Objective: Identifying disability-related brain changes is important for multiple sclerosis (MS) patients. Currently, there is no clear understanding about which pathological features drive disability in single MS patients. In this work, we propose a novel comprehensive approach, GAMER-MRIL, leveraging whole-brain quantitative MRI (qMRI), convolutional neural network (CNN), and an interpretability method from classifying MS patients with severe disability to investigating relevant pathological brain changes. Methods: One-hundred-sixty-six MS patients underwent 3T MRI acquisitions. qMRI informative of microstructural brain properties was reconstructed, including quantitative T1 (qT1), myelin water fraction (MWF), and neurite density index (NDI). To fully utilize the qMRI, GAMER-MRIL extended a gated-attention-based CNN (GAMER-MRI), which was developed to select patch-based qMRI important for a given task/question, to the whole-brain image. To find out disability-related brain regions, GAMER-MRIL modified a structure-aware interpretability method, Layer-wise Relevance Propagation (LRP), to incorporate qMRI. Results: The test performance was AUC=0.885. qT1 was the most sensitive measure related to disability, followed by NDI. The proposed LRP approach obtained more specifically relevant regions than other interpretability methods, including the saliency map, the integrated gradients, and the original LRP. The relevant regions included the corticospinal tract, where average qT1 and NDI significantly correlated with patients' disability scores ($\rho$=-0.37 and 0.44). Conclusion: These results demonstrated that GAMER-MRIL can classify patients with severe disability using qMRI and subsequently identify brain regions potentially important to the integrity of the mobile function. Significance: GAMER-MRIL holds promise for developing biomarkers and increasing clinicians' trust in NN.

Vođenje je važna odrednica kvalitetnog funkcioniranja i perspektive razvoja predškolske ustanove. Kvalitetno vođenje i funkcioniranje predškolske ustanove ne ovisi samo o jednoj osobi, nego o cijelom kolektivu. U radu su prikazani rezultati istraživanja mišljenja odgajatelja, ravnatelja i stručnih suradnika o utjecaju kvalitete odnosa na kulturu ustanove, raspodjeli prava i odgovornosti u njihovim ustanovama, načinu donošenja odluka, ulozi ravnatelja i značaju vođenja, potpore i uvažavanja mišljenja u postizanju kvalitetnijih suradničkih odnosa. U istraživanju je sudjelovalo 122 ispitanika iz devet predškolskih ustanova Zeničko-dobojskog kantona. Kao istraživački postupci primijenjeni su anketiranje, procjenjivanje i prosuđivanje, uz odgovarajuće instrumente (upitnici i skale stavova). Primijenjene metode u istraživanju su: metoda teorijske analize, deskriptivno-analitička i servey metoda. Rezultati su pokazali da kvalitetni odnosi uposlenika pozitivno utječu na kulturu predškolske ustanove te da većina ispitanika smatra da je za rad potrebno kvalitetno vođenje i potpora. Potvrđeno je da kvaliteta rada ustanove ovisi o spremnosti rukovodstva na suodlučivanje i dijeljenje prava i odgovornosti sa svim uposlenicima, što u konačnici sve uposlenike dovodi u ravnopravan odnos.Vjerojatnost uspješnoga rješavanja problema veća je ukoliko ga rješava veći broj ljudi sa zajedničkim ciljem. Istaknuta je potreba za pravednom raspodjelom odgovornosti i zajedničkim rješavanjem problema. Ukupni rezultati svih ustanova pokazali su da je potrebno angažiranje svih uposlenih na izgradnji suradničkih odnosa kako bi se postiglo unaprjeđenje kvalitete rada predškolske ustanove.

