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This presented research delves into the challenges and approaches encompassed in allotting available resources for the maintenance and renovation of crucial infrastructure assets, focusing intently on buildings in Old Cairo earmarked for relocation to the new administrative capital, manipulating an integral empirical assessment and advanced modeling techniques. Amidst intensifying imperatives for robust infrastructure against a backdrop of financial constraints and hastened asset deterioration, this study proposes a cutting-edge, thorough approach to fund distribution. The developed approach incorporates asset hierarchy and classification, condition assessment via pilot survey, Markov chain model for degradation anticipation, stakeholder perception analysis through questionnaires for comparative analysis, and constructing an optimization model for fund allocation. The findings unveiled the dire condition of the selected infrastructure assets and the pressing requisite for strategic maintenance and renovation interventions. The developed approach offered a pragmatic evidence-based approach concerning decision-makers, improving resource allocation efficacy and fostering urban development schemes. This paper calls for protractible presented methodologies to a broad spectrum of assets and geographies and integrating incipient technologies for dynamic asset management approaches.

Abstract Introduction The assessment of hemodynamic status in polytrauma patients is an important principle of the primary survey of trauma patients, and screening for ongoing hemorrhage and assessing the efficacy of resuscitation is vital in avoiding preventable death and significant morbidity in these patients. Invasive procedures may lead to various complications and the IVC ultrasound measurements are increasingly recognized as a potential noninvasive replacement or a source of adjunct information. Aimof this study The study aimed to determine if repeated ultrasound assessment of the inferior vena cava (diameter, collapsibility (IVC- CI) in major trauma patients presenting with collapsible IVC before resuscitation and after the first hour of resuscitation will predict total intravenous fluid requirements at first 24 h. Patients & methods The current study was conducted on 120 patients presented to the emergency department with Major blunt trauma (having significant injury to two or more ISS body regions or an ISS greater than 15). The patients(cases) group (shocked group) (60) patients with signs of shock such as decreased blood pressure 100 b/m, cold, clammy skin, capillary refill > 2 s and their shock index above0.9. The control group (non-shocked group) (60) patients with normal blood pressure and heart rate, no other signs of shock (normal capillary refill, warm skin), and (shock index ≤ 0.9). Patients were evaluated at time 0 (baseline), 1 h after resucitation, and 24 h after 1st hour for:(blood pressure, pulse, RR, SO2, capillary refill time, MABP, IVCci, IVCmax, IVCmin). Results Among 120 Major blunt trauma patients, 98 males (81.7%) and 22 females (18.3%) were included in this analysis; hypovolemic shocked patients (60 patients) were divided into two main groups according to IVC diameter after the first hour of resuscitation; IVC repleted were 32 patients (53.3%) while 28 patients (46.7%) were IVC non-repleted. In our study population, there were statistically significant differences between repleted and non-repleted IVC cases regarding IVCD, DIVC min, IVCCI (on arrival) (after 1 h) (after 24 h of 1st hour of resuscitation) ( p-value 38.5 has a sensitivity of 80.0% and Specificity of 85.71% with AUC 0.971 and a good 95% CI (0.938 – 1.0), which means that IVCci of 38.6% or more can indicate fluid responsiveness. We also found that IVCci 1 h (after fluid resuscitation) at cut-off point > 28.6 has a sensitivity of 80.0% and Specificity of 75% with AUC 0.886 and good 95% CI (0.803 – 0.968), which means that IVCci of 28.5% or less can indicate fluid unresponsiveness after 1st hour of resuscitation. We found no statistically significant difference between repleted and non-repleted cases regarding fluid requirement and amount of blood transfusion at 1st hour of resuscitation (p-value = 0.104). Conclusion Repeated bedside ultrasonography of IVCD, and IVCci before and after the first hour of resuscitation could be an excellent reliable invasive tool that can be used in estimating the First 24 h of fluid requirement in Major blunt trauma patients and assessment of fluid status.

The construction industry embodies a paramount role in the economic growth of various nations, including the Middle East and North Africa (MENA) region. Despite its significance, the industry faces construction disputes and payment issues, inducing financial losses and project postponements. Consequently, the construction industry has mutated smart contracts to enhance operational efficiency, which automates contract management tasks and offers perks, including transparency and efficiency. However, the adoption of smart contracts in the MENA construction sector remains limited, and the region lacks thorough research on this topic. This study addresses this gap by examining the level of cognizance and apprehension of smart contracts among construction industry stakeholders in the MENA region. The research employs Structural Equation Modeling (SEM) to analyze the relative importance of implementing smart contracts within different project lifecycle phases and relevant practices and identify the hindrances impacting MENA’s smart contract deployment. A practical implementation of smart contract-based tendering employing the Trakti platform is paraded. The findings unveiled the infancy of smart contract adoption in the MENA construction sector. They revealed the substantial importance of implementing smart contracts in the Project Execution Phase, Project Closure, and Monitoring and Control Phase, attaining relative weights of 23.23%, 21.62%, and 20.50%, respectively.

This study examines the critical success factors (CSFs) crucial for the effective deployment of public-private partnership (PPP) models in sustainable housing projects in the Kingdom of Saudi Arabia (KSA), underpinning the nation's Vision 2030. Through a robust methodology that incorporates a profound literature review, structured interviews, and a survey involving key stakeholders, the study prioritizes fourteen significant CSFs integral to PPP efficacy. Employing Analytical Hierarchy Process analysis, key outcomes underscore the paramount importance of technical aspects with an emphasis on sustainability, tailoring risk-sharing and allocation to encompass green technologies and eco-friendly practices, and economic stability in the light of long-term environmental sustainability in fostering successful sustainable housing projects. Notably, the Build-Operate-Transfer (BOT) model is categorized as the most effective PPP modality, attaining a mean importance score of 4.07. This model is contrasted with other modalities such as Design-Build-Operate (DBO) and Build-Own-Lease-Transfer (BOLT), which scored lower in effectiveness. This comprehensive evaluation provides crucial insights for policymakers and practitioners, emphasizing the strategic selection of PPP modalities and the prioritization of CSFs to enhance the sustainability and effectiveness of housing projects in KSA.

The construction sector is more complicated and prone to risk than many other industries due to the size of the projects and the financial capital involved. Arranging insurance is the prudent course of action for risk management in the construction sector. There is a lack of clarity in insurance policies for public construction projects in the Kingdom of Saudi Arabia (KSA), which poses additional risks to all involved contracting parties. The aim of this research is to evaluate insurance policies in the KSA's public construction projects to identify the key deficiencies and obstacles and provide a road map for improvement in the insurance sector concerning insurance against financial losses, professional liability, defects' liability, hidden defects, and others. Forty-two contractors and forty-two owners in Saudi Arabia were surveyed, using a questionnaire to gather information for the study about their knowledge of and attitudes regarding risk transfer through insurance (professional liability, defects liability, and hidden defects). The study also covers the selection criteria for insurance policies for projects that potentially shift risk to the construction sector. Ten criteria were also examined as potential sources of liability issues and suggested as potential remedies in KSA. The findings indicate that the duty and liability of engineers and those participating in these projects can be offset by engineers' insurance against professional errors and hidden flaws, and by the construction industry's clear liability policy. Additionally, the research is envisaged to contribute to construction projects' overall quality and safety, ensuring that robust legal and financial safeguards protect all stakeholders.

This study explores integrating Building Information Modeling (BIM) and Value Engineering (VE) to enhance cost management and project value optimization in residential construction. The primary aim is to develop a comprehensive framework that synergizes 5th Dimension Building Information Modeling (5D BIM) with VE processes to identify and evaluate the most cost-effective construction alternatives. Employing a mixed-methods approach, this research includes an extensive review of existing practices, an integrated BIM-VE framework proposal, and the application of 5D BIM principles to improve visualization, cost estimation, and scheduling. The findings reveal that integrating BIM and VE significantly enhances project efficiency, quality, and cost-effectiveness. Specifically, the case study of a twin villa project demonstrates a 42% reduction in floor material costs and a 30% reduction in door material costs, resulting in an overall project cost savings of 35%. Additionally, the integrated approach contributes to a 15% reduction in project duration and a notable improvement in design quality and stakeholder collaboration. This research contributes significantly by providing a robust framework for BIM and VE integration, emphasizing its potential to revolutionize cost management practices in the construction industry. The novelty of this study lies in its detailed and practical approach to merging BIM with VE, offering a viable solution for resource optimization and sustainable building practices. This study highlights the transformative potential of BIM-VE integration, advocating for its broader adoption to achieve superior