Search

Abstract First-line treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL) typically involves 6x R-CHOP21 or 6x R-CHOP21 with two additional rituximab administrations (6x R-CHOP21 + 2 R). In contemporary practice, this treatment choice might be guided by interim PET scan results. This nationwide, population-based study investigates the comparative effectiveness of these treatment regimens in an era where interim PET-guided treatment decisions were not standard practice. Utilizing the Netherlands Cancer Registry, we identified 1577 adult patients diagnosed with advanced-stage DLBCL between 2014–2018 who completed either 6x R-CHOP21 (43%) or 6x R-CHOP21 + 2 R (57%). We used propensity scores to assess differences in event-free survival (EFS) and overall survival (OS). At five years, EFS (hazard ratio of 6x R-CHOP21 + 2 R versus 6x R-CHOP21 [HR] = 0.89; 95% confidence interval [CI], 0.72–1.09) and OS (HR = 0.93; 95% CI, 0.73–1.18) were not significantly different between both regimens. In exploratory risk-stratified analysis according to the International Prognostic Index (IPI), high-IPI patients (i.e., scores of 4-5) benefit most from 6x R-CHOP21 + 2 R (5-year absolute risk difference of EFS = 16.8%; 95% CI, −0.4%−34.1% and OS = 12.1%; 95% CI, −5.4–29.6%). Collectively, this analysis reveals no significant differences on average in EFS and OS between the two treatments. However, the potential benefits for high-risk patients treated with 6x R-CHOP21 + 2 R underscore the need for future research.

Background and Aim: Toxoplasmosis is caused by the parasite Toxoplasma gondii. Cats are the only known hosts that excrete resistant oocysts. Wild rats serve as crucial reservoirs and intermediate hosts for T. gondii’s survival and dissemination. Consuming soil and water containing oocysts can lead to illness. This study aimed to estimate the prevalence of toxoplasmosis in wild rats through molecular detection as an indicator of environmental contamination in Surabaya. Materials and Methods: One hundred rats were collected from the three areas (housing, dense settlements, and traditional markets) and distributed into the five zones: West, East, Central, North, and South of Surabaya. Brain tissue samples were extracted using a Geneaid™ (New Taipei City, Taiwan) DNA isolation kit and analyzed through the loop-mediated isothermal amplification (LAMP) method. Results: The study analyzed brain tissue from 100 wild rats, consisting of 77 Rattus tanezumi and 33 Rattus norvegicus, displaying 30% LAMP positivity. The study revealed that 30% (30/100) of wild rats tested were infected with T. gondii. The molecular prevalence rate in male rats was 32.35% (22/68), compared to females with 25% (8/32). 41.9% of the housing population, 33.3% of traditional markets, and 22.6% of dense settlements had the highest molecular prevalence. The high positive molecular rate at the trapping site can be attributed to cats and dense populations. Conclusion: Thirty percentage wild rats were tested positive for toxoplasmosis in Surabaya, East Java, Indonesia using LAMP method. Implementing strict control and monitoring is crucial in preventing the transmission of diseases from wild rats to humans. It is necessary to carry out further research related to genetic analysis of T. gondii to determine the type of T. gondii that infects animals and humans in Surabaya through bioassay and molecular test.

