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Aiming at the demand for subjective evaluation of driveability for fuel cell vehicles, the modeling and evaluation method of driveability for fuel cell vehicles were studied in this paper. Firstly, a real-time model of the fuel cell vehicle powertrain system was established, which included the fuel cell model, power battery model, DC/DC converter model and drive motor model. Secondly, it was integrated with the vehicle dynamics model to form a virtual prototype of a fuel cell vehicle. And a virtual subjective evaluation platform for fuel cell vehicles was built by combining the virtual prototype and high-fidelity driving simulator. Thirdly, a subjective evaluation method of driveability for fuel cell vehicles was proposed, which included the starting performance, acceleration performance, uniform speed performance and tip-in/tip-out performance. Finally, the paper used the platform and method mentioned above to conduct subjective evaluations of the fuel cell vehicles. [ABSTRACT FROM AUTHOR]

Clouds are crucial in regulating the Earth's energy budget. Global cloud top heights have been easily retrieved from satellite measurements, but there are few methods for determining cloud base height (CBH) from satellite measurements. The Cloud Base Altitude Spatial Extrapolator (CBASE) algorithm was proposed to derive the height of the lower-troposphere liquid cloud base by using the Cloud-Aerosol Lidar with Orthogonal polarization cloud aerosol LiDAR (CALIOP) profiles and weather observations at airports from aviation routine and special weather report (METARs and SPECIs, called METAR) observation data in the United States. A modification to the CBASE algorithm over China (CNMETAR-CBASE) is presented in this paper. In this paper, the ability of the CBASE algorithm to calculate CBH in China is evaluated, and METAR observations over China (CNMETAR) were then used to modify the CBASE algorithm. The results including CNMETAR observation data in China can better retrieve CBH over China compared with the results using the original CBASE algorithm, and the accuracy of the global CBH results has been improved. Overestimations of CBH with the original algorithm range from 500 to 800 m in China, which have been reduced to about 300 m with an improved algorithm. The deviations calculated by the algorithm also have a significant reduction, from 480 m (CBASE) to 420 m (CNMETAR-CBASE). In conclusion, the modified CBASE algorithm not only calculates the CBH more accurately in China but also improves the results of the global CBH retrieved from satellites. [ABSTRACT FROM AUTHOR]

This paper thoroughly assesses the ARM and RISC-V architectures in the context of high-performance computing (HPC). It includes an analysis of Docker and Kubernetes integration. Our study aims to evaluate and compare these systems' performance, scalability, and practicality in a general context and then assess the impact they might have on special use cases, like HPC. ARM-based systems exhibited better performance and seamless integration with Docker and Kubernetes, underscoring their advanced development and effectiveness in managing high-performance computing workloads. On the other hand, despite their open-source architecture, RISC-V platforms presented considerable intricacy and difficulties in working with Kubernetes, which hurt their overall effectiveness and ease of management. The results of our study offer valuable insights into the practical consequences of implementing these architectures for HPC, highlighting ARM's preparedness and the potential of RISC-V while acknowledging the increased complexity and significant trade-offs involved at this point. [ABSTRACT FROM AUTHOR]

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents' medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply–demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a "concentrically decreasing" pattern. The rating ranged from "very reasonable" to "less reasonable", with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as "less reasonable" occupied 38.73% of the total area. These results indicate that the model accounted for residents' travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources. [ABSTRACT FROM AUTHOR]

Background: We aimed to compare among patients with high-type anorectal malformations (ARM): (i) short- and long-term outcomes of laparoscopic-assisted anorectoplasty (LAARP) compared to classic posterior sagittal anorectoplasty (PSARP) and (ii) the results of single-stage versus staged PSARP. Methods: Using a defined search strategy, two independent investigators systematically reviewed the English literature. PRISMA guidelines were followed, and meta-analysis was performed using RevMan5.3. Results: Of 567 abstracts screened, 7 papers have been included (254 pts; 121 PSARP, 133 LAARP) in the first systematic review and meta-analysis. The length of hospitalization was shortened in LAARP versus PSARP (10.9 versus 14.4 days; p < 0.0001). PSARP and LAARP were comparable in terms of early postoperative complications (28.9% versus 24.7%; p = ns) and rectal prolapse (21.6% versus 17.5%; p = ns). At long-term follow-up, the presence of voluntary bowel movements (74.0% versus 83.5%; p = ns) and the incidence of soiling (45.5% versus 47.6%; p = ns) were similar in both PSARP and LAARP. Six papers (297 pts) were included in the second systematic review, with three comparative studies included in the meta-analysis (247 pts; 117 one-stage, 130 staged procedures). No significant difference in terms of presence of voluntary bowel movements after single-stage versus staged procedures (72.6% versus 67.3%; p = ns) has been detected. Conclusions: LAARP seems to be a safe and effective procedure, showing short- and long-term outcomes similar to PSARP. One-stage PSARP could be a safe alternative to the classic three-stage procedure, even for those infants with high-type ARM. Further and larger comparative studies would be needed to corroborate these partial existing data. [ABSTRACT FROM AUTHOR]

Crowdsourcing applications that integrate storytelling and geotagging capabilities offer new avenues for engaging the public in cultural heritage. However, standardised evaluation frameworks are lacking. This paper presents an applied evaluation methodology involving the analysis of relevant web-based tools. Towards this goal, this paper presents the development of crowdsourcing applications using, as a case study, the collection of myths and legends associated with the monumental heritage site of the Palace of the Grand Master of the Knights of Rhodes in Greece. Additionally, the paper presents an evaluation conducted through a criteria-based approach and user-based survey. The study reviews the concepts of crowdsourcing and digital storytelling within digital heritage, along with current concepts of living heritage and folklore, and examines relevant initiatives. The evaluation follows a four-stage methodology: (i) initial web-based tool selection based on the minimum requirements of web compatibility, crowdsourced data display, and map-based storytelling capability; (ii) application development using the selected web-based tools; (iii) a five-criteria assessment, based on the factors of open access, usability/tool support, participatory content/story creation, metrics provision and metadata model usage; and (iv) a crowd-based survey, indicating the most effective option. Findings from 100 respondents reveal limited exposure to participatory storytelling applications but interest in contributing content. Social media and influential figures serve as key channels for promoting crowdsourcing open calls. The results highlight gaps in understanding user expectations and perceptions, suggesting future research for gaining insights into engagement rates. [ABSTRACT FROM AUTHOR]

This paper presents a fully automated experimental setup tailored for evaluating the effectiveness of augmented and virtual reality technologies in healthcare settings for regulatory purposes, with a focus on the characterization of depth sensors. The setup is constructed as a modular benchtop platform that enables quantitative analysis of depth cameras essential for extended reality technologies in a controlled environment. We detail a design concept and considerations for an experimental configuration aimed at simulating realistic scenarios for head-mounted displays. The system includes an observation platform equipped with a three-degree-of-freedom motorized system and a test object stage. To accurately replicate real-world scenarios, we utilized an array of sensors, including commonly available range-sensing cameras and commercial augmented reality headsets, notably the Intel RealSense L515 LiDAR camera, integrated into the motion control system. The paper elaborates on the system architecture and the automated data collection process. We discuss several evaluation studies performed with this setup, examining factors such as spatial resolution, Z-accuracy, and pixel-to-pixel correlation. These studies provide valuable insights into the precision and reliability of these technologies in simulated healthcare environments. [ABSTRACT FROM AUTHOR]

Modern challenges such as the liberalization of the railway sector and growing demands for sustainability, high-quality services, and user satisfaction set new standards in railway operations. In this context, railway infrastructure managers (RIMs) play a crucial role in ensuring innovative approaches that will strengthen the position of railways in the market by enhancing efficiency and competitiveness. Evaluating their performance is essential for assessing the achieved objectives, and it is conducted through a wide range of key performance indicators (KPIs), which encompass various dimensions of operations. Monitoring and analyzing KPIs are crucial for improving service quality, achieving sustainability, and establishing a foundation for research and development of new strategies in the railway sector. This paper provides a detailed overview and evaluation of KPIs for RIMs. This paper creates a framework for RIM evaluation using various scientific methods, from identifying KPIs to applying complex analysis methods. A novel hybrid model, which integrates the fuzzy Delphi method for aggregating expert opinions on the KPIs' importance, the extended fuzzy analytic hierarchy process (AHP) method for determining the relative weights of these KPIs, and the ADAM method for ranking RIMs, has been developed in this paper. This approach enables a detailed analysis and comparison of RIMs and their performances, providing the basis for informed decision-making and the development of new strategies within the railway sector. The analysis results provide insight into the current state of railway infrastructure and encourage further efforts to improve the railway sector by identifying key areas for enhancement. The main contributions of the research include a detailed overview of KPIs for RIMs and the development of a hybrid multi-criteria decision making (MCDM) model. The hybrid model represents a significant step in RIM performance analysis, providing a basis for future research in this area. The model is universal and, as such, represents a valuable contribution to MCDM theory. [ABSTRACT FROM AUTHOR]