Savremeni trendovi u zapošljavanju kandidata na otvorenom tržištu rada podrazumijevaju sve veću zastupljenost menadžera ljudskih resursa i regrutera u kompanijama, potencijalnim poslodavcima, koji su koordinatori procesa pronalaska, intervjuiranja, selekcije i zapošljavanja radnika. Kako su oni, sve češće, prve karike u lancu zapošljavanja i za osobe s invaliditetom, cilj ovog istraživanja je ispitati percepciju regrutera i menadžera ljudskih resursa o najprimjerenijim oblicima zapošljavanja i teškoćama pri zapošljavanju osoba s invaliditetom. Istraživanje je sprovedeno na prigodnom uzorku koji je sačinjavalo 18 ispitanika oba spola, s područja Hercegovačko-neretvanskog (33,3%), Tuzlanskog (11,1%) i Kantona Sarajevo (55,6%), primjenom Upitnika o mišljenju poslodavaca o radu i zapošljavanju osoba s invaliditetom (Kozjak i Lapat, 2018). Rezultati istraživanja pokazuju da regruteri i menadžeri ljudskih resursa uglavnom imaju pozitivna mišljenja i percepciju prema zapošljavanju osoba s invaliditetom. Najveće frekvencije percipiranih teškoća pri zapošljavanju osoba sa invaliditetom se odnose na pojedine varijable u područjima komunikacije s osobama s invaliditetom i prilagodbe radnog mjesta, dok se radna efikasnost osobe s invaliditetom i utjecaj osobe s invaliditetom na druge uposlenike ne percipiraju kao teškoće za zapošljavanje osoba s invaliditetom. Postojanje statistički značajnih razlika najviše je utvrđeno u odnosu na djelatnost kompanije u kojoj su zaposleni ispitanici. Rezultati također pokazuju da regruteri i menadžeri ljudskih resursa percipiraju zapošljavanje na otvorenom tržištu rada najprimjerenijim oblikom zapošljavanja osoba s invaliditetom, te da nisu utvrđene statistički značajne razlike u odnosu na djelatnost kompanije u kojoj su zaposleni ili prethodno osobno i profesionalno iskustvo s osobama s invaliditetom.

PurposeThis paper aims to develop preliminary damage scenarios for unreinforced masonry buildings located in low to moderate seismic hazard areas in Algeria, taking into account the specific site effects.Design/methodology/approachThree soil types were considered in this analysis according to the definition of the Algerian seismic code (RPA99/2003). Peak ground acceleration values were assigned to each soil type issued from a probabilistic seismic hazard analysis (PSHA). To highlight the effect of soil conditions on the seismic vulnerability analysis of masonry buildings, a site vulnerability increment is carried out, and the macroseismic Risk-UE method has been adopted and applied by developing two main seismic scenarios according to both return periods of the PSHA, 100 and 475 years, respectively.FindingsBased on the preliminary results of rock site condition, it can be outlined that the significant damage obtained for different earthquake scenarios discovered a substantial worldwide seismic risk to the building stock of the study area. Once the site effect is integrated into the analysis, more high values of vulnerability indexes and expected damages are obtained. Moreover, it can be concluded that soft soil (S3) is a little bit more influential than stiff soil (S2) on the final vulnerability index compared to (S1). However, the difference between the soil effect S2 and S3 on the vulnerability index can be neglected.Research limitations/implicationsResearchers are encouraged to test the mechanical approaches for more detailed outcomes of a specific building analysis.Practical implicationsThis research proves to the Algerian decision-makers that due to the site effects and the vulnerability of the masonry buildings, an urgent intervention program is required even for existing buildings located in low to moderate seismic hazard areas.Originality/valueSeveral seismic vulnerability types of research have been conducted in Algeria for the unreinforced masonry buildings in moderate to high seismic areas in which generally the soil effect is neglected. In this context, this research paper proves that due to the site effects and the vulnerability of the masonry buildings, special attention is required even for existing buildings located in low to moderate seismic hazard areas. With this conclusion, the requirement of taking into account the soli effect in the high seismic areas is even more pronounced and should be conducted.