In order to fulfill the demand for high energy and capacity, an electrode with high-voltage capability, namely LiNi0.5Mn1.5O4 (LNMO) that has an operating potential of up to 4.7 V vs Li/Li+, is currently becoming popular in Li-ion battery chemistries. This research produced LNMO by using a solid-state method with only one-step synthesis route to compare its electrochemical performance with different lithium sources, including hydroxide (LNMO-LiOH), acetate (LNMO-LiAce), and carbonate (LNMO-LiCar) precursors. TGA/DSC was first performed for all three sample precursors to ensure the optimal calcination temperature, while XRD and SEM characterized the physical properties. The electrochemical measurements, including cyclic voltammetry and charge-discharge, were conducted in the half-cell configurations of LNMO//Li-metal using a standard 1 M LiPF6 electrolyte. LNMO-LiOH samples exhibited the highest purity and the smallest particle size, with values of 93.3% and 418 nm, respectively. In contrast, samples with higher impurities, such as LNMO-LiCar, mainly in the form of LixNi1-xO (LiNiO), displayed the largest particle size. The highest working voltage possessed by LNMO-LiOH samples was 4.735 V vs Li/Li+. The results showed that LNMO samples with LiNiO impurities would affect the reaction behavior that occurs at the cathode-electrolyte interface during the release of lithium-ions, resulting in high resistance at the battery operations and decreasing the specific capacity of the LNMO during discharging. The highest value, shown by LNMO-LiOH, was up to 92.75 mAh/g. On the other side, LNMO-LiCar only possessed a specific capacity of 44.57 mAh/g, indicating a significant impact of different lithium sources in the overall performances of LNMO cathode.

This research aims to analyze the role of the Regional Supervisory Council in enforcing the Law on Notary Positions in East Lombok Regency, the form of supervision carried out by the Regional Supervisory Council (MPD) on Notaries in the East Lombok area. This research is empirical juridical legal research, namely legal research regarding the application and implementation of legal provisions that apply to the conditions in society. The results of the study show that the supervision carried out by the MPD for notaries in East Lombok Regency is providing seminars on notarialism, holding meetings once a month, which the MPD and notaries attend to evaluate the performance of fellow notaries in East Lombok district and make visits at least once a year to check notary protocols. The law on the Position of Notaries (UUJN) is a guideline for notaries in carrying out their duties and responsibilities. If a notary commits a violation, the MPD will report it to the MPW (Regional Supervisory Council) and be given sanctions.

Objective Acute myeloid leukaemia (AML) prognosis is enhanced with intensive remission induction chemotherapy (ICT) in eligible patients. However, ICT eligibility perceptions may differ among healthcare professionals. This nationwide, population-based study aimed to explore regional variation in ICT application and its relation with overall survival (OS).Methods and analysis We compared nine Dutch regional networks using data from the Netherlands Cancer Registry. Regional variance was assessed for the entire population and age subgroups (ie, ≤60 years and >60 years) using multivariable mixed effects logistic and Cox proportional hazard regression analyses, expressed via median OR (MOR) and median HR (MHR).Results Including all adult AML patients from 2014 to 2018 (N=4060 patients; 58% males; median age, 70 years), 1761 (43%) received ICT. ICT application varied from 36% to 57% (MOR 1.36 (95% CI 1.11 to 1.58)) across regions, with minor variations for patients aged ≤60 years (MOR 1.16 (95% CI 1.00 to 1.40)) and more extensive differences for those aged >60 years (MOR 1.43 (95% CI 1.16 to 1.63)). Median OS spanned 4.9–8.4 months across regions (MHR 1.11 (95% CI 1.00 to 1.15)), with pronounced differences in older patients (MHR 1.12 (95% CI 1.08 to 1.20)) but negligible differences in the younger group (MHR 1.02 (95% CI 1.00 to 1.14)). Survival differences for the total population and the older patients decreased to respectively, MHR 1.09 (95% CI 1.00 to 1.13) and 1.10 (95% CI 1.04 to 1.18), after additional adjustment for the probability of receiving ICT within a region, indicating approximately 10% unexplained differences.Conclusion Regional disparities in ICT application and survival exist, especially in older AML patients. However, ICT application differences partially explain survival disparities, indicating the need for more standardised ICT eligibility criteria and a better understanding of underlying causes of outcome disparities.