Submerged floating tunnels (SFTs), also known as the Archimedes Bridge, are new transportation structures designed for crossing deep waters. Compared with cross-sea bridges and subsea tunnels, SFTs offer superior environmental adaptability, reduced construction costs, and an enhanced spanning capacity, highlighting their significant development potential and research value. This paper introduces a new type of SFT scale model for hydrodynamic experiments, adhering to the criteria for geometric similarity, motion similarity, and dynamic similarity principles, including the Froude and Cauchy similarity principles. This model enables the accurate simulation of the elastic deformation of the tunnel body and complex hydrodynamic phenomena, such as fluid–structure interactions and vortex–induced vibrations. Moreover, this paper details the design methodology, fabrication process, and method for similarity evaluation, covering the mass, deflection under load, natural frequency in air, and the natural frequency of the various underwater motion freedoms of the model. The results of our experiments and numerical simulations demonstrate a close alignment, proving the reliability of the new SFT scale model. The frequency distribution observed in the white noise wave tests indicates that the SFT equipped with inclined mooring cables experiences a coupled interaction between horizontal motion, vertical motion, and rotation. Furthermore, the design methodology of this model can be applied to other types of SFTs, potentially advancing technical progress in scale modeling of SFTs and enhancing the depth of SFT research through hydrodynamic experiments. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper discusses the challenges in treating high-grade gliomas, particularly glioblastomas, which are aggressive brain tumors with high recurrence rates. It highlights the limitations of current diagnostic imaging modalities, such as gadolinium-based MRI, in accurately detecting tumor recurrence versus treatment-related changes. The paper explores the emerging role of positron emission tomography (PET) in glioma imaging, especially with the use of radiotracers like PSMA, which can help differentiate between tumor recurrence and treatment effects. Furthermore, the paper reviews the concept of theranostics, which integrates diagnostics and therapy, offering a targeted approach to glioma treatment. It discusses various radioligands, including PSMA, 213Bi-DOTA-substance P, 90Y-DOTATOC, 18F-FDOPA, p-[131I]-iodo-L-phenylalanine, and 18F-GE-180, which have shown promise in diagnosing and treating recurrent gliomas. The potential of theranostics to minimize systemic toxicity and improve treatment outcomes is emphasized. Moreover, the paper highlights the importance of considering quality-of-life (QOL) outcomes in glioma patients, as conventional treatments often have significant impacts on patients' well-being. While theranostics offers a personalized approach to treatment, its potential promise for functional outcomes and QOL needs further investigation. The paper suggests that future research should focus on understanding the broader implications of theranostics on patient well-being, incorporating factors such as demographics, tumor characteristics, and treatment-related effects into QOL assessments. Overall, the paper underscores the potential of theranostics to revolutionize glioma management and improve patient outcomes in the future. Gliomas represent the most commonly occurring tumors in the central nervous system and account for approximately 80% of all malignant primary brain tumors. With a high malignancy and recurrence risk, the prognosis of high-grade gliomas is poor, with a mean survival time of 12–18 months. While contrast-enhanced MRI serves as the standard diagnostic imaging modality for gliomas, it faces limitations in the evaluation of recurrent gliomas, failing to distinguish between treatment-related changes and tumor progression, and offers no direct therapeutic options. Recent advances in imaging modalities have attempted to address some of these limitations, including positron emission tomography (PET), which has demonstrated success in delineating tumor margins and guiding the treatment of recurrent gliomas. Additionally, with the advent of theranostics in nuclear medicine, PET tracers, when combined with therapeutic agents, have also evolved beyond a purely diagnostic modality, serving both diagnostic and therapeutic roles. This review will discuss the growing involvement of theranostics in diagnosing and treating recurrent gliomas and address the associated impact on quality of life and functional recovery. [ABSTRACT FROM AUTHOR]

Simple Summary: Acute promyelocytic leukemia (APL) stands as a remarkable success in achieving high cure rates with chemotherapy-free treatment regimens. Despite these remarkable outcomes, hematologists managing patients with APL take into consideration the distinct side effects associated with the two dual differentiation agents, i.e., all-transretinoic acid (ATRA) and arsenic trioxide (ATO). The objective of this paper is to review relevant literature data and discuss the recommended management strategies of non-hematologic early and late complications that arosein patients diagnosed with APL who were treated with ATO and ATRA-based regimens. The hallmark of acute promyelocytic leukemia (APL) is the presence of the characteristic fusion transcript of the promyelocytic leukemia gene with the retinoic acid receptor α gene (PML::RARA). The PML::RARA fusion is a molecular target for all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Therapies based on ATRA plus ATO have excellent outcomes in terms of complete remission rates, overall survival, and achievement of deep and durable molecular responses with a very low incidence of relapse. However, although the combination of ATRA and ATO has lower hematologic toxicity than standard chemotherapy, its use is associated with a spectrum of distinctive toxicities, such as differentiation syndrome, liver toxicity, QT interval prolongation, and neurotoxicity. Rigorous monitoring of patients' clinical evolution is indispensable for identifying and addressing each complication. The objective is to maintain an equilibrium between treatment-induced adverse events and therapeutic efficacy. This paper focused on non-hematologic complications associated with the combination of ATRA and ATO. Additionally, we discuss late-onset complications of this therapy. In summary, the majority of treatment-related adverse events are manageable, self-limiting, and reversible. More so, there seems to be a lower incidence rate of secondary neoplasms compared to standard chemotherapy. However, further research is required to assess how the ATRA plus ATO regimen affects the emergence of additional comorbidities. [ABSTRACT FROM AUTHOR]

In this paper, the aim is to classify torque signals that are received from a 3-DOF manipulator using a pattern recognition neural network (PR-NN). The output signals of the proposed PR-NN classifier model are classified into four indicators. The first predicts that no collisions occur. The other three indicators predict collisions on the three links of the manipulator. The input data to train the PR-NN model are the values of torque exerted by the joints. The output of the model predicts and identifies the link on which the collision occurs. In our previous work, the position data for a 3-DOF robot were used to estimate the external collision torques exerted by the joints when applying collisions on each link, based on a recurrent neural network (RNN). The estimated external torques were used to design the current PR-NN model. In this work, the PR-NN model, while training, could successfully classify 56,592 samples out of 56,619 samples. Thus, the model achieved overall effectiveness (accuracy) in classifying collisions on the robot of 99.95%, which is almost 100%. The sensitivity of the model in detecting collisions on the links "Link 1, Link 2, and Link 3" was 97.9%, 99.7%, and 99.9%, respectively. The overall effectiveness of the trained model is presented and compared with other previous entries from the literature. [ABSTRACT FROM AUTHOR]

The aim of this paper is to present the results of an impact evaluation of a community center in health, capacity building, and digital access, which form an approximation of quality of life, in the population of Santa Fe town in Mexico City, from 2022 to 2024. The methodology is quantitative, using an impact index and the differences in differences (DD) technique. The data were obtained from primary sources with surveys undertaken via questionnaires. The center is operated by a private university and funded by private firms. The results show a positive impact of 0.287127 out of 1 on the weighted impact index, which allows us to consider this program successful in improving the quality of life of the target population. Through impact evaluation, the effectiveness of interventions and opportunities for improvement are identified, fostering collaboration among local actors, including community members, state-run public programs, and community centers. This collaborative effort improves the quality of life, creating a sustainable community wherein each actor addresses specific needs. Impact evaluation plays a crucial role in measuring sustainability because it is a continuous improvement process that, when combined with other actions, enhances the community's overall well-being. [ABSTRACT FROM AUTHOR]

In the realm of intelligent sports, the integration of triboelectric nanogenerators (TENGs) marks a transformative approach toward energy sustainability and more advanced athletic monitoring. By leveraging the principle of triboelectricity, TENGs ingeniously convert mechanical energy from athletes' movements into electrical energy, which offers a green and efficient power solution for wearable technology. This paper presents an innovative study on the application of TENG technology in sports science, with the results illustrating the potential utility of TENGs in revolutionizing the way we monitor, analyze, and enhance athletic performance. Through the development of self-powered wearables and equipment, TENGs facilitate real-time data collection on physiological and biomechanical parameters, ultimately enabling personalized training adjustments and injury prevention strategies. Our findings underscore the dual benefit of TENGs in promoting environmental sustainability by reducing the overall reliance on traditional energy sources and growing the capabilities of intelligent sports systems. This research contributes to the burgeoning field of nano-energy sports applications while setting the stage for future explorations into the optimization of TENG integration in athletic performance enhancement. Finally, the paper concludes by discussing remaining challenges in this area and opportunities for further research. [ABSTRACT FROM AUTHOR]

