Affine-invariant contracting-point methods for Convex Optimization

In this paper, we develop new affine-invariant algorithms for solving composite convex minimization problems with bounded domain. We present a general framework of Contracting-Point methods, which solve at each iteration an auxiliary subproblem restricting the smooth part of the objective function onto contraction of the initial domain. This framework provides us with a systematic way for developing optimization methods of different order, endowed with the global complexity bounds. We show that using an appropriate affine-invariant smoothness condition, it is possible to implement one iteration of the Contracting-Point method by one step of the pure tensor method of degree $$p \ge 1$$ p ≥ 1 . The resulting global rate of convergence in functional residual is then $${\mathcal {O}}(1 / k^p)$$ O ( 1 / k p ) , where k is the iteration counter. It is important that all constants in our bounds are affine-invariant. For $$p = 1$$ p = 1 , our scheme recovers well-known Frank–Wolfe algorithm, providing it with a new interpretation by a general perspective of tensor methods. Finally, within our framework, we present efficient implementation and total complexity analysis of the inexact second-order scheme $$(p = 2)$$ ( p = 2 ) , called Contracting Newton method. It can be seen as a proper implementation of the trust-region idea. Preliminary numerical results confirm its good practical performance both in the number of iterations, and in computational time.

Study of various treatment modalities of caesarean scar pregnancy

Background: Caesarean scar pregnancy (CSP) can be defined as the implantation of the gestational sac within the scar of a previous caesarean surgery. Incidence of CSP is 1 in 1800 pregnancies.Methods: It is a retrospective study based on clinical diagnosis and management of CSP of women who presented to the obstetrics and gynaecology department SVP hospital from January 2008 to August 2021. Total number of cases of CSP were 28. Incidence, gestational age, ultrasound findings, serum β-human chorionic gonadotropin (β-hCG) levels, flow profiles of color Doppler, and different methods of treatment were recorded. Diagnosis was confirmed by ultrasound.Results: In this study, all 28 cases of CSP considered were offered definitive management. In present study 5 cases (17.88%) showed torrential haemorrhage during dilatation and evacuation (D and E) which was treated by various methods like 1 (3.57%) Foley’s tamponade, 1 (3.57%) uterine artery embolization (UAE) and 3 (10.71%) hysterectomy. Hysterotomy was performed in 13 cases (46.42%) and (7.69%) of heterotrophic CSP (HCSP). One case (3.84%) of CSP presented at 26 weeks of gestation with haemorrhagic shock, underwent obstetric hysterectomy.Conclusions: There is a rise in the incidence of CSP because of increase in the global rate of caesarean sections and early transvaginal USG in pregnancy. Transvaginal sonography is the best diagnostic tool. Medical management can be offered when diagnosis is made at gestational age of <7 weeks. Whereas, surgical modalities have shown better results at >7 weeks of gestational age. Surgical management has an advantage of shorter follow up.

Oncolytic Viruses and Cancer, Do You Know the Main Mechanism?

The global rate of cancer has increased in recent years, and cancer is still a threat to human health. Recent developments in cancer treatment have yielded the understanding that viruses have a high potential in cancer treatment. Using oncolytic viruses (OVs) is a promising approach in the treatment of malignant tumors. OVs can achieve their targeted treatment effects through selective cell death and induction of specific antitumor immunity. Targeting tumors and the mechanism for killing cancer cells are among the critical roles of OVs. Therefore, evaluating OVs and understanding their precise mechanisms of action can be beneficial in cancer therapy. This review study aimed to evaluate OVs and the mechanisms of their effects on cancer cells.

Promoting the Practice of Exclusive Breastfeeding: A Philosophic Scoping Review

Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study is to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2000 - 2020. Results The online search yielded 877 articles, however, only 40 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n=1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 10) and social cognitive theories (n = 17). Theories of self-efficacy and planned behaviour were the most effective theories that increased exclusive breastfeeding rates. Conclusions Theory-based exclusive breastfeeding promotion strategies are effective to increase the rates of exclusive breastfeeding. Theory of planned behaviour is better compared with theories of self-efficacy for program content development and implementation in Randomized Controlled Trial studies. Future breastfeeding interventions should be based on relevant philosophies and guided by theories of self-efficacy and planned behaviours.