Sex identification of Sun Conures (Aratinga solstitialis) is crucial for breeding and preservation, as well as increasing sun conure populations. These birds are sexually monomorphic. Therefore, Determination between male and female carried out by their morphology examination. The Polymerase Chain Reaction (PCR) method, utilizing molecular-based technology, was employed to determine the sex of Aratinga solstitialis in this study. The P2 and P8 primers were utilized in this method, which has been deemed suitable and accurate for sex identification through calamus samples. The research focused on two 28-month-old Aratinga solstitialis birds. Calamus samples were collected and subjected to PCR amplification using the extracted calamus. The resulting PCR products were then visualized using electrophoresis with a 1% agarose gel. In the electrophoresis photo, the presence of two bands indicated a female specimen, whereas a single band indicated a male specimen. The result of the gel electrophoresis research showed that both of the Aratinga solstitialis were male with one band of each bird on ranged from 300-400 base pairs. The result show that the Polymerase Chain Reaction method in terms for sex identification on monomorphic birds, especially Aratinga solstitialis birds is very effective to differentiate the sex of young birds and the adults.

This study investigates the effects of carbon nanomaterials (CN), specifically nanohorns (CNHs) and nanotubes (MWCNTs), on geopolymer carbon nanocomposites (GCN). The research investigates 0.2%, 0.5% and 1.0% of CN and two curing conditions to understand their impact on the microstructure, morphology, and performance of GCN. Analytical techniques such as MIP, TGA-DTA, FTIR, Raman, SEM, and EDX are utilized to analyze the nanoadditives in alkali-silicate suspensions, fresh and hardened GCN. Ultrasonication is important for achieving better dispersion of MWCNTs, while CNH disperses more easily. Both MWCNTs and CNHs enhance flexural strength by up to around 58% and 44%, respectively, and reduce crack formation compared to the pristine geopolymer. Hydrothermal curing, despite leading to higher porosity, improves flexural strength due to increased geopolymerisation. The formation of a cross-polymerized network with oxo bonds and the release of water during the process contribute to increased strength and porosity, respectively.

In the pursue of environmentally-friendly binders for the construction industry, metakaolin (MK) has emerged as promising material, with its hardening performance primarily driven by pozzolanic reactions. However, in systems containing MK and calcium hydroxide (CH), transformation reactions from metastable to stable phases, particularly in excessive CH conditions, can adversely affect material properties. To anticipate these processes, this study introduces a stoichiometry-based reaction modeling approach for pozzolanic MK reactions, encompassing both short-term kinetics and long-term transformation processes. The primary pozzolanic reactions of MK are briefly outlined, highlighting two sequential, partially overlapping reactions forming C4AH13 and C2ASH8. Short-term reaction kinetics are modeled using isothermal calorimetry measurements and deconvoluting the two reaction peaks. The model is in good agreement with experimental quantitative X–ray diffraction (qXRD), thermogravimetric analysis (TGA) and helium pycnometer (density, i.e. solid volume) results. Model limitations are discussed based on qualitative scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX) analysis. Leveraging the proposed model, the temperature dependency of pozzolanic MK reactions is analyzed, revealing an activation energy for the primary reaction of 84 kJ/mol. The model is intended to lay a foundation for designing innovative binder systems based on metakaolin, while paving the way for sustainable construction in the future.

In pattern mining, high-utility itemset mining (HUIM) is useful for discovering high-utility patterns. The study of HUIM using heuristic techniques reflects issues in producing better offspring. It is ineffective in terms of search space organization, population diversity, and utility calculation, which impact runtime and accuracy. It is observed that very few researchers have experimented with genetic algorithm (GA) and are still facing the same issues as mentioned before. To overcome these problems, a novel approach is proposed for HUIM using modified GA and optimized local search (HUIM-MGALS) with six potential contributions. First is linking the utility with the Bitmap dataset to reduce utility access time, leading to effective search space organization. Second, HUIM-MGALS employs a fitness scaling strategy to avoid redundancy. Third, a high-utility itemset (HUI) revision strategy is employed to explore significant HUIs. Modified population diversity maintenance strategy and iterative crossover help to preserve significant HUIs and improve search capability as fourth and fifth contributions. Sixth, the use of multiple mutations refines the wasted individuals to boost accuracy. Extensive experimentation showed that HUIM-MGALS significantly outperforms the presented algorithms, up to 8.6 times faster. It also demonstrates superior HUI discovery capabilities for both sparse and dense datasets. This is supported by the modified population diversity maintenance strategy, which is proved to be the most impactful modification for HUI discovery in HUIM-MGALS. [ABSTRACT FROM AUTHOR]