Simple Summary: Proton therapy is a crucial tool for head and neck and skull-base cancers, offering benefits over photon therapy by lowering the risk of adverse effects. However, its full potential could be further explored by better characterizing the uncertainties related to its relative biological effectiveness. Addressing these uncertainties is crucial for maximizing the potential of proton therapy. We explore the significance of proton therapy's biological impact in these cancers, review relative biological effectiveness uncertainties and modeling, and examine clinical outcomes and evidence linking specific biological factors to patient adverse effects. Additionally, we review the current clinical practices and provide insights into innovative developments and their future clinical implementation. Proton therapy has emerged as a crucial tool in the treatment of head and neck and skull-base cancers, offering advantages over photon therapy in terms of decreasing integral dose and reducing acute and late toxicities, such as dysgeusia, feeding tube dependence, xerostomia, secondary malignancies, and neurocognitive dysfunction. Despite its benefits in dose distribution and biological effectiveness, the application of proton therapy is challenged by uncertainties in its relative biological effectiveness (RBE). Overcoming the challenges related to RBE is key to fully realizing proton therapy's potential, which extends beyond its physical dosimetric properties when compared with photon-based therapies. In this paper, we discuss the clinical significance of RBE within treatment volumes and adjacent serial organs at risk in the management of head and neck and skull-base tumors. We review proton RBE uncertainties and its modeling and explore clinical outcomes. Additionally, we highlight technological advancements and innovations in plan optimization and treatment delivery, including linear energy transfer/RBE optimizations and the development of spot-scanning proton arc therapy. These advancements show promise in harnessing the full capabilities of proton therapy from an academic standpoint, further technological innovations and clinical outcome studies, however, are needed for their integration into routine clinical practice. [ABSTRACT FROM AUTHOR]

Geological hazards are widely distributed, cause huge losses, and have always been the focus of attention for engineering and environmental geologists. Geological hazard evaluation is the basis of research and has important theoretical significance for preventing and controlling geological hazards. Therefore, geological hazard evaluation has become the focus of engineering and environmental geology. The question of how to build a universal index system model of geological hazard evaluation is an urgent problem that needs to be solved in geological hazard evaluation. Based on a large amount of previous research data, this paper takes landslide hazard as an example and systematically expounds the main problems that need to be solved in the current geological hazard evaluation from five aspects: basic concept, evaluation scope and accuracy, evaluation index system and evaluation criteria, evaluation method, and applicability of evaluation results. A landslide hazard assessment index system model is proposed, which applies to all regions, including all of the factors that may affect the formation of landslides. It is also hoped that this will be used as an example to establish various types of disaster evaluation and assessment systems. If the parameter has no value in the assessment process, it can be processed as 0. On this basis, further research is suggested from the perspectives of the geological hazard evaluation level, geological hazard evaluation theory, and method. To provide thoughts on and suggestions for geological hazard risk assessment method research, standard revision, investigation and evaluation, and risk management and control need to be considered. [ABSTRACT FROM AUTHOR]

Agents and agent-based systems are becoming essential in the development of various fields, such as artificial intelligence, ubiquitous computing, ambient intelligence, autonomous computing, and intelligent robotics. The concept of autonomous agents, inspired by the observed agency in living systems, is also central to current theories on the origin, development, and evolution of life. Therefore, it is crucial to develop an accurate understanding of agents and the concept of agency. This paper begins by discussing the role of agency in natural systems as an inspiration and motivation for agential technologies and then introduces the idea of artificial agents. A systematic approach is presented for the classification of artificial agents. This classification aids in understanding the existing state of the artificial agents and projects their potential future roles in addressing specific types of problems with dedicated agent types. [ABSTRACT FROM AUTHOR]

Simple Summary: Completion lobectomy (CL) entails the resection of the remaining pulmonary lobe subsequent to wedge resection or segmentectomy. Indications for CL include reoperations for multiple or relapsed lung cancers and metastatic lung tumors, and the prognostic advantage of these procedures has been widely reported. However, ipsilateral surgical treatments, particularly within the same lobe, present challenges due to the development of intrapleural adhesions, rendering reoperation more difficult and time-consuming. VATS has emerged as the gold standard in the surgical treatment of early-stage NSCLC, offering superior postoperative outcomes when compared to thoracotomy. Its efficacy has been well established, even during complex procedures. However, its application in ipsilateral reoperations remains anecdotal, and to the best of our knowledge, no studies have analyzed the safety and efficacy of uniportal-VATS in this setting. This paper aims to evaluate the role of iniportal-VATS in CL long after wedge resection or anatomical segmentectomy in the same lobe. Background: Completion lobectomy (CL) following a prior resection in the same lobe may be complicated by severe pleural or hilar adhesions. The role of uniportal video-assisted thoracoscopic surgery (U-VATS) has never been evaluated in this setting. Methods: Data were collected from two Italian centers. Between 2015 and 2022, 122 patients (60 men and 62 women, median age 67.7 ± 8.913) underwent U-VATS CL at least 4 weeks after previous lung surgery. Results: Twenty-eight (22.9%) patients were affected by chronic obstructive pulmonary disease (COPD) and twenty-five (20.4%) were active smokers. Among the cohort, the initial surgery was performed using U-VATS in 103 (84.4%) patients, triportal-VATS in 8 (6.6%), and thoracotomy in 11 (9.0%). Anatomical segmentectomy was the initial surgery in 46 (37.7%) patients, while hilar lymphadenectomy was performed in 16 (13.1%) cases. CL was performed on 110 (90.2%) patients, segmentectomy on 10 (8.2%), and completion pneumonectomy on 2 (1.6%). Upon reoperation, moderate pleural adhesions were observed in 38 (31.1%) patients, with 2 (1.6%) exhibiting strong adhesions. Moderate hilar adhesions were found in 18 (14.8%) patients and strong adhesions in 11 (9.0%). The median operative time was 203.93 ± 74.4 min. In four (3.3%) patients, PA taping was performed. One patient experienced intraoperative bleeding that did not require conversion to thoracotomy. Conversion to thoracotomy was necessary in three (2.5%) patients. The median postoperative drainage stay and postoperative hospital stay were 5.67 ± 4.44 and 5.52 ± 2.66 days, respectively. Postoperative complications occurred in 34 (27.9%) patients. Thirty-day mortality was null. Histology was the only factor found to negatively influence intraoperative outcomes (p = 0.000). Factors identified as negatively impacting postoperative outcomes at univariate analyses were male sex (p = 0.003), age > 60 years (p = 0.003), COPD (p = 0.014), previous thoracotomy (p = 0.000), previous S2 segmentectomy (p = 0.001), previous S8 segmentectomy (p = 0.008), and interval between operations > 5 weeks (p= 0.005). In multivariate analysis, only COPD confirmed its role as an independent risk factor for postoperative complications (HR: 5.12, 95% CI (1.07–24.50), p = 0.04). Conclusions: U-VATS CL seems feasible and safe after wedge resection and anatomical segmentectomy. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDPs) represent a significant source of severe maternal and fetal morbidity. Screening strategies relying on traditional medical history and clinical risk factors have traditionally shown relatively modest performance, mainly in the prediction of preeclampsia, displaying a sensitivity of 37% for the early-onset form and 29% for the late-onset form. The development of more accurate predictive and diagnostic models of preeclampsia in the early stages of pregnancy represents a matter of high priority. The aim of the present paper is to create an effective second trimester prediction algorithm of early-onset HDP occurrence and severity, by combining the following two biochemical markers: a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and uterine artery Doppler ultrasound parameters, namely the pulsatility index (PI) and the resistivity index (RI), in a population of high-risk pregnant women, initially assessed through traditional risk factors. A prospective single-center observational longitudinal study was conducted, in which 100 women with singleton pregnancy and traditional clinical and medical history risk factors for preeclampsia were enrolled at 24 weeks of gestation. Shortly after study enrollment, all women had their sFlt-1 and PlGF levels and mean uterine artery PI and RI determined. All pregnancies were followed up until delivery. Receiver operating characteristic (ROC) analysis established algorithms based on cutoffs for the prediction of the later development of preeclampsia: PI 1.25 (96.15% sensitivity, 86.49% specificity), RI 0.62 (84.6% sensitivity, 89.2% specificity) and sFlt-1/PlGF ratio 59.55 (100% sensitivity, 89.2% specificity). The sFlt-1/PlGF ratio was the best predictor for preeclampsia, as it displayed the highest area under the curve (AUC) of 0.973. The prediction algorithm for the severe form of preeclampsia, complicated by fetal growth restriction leading to preterm birth, antepartum fetal demise or acute fetal distress with a cerebro-placental ratio of