Lateral meniscal posterior root tears experience acceptable healing status after transtibial repair technique

Purpose To evaluate patient MRI results, demography and clinical outcome following transtibial repair of lateral and medial meniscal posterior root tears. Methods Patients treated with transtibial repairs of posterior meniscal root tears from 2015 through 2018 performed pre- and postoperative MRI scans. Outcome measures were continuity/discontinuity of the meniscal root and change in meniscal extrusion on MRI. Other outcomes were KOOS, Lysholm score, Tegner activity scale and the Global Rate of Change (GRoC) score for function and pain at follow-up. Study design Retrospective case-series. Results Of 41 patients, 36 attended follow-up at mean 26 (12–38) months postoperatively. At follow-up, 11 out of 18 lateral meniscus posterior root tear (LMPRT) versus 5 out of 18 medial meniscus posterior root tear (MMPRT) repairs were classified as healed. Meniscal extrusion decreased in LMPRTs from of 2.3 ± 1.5 mm to 1.4 ± 1.09 mm (p = 0.080) and increased in MMPRTs from 3.1 ± 1.6 mm to 4.8 ± 1.9 mm (p = 0.005) at FU (between-group difference, p < 0.001). LMPRT repairs were associated with ACL injury and additional meniscal injury and were younger and with lower BMI. No between-group differences were found for KOOS, Lysholm or GRoC Function scores. Tegner scale was higher and GRoC Pain score lower in the LMPRT group compared to the MMPRTs. Conclusion Following transtibial repair for meniscal posterior root repairs, the LMPRTs had a higher frequency of healing, whereas most MMPRTs continued to extrude, despite surgical intervention. The study confirmed that LMPRTs and MMPRTs differ in demography and associated injuries.

Sustained acoustic medicine for the treatment of musculoskeletal injuries: a systematic review and meta-analysis

Background Musculoskeletal injuries account for 10 million work-limited days per year and often lead to both acute and/or chronic pain, and increased chances of re-injury or permanent disability. Conservative treatment options include various modalities, nonsteroidal anti-inflammatory drugs, and physical rehabilitation programs. Sustained Acoustic Medicine is an emerging prescription home-use mechanotransductive device to stimulate cellular proliferation, increase microstreaming and cavitation in situ, and to increase tissue profusion and permeability. This research aims to summarize the clinical evidence on Sustained Acoustic Medicine and measurable outcomes in the literature. Methods A systematic literature review was conducted using PubMed, EBSCOhost, Academic Search Complete, Google Scholar and ClinicalTrials.gov to identify studies evaluating the effects of Sustained Acoustic Medicine on the musculoskeletal system of humans. Articles identified were selected based on inclusion criteria and scored on the Downs and Black checklist. Study design, clinical outcomes and primary findings were extracted from included studies for synthesis and meta-analysis statistics. Results A total of three hundred and seventy-two participants (372) were included in the thirteen clinical research studies reviewed including five (5) level I, four (4) level II and four (4) level IV studies. Sixty-seven (67) participants with neck and back myofascial pain and injury, one hundred and fifty-six (156) participants with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren–Lawrence grade II/III), and one hundred forty-nine (149) participants with generalized soft-tissue injury of the elbow, shoulder, back and ankle with limited function. Primary outcomes included daily change in pain intensity, change in Western Ontario McMaster Osteoarthritis Questionnaire, change in Global Rate of Change, and functional outcome measures including dynamometry, grip strength, range-of-motion, and diathermic heating (temperature measurement). Conclusion Sustained Acoustic Medicine treatment provides tissue heating and tissue recovery, improved patient function and reduction of pain. When patients failed to respond to physical therapy, Sustained Acoustic Medicine proved to be a useful adjunct to facilitate healing and return to work. As a non-invasive and non-narcotic treatment option with an excellent safety profile, Sustained Acoustic Medicine may be considered a good therapeutic option for practitioners.

Response of vegetation and carbon fluxes to brown lemming herbivory in Northern Alaska

The Arctic is warming at double the average global rate, affecting the carbon cycle of tundra ecosystems. Most research on carbon fluxes from Arctic tundra ecosystems has focused on abiotic environmental controls (e.g. temperature, rainfall, or radiation). However, Arctic tundra vegetation, and therefore the carbon balance of these ecosystems, can be substantially impacted by herbivory. In this study we tested how vegetation consumption by brown lemmings (Lemmus trimucronatus) can impact carbon exchange of a wet-sedge tundra ecosystem near Utqiaġvik, Alaska during the summer, and the recovery of vegetation during a following summer. We placed brown lemmings in individual enclosure plots and tested the impact of lemmings’ herbivory on carbon dioxide (CO2) and methane (CH4) fluxes and the normalized difference vegetation index (NDVI) immediately after lemming removal and during the following growing season. During the first summer of the experiment, lemmings’ herbivory reduced plant biomass (as shown by the decrease in the NDVI) and decreased CO2 uptake, while not significantly impacting CH4 emissions. Methane emissions were likely not significantly affected due to CH4 being produced deeper in the soil and escaping from the stem bases of the vascular plants. The summer following the lemming treatments, NDVI and CO2 fluxes returned to magnitudes similar to those observed before the start of the experiment, suggesting recovery of the vegetation, and a transitory nature of the impact of lemming herbivory. Overall, lemming herbivory has short-term but substantial effects on carbon sequestration by vegetation and might contribute to the considerable interannual variability in CO2 fluxes from tundra ecosystems.

