = –0.00, 95% CI: − 0.01 ~ 0.01; Z = 0.38, P = 0.70 and 10–24 min MD = − 0.01, 95% CI: − 0.02 ~ 0.00; Z = 1.43, P = 0.15 did not show significant effects on CMJ height. These findings indicate that 4-min and 5–8 min intervals significantly enhance CMJ height, while intervals shorter than 4 min or longer than 8 min do not have a significant impact.
The multi-criteria decision-making (MCDM) field has long sought tools capable of adeptly capturing the intricacies of human decision-making amidst uncertainty. Hesitant fuzzy sets (HFS) have become a ...cornerstone in the MCDM field due to their ability to capture the intricacies of human decision-making under uncertainty. Nonetheless, we identified a significant gap in traditional HFS formulations, which often fail to fully harness the nuanced and implicit preferences of decision-makers (DMs). This shortcoming can lead to suboptimal decision outcomes in complex and uncertain environments. We introduce the normal wiggly hesitant fuzzy set (NWHFS), a novel construct that encapsulates both explicit and implicit preferences within a more representative framework. This study pioneers the development of new correlation coefficients for NWHFSs, offering a robust quantitative measure to elucidate the intricate relationships between variables. Our findings demonstrate that NWHFSs significantly enhance the MCDM process, providing a nuanced perspective that traditional HFS models cannot match. The proposed correlation coefficients not only reveal the concealed preferences of DMs but also broaden the decision-making spectrum, offering a more profound understanding of the relationships between alternatives and criteria. We illustrate the superiority of our approach through comparative analysis with existing methods, highlighting its ability to discern subtleties that other models overlook. Moreover, we integrate NWHFSs into clustering analysis, showcasing their potential to classify data sources with shared attributes effectively. This integration is particularly noteworthy for its ability to navigate complex datasets, offering a new dimension in data mining and resource retrieval. In essence, our study redefines the MCDM paradigm by introducing NWHFSs and their correlation coefficients, setting a new standard for decision-making accuracy and insight. The implications of our work extend beyond theory, offering practical solutions to real-world decision-making challenges.
We conduct an exploratory qualitative comparative case analysis of the S&P 1500 firms with the aim of elaborating theory on how corporate governance mechanisms work together effectively. To do so, we ...integrate extant theory and research to specify the bundle of mechanisms that operate to mitigate the agency problem among publicly traded corporations and review what previous research has said about how these mechanisms combine. We then use the fuzzy-set approach to qualitative comparitive analysis (QCA) to explore the combinations of governance mechanisms that exist among the S&P 1500 firms that achieve high (and not-high) profitability. Our findings suggest that high profits result when CEO incentive alignment and monitoring mechanisms work together as complements rather than as substitutes. Furthermore, they show that high profits are obtained when both internal and external monitoring mechanisms are present. At the same time, however, monitoring mechanisms evidently combine in complex ways such that there may be simultaneity of substitution and complementarity among and across the various monitoring and control mechanisms. Our findings clearly suggest that the effectiveness of board independence and CEO non-duality—governance mechanisms widely believed to singularly resolve the agency problem—depends on how each combine with the other mechanisms in the governance bundle.
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