First-line treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL) typically involves 6x R-CHOP21 or 6x R-CHOP21 with two additional rituximab administrations (6x R-CHOP21 + 2 R). In contemporary practice, this treatment choice might be guided by interim PET scan results. This nationwide, population-based study investigates the comparative effectiveness of these treatment regimens in an era where interim PET-guided treatment decisions were not standard practice. Utilizing the Netherlands Cancer Registry, we identified 1577 adult patients diagnosed with advanced-stage DLBCL between 2014–2018 who completed either 6x R-CHOP21 (43%) or 6x R-CHOP21 + 2 R (57%). We used propensity scores to assess differences in event-free survival (EFS) and overall survival (OS). At five years, EFS (hazard ratio of 6x R-CHOP21 + 2 R versus 6x R-CHOP21 [HR] = 0.89; 95% confidence interval [CI], 0.72–1.09) and OS (HR = 0.93; 95% CI, 0.73–1.18) were not significantly different between both regimens. In exploratory risk-stratified analysis according to the International Prognostic Index (IPI), high-IPI patients (i.e., scores of 4-5) benefit most from 6x R-CHOP21 + 2 R (5-year absolute risk difference of EFS = 16.8%; 95% CI, −0.4%−34.1% and OS = 12.1%; 95% CI, −5.4–29.6%). Collectively, this analysis reveals no significant differences on average in EFS and OS between the two treatments. However, the potential benefits for high-risk patients treated with 6x R-CHOP21 + 2 R underscore the need for future research. [ABSTRACT FROM AUTHOR]

This study looks at conflict management strategies that apply productive cooperation and communication to enhance team performance. As part of the literature analysis process, several conflict resolution strategies employed by work teams were evaluated to determine how they affected both individual and group performance. An assessment of these tactics' contribution to creating a peaceful and effective work environment was one of the research's goals. It is intended that this research will help determine the most effective approaches that not only deal with conflict in a positive way but also promote teamwork and collaboration. In order to improve work satisfaction, employee engagement, and overall organizational performance, useful advice will be made to assist organizations in implementing effective conflict management practices. Findings from the literature also highlight the importance of collaboration and effective communication in improving team performance. Therefore, conflict management strategies, collaboration, and good communication are considered key interacting factors in creating a productive, innovative, and harmonious work environment, which becomes crucial for team success in various organizational contexts. [ABSTRACT FROM AUTHOR]

Four derivatives of 2'‐hydoxychalcone were synthesized through Claisen‐Schmidt condensation by combining 2'‐hydroxyacetophenone and four different benzaldehyde derivatives (o‐vanillin, salicylaldehyde, p‐anisaldehyde, and benzaldehyde) in the presence of a base. The reactions took place in an ionic liquid, 1‐dodecyl‐3‐methylimidazolium bromide ([DDMIm]Br), and were facilitated by microwave irradiation. The reactions were completed within 10 to 15 minutes, yielding products with chemical yields ranging from 52.64 % to 83.42 %. The structures of the synthesized products were confirmed using 1H NMR and 13C NMR spectroscopy. Additionally, antimicrobial activity tests demonstrated the effectiveness of specific derivatives against Staphylococcus aureus and Escherichia coli, underscoring the importance of hydroxy and methoxy groups on the aromatic ring in inhibiting microbial growth. These findings provide valuable knowledge for developing chalcone derivatives with improved properties and potential applications in drug discovery. Furthermore, the synthesized products′ reactivity was analyzed using Frontier Molecular Orbital (FMO) and their reactivity site was mapped using Molecular Electrostatic Potential (MEP). Lastly, molecular docking analysis was attempted to explain antibacterial activities from all products. Nonetheless, the molecular docking simulations conducted in this study were inadequate to fully account for the antimicrobial activity observed in all the products. [ABSTRACT FROM AUTHOR]