Background: Drug desensitization allows for safe administration of a drug to a patient with a previous hypersensitivity reaction. Successful desensitization protocols have been described for different medications, including protocols for oncology patients. Few cases of desensitization to sorafenib and imatinib have been described in the literature so far. Objective: The objective of this paper is to describe the process of the sorafenib and imatinib drug hypersensitivity diagnosis and desensitization process in two patients. Methods: Two oncology patients who experienced non-immediate hypersensitivity reactions to sorafenib and imatinib underwent desensitization to these drugs. We designed a protocol for the first patient and used a modified protocol from the literature for the second patient. Results: By using a slow desensitization technique and gradual tapering of corticosteroids and antihistamines, both patients reached the target dose of the incriminated drug. Conclusions: Desensitization to sorafenib and imatinib can be an effective therapeutic option in patients with hypersensitivity to those medications, without alternative treatment options. [ABSTRACT FROM AUTHOR]

Simple Summary: Percutaneous cryoablation (PCA) is a minimally invasive procedure that should be considered in comorbid patients with stage T1 renal tumours who are suboptimal candidates for partial nephrectomy (PN). However, there is a scarcity of scientific data regarding the efficacy of PCA. The aim of this meta-analysis was to compare PCA and PN in terms of complications, renal function and survival outcomes. According to this analysis, PCA is associated with fewer complications than PN. Moreover, in tumours up to 4 cm, it provides the same time without local recurrence. Therefore, PCA should be proposed to patients with cT1 renal tumours who are not fit for PN but want to undergo a radical treatment. Percutaneous cryoablation (PCA) can be an alternative to partial nephrectomy (PN) in selected patients with stage T1 renal tumours. Existing meta-analyses regarding ablative techniques compared both laparoscopic and PCA with PN. That is why we decided to perform a meta-analysis that focused solely on PCA. The aim of this study was to compare the complications and functional and oncological outcomes between PCA and PN. A systematic literature search was performed in January 2024. Data for dichotomous and continuous variables were expressed as pooled odds ratios (ORs) and mean differences (MDs), both with 95% confidence intervals (CIs). Effect measures for the local recurrence-free survival (LRFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS) were expressed as pooled hazard ratios with 95% CIs. Among 6487 patients included in the 14 selected papers, 1554 (23.9%) and 4924 (76.1%) underwent PCA and PN, respectively. Compared with the PN group, patients undergoing PCA had significantly lower overall and major postoperative complication rates. There was no difference in renal function between PCA and PN groups. When analysing collective data for cT1 renal carcinoma, PCA was associated with worse LRFS compared with PN. However, subgroup analysis revealed that in the case of PCA, LRFS was not decreased in patients with cT1a tumours. Moreover, patients undergoing robotic-assisted PN had improved LRFS compared with those undergoing PCA. No significant differences were observed between PCA and PN in terms of MFS and CSS. Finally, PCA was associated with worse OS than PN in both collective and subgroup analyses. In conclusion, PCA is associated with favourable postoperative complication rates relative to PN. Regarding LRFS, PCA is not worse than PN in cT1a tumours but has a substantially relevant disadvantage in cT1b tumours. Also, RAPN might be the only surgical modality that provides better LRFS than PCA. In cT1 tumours, PCA shows MFS and CSS comparable to PN. Lastly, PCA is associated with a shorter OS than PN. [ABSTRACT FROM AUTHOR]

Simple Summary: The Sarcoma Assessment Measure (SAM) is a special questionnaire for patients with sarcomas, a type of cancer. It was created with input from both patients and healthcare professionals and is meant to be used by professionals to better understand how sarcoma affects a patient's life. We tested the SAM on 762 patients who had different types of sarcomas and ranged in age from 13 to 82. We found that the SAM could be a useful tool for both researchers and healthcare professionals to assess how sarcoma symptoms impact a patient's life. However, more testing with a larger and more diverse group of patients is needed to be sure it is a good outcome measure in drug trials. The Sarcoma Assessment Measure (SAM) was developed as a sarcoma-specific patient-reported outcome measure to be used in clinical practice. We have reported in detail how SAM has been developed in collaboration with patients and healthcare professionals. The aim of this paper is to report the preliminary validation of SAM. The 22-item SAM was administered alongside a validated quality of life questionnaire and measure of activities of daily living. Linear modelling was used to build a measure, which had predictive validity in comparison to more established outcome measures. Of the 762 patients who participated in the study, 44.1% identified as male, and participant age ranged from 13 to 82 years. Clinically, participants presented with a range of soft tissue (82.2%) and bone (21.8%) sarcomas. Our preliminary analysis indicates that SAM accounts for 35% of the global quality of life scale and 18% of the Toronto Extremity Salvage Scale (TESS); so psychometrically, it overlaps with quality of life and activities of daily living, but also measures distinct concerns. This demonstrates that this measure picks up issues that are important to patients with sarcoma that are not reflected in other measures. We have established the preliminary validity of SAM and believe it has utility as a patient-reported outcome measure both as a research tool and for assessing the impact of symptoms and dysfunction related to sarcoma as part of clinical care. Further validation using a larger and more clinically diverse sample is now needed. [ABSTRACT FROM AUTHOR]

This study used ratings to form teams of participants with different risk management competence levels to determine if a collectively optimised team performed a risk management exercise better than a marginally or a sub-optimised team. This paper also determined whether team performance was better than individual performance on a risk management exercise. An experimental group was split into three teams of six participants based on their individual risk scenario exercise outcomes. The collectively optimised team had at least one member rated as having some high-level or expert competency in one of the seven risk management process elements. So, jointly, the group had this competency level in all elements. Similarly, the marginally optimised team's members were rated as having just above average or high-level competency in the seven elements. Likewise, the sub-optimised team's members were rated as having just above average competency, just below average, or no competency in the seven elements. Each team undertook the risk scenario exercise, and two observers rated their performances, as recorded on a video camera. The results were that the collectively optimised team performed better in each of the seven risk management elements than the other teams (the marginally optimised or the sub-optimised team). However, a significant difference was only evident between the collectively optimised and sub-optimised teams across all elements. Also, the teams performed better in each of the seven elements than individuals. These results imply that a team collectively optimised in the seven elements of the risk management process can better perform a risk management process than a sub-optimised team. These competency outcomes could be used to assemble risk management teams that are collectively optimised, leading to better results from the risk management process. [ABSTRACT FROM AUTHOR]

Background: Ulcerative colitis (UC) is a relapsing–remitting inflammatory condition that has an increasing incidence across the world, including in the Middle East. Biological monoclonal antibody drugs (biologics) have been shown to be advantageous in treating UC. We undertook a review of the currently available biological and small-molecule therapies, with a particular emphasis on those currently licensed in the United Arab Emirates (UAE). Methods: We conducted a literature search for studies on biological therapies using the PubMed, MEDLINE, and Embase databases using a list of keywords that were generated following referral to existing treatment guidelines for UC. Papers looking at biological and small-molecule treatments for UC in adult populations were included. Pediatric, pregnancy, and cost-effectiveness studies were excluded. Results and Discussion: There are currently three classes of biologics (anti-tumor necrosis factors (anti-TNFs), anti-integrins, and anti-interleukins) and one class of small-molecule therapy (Janus kinase (JAK) inhibitor) licensed for UC treatment in the UAE. Within the anti-TNF class, three medications have been approved: infliximab, adalimumab, and golimumab. For JAK inhibitors, there are two: tofacitinib and upadacitinib. There is only one licensed medication in the remaining classes: vedolizumab (anti-integrin) and ustekinumab (anti-interleukin). The length of studies varied from 6–8 weeks for induction studies and 52 weeks for maintenance studies. The studies demonstrated increased efficacy in these medications compared to placebos when clinical response, clinical remission, and other secondary measures such as mucosal healing were assessed following the induction and maintenance phases. Biosimilars of infliximab and adalimumab are also available for treating UC, and their safety and efficacy were compared to their biologic originators. Conclusions: The introduction of biologics has been proven to be beneficial for the treatment of UC. This review summarizes the efficacy and safety of each biological class in the treatment of the disease; however, biological drug registries and further studies are required to offer more insight into the comparative efficacy and safety of these agents. [ABSTRACT FROM AUTHOR]

This paper presents a pioneering methodology for refining product recommender systems, introducing a synergistic integration of unsupervised models—K-means clustering, content-based filtering (CBF), and hierarchical clustering—with the cutting-edge GPT-4 large language model (LLM). Its innovation lies in utilizing GPT-4 for model evaluation, harnessing its advanced natural language understanding capabilities to enhance the precision and relevance of product recommendations. A flask-based API simplifies its implementation for e-commerce owners, allowing for the seamless training and evaluation of the models using CSV-formatted product data. The unique aspect of this approach lies in its ability to empower e-commerce with sophisticated unsupervised recommender system algorithms, while the GPT model significantly contributes to refining the semantic context of product features, resulting in a more personalized and effective product recommendation system. The experimental results underscore the superiority of this integrated framework, marking a significant advancement in the field of recommender systems and providing businesses with an efficient and scalable solution to optimize their product recommendations. [ABSTRACT FROM AUTHOR]

