Affine-Invariant Outlier Detection and Data Visualization

A wealth of data is generated daily by social media websites that is an essential component of the Big Data Revolution. In many cases, the data is anonymized before being disseminated for research and analysis. This anonymization process distorts the data so that some essential characteristics are lost which may not be captured by methods that are not robust against such transformations. In this paper we propose novel algorithms, for two-dimensional data, for a recently discovered statistical data analysis measure, the Ray Shooting Depth (RSD) that provides an affineinvariant ranking of data points. In addition, we prove some complexity results and illustrate some of the desirable properties of RSD via comparisons with other similar notions. We develop an open-source data visualization tool based on RSD, and show its applications in distribution estimation, outlier detection, and 2D tolerance-region construction

What should be included in case report forms? Development and application of novel methods to inform surgical study design:a mixed methods case study in parastomal hernia prevention

OBJECTIVES: To describe the development and application of methods to optimise the design of case report forms (CRFs) for clinical studies evaluating surgical procedures, illustrated with an example of abdominal stoma formation. DESIGN: (1) Literature reviews, to identify reported variations in surgical components of stoma formation, were supplemented by (2) intraoperative qualitative research (observations, videos and interviews), to identify unreported variations used in practice to generate (3) a ‘long list’ of items, which were rationalised using (4) consensus methods, providing a pragmatic list of CRF items to be captured in the Cohort study to Investigate the Prevention of parastomal HERnias (CIPHER) study. SETTING: Two secondary care surgical centres in England. PARTICIPANTS: Patients undergoing stoma formation, surgeons undertaking stoma formation and stoma nurses. OUTCOME MEASURES: Successful identification of key CRF items to be captured in the CIPHER study. RESULTS: 59 data items relating to stoma formation were identified and categorised within six themes: (1) surgical approach to stoma formation; (2) trephine formation; (3) reinforcing the stoma trephine with mesh; (4) use of the stoma as a specimen extraction site; (5) closure of other wounds during the procedure; and (6) spouting the stoma. CONCLUSIONS: This study used multimodal data collection to understand and capture the technical variations in stoma formation and design bespoke CRFs for a multicentre cohort study. The CIPHER study will use the CRFs to examine associations between the technical variations in stoma formation and risks of developing a parastomal hernia. TRIAL REGISTRATION NUMBER: ISRCTN17573805

Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study

Background: Radical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective total mesorectal excision could reduce the adverse effects of treatment without substantially compromising oncological outcomes. We investigated the feasibility of recruiting patients to a randomised trial comparing an organ-preserving strategy with total mesorectal excision. Methods: TREC was a randomised, open-label feasibility study done at 21 tertiary referral centres in the UK. Eligible participants were aged 18 years or older with rectal adenocarcinoma, staged T2 or lower, with a maximum diameter of 30 mm or less; patients with lymph node involvement or metastases were excluded. Patients were randomly allocated (1:1) by use of a computer-based randomisation service to undergo organ preservation with short-course radiotherapy followed by transanal endoscopic microsurgery after 8–10 weeks, or total mesorectal excision. Where the transanal endoscopic microsurgery specimen showed histopathological features associated with an increased risk of local recurrence, patients were considered for planned early conversion to total mesorectal excision. A non-randomised prospective registry captured patients for whom randomisation was considered inappropriate, because of a strong clinical indication for one treatment group. The primary endpoint was cumulative randomisation at 12, 18, and 24 months. Secondary outcomes evaluated safety, efficacy, and health-related quality of life assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and CR29 in the intention-to-treat population. This trial is registered with the ISRCTN Registry, ISRCTN14422743. Findings: Between Feb 22, 2012, and Dec 19, 2014, 55 patients were randomly assigned at 15 sites; 27 to organ preservation and 28 to radical surgery. Cumulatively, 18 patients had been randomly assigned at 12 months, 31 at 18 months, and 39 at 24 months. No patients died within 30 days of initial treatment, but one patient randomly assigned to organ preservation died within 6 months following conversion to total mesorectal excision with anastomotic leakage. Eight (30%) of 27 patients randomly assigned to organ preservation were converted to total mesorectal excision. Serious adverse events were reported in four (15%) of 27 patients randomly assigned to organ preservation versus 11 (39%) of 28 randomly assigned to total mesorectal excision (p=0·04, χ2 test). Serious adverse events associated with organ preservation were most commonly due to rectal bleeding or pain following transanal endoscopic microsurgery (reported in three cases). Radical total mesorectal excision was associated with medical and surgical complications including anastomotic leakage (two patients), kidney injury (two patients), cardiac arrest (one patient), and pneumonia (two patients). Histopathological features that would be considered to be associated with increased risk of tumour recurrence if observed after transanal endoscopic microsurgery alone were present in 16 (59%) of 27 patients randomly assigned to organ preservation, versus 24 (86%) of 28 randomly assigned to total mesorectal excision (p=0·03, χ2 test). Eight (30%) of 27 patients assigned to organ preservation achieved a complete response to radiotherapy. Patients who were randomly assigned to organ preservation showed improvements in patient-reported bowel toxicities and quality of life and function scores in multiple items compared to those who were randomly assigned to total mesorectal excision, which were sustained over 36 months’ follow-up. The non-randomised registry comprised 61 patients who underwent organ preservation and seven who underwent radical surgery. Non-randomised patients who underwent organ preservation were older than randomised patients and more likely to have life-limiting comorbidities. Serious adverse events occurred in ten (16%) of 61 non-randomised patients who underwent organ preservation versus one (14%) of seven who underwent total mesorectal excision. 24 (39%) of 61 non-randomised patients who underwent organ preservation had high-risk histopathological features, while 25 (41%) of 61 achieved a complete response. Overall, organ preservation was achieved in 19 (70%) of 27 randomised patients and 56 (92%) of 61 non-randomised patients. Interpretation: Short-course radiotherapy followed by transanal endoscopic microsurgery achieves high levels of organ preservation, with relatively low morbidity and indications of improved quality of life. These data support the use of organ preservation for patients considered unsuitable for primary total mesorectal excision due to the short-term risks associated with this surgery, and support further evaluation of short-course radiotherapy to achieve organ preservation in patients considered fit for total mesorectal excision. Larger randomised studies, such as the ongoing STAR-TREC study, are needed to more precisely determine oncological outcomes following different organ preservation treatment schedules. Funding: Cancer Research UK

Toward the Noninvasive Diagnosis of Alzheimer’s Disease:Molecular Basis for the Specificity of Curcumin for Fibrillar Amyloid-β

Recent studies show that curcumin, a naturally fluorescent dye, can be used for the noninvasive optical imaging of retinal amyloid-β (Aβ) plaques. We investigated the molecular basis for curcumin’s specificity for hierarchical Aβ structures using molecular dynamics simulations, with a focus on how curcumin is able to detect and discriminate different amyloid morphologies. Curcumin inhibits and breaks up β-sheet formation in Aβ monomers. With disordered Aβ structures, curcumin forms a coarse-grained composite structure. With an ordered fibril, curcumin’s interaction is highly specific, and the curcumin molecules are deposited in the fibril groove. Curcumin tends to self-aggregate, which is finely balanced with its affinity for Aβ. This tendency concentrates curcumin molecules at Aβ deposition sites, potentially increasing the fluorescence signal. This is probably why curcumin is such an effective amyloid imaging agent

A case study of different magnetic strength fields and thermal energy effects in vortex generation of Ag-TiO2 hybrid nanofluid flow