The type of this research is qualitative-descriptive. Thirty schools located in the city of Sorong, covering primary to secondary education levels, were selected as the research locations. Approximately 35 Catholic religion teachers participated as research informants. Interview, observation, and documentation study techniques were used as methods to collect data. This research aims to examine the implementation and effectiveness of the Catholic Religious Education (PAK) learning process in schools. The researchers then attempted to explore further how schools continuously strive to improve the quality of implementing Catholic Religious Education in schools for fostering attitudes and behaviors of religious tolerance in schools. Through the Catholic Religious Education learning model, students are able to: First, adopt a critical attitude towards various issues related to racism, fanaticism, ethnicity, and repressive aspects in society. Second, conduct studies on various issues stemming from diverse perspectives of religions and other beliefs, thereby fostering awareness of cultural diversity and peace. Third, develop cooperative learning skills and decision-making skills so that students are ready to become good citizens in terms of social and democratic aspects as well as tolerant. [ABSTRACT FROM AUTHOR]

In this study, we demonstrate a facile, durable and inexpensive technique of producing silver nanoparticles-decorated multi-walled carbon nanotubes (MWCNT/AgNP) on the easy-to-use screen-printed carbon electrodes (SPCE) for non-enzymatic detection of uric acid (UA) in an electrochemical sensor. The developed sensors show great durability for three months in storage, and high specificity performance for preclinical study using spiked UA in a synthetic urine sample. A simple route for this hybrid nanocomposite was proposed through an oxidation–reduction with reflux (ORR) process. A significant increase in the electroactive surface area of SPCE was achieved by modifying it with MWCNT/AgNP. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive x-ray spectroscopy (EDX), Fourier-transform infrared (FT-IR) spectroscopy, Raman spectroscopy, and x-ray diffraction (XRD) analysis confirmed this synthesis. The nanocomposite nanostructure electrodes achieved an outstanding UA detection with sensitivity of 0.1021 μ A μ M−1 and a wide dynamic range of 10–1000 μ M. In phosphate-buffered saline (PBS), the measurements achieved a detection limit of 84.04 nM while in pure synthetic urine; it was 6.074 μ M. The constructed sensor exhibits excellent stability and durability for several months, and great specificity against interfering compounds, including dopamine (DA), urea, and glucose. Overall, the present outcomes denote the potential of MWCNT/AgNP-decorated SPCE for early uric acid diagnostics tools in health monitoring. [ABSTRACT FROM AUTHOR]

This letter published in the Blood Cancer Journal discusses the challenges in treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and the limited efficacy of current treatment options. The authors aim to validate the findings of the SCHOLAR-1 study, which reported poor outcomes for patients with refractory DLBCL, in a population-based study in the Netherlands. The study analyzes data from the Netherlands Cancer Registry and includes 197 patients with DLBCL, transformed follicular lymphoma (tFL), and primary mediastinal B-cell lymphoma (PMBCL). The study findings suggest that the prognosis for patients with relapsed or refractory DLBCL remains poor, despite recent advances in treatment options. The study highlights the need for improved treatment strategies for these patients. [Extracted from the article]