Simulation models are a valuable tool for exoskeleton development, especially for system optimization and evaluation. It allows an assessment of the performance and effectiveness of exoskeletons even at an early stage of their development without physical realization. Due to the closed physical interaction between the exoskeleton and the user, accurate modeling of the human–exoskeleton interaction in defined scenarios is essential for exoskeleton simulations. This paper presents a novel approach to simulate exoskeleton motion in response to human motion and the interaction forces at the physical interfaces between the human and the exoskeleton. Our approach uses a multibody model of a shoulder exoskeleton in MATLAB R2021b and imports human motion via virtual markers from a digital human model to simulate human–exoskeleton interaction. To validate the human-motion-based approach, simulated exoskeleton motion and interaction forces are compared with experimental data from a previous lab study. The results demonstrate the feasibility of our approach to simulate human–exoskeleton interaction based on human motion. In addition, the approach is used to optimize the support profile of an exoskeleton, indicating its potential to assist exoskeleton development prior to physical prototyping. [ABSTRACT FROM AUTHOR]

In this paper, we present a novel Artificial Intelligence (AI) -empowered system that enhances large language models and other machine learning tools with rules to provide primary care diagnostic advice to patients. Specifically, we introduce a novel methodology, represented through a process diagram, which allows the definition of generative AI processes and functions with a focus on the rule-augmented approach. Our methodology separates various components of the generative AI process as blocks that can be used to generate an implementation data flow diagram. Building upon this framework, we utilize the concept of a dialogue process as a theoretical foundation. This is specifically applied to the interactions between a user and an AI-empowered software program, which is called "Med|Primary AI assistant" (Alpha Version at the time of writing), and provides symptom analysis and medical advice in the form of suggested diagnostics. By leveraging current advancements in natural language processing, a novel approach is proposed to define a blueprint of domain-specific knowledge and a context for instantiated advice generation. Our approach not only encompasses the interaction domain, but it also delves into specific content that is relevant to the user, offering a tailored and effective AI–user interaction experience within a medical context. Lastly, using an evaluation process based on rules, defined by context and dialogue theory, we outline an algorithmic approach to measure content and responses. [ABSTRACT FROM AUTHOR]

Assessment of prosody is not usually included in the evaluation of oral expression skills of L2 Spanish learners. Some of the factors that probably explain this fact are the lack of adequate materials, correctness models and tools to carry out this assessment. This paper describes one of the results of the ProA (Prosody Assessment) project, a web tool for the online assessment of Spanish prosody. The tool allows the online development of evaluation tests and rubrics, the completion of these tests and their remote scoring. An example of use of this tool for research purposes is also presented: three prosodic parameters (global energy, speech rate, F0 range) of a set of oral productions of two L2 Spanish learners, collected using the tests developed in the project, were evaluated by three L2 Spanish teachers using the web tool and the rubrics developed also in the ProA project, and the obtained ratings were compared with the results of the acoustic analysis of these parameters in the material to determine to what extent there was a correlation between evaluators' judgements and prosodic parameters. The results obtained may be of interest, for example, for the development of future automatic prosody assessment systems. [ABSTRACT FROM AUTHOR]

Analysing message streams in a dynamic environment is challenging. Various methods and metrics are used to evaluate message classification solutions, but often fail to realistically simulate the actual environment. As a result, the evaluation can produce overly optimistic results, rendering current solution evaluations inadequate for real-world environments. This paper proposes a framework based on the simulation of real-world message streams to evaluate classification solutions. The framework consists of four modules: message stream simulation, processing, classification and evaluation. The simulation module uses techniques and queueing theory to replicate a real-world message stream. The processing module refines the input messages for optimal classification. The classification module categorises the generated message stream using existing solutions. The evaluation module evaluates the performance of the classification solutions by measuring accuracy, precision and recall. The framework can model different behaviours from different sources, such as different spammers with different attack strategies, press media or social network sources. Each profile generates a message stream that is combined into the main stream for greater realism. A spam detection case study is developed that demonstrates the implementation of the proposed framework and identifies latency and message body obfuscation as critical classification quality parameters. [ABSTRACT FROM AUTHOR]

Population growth, urbanization, and climate change have significantly contributed to environmental degradation, posing severe consequences for humans and other species. By integrating ecological objectives with human-centric goals, a path towards a sustainable, multi-species future is possible. Current sustainable design principles have shown positive environmental impacts by addressing human-centric objectives such as enhancing green infrastructure, energy efficiency, thermal comfort, and more. However, the incorporation of multi-species design criteria remains unresolved. This paper proposes a conceptual framework in which human-centric and ecological design objectives are defined and associated through the selection of key performance indicators (KPIs) represented by numerical thresholds. But, while the objective-KPI relationship is an established path in architectural design, the same does not apply for preserving and promoting biodiversity. The proposed conceptual framework identifies, defines, and associates the relevant objective-KPI relationships for all stakeholders and becomes the basis for evaluating the project computationally. Such an approach is currently lacking. [ABSTRACT FROM AUTHOR]

Lithium-ion batteries (LIBs) have a wide range of applications in different fields, starting with electronics and energy storage systems. The potential of LIBs in the transportation sector is high, especially for electric vehicles (EVs). This study aims to investigate the efficiency and effectiveness of, and justification for, the application of LIBs in the field of transport, primarily in EVs. The research focuses on single and multi-criteria evaluations of the efficiency of LIBs. Previous studies in which LIBs were evaluated using cost–benefit analysis (CBA) and multi-criteria decision-making methods (MCDM) were analysed. An electronic literature search of the Web of Science, Scopus, and other relevant databases was performed. The literature was searched using the keywords: "lithium-ion batteries"; "multi-criteria decision-making"; "cost-benefit analysis"; "energy storage"; "vehicles"; "PROMETHEE" (or other MCDM method)". A total of 40 scientific articles concerning the application of CBA (of which are 20%) and MCDM methods between 1997 and 2023, worldwide, were analysed. The results show multiple applications of both CBA and MCDM methods. The main findings of the areas of application were summarised and future research was discussed. [ABSTRACT FROM AUTHOR]

Assessment of muscle tone in a clinical setting is important for the physiotherapist to better analyse and establish appropriate treatments for CNS disorders. This study aims to review and summarise how to assess changes in tone in the context of adult rehabilitation. Secondarily, this study aimed to identify the central nervous system disorders, the respective variable/concept under study, and the testing procedures employed. PRISMA-ScR guidelines were followed using the "population", "concept", and "context" to define the eligibility criteria and to delineate the research question. PubMed®, Science Direct®, Web of Science™, and Google Scholar® databases were used to search the literature. The search included studies published between 2011 and March 2023 in Portuguese, English, French, and Spanish that assessed an adult population (>19 years) with CNS injury. Review articles, qualitative studies, conference proceedings, letters to the editor, and editorials were excluded. Initially, 1519 references were identified, of which eight met the eligibility criteria. The measurement instruments included the Modified Ashworth Scale (n = 5), the Modified Modified Ashworth Scale (n = 3), the BioTone™ system (n = 2), the Montreal Spasticity Measurement (n = 1), and the Tone Evaluation Scale (n = 1). The health conditions considered included stroke sequelae (n = 7), multiple sclerosis (n = 4), spinal cord injuries (n = 4), cerebral palsy (n = 2), brain tumour (n = 2), and traumatic brain injuries (n = 3). The concepts of spasticity (n = 7) and muscle tone (n = 2) were explored. Considering the variables spasticity and muscle tone in different CNS disorders, mainly stroke, subjective instruments were preferred compared to objective ones, with the Modified Ashworth Scale being highlighted. [ABSTRACT FROM AUTHOR]

According to data in the literature, natural products and essential oils are often used in dental practice. To develop a new oromucosal spray for the treatment of infectious and inflammatory diseases of the oral cavity, clove CO2 extract and essential oils of lavender and grapefruit were used as active pharmaceutical ingredients. Clove extract was obtained by the method of subcritical extraction from various raw materials, the choice of which was based on the yield of the CO2 extract and the study of its phytochemical and microbiological properties. Based on the results of microscopic and diffraction analyses, the rational time of ultrasonic exposure for the emulsion of active pharmaceutical ingredients was established. Mucoadhesive polymers were used as stabilizers of the two-phase system and prolongators. This article discusses the impact of the type and concentration of mucoadhesive polymers on the stability of the emulsion system; the viscous, textural, adhesive, and film characteristics of oromucosal spray; and the parameters determining sprayability. [ABSTRACT FROM AUTHOR]