Vortices grab the attention of many scientists while analyzing any flow model due to their importance in interpreting fluid mixing and mass transport phenomena. Since vortices exist in the natural environment, so researchers need to investigate them whenever they are encountered. Solar collectors, automobile cooling, engine applications, thermal management, and machine cutting, are just a few of the major areas in which most hybrid nanofluids could help to improve overall performance. The goal of this study is to demonstrate the highly complex dynamics of a Lorentz force, which governs the rotation of nanoparticles and the composition of the complex configuration of eddies inside the fluid flow of the hybrid fluid carrying Silver (Ag), and Titanium dioxide (TiO2) nanoparticles. The existing research offers an innovative analysis that investigates the isotherms and streamlines around the magnetic strips in the flow regime and thermal hydrogen energy bonds. The alternating direction implicit (ADI) methodology combined with central differences has been incorporated to determine the numerical solution of the problem. Confined Lorentz force is noticed to be a root of nano-sized hybrid particle's spinning, resulting in the complex structure of vortices in the flow field and the thermal hydrogen energy. The fixed values of the parameters that have been used in the simulation process are: Mn=5, Re=5, φ1 = 0.05, and φ2 = 0.02 unless otherwise mentioned. The findings reveal that, as the magnetic fields are strengthened, the degeneracy of both primary vortices can be seen immediately, which gives rise to two new relatively small vortices squeezed along the two vertical walls. However, as the Reynolds number increases, new vortices of different strengths and rotational directions in the flow regime can be noticed. It is found that the Reynolds number is responsible for increasing the Nussselt number along the lower horizontal wall. The magnetic parameter, on the other hand, adds a zigzag behavior to the Nusselt number. Finally, as Ag-TiO2 concentration increases, the Nusselt number becomes more sensitive

Molecular Interaction and Magnetic Dipole Effects on Fully Developed Nanofluid Flowing via a Vertical Duct Applying Finite Volume Methodology

Interpreting the complex interaction of nanostructured fluid flow with a dipole in a duct, with peripherally uniform temperature distribution, is the main focus of the current work. This paper also sheds light on the changes in the Nusselt number, temperature profiles, and velocity distributions for the fully developed nanofluid flow in a vertical rectangular duct due to a dipole placed near a corner of the duct. A finite volume approach has been incorporated for the numerical study of the problem. It is interesting to note the unusually lower values of the Nusselt number for the higher values of the ratio Gr/Re. Due to the nanostructure in the fluid, an enhancement in the Nusselt number has been noted, which is strongly supported by the magnetic field caused by the dipole. However, as the duct shape is transformed from rectangular to square, the Nusselt number is reduced remarkably. Further, as the dipole is brought nearer to the duct corner, the Nusselt number increases significantly. On the other hand, the flow reversal in the middle of the duct has been noted at higher values of the ratio Gr/Re. The dipole is noted to have a low impact on the reversal flow as well as on the temperature distribution

Molecular Interaction and Magnetic Dipole Effects on Fully Developed Nanofluid Flowing via a Vertical Duct Applying Finite Volume Methodology

Interpreting the complex interaction of nanostructured fluid flow with a dipole in a duct, with peripherally uniform temperature distribution, is the main focus of the current work. This paper also sheds light on the changes in the Nusselt number, temperature profiles, and velocity distributions for the fully developed nanofluid flow in a vertical rectangular duct due to a dipole placed near a corner of the duct. A finite volume approach has been incorporated for the numerical study of the problem. It is interesting to note the unusually lower values of the Nusselt number for the higher values of the ratio Gr/Re. Due to the nanostructure in the fluid, an enhancement in the Nusselt number has been noted, which is strongly supported by the magnetic field caused by the dipole. However, as the duct shape is transformed from rectangular to square, the Nusselt number is reduced remarkably. Further, as the dipole is brought nearer to the duct corner, the Nusselt number increases significantly. On the other hand, the flow reversal in the middle of the duct has been noted at higher values of the ratio Gr/Re. The dipole is noted to have a low impact on the reversal flow as well as on the temperature distribution

Bringing light to our darkest corner.

RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.Accepted version (12 month embargo