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Mobile devices, such as smartphones and laptops, face energy consumption challenges due to battery limitations, with Wi-Fi being one of the major sources of energy consumption in these devices. The IEEE 802.11 standard addresses this issue with Power Saving Mode (PSM), which reduces power consumption but increases latency. To mitigate this latency, Adaptive-PSM (A-PSM) dynamically switches between PSM and Constantly Awake Mode (CAM); however, the associated Idle Listening (IL) process still results in high energy consumption. Various strategies have been proposed to optimize IL time; however, Medium Access Control (MAC)-level contention and network delays limit their effectiveness. To overcome these limitations, we propose MILD (Minimizing Idle Listening energy consumption via Down-clocking), a novel scheme that reduces energy consumption without compromising throughput. MILD introduces specialized preambles for Packet Arrival Detection (PAD) and Device Address Recognition (DAR), allowing the client to operate in a down-clocked state during IL and switch to full clocking only when necessary. Experimental results demonstrate that MILD reduces energy consumption by up to 23.6% while maintaining a minimal throughput loss of 12.5%, outperforming existing schemes.

Background : Radiomics is a non-invasive and cost-effective method for predicting the biological characteristics of tumors. In this study, we explored the association between radiomic features derived from magnetic resonance imaging (MRI) and genetic alterations in patients with breast cancer. Methods : We reviewed electronic medical records of patients with breast cancer patients with available targeted next-generation sequencing data available between August 2018 and May 2021. Substraction imaging of T1-weighted sequences was utilized. The tumor area on MRI was segmented semi-automatically, based on a seeded region growing algorithm. Radiomic features were extracted using the open-source software 3D slicer (version 5.6.1) with PyRadiomics extension. The association between genetic alterations and radiomic features was examined. Results : In total, 166 patients were included in this study. Among the 50 panel genes analyzed, only TP53 mutations were significantly associated with radiomic features. Compared with TP53 wild-type tumors, TP53 mutations were associated with larger tumor size, advanced stage, negative hormonal receptor status, and HER2 positivity. Tumors with TP53 mutations exhibited higher values for Gray Level Non-Uniformity, Dependence Non-Uniformity, and Run Length Non-Uniformity, and lower values for Sphericity, Low Gray Level Emphasis, and Small Dependence Low Gray Level emphasis compared to TP53 wild-type tumors. Six radiomic features were selected to develop a composite radiomics score. Receiver operating characteristic curve analysis showed an area under the curve of 0.786 (95% confidence interval, 0.719-0.854; p < 0.001). Conclusions : TP53 mutations in breast cancer can be predicted using MRI-derived radiomic analysis. Further research is needed to assess whether radiomics can help guide treatment decisions in clinical practice.