Based on the WAVEWATCH III wave model, China's National Marine Environmental Forecasting Center has developed an operational global ocean wave forecasting system that covers the Arctic region. In this study, in situ buoy observations and satellite remote sensing data were used to perform a detailed evaluation of the system's forecasting results for 2022, with a focus on China's offshore and global ocean waters, so as to comprehensively understand the model's forecasting performance. The study results showed the following: In China's coastal waters, the model had a high forecasting accuracy for significant wave heights. The model tended to underestimate the significant wave heights in autumn and winter and overestimate them in spring and summer. In addition, the model slightly underestimated low (below 1 m) wave heights, while overestimating them in other ranges. In terms of spatial distribution, negative deviations and high scatter indexes were observed in the forecasting of significant wave heights in semi-enclosed sea areas such as the Bohai Sea, Yellow Sea, and Beibu Gulf, with the largest negative deviation occurring near Liaodong Bay of the Bohai Sea (−0.18 m). There was a slight positive deviation (0.01 m) in the East China Sea, while the South China Sea exhibited a more significant positive deviation (0.17 m). The model showed a trend of underestimation for the forecasting of the mean wave period in China's coastal waters. In the global oceanic waters, the forecasting results of the model were found to have obvious positive deviations for most regions, with negative deviations mainly occurring on the east coast and in relatively closed basins. There were latitude differences in the forecasting deviations of the model: specifically, the most significant positive deviations occurred in the Southern Ocean, with smaller positive deviations toward the north, while a slight negative deviation was observed in the Arctic waters. Overall, the global wave model has high reliability and can meet the current operational forecasting needs. In the future, the accuracy and performance of ocean wave forecasting can be further improved by adjusting the parameterization scheme, replacing the wind fields with more accurate ones, adopting spherical multiple-cell grids, and data assimilation. [ABSTRACT FROM AUTHOR]

Surface downward longwave radiation (SDLR) is crucial for maintaining the global radiative budget balance. Due to their ease of practicality, SDLR parameterization models are widely used, making their objective evaluation essential. In this study, against comprehensive ground measurements collected from more than 300 globally distributed sites, four SDLR parameterization models, including three popular existing ones and a newly proposed model, were evaluated under clear- and cloudy-sky conditions at hourly (daytime and nighttime) and daily scales, respectively. The validation results indicated that the new model, namely the Peng model, originally proposed for SDLR estimation at the sea surface and applied for the first time to the land surface, outperformed all three existing models in nearly all cases, especially under cloudy-sky conditions. Moreover, the Peng model demonstrated robustness across various land cover types, elevation zones, and seasons. All four SDLR models outperformed the Global Land Surface Satellite product from Advanced Very High-Resolution Radiometer Data (GLASS-AVHRR), ERA5, and CERES_SYN1de-g_Ed4A products. The Peng model achieved the highest accuracy, with validated RMSE values of 13.552 and 14.055 W/m2 and biases of −0.25 and −0.025 W/m2 under clear- and cloudy-sky conditions at daily scale, respectively. Its superior performance can be attributed to the inclusion of two cloud parameters, total column cloud liquid water and ice water, besides the cloud fraction. However, the optimal combination of these three parameters may vary depending on specific cases. In addition, all SDLR models require improvements for wetlands, bare soil, ice-covered surfaces, and high-elevation regions. Overall, the Peng model demonstrates significant potential for widespread use in SDLR estimation for both land and sea surfaces. [ABSTRACT FROM AUTHOR]

The instability (in processing time) in the flow-drill screwing process is undesired but inescapable due to variations in material property, gauge, and process parameters. A substantial number of materials and lab labor need to be used to test and control the variability of the real manufacturing joining process. To enhance the stability and efficiency of the screwing process, this study seeks multi-disciplinary collaboration by applying linear-regression modeling. Six hundred and forty-eight data points were collected and split into an 80% training set for model building and a 20% test set for model validation. A multiple linear-regression model was built. The results indicated that, compared to variable base level (6000 rpm rotational speed and 1100 N downforce), higher rotational speed (8000 rpm, 7000 rpm), greater downforce (1200 N, 1300 N), and their interaction were significantly associated with passage (processing) time, while the switch point did not significantly affect passage time. The interaction plot and effect size were adopted to provide measurements of the effect magnitude on processing time. The coefficient of determination indicated that 86% of the variability in the passage time can be explained by this model. Statistical analysis, such as data visualization, statistical modeling, and other data-driven analysis methods, can be used to detect underlying relationships between variables, investigate variations, and make predictions in the manufacturing process. The outcomes from the data-driven analysis can benefit from improving the economical manufacturing system, refining the processing setting, and reducing test material costs, labor, and lead time. [ABSTRACT FROM AUTHOR]

The healthcare environment faced by nurses is complex, with high workloads and situations of high comorbidity. The integration of nurses into the work environment is a cause for concern, and improvements are sought for their incorporation into the workforce. The benefits of mentoring programs are described not only for nurses but also for patients with safer practices and benefits for the institution due to the increased commitment of its professionals. A methodological article that illustrates the complete process to design and implement a tutoring program for new nurses in an emergency department is presented. The competency profile required for the figure of tutor was developed, including the steps followed for the development of the program and the structure and phases of which it is composed, as well as the validation of the evaluation instruments of the process. A strength was the participation of experts during the in-depth analysis of the competency profile, as well as in the adaptation of the evaluation items, which endorses the pertinence, relevance, usefulness, and clarity of the content of this program. The transparency in this methodology makes it possible to follow the steps for its reproduction and applicability in other hospitals. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. Methods: The scale's structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. Results: EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. Conclusions: This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment. [ABSTRACT FROM AUTHOR]

(1) Objective: to investigate the effectiveness of telephysiotherapy compared with traditional rehabilitation for elderly patients and determine the factors impacting its efficacy. (2) Method: Five online databases (PubMed, Google Scholar, Scopus, Web of Science, and Cochrane) were reviewed up to 31 July 2023. The search included the literature in English from 2014 to 2023, to capture the latest practices in telephysiotherapy for elderly patients. Data from all qualified studies were independently extracted by two authors, quantifying effect size to reflect treatment performance. (3) Results: 222 records from 19 articles were analyzed. The effect size for telephysiotherapy was 0.350 (95% C.I. = 0.283–0.416; p < 0.01). The standardized mean differences for physical and psychological outcomes were 0.406 (95% C.I. = 0.325–0.488; p < 0.01) and 0.223 (95% C.I. = 0.110–0.336; p < 0.01), respectively. (4) Conclusions: Telephysiotherapy was more effective than traditional rehabilitation, significantly improving the physical and psychological status of elderly patients. The factors influencing the effectiveness of telephysiotherapy were intervention type, intervention duration, outcome, and gender. [ABSTRACT FROM AUTHOR]

The pervasive spread of fake news in online social media has emerged as a critical threat to societal integrity and democratic processes. To address this pressing issue, this research harnesses the power of supervised AI algorithms aimed at classifying fake news with selected algorithms. Algorithms such as Passive Aggressive Classifier, perceptron, and decision stump undergo meticulous refinement for text classification tasks, leveraging 29 models trained on diverse social media datasets. Sensors can be utilized for data collection. Data preprocessing involves rigorous cleansing and feature vector generation using TF-IDF and Count Vectorizers. The models' efficacy in classifying genuine news from falsified or exaggerated content is evaluated using metrics like accuracy, precision, recall, and more. In order to obtain the best-performing algorithm from each of the datasets, a predictive model was developed, through which SG with 0.681190 performs best in Dataset 1, BernoulliRBM has 0.933789 in Dataset 2, LinearSVC has 0.689180 in Dataset 3, and BernoulliRBM has 0.026346 in Dataset 4. This research illuminates strategies for classifying fake news, offering potential solutions to ensure information integrity and democratic discourse, thus carrying profound implications for academia and real-world applications. This work also suggests the strength of sensors for data collection in IoT environments, big data analytics for smart cities, and sensor applications which contribute to maintaining the integrity of information within urban environments. [ABSTRACT FROM AUTHOR]