Geopolymers offer a potential alternative to ordinary Portland cement owing to their performance in mechanical and thermal properties, as well as environmental benefits stemming from a reduced carbon footprint. This paper endeavors to build upon prior atomistic computational work delving deeper into the intricate relationship between pH levels and the resulting material's properties, including pore size distribution, geopolymer nucleate cluster dimensions, total system energy, and monomer poly-condensation behavior. Coarse-grained Monte Carlo (CGMC) simulation inputs include tetrahedral geometry and binding energy parameters derived from DFT simulations for aluminate and silicate monomers. Elevated pH values may can alter reactivity and phase stability, or, in the structural concrete application, may passivate the embedded steel reinforcement. Thus, we examine the effects of pH values set at 11, 12, and 13 (based on silicate speciation chemistry), investigating their respective contributions to the nucleation of geopolymers. To simulate a larger system to obtain representative results, we propose the numerical implementation of an Octree cell. Finally, we further digitize the resulting expanded structure to ascertain pore size distribution, facilitating a comparative analysis. The novelty of this study is underscored by its expansion in both system size, more accurate monomer representation, and pH range when compared to previous CGMC simulation approaches. The results unveil a discernible correlation between the number of clusters and pores under specific pH levels. This links geopolymerization mechanisms under varying pH conditions to the resulting chemical properties and final structural state. [ABSTRACT FROM AUTHOR]

Gold nanodendrite (AuND) is a type of gold nanoparticles with dendritic or branching structures that offers advantages such as large surface area and high conductivity to improve electrocatalytic performance of electrochemical sensors. AuND structures can be synthesized using electrodeposition method utilizing cysteine as growth directing agent. This method can simultaneously synthesize and integrate the gold nanostructures on the surface of the electrode. We conducted a comprehensive study on the synthesis of AuND on screen-printed carbon electrode (SPCE)-based working electrode, focusing on the optimization of electrodeposition parameters, such as applied potential, precursor solution concentration, and deposition time. The measured surface oxide reduction peak current and electrochemical surface area from cyclic voltammogram were used as the optimization indicators. We confirmed the growth of dendritic gold nanostructures across the carbon electrode surface based on FESEM, EDS, and XRD characterizations. We applied the SPCE/AuND electrode as a nonenzymatic sensor on ascorbic acid (AA) and obtained detection limit of 16.8 μM, quantification limit of 51.0 μM, sensitivity of 0.0629 μA μM -1 , and linear range of 180-2700 μM (R 2 value = 0.9909). Selectivity test of this electrode against several interferences, such as uric acid, dopamine, glucose, and urea, also shows good response in AA detection., (© 2024. The Author(s).)

This study employs computational chemistry to investigate the detailed mechanisms behind the dissolution of thermally activated clays, which are emerging as promising supplementary cementitious materials (SCM) for enhancing concrete properties and reducing carbon footprint. Specifically, the study employs a first-principles methodology for obtaining activation energies (Δ E a ) involved in the dissolution of metakaolinite (MK) silicate units using NaOH and KOH activators. The investigation includes considerations of hydrolyzing oxo-bridging covalent bonds, van der Waals (vdW) interactions, and the influence of water molecules surrounding alkali cations. The study employs the enhanced dimer method within density functional theory (DFT) to propose four models for determining the activation energies required to break oxo-bridging bonds. The results demonstrate that KOH generally requires lower activation energies than NaOH, particularly when considering vdW interactions. They also highlight the lower activation energy required for commencing the dissolution of silicate units and emphasize the significance of the hydration shell around cations. The proposed methodology contributes to establishing a systematic database of atomistic activation energies, essential for atomistic kinetic Monte Carlo upscaling and mesoscopic forward dissolution rate calculations in clays. This holds relevance in understanding their reactivity within cementitious materials.