The Effect of Preoperative Behavioral Intervention on Pain, Anxiety, Opioid Use, and Function in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Study

ABSTRACT Objective To evaluate the efficacy of preoperative cognitive-behavioral psychoeducation (CBE) for improved pain, anxiety, opioid use, and postoperative function in total knee arthroplasty (TKA) patients. Methods A randomized controlled trial was conducted among 36 military health system beneficiaries attending preoperative education for TKA. The standard of care (SOC) group (n = 18) received information on home safety, rehabilitation, postoperative precautions, and pain management. In addition, the occupational therapy led CBE group (n = 16) received information on principles of holistic wellness (healing process, effects of stress on healing, heart-rate control through diaphragmatic breathing, anti-inflammatory nutrition, goal setting, and mental imagery). Outcomes of interest: knee active range of motion, pain (Defense and Veterans Pain Rating Scale), opioid medication use, heart-rate coherence (emwave2), anxiety (Generalized Anxiety Disorder Scale), and function (Knee Outcome Survey Activities of Daily Living [KOS-ADL], modified Functional Independence Measure, and Global Rate of Change). Results The CBE group demonstrated significantly greater decline in pain overall, with activity, and during sleep in relation to the SOC group when comparing visit 1 to visit 5. Opioid medication use was significantly lower for CBE versus SOC. Postoperative General Anxiety Disorder-7 scores decreased significantly among CBE participants with similar increase in high heart rate coherence. Function significantly improved postoperatively based on KOS-ADL and Global Rate of Change scores. Twice as many CBE participants had same-day discharge compared to SOC participants and most CBE participants continued with healthy lifestyle recommendations at the 3-month follow-up. Conclusion A cognitive-behavioral approach to preoperative education may improve postoperative pain, anxiety, and function while decreasing opioid use among TKA patients. Findings from this pilot study support further research to examine similar interventions among distinct surgical populations and encourage further evaluation on the effects of CBE to enhance health and healthcare delivery.

Lithium in the Green Energy Transition: The Quest for Both Sustainability and Security

Considering the quest to meet both sustainable development and energy security goals, we explore the ramifications of explosive growth in the global demand for lithium to meet the needs for batteries in plug-in electric vehicles and grid-scale energy storage. We find that heavy dependence on lithium will create energy security risks because China has a dominant position in the lithium supply chain and both Europe and North America seek to curtail reliance on China throughout their supply chains. We also find that efforts to expand lithium mining have been much less successful in Chile, the United States, and Europe than in Australia. Local communities resist licensing of new lithium mines due to a variety of environmental, social, and economic concerns. There are alternative technologies that may make lithium mining more sustainable such as direct lithium extraction, but the timing of commercialization of this process is uncertain. Progress is also being made in battery recycling and in alternative battery designs that do not use lithium. Such advances are unlikely to attenuate the global rate of growth in lithium demand prior to 2030. We conclude that tradeoffs between sustainability and energy security are real, especially in the next decade.

Insights Into the Pathologic Roles and Regulation of Eukaryotic Elongation Factor-2 Kinase

Eukaryotic Elongation Factor-2 Kinase (eEF2K) acts as a negative regulator of protein synthesis, translation, and cell growth. As a structurally unique member of the alpha-kinase family, eEF2K is essential to cell survival under stressful conditions, as it contributes to both cell viability and proliferation. Known as the modulator of the global rate of protein translation, eEF2K inhibits eEF2 (eukaryotic Elongation Factor 2) and decreases translation elongation when active. eEF2K is regulated by various mechanisms, including phosphorylation through residues and autophosphorylation. Specifically, this protein kinase is downregulated through the phosphorylation of multiple sites via mTOR signaling and upregulated via the AMPK pathway. eEF2K plays important roles in numerous biological systems, including neurology, cardiology, myology, and immunology. This review provides further insights into the current roles of eEF2K and its potential to be explored as a therapeutic target for drug development.