Simple Summary: In the era of direct-acting antiviral (DAA) agents, chronic hepatitis C virus (HCV) infection has become a curable disease. Eradication of the virus remains a major goal for the World Health Organization (WHO) by 2030. Main obstacles seem to be the lack of national screenings and shortage of knowledge among patients and healthcare professionals. There also remain, scarcely described in the literature, specific groups of patients who, due to their comorbidities such as malignant tumors, may not be considered as candidates eligible for DAA treatment. In our study, we aimed to characterize and present treatment efficacy in individuals with chronic hepatitis C and an active malignancy treated in Poland in years 2015–2020 with DAAs and compare their outcomes with a treated population with no active malignancy. The obtained results indicate high effectiveness and a low number of premature treatment discontinuations for the majority of patients with active malignancies, with some concerns around HCCs. We believe that data provided by this study will lead to more efficient elaboration of the standard of care in this population. Background: Over the past years, the introduction of direct-acting antivirals (DAAs) revolutionized chronic hepatitis C treatment. We aimed to characterize and assess treatment efficacy in three specific groups of patients treated with DAAs: those with active solid malignant tumors (SMTs), hematological diseases (HDs) and hepatocellular carcinomas (HCCs). Methods: A total of 203 patients with active oncological disease (SMT n = 61, HD = 67, HCC n = 74) during DAA treatment in 2015–2020 selected from the EpiTer-2 database were analyzed retrospectively and compared to 12,983 patients without any active malignancy. Results: Extrahepatic symptoms were more frequent in HD patients (17.2% vs. SMT = 10.3%, HCC = 8.2%, without = 7.8%, p = 0.004). HCC patients characterized with the highest ALT activity (81 IU/L vs. SMT = 59.5 IU/L, HD = 52 IU/L, without = 58 IU/L, p = 0.001) more often had F4 fibrosis as well (86.11% vs. SMT = 23.3%, HD = 28.8%, controls = 24.4%, p = 0.001). A significant majority of subjects in HCC, HD and SMT populations completed the full treatment plan (HCC = 91%; n = 67, HD = 97%; n = 65, SMT = 100%; n = 62). Concerning the treatment efficacy, the overall sustained virologic response, excluding non-virologic failures, was reported in 93.6% HD, 90.16% SMT and 80.6% in HCC patients. Conclusions: As presented in our study, DAA therapy has proven to be highly effective and safe in patients with active SMTs and HDs. However, therapy discontinuations resulting from liver disease progression remain to be the major concern in HCC patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Squamous cell carcinoma of the anus or anal cancer is increasing in prevalence, and the standard treatment of mitomycin and 5-fluorouracil is too toxic for many patients. Unfortunately, there is currently no standard of care for what to do for this disease when someone is not a candidate for this aggressive treatment. Here, we demonstrate the promising preliminary toxicity profile and efficacy of the combination of weekly carboplatin and paclitaxel chemotherapy for patients with localized anal cancer. This regimen was able to complete 80% of the intended treatments with anticipated toxicities, and 89% achieved a complete clinical response. This combination is a promising regimen and is already being investigated further in a clinical trial. Background: Although squamous cell carcinoma of the anus (SCCA) is a relatively uncommon malignancy in the United States, it continues to increase in incidence. Treatment for locoregional disease includes mitomycin and 5-fluorouracil with radiation. This combination is associated with significant toxicity, limiting its use in patients who are older or have certain comorbidities. Carboplatin and paclitaxel (C/P) is an accepted treatment regimen for metastatic SCCA. We aim to evaluate the efficacy and toxicity of weekly C/P given with radiation for patients unable to receive standard chemoradiation for SCCA. Methods: From our cancer registry, adult patients who received weekly intravenous C/P concurrent with standard-dose radiation for localized SCCA were included in this study. Clinical response was determined based on the evidence of disease on imaging and/or anoscopy. Toxicities were graded according to the CTCAE v5. Results: Ten patients were included; eight were female, and the median age was 75.5 years (54–87). Six had T2 disease, and four had T3 tumors. Four had node-positive disease. The majority (70%) of patients were dosed at standard C (AUC 2) and P (50 mg/m2), with a limited subset requiring dose reduction for baseline performance status. Patients completed a mean of 78.3% (40–100%) of the intended treatments. A total of 89% of the patients achieved a complete clinical response. With a median follow-up of 25.8 months (3.4–50.4 months), 67% of the patients are alive and without recurrence. Two patients have had local recurrence, and one patient had metastatic progression. The most common toxicities of any grade included leukopenia (100%), anemia (100%), radiation dermatitis (100%), diarrhea (100%), and fatigue (100%). Grade 3 or higher toxicities included neutropenic fever (20%), neutropenia (30%), and anemia (30%). Conclusions: This study demonstrates promising tolerability and efficacy for weekly C/P chemoradiation for patients with anal cancer unable to receive mitomycin and 5-fluorouracil. This regimen merits further investigation in prospective clinical trials. [ABSTRACT FROM AUTHOR]

Chronic diseases affect more than 80% of older adults. One modifiable risk factor for secondary prevention is physical activity. Public parks are an essential resource for physical activity, but environmental features may limit participation. Our aims were (1) to assess the feasibility and utility of the Path Environment Audit Tool (PEAT) for use in a larger-scale study focused on older adults and (2) to examine the physical activity-promoting features of five public parks. Methods: A descriptive study design was used to assess five public parks in Riyadh, Saudi Arabia, from April to June 2022. Additionally, process, resource, and management assessments were also conducted. Results: The PEAT was easy to use, but additions are recommended to increase relevance to older adults with chronic disease. Descriptive analyses revealed positive features, such as adequate lighting, but other features such as path slope were more variable. Conclusions: Study findings can guide the future use of the PEAT for older adult participants and inform environmental modifications. [ABSTRACT FROM AUTHOR]

Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. We conducted a literature review in MEDLINE, EMBASE, and Scopus from 1 January 1982 to 20 October 2023. Abstracts were screened against inclusion criteria, and eligible studies underwent a full-text review. Data was extracted from the included studies, and a framework analysis approach summarized the evidence regarding ketamine's use in patients with cancer. A total of 21 randomized clinical trials were included, and the quality of all the included studies was good or fair. Significant improvements in pain scores and reduced morphine consumption were consistently observed with intravenous ketamine administration for postoperative pain control, particularly when combined with other analgesics such as morphine. Ketamine was less effective when used as an analgesic for chronic pain management, with several studies on neuropathic pain or chemotherapy-induced neuropathy finding minimal significant effect on reduction of pain scores or morphine requirements. The efficacy of ketamine in pain management appears to depend on factors such as dosage, route of administration, and patient population. [ABSTRACT FROM AUTHOR]

Simple Summary: This study evaluated the ability of Large Language Models (LLMs) to classify subjective toxicities from chemotherapy by comparing them with expert oncologists. Using fictitious cases, it was demonstrated that LLMs can achieve accuracy similar to that of oncologists in general toxicity categories, although they need improvement in specific categories. LLMs show great potential for enhancing patient monitoring and reducing the workload of doctors. Future research should focus on training LLMs specifically for medical tasks and validating these findings with real patients, always ensuring accuracy and ethical data management. Introduction: Large Language Models (LLMs), such as the GPT model family from OpenAI, have demonstrated transformative potential across various fields, especially in medicine. These models can understand and generate contextual text, adapting to new tasks without specific training. This versatility can revolutionize clinical practices by enhancing documentation, patient interaction, and decision-making processes. In oncology, LLMs offer the potential to significantly improve patient care through the continuous monitoring of chemotherapy-induced toxicities, which is a task that is often unmanageable for human resources alone. However, existing research has not sufficiently explored the accuracy of LLMs in identifying and assessing subjective toxicities based on patient descriptions. This study aims to fill this gap by evaluating the ability of LLMs to accurately classify these toxicities, facilitating personalized and continuous patient care. Methods: This comparative pilot study assessed the ability of an LLM to classify subjective toxicities from chemotherapy. Thirteen oncologists evaluated 30 fictitious cases created using expert knowledge and OpenAI's GPT-4. These evaluations, based on the CTCAE v.5 criteria, were compared to those of a contextualized LLM model. Metrics such as mode and mean of responses were used to gauge consensus. The accuracy of the LLM was analyzed in both general and specific toxicity categories, considering types of errors and false alarms. The study's results are intended to justify further research involving real patients. Results: The study revealed significant variability in oncologists' evaluations due to the lack of interaction with fictitious patients. The LLM model achieved an accuracy of 85.7% in general categories and 64.6% in specific categories using mean evaluations with mild errors at 96.4% and severe errors at 3.6%. False alarms occurred in 3% of cases. When comparing the LLM's performance to that of expert oncologists, individual accuracy ranged from 66.7% to 89.2% for general categories and 57.0% to 76.0% for specific categories. The 95% confidence intervals for the median accuracy of oncologists were 81.9% to 86.9% for general categories and 67.6% to 75.6% for specific categories. These benchmarks highlight the LLM's potential to achieve expert-level performance in classifying chemotherapy-induced toxicities. Discussion: The findings demonstrate that LLMs can classify subjective toxicities from chemotherapy with accuracy comparable to expert oncologists. The LLM achieved 85.7% accuracy in general categories and 64.6% in specific categories. While the model's general category performance falls within expert ranges, specific category accuracy requires improvement. The study's limitations include the use of fictitious cases, lack of patient interaction, and reliance on audio transcriptions. Nevertheless, LLMs show significant potential for enhancing patient monitoring and reducing oncologists' workload. Future research should focus on the specific training of LLMs for medical tasks, conducting studies with real patients, implementing interactive evaluations, expanding sample sizes, and ensuring robustness and generalization in diverse clinical settings. Conclusions: This study concludes that LLMs can classify subjective toxicities from chemotherapy with accuracy comparable to expert oncologists. The LLM's performance in general toxicity categories is within the expert range, but there is room for improvement in specific categories. LLMs have the potential to enhance patient monitoring, enable early interventions, and reduce severe complications, improving care quality and efficiency. Future research should involve specific training of LLMs, validation with real patients, and the incorporation of interactive capabilities for real-time patient interactions. Ethical considerations, including data accuracy, transparency, and privacy, are crucial for the safe integration of LLMs into clinical practice. [ABSTRACT FROM AUTHOR]