Background: Sodium glucose cotransporter 2 (SGLT2) inhibitors improve clinical outcomes in several populations including type 2 diabetes (T2D), chronic renal insufficiency, and heart failure (HF). However, limited data exist on their effects on atrial fibrillation (AF)., Methods: We conducted a retrospective cohort study using the National Health Insurance Service database. A total of 4,771 patients with T2D and AF who were newly prescribed SGLT2 inhibitors or DPP4 inhibitors were selected and matched in a 1:2 ratio by propensity score with 37 confounding variables. We assessed the effect of SGLT2 inhibitors on the composite outcome of either HF hospitalization or death., Results: Over a median follow-up of 31 months, patients on SGLT2 inhibitors were associated with a lower risk of hospitalizations for HF or mortality compared to those on DPP4 inhibitors (HR 0.61; 95% CI 0.44-0.85; P = 0.004). SGLT2 inhibitor use was also associated with a lower risk of mortality (HR 0.61; 95% CI 0.39-0.94; P = 0.025) and CV mortality (HR 0.43; 95% CI 0.21-0.86; P = 0.018), but not of MI (HR 1.22 [95% CI 0.72-2.09]; P = 0.461) or stroke (HR 1.00 [95% CI 0.75-1.33]; P = 0.980). The incidence of hospitalizations for HF, although statistically insignificant, tended to be lower in the SGLT2 inhibitor group (HR 0.63 [95% CI 0.39-1.02]; P = 0.062)., Conclusion: In a nationwide cohort of patients with T2D and AF, SGLT2 inhibitor was associated with a lower risk of mortality, which may suggest that SGLT2 inhibitors may be considered as the first-line antidiabetic medication in patients with T2D and AF., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Hypoxic liver injury (HLI) and Killip classification are poor prognostic factors in patients with ST-segment elevation myocardial infarction (STEMI). This study investigates the interrelationship between hypoxic liver injury (HLI) and Killip classification., Method and Results: A total of 1,537 STEMI patients who underwent percutaneous coronary intervention (PCI) from 2007 to 2014 at four tertiary hospitals in the Incheon-Bucheon province were enrolled in this study. The patients were divided into four groups based on their Killip classification at presentation in the emergency room (ER). HLI was defined as a ≥2-fold increase in serum aspartate transaminase (AST). The incidence of HLI showed incremental tendency with respect to the Killip classification (19.5%, 19.4%, 34.6%, and 37.8%, respectively; p  < 0.001). Left ventricular ejection fraction (LVEF) was below 45% in symptomatic, overt heart failure patients (Killip class II, III, and IV). Both initial and peak AST levels increased in accordance with Killip classification along with cardiac biomarkers. In-hospital mortality was directly related to Killip classification (2.3%, 7.3%, 16.3%, 29.2%) with statistical significance. Univariate and multivariate Cox regression analysis showed that the presence of HLI and combined Killip classification III and IV were poor prognostic factors, even after adjusting for conventional clinical risk factors. Receiver operating characteristic (ROC) analysis showed that combination of HLI and Killip classification was the most sensitive predictor of mortality (AUC 0.832, 95% CI 0.78-0.882). Kaplan-Meier curve showed that patients with HLI and Killip class (III and IV) had the lowest event-free survival regarding in-hospital mortality and major cardiovascular and cerebrovascular events., Conclusions: The presence of HLI and Killip classification were directly related to worse prognosis in STEMI patients. Early recognition of HLI and accurate assessment of Killip classification is warranted for effective management of STEMI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2025 Choi, Jang, Kim, Suh, Baek, Shin, Woo, Kim, Moon, Suh, Kang, Park and Kwon.)

Background/objectives: Neoadjuvant chemotherapy followed by concurrent chemoradiation therapy (NACT + CCRT) and adjuvant chemotherapy following CCRT (CCRT + ACT) have inconsistent effects on the survival of women with locally advanced cervical cancer (LACC) compared to CCRT. Moreover, the effects of NACT + CCRT and CCRT + ACT have not been clearly compared. This study compared the effects of NACT + CCRT and CCRT + ACT on survival using a network meta-analysis to select the optimal treatment in women with LACC., Methods: The PubMed, Medline, and Embase databases were searched, and six randomized controlled trials assessing the progression-free survival (PFS) and overall survival (OS) in women with newly diagnosed LACC treated with NACT + CCRT, CCRT + ACT, or CCRT alone (controls) were identified. A network meta-analysis was conducted., Results: Indirect comparisons showed no significant differences in PFS and OS between NACT + CCRT and CCRT + ACT. Direct comparisons also showed similar PFS and OS between NACT + CCRT and CCRT and between CCRT + ACT and CCRT. CCRT + ACT exhibited the highest surface under the cumulative ranking curve (SUCRA) value as a better treatment option for the PFS and OS (CCRT + ACT vs. NACT + CCRT vs. CCRT: 72% vs. 26.8% vs. 51.2% in PFS and 64.3% vs. 45.1% vs. 40.7% in OS)., Conclusions: In women with LACC, NACT + CCRT had no different effects on the PFS and OS compared to CCRT + ACT, despite the relatively higher SUCRA value observed for CCRT + ACT. Further studies are warranted to clarify the effects of these strategies.