Background and Aim: Toxoplasmosis is caused by the parasite Toxoplasma gondii . Cats are the only known hosts that excrete resistant oocysts. Wild rats serve as crucial reservoirs and intermediate hosts for T. gondii's survival and dissemination. Consuming soil and water containing oocysts can lead to illness. This study aimed to estimate the prevalence of toxoplasmosis in wild rats through molecular detection as an indicator of environmental contamination in Surabaya., Materials and Methods: One hundred rats were collected from the three areas (housing, dense settlements, and traditional markets) and distributed into the five zones: West, East, Central, North, and South of Surabaya. Brain tissue samples were extracted using a Geneaid™ (New Taipei City, Taiwan) DNA isolation kit and analyzed through the loop-mediated isothermal amplification (LAMP) method., Results: The study analyzed brain tissue from 100 wild rats, consisting of 77 Rattus tanezumi and 33 Rattus norvegicus , displaying 30% LAMP positivity. The study revealed that 30% (30/100) of wild rats tested were infected with T. gondii . The molecular prevalence rate in male rats was 32.35% (22/68), compared to females with 25% (8/32). 41.9% of the housing population, 33.3% of traditional markets, and 22.6% of dense settlements had the highest molecular prevalence. The high positive molecular rate at the trapping site can be attributed to cats and dense populations., Conclusion: Thirty percentage wild rats were tested positive for toxoplasmosis in Surabaya, East Java, Indonesia using LAMP method. Implementing strict control and monitoring is crucial in preventing the transmission of diseases from wild rats to humans. It is necessary to carry out further research related to genetic analysis of T. gondii to determine the type of T. gondii that infects animals and humans in Surabaya through bioassay and molecular test., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Puspitasari, et al.)

Objective . Monitoring of apnea of prematurity, performed in neonatal intensive care units by detecting central apneas (CAs) in the respiratory traces, is characterized by a high number of false alarms. A two-step approach consisting of a threshold-based apneic event detection algorithm followed by a machine learning model was recently presented in literature aiming to improve CA detection. However, since this is characterized by high complexity and low precision, we developed a new direct approach that only consists of a detection model based on machine learning directly working with multichannel signals. Approach . The dataset used in this study consisted of 48 h of ECG, chest impedance and peripheral oxygen saturation extracted from 10 premature infants. CAs were labeled by two clinical experts. 47 features were extracted from time series using 30 s moving windows with an overlap of 5 s and evaluated in sets of 4 consecutive moving windows, in a similar way to what was indicated for the two-step approach. An undersampling method was used to reduce imbalance in the training set while aiming at increasing precision. A detection model using logistic regression with elastic net penalty and leave-one-patient-out cross-validation was then tested on the full dataset. Main results . This detection model returned a mean area under the receiver operating characteristic curve value equal to 0.86 and, after the selection of a FPR equal to 0.1 and the use of smoothing, an increased precision (0.50 versus 0.42) at the expense of a decrease in recall (0.70 versus 0.78) compared to the two-step approach around suspected apneic events. Significance . The new direct approach guaranteed correct detections for more than 81% of CAs with length L ≥ 20 s, which are considered among the most threatening apneic events for premature infants. These results require additional verifications using more extensive datasets but could lead to promising applications in clinical practice., (Creative Commons Attribution license.)

Purpose: The aim of this study was to evaluate the reliability of assessing preoperative conventional X-ray diagnostics in determining whether a comminuted clavicle fracture is present., Methods: A total of 326 patients with complete clinical and radiological documentation treated for a central clavicle fracture at the author's department between January 1, 2012, and June 30, 2023, were included. Among these, 73 were female, and 253 were male in a mean age of 37.5 ± 17 years., Results: On preoperative X-ray images or operation reports, 109 (33%) or 78 (24%) simple and 217 (67%) or 248 (76%) comminuted fractures were identified. Thity-one out of 248 comminuted fractures were only discovered intraoperatively, accounting for 13%. According to the AO classification on preoperative X-ray or operation reports, 109 or 78 fractures were classified as type A (33% or 24%), 51 or 45 as type B (16% or 14%), and 166 or 203 as type C (51% or 62%). For 40 patients, the discrepancy between the preoperative X-ray and the intraoperative fracture type led to a change in the surgical procedure. This represents 12% of the total cohort or 91% of the fractures that were classified differently preoperatively compared to intraoperatively. In these cases, fractures were treated with open reduction and angular stable plate osteosynthesis instead of the preoperatively planned elastic stable intramedullary nailing (ESIN)., Conclusion: The results of this study suggest that conventional X-ray diagnostics may not always detect comminuted clavicle shaft fractures. The treating physician should be aware of this issue., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)