Simple Summary: This research investigates the effectiveness and safety of totally implantable vascular access devices (TIVADs) used for delivering treatments such as chemotherapy. Over a five-year period, 70 patients received TIVADs through a standardized surgical method under local anesthesia. The study found very low complication rates, with only two notable incidents: one device needed adjustment due to a flipped catheter, and one infection occurred after over three years of use. The procedural success rate was 100%, with devices typically lasting around 22 months, and some even up to five years. These findings suggest that TIVADs are a reliable and safe option for long-term venous access, significantly benefiting routine clinical practices. Background: Daily clinical practice requires repeated and prolonged venous access for delivering chemotherapy, antibiotics, antivirals, parenteral nutrition, or blood transfusions. This study aimed to investigate the performance and the safety of totally implantable vascular access devices (TIVADs) over a 5-year follow-up period through a standardized well-trained surgical technique and patient management under local anesthesia. Methods: In a retrospective, observational, and monocentric study, 70 patients receiving POLYSITE® TIVADs for chemotherapy were included. The safety endpoints focused on the rate of perioperative, short-term, and long-term complications. The performance endpoints included vein identification for device insertion and procedural success rate. Results: The study demonstrated no perioperative or short-term complications related to the TIVADs. One (1.4%) complication related to device manipulation was identified as catheter flipping, which led to catheter adjustment 56 days post-placement. Moreover, one (1.4%) infection due to usage conditions was observed, leading to TIVAD removal 3 years and 4 months post-surgery. Catheter placement occurred in cephalic veins (71.4%), subclavian veins (20%), and internal jugular veins (8.6%). The procedural success rate was 100%. Overall, the implantable ports typically remained in place for an average of 22.4 months. Conclusions: This study confirmed the TIVADs' performance and safety, underscored by low complication rates compared to published data, thereby emphasizing its potential and compelling significance for enhancing routine clinical practice using a standardized well-trained surgical technique and patient management. [ABSTRACT FROM AUTHOR]

Numerous researchers have endeavored to amalgamate critical transit-oriented development (TOD) indicators, such as development density, walkability, and diversity, into a single TOD index to assess TOD performance. However, implementing TOD in megacities necessitates a more comprehensive selection of indicators, an objective calculation methodology, and accessible calculation data for the TOD index. This study introduces a method based on multi-indicator TOD performance assessment using multi-source urban big data; it uses Shanghai as a case study to evaluate and analyze the impact of site characteristics on performance. The method constructs the Comprehensive Socio-Economic Development Index (CSEDI) based on four indicators of TOD site operations. It establishes a multivariate regression model utilizing principal component analysis to extract 22 leading component indicators as independent variables from 71 indicators associated with TOD. Within the sample space of 77 rail transit TOD sites in Shanghai, the CSEDI exhibited a robust correlation with the independent variables. The evaluation results of the case study demonstrate consistency with the development characteristics of the city and the sites, indicating that the evaluation method can guide the renovation of existing sites and the development of new sites. [ABSTRACT FROM AUTHOR]

Utilizing observed wind speed and direction data from observation stations near the Taiwan Strait and ocean buoys, along with forecast data from the EC model, GRAPES_GFS model, and PanGu weather prediction model within the same period, RMSE, MAE, CC, and other parameters were calculated. To comparatively evaluate the forecasting performance of the PanGu weather prediction model on the sea surface wind field near the Taiwan Strait from 00:00 on 1 June 2023, to 23:00 on 31 May 2024. The PanGu weather prediction model is further divided into the ERA5 (PanGu) model driven by ERA5 initial fields and the GRAPES_GFS (PanGu) model driven by GRAPES_GFS initial fields. The main conclusions are as follows: (1) over a one-year evaluation period, for wind speed forecasts with lead times of 0 h to 120 h in the Taiwan Strait region, the overall forecasting skill of the PanGu weather prediction model is superior to that of the model forecasts; (2) different initial fields input into the PanGu weather prediction model lead to different final forecast results, with better initial field data corresponding to forecast results closer to observations, thus indicating the operational transferability of the PanGu model in smaller regions; (3) regarding forecasts of wind speed categories, the credibility of the results is high when the wind speed level is ≤7, and the PanGu weather prediction model performs better among similar forecasts; (4) although the EC model's wind direction forecasts are closer to the observation field results, the PanGu weather forecasting model also provides relatively accurate and rapid forecasts of the main wind directions within a shorter time frame. [ABSTRACT FROM AUTHOR]

Despite their emerging use, the in vivo behaviour of dual-mobility (DM) total hip replacements (THRs) is not well understood. Therefore, the purpose of this study was to assess the articulating surfaces of 20 early-retrieved DM polyethylene liners (mean length of implantation 20.0 ± 18.8 months) for damage to improve the current understanding of their in vivo functional mechanisms. The internal and external surfaces of each liner were visually and geometrically assessed, and the material composition of embedded debris particles were further characterized. Scratching and pitting were the most common modes of damage identified on either surface, and a high incidence of burnishing (50%) and embedded debris (65%) were observed on the internal and external surfaces, respectively. Embedded debris particles were commonly titanium- or iron-based, although other materials such as cobalt-chrome and tantalum were also identified. The geometric assessment demonstrated highly variable damage patterns across the liners, with the internal surfaces commonly presenting with crescent-shaped, circumferential, or circular regions of penetration whilst the external surfaces commonly presented with regions of deep pitting or gouging. This study demonstrates that DM-THRs primarily articulate at the head/liner junction, and that polyethylene liners are capable of rotating about the femoral neck axis, although the extent of this may be limited in some cases. Additionally, this study suggests that intra-prosthetic dislocation and edge loading may remain pertinent failure mechanisms of DM implants despite the advent of highly crosslinked polyethylene and design features, thus highlighting the need for enhanced monitoring of these devices. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to evaluate the derived neutrophil to lymphocyte ratio (dNLR) in predicting the prognosis of patients with locally advanced oral squamous cell carcinoma, as well as the survival benefits from induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (5-FU). The dNLR is an independent negative predictive factor for the disease. Patients with cTNM stage III disease and a low dNLR may benefit from induction chemotherapy. Background: This study aimed to evaluate the derived neutrophil to lymphocyte ratio (dNLR) in predicting the prognosis of patients with locally advanced oral squamous cell carcinoma (LAOSCC) and to assess the survival benefits from docetaxel, cisplatin, and 5-fluorouracil (5-FU) (TPF) induction chemotherapy (IC). Methods: Patients from a phase III trial involving TPF IC in stage III/IVA OSCC patients (NCT01542931) were enrolled. Receiver operating characteristic curves were constructed, and the area under the curve was computed to determine dNLR cutoff points. Kaplan–Meier survival estimates and Cox proportional hazards models were used for longitudinal analysis. Results: A total of 224 patients were identified (median age: 55.4 years; range: 26 to 75 years; median follow-up: 90 months; range: 3.2 to 93 months). The cutoff point for the dNLR was 1.555. Multivariate analysis showed that the dNLR was an independent negative predictive factor for survival (overall survival (OS): hazard ratio (HR) = 1.154, 95% confidence interval (CI): 1.018–1.309, p = 0.025; disease-free survival (DFS): HR = 1.123, 95% CI: 1.000–1.260, p = 0.050; local recurrence-free survival (LRFS): HR = 1.134, 95% CI: 1.002–1.283, p = 0.047; distant metastasis-free survival (DMFS): HR = 1.146, 95% CI: 1.010–1.300, p = 0.035). A low dNLR combined with cTNM stage III disease predicted benefit from TPF IC for the patients [OS (χ2 = 4.674, p = 0.031), DFS (χ2 = 7.134, p = 0.008), LRFS (χ2 = 5.937, p = 0.015), and DMFS (χ2 = 4.832, p = 0.028)]. Conclusions: The dNLR is an independent negative predictive factor in LAOSCC patients. Patients with cTNM stage III disease and a low dNLR can benefit from TPF IC. [ABSTRACT FROM AUTHOR]