Background: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease that culminates in respiratory failure and death due to irreversible scarring of the distal lung. While initially considered a chronic inflammatory disorder, the aberrant function of the alveolar epithelium is now acknowledged as playing a central role in the pathophysiology of IPF. This study aimed to investigate the regenerative capacity of alveolar type 2 (AT2) cells using IPF-derived alveolar organoids and to examine the effects of disease progression on this capacity., Methods: Lung tissues from three pneumothorax patients and six IPF patients (early and advanced stages) were obtained through video-assisted thoracoscopic surgery and lung transplantation. HTII-280+ cells were isolated from CD31-CD45-epithelial cell adhesion molecule (EpCAM)+ cells in the distal lungs of IPF and pneumothorax patients using fluorescence-activated cell sorting (FACS) and resuspended in 48-well plates to establish IPF-derived alveolar organoids. Immunostaining was used to verify the presence of AT2 cells., Results: FACS sorting yielded approximately 1% of AT2 cells in early IPF tissue, and the number decreased as the disease progressed, in contrast to 2.7% in pneumothorax. Additionally, the cultured organoids in the IPF groups were smaller and less numerous compared to those from pneumothorax patients. The colony forming efficiency decreased as the disease advanced. Immunostaining results showed that the IPF organoids expressed less surfactant protein C (SFTPC) compared to the pneumothorax group and contained keratin 5+ (KRT5+) cells., Conclusion: This study confirmed that the regenerative capacity of AT2 cells in IPF decreases as the disease progresses, with IPF-derived AT2 cells inherently exhibiting functional abnormalities and altered differentiation plasticity.

Objectives: To investigate the value of body composition indices derived from pre-procedural computed tomography (CT) in predicting 1-year mortality among patients who underwent transcatheter aortic valve replacement (TAVR)., Materials and Methods: We assessed consecutive patients who underwent TAVR between June 2016 and December 2021 at a single academic medical center. Skeletal muscle and subcutaneous fat area at the T4, T12, and L3 levels on pre-procedural CT were measured. The association between body composition and 1-year mortality was evaluated using Cox proportional hazard regression analysis., Results: Finally, 408 patients were included (185 men and 223 women; mean age, 81.7 ± 5.1 years; range, 62-98 years). Post-procedural death occurred in 13.2% of patients. The muscle-height index and fat-height index at the L3 level were more strongly correlated with those at the T12 level (r = 0.765, p < 0.001 and r = 0.932, p < 0.001, respectively) than with those at the T4 level (r = 0.535, p < 0.001 and r = 0.895, p < 0.001, respectively). The cumulative 1-year mortality rate was highest for patients with both sarcopenia and adipopenia (26%), followed by those with adipopenia only (17%), those with sarcopenia only (12%), and those with neither sarcopenia nor adipopenia (8%, p = 0.002). Multivariable analysis revealed that body composition at the T12 level was an independent risk factor for 1-year mortality (hazard ratio: 4.09, 95% confidence interval: 2.01-8.35) in patients with both sarcopenia and adipopenia (p < 0.001)., Conclusion: Sarcopenia or adipopenia assessed with CT at the thoracic level may be valuable for stratifying 1-year all-cause mortality in patients who undergo TAVR., Clinical Relevance Statement: Skeletal muscle and subcutaneous fat mass indices at the level of T12, measured on pre-procedural CT, have value for risk stratification of 1-year all-cause mortality in patients who undergo transcatheter aortic valve replacement., Key Points: Sarcopenia and adipopenia are associated with the prognosis of patients undergoing transcatheter aortic valve replacement. Body composition at the T12 level was an independent risk factor for 1-year all-cause mortality. Sarcopenia or adipopenia assessed at T12 with pre-procedural CT is valuable for risk stratification., Competing Interests: Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Y.J.K. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: One of the authors (Mr. Yun Ho Roh) has significant statistical expertise. Informed consent: Written informed consent was waived by the Institutional Review Board. Ethical approval: Institutional Review Board approval was obtained. Study subjects or cohorts overlap: No study subjects have been previously reported. Methodology: Diagnostic or prognostic study Performed at one institution, (© 2024. The Author(s), under exclusive licence to European Society of Radiology.)