Background The aim of this work is to evaluate the performance of radiomics predictions for a range of molecular, genomic and clinical targets in patients with clear cell renal cell carcinoma (ccRCC) and demonstrate the impact of novel feature selection strategies and sub-segmentations on model interpretability. Methods Contrast-enhanced CT scans from the first 101 patients recruited to the TRACERx Renal Cancer study (NCT03226886) were used to derive radiomics classification models to predict 20 molecular, histopathology and clinical target variables. Manual 3D segmentation was used in conjunction with automatic sub-segmentation to generate radiomics features from the core, rim, high and low enhancing sub-regions, and the whole tumour. Comparisons were made between two classification model pipelines: a Conventional pipeline reflecting common radiomics practice, and a Proposed pipeline including two novel feature selection steps designed to improve model interpretability. For both pipelines nested cross-validation was used to estimate prediction performance and tune model hyper-parameters, and permutation testing was used to evaluate the statistical significance of the estimated performance measures. Further model robustness assessments were conducted by evaluating model variability across the cross-validation folds. Results Classification performance was significant ( p  < 0.05, H_0:AUROC = 0.5) for 11 of 20 targets using either pipeline and for these targets the AUROCs were within ± 0.05 for the two pipelines, except for one target where the Proposed pipeline performance increased by > 0.1. Five of these targets (necrosis on histology, presence of renal vein invasion, overall histological stage, linear evolutionary subtype and loss of 9p21.3 somatic alteration marker) had AUROC > 0.8. Models derived using the Proposed pipeline contained fewer feature groups than the Conventional pipeline, leading to more straightforward model interpretations without loss of performance. Sub-segmentations lead to improved performance and/or improved interpretability when predicting the presence of sarcomatoid differentiation and tumour stage. Conclusions Use of the Proposed pipeline, which includes the novel feature selection methods, leads to more interpretable models without compromising prediction performance. Trial registration NCT03226886 (TRACERx Renal)

A state-of-the-art large eddy simulation code has been developed to solve compressible flows in turbomachinery. The code has been en-gineered with a high degree of scalability, enabling it to effectively leverage the many-core architecture of the new Sunway system. A consistent performance of 115.8 DP-PFLOPs has been achieved on a high-pressure turbine cascade consisting of over 1.69 billion mesh elements and 865 billion Degree of Freedoms (DOFs). By leveraging a high-order unstructured solver and its portability to large hetero-geneous parallel systems, we have progressed towards solving the

Abstract Objectives We present the original technique of compression hemostatic sutures on the lower uterine segment due to early postpartum hemorrhage during cesarean section, with a literature review. Methods A retrospective clinical case study was conducted at the tertiary perinatal center. Twelve patients had nine planned and three urgent cesarean sections due to antenatally verified placenta previa and/or placenta accreta spectrum and defined early postpartum hemorrhage > 1000 mL during cesarean section. As the use of uterotonics failed to produce any effect and hemorrhage persisted, compression sutures of the lower uterine segment were made by our own technique, as follows: below the hysterotomy, a horizontal corrugated suture is placed from the right to the left corner and after 2–3 cm vertically and backwards at several sites from the left to the right corner, where it is tightened. Results Seven patients had one cesarean section, three patients had two cesarean sections, and seven patients had pregnancy from the in vitro fertilization procedure in their history. There were six patients with placenta previa and six patients with anterior invasive placenta accreta or increta. Original hemostatic procedure was applied successfully in ten cases, and after placement of O'Leary suture and persistent bleeding in two cases. In this group, no hysterectomy was performed, and patients received blood transfusion of 440–880 mL. Three patients later had spontaneous pregnancies. Conclusion Our own hemostatic method with a simple technique, fast learning, and minimal logistics contributes to successful management of this currently global problem of morbidly adherent placenta previa.

Additions to the moth fauna of Bosnia and Herzegovina and Croatia are given. We report on first observations of five species and on reconfirmation of one species after eight decades. In Croatia, we recorded the species Eublemma cochylioides (Guenée, 1852) for the first time, while Eublemma himmighoffeni (Millière, 1867) has been confirmed in the country after 85 years. We report on the first observation of five moth species for Bosnia and Herzegovina: Triodia adriaticus (Osthelder, 1931), Eumera regina Staudinger, 1892, Dryobotodes monochroma (Esper, 1790), Lithophane lapidea (Hübner, [1808]) and Nycteola columbana (Turner, 1925). Even though these records could be expected due to species general distributions, they fill the knowledge of moth diversity of both countries and the wider region.

Erosion, soil loss and consequent nutrient fluxes impair water quality and can degrade arable soils. Erosion rates in Sweden are generally low but episodic losses of suspended solids (SS) can affect water quality. Identifying critical source areas (CSAs) and “hot moments” is essential to reduce erosive losses from arable land. Here we use a distributed, dynamic high-resolution erosion model that simulates the sum of all transported material, i.e., erosion within the soil profile, on the soil surface and transport through drainage systems. We simulate monthly SS transport in six small agricultural catchments with varying soil texture over 8 years. Kling-Gupta Efficiency (KGE) was used as model performance statistics, and calibration (KGE = 0.45–0.78) and validation (KGE = 0.64–0.83) showed acceptable model performance for all catchments, with mean annual SS losses between 2.1 and 31.5 t km-2yr-1. Equifinality could be minimised by using more precise initial parameter values. We suggest that the model can be applied to comparable unmonitored catchments to identify erosion-sensitive periods and CSAs.

As technology continues to shape the landscape of education, the need for effective evaluation frameworks for sustainable technology-enhanced learning (TEL) becomes increasingly vital. This study presents an expert-opinion-based evaluation framework, utilizing Z-numbers and the fuzzy logarithm methodology of additive weights (LMAW), to assess the sustainability of TEL approaches. This framework focuses on four main criteria: cloud services compliance, cloud M-Learning essentials, system and technological advancement, and organizations management readiness. Additionally, it incorporates 17 sub-criteria to provide a comprehensive evaluation of the system. Drawing on the expertise of subject matter specialists, the evaluation framework utilizes Z-numbers to account for the inherent uncertainty and imprecision in expert judgments. The fuzzy LMAW is applied to calculate the overall scores for each criterion and sub-criterion, enabling a quantitative measure of their importance in the evaluation process. The findings of this study will contribute to the development of a robust and scientifically rigorous evaluation framework for sustainable TEL. By incorporating expert opinions and employing Z-LMAW, decision-makers and stakeholders can objectively assess the sustainability of TEL systems. This framework holds promise for informing the design and implementation of strategies to enhance the quality, compliance, and technological advancements in TEL environments.

Despite initial responses to hormone treatment, metastatic prostate cancer invariably evolves to a lethal state. To characterize the intra-patient evolutionary relationships of metastases that evade treatment, we perform genome-wide copy number profiling and bespoke approaches targeting the androgen receptor (AR) on 167 metastatic regions from 11 organs harvested post-mortem from 10 men who died from prostate cancer. We identify diverse and patient-unique alterations clustering around the AR in metastases from every patient with evidence of independent acquisition of related genomic changes within an individual and, in some patients, the co-existence of AR-neutral clones. Using the genomic boundaries of pan-autosome copy number changes, we confirm a common clone of origin across metastases and diagnostic biopsies, and identified in individual patients, clusters of metastases occupied by dominant clones with diverged autosomal copy number alterations. These autosome-defined clusters are characterized by cluster-specific AR gene architectures, and in two index cases are topologically more congruent than by chance (p-values 3.07 × 10−8 and 6.4 × 10−4). Integration with anatomical sites suggests patterns of spread and points of genomic divergence. Here, we show that copy number boundaries identify treatment-selected clones with putatively distinct lethal trajectories.

Evolutionary algorithms have gained widespread recognition as a viable approach to numerous optimization problems that are characterized by infeasible optimal solutions, owing to the presence of large search spaces and computational limitations. Forecasting personnel radiation exposure can be one of these problems. Radiation exposure poses risks to various practitioners as well as patients in the healthcare facilities. In this study, we model the problem as a specific time series instance. Moreover, we investigate the impact of the training an adaptive neuro fuzzy system using evolutionary algorithms, namely, Genetic Algorithm (GA) and Particle Swarm Optimization (PSO), on the overall performance of forecasting personnel radiation exposure. The results show that GA and PSO could provide effective solution. On the other hand, they might be highly affected by the initial state of the fuzzy inference system leading to unstable performances. We recommend further experimentation with a combination of other advanced optimization and machine learning methods to assure the most effective results.

This study performed a mechanical stability analysis for the impact of axial pressure on an Ultra X external unilateral fixation device applied to a tibia with an open fracture. The real construction of the fixation device was used to create a 3D geometric model using a Finite Element Method (FEM) model, which was made to perform structural analysis in the CATIA V5 (Computer Aided Three-dimensional Interactive Application) CAD/CAE system. Specific stresses and displacements were observed at points of interest using structural analysis. The focus was on the relative displacements of the proximal and distal bone segments in the fracture zone. These displacements were used to calculate the stiffnesses of the bone in the fracture zone and the fixation device itself. The results obtained provide the necessary information regarding the stability of the Ultra X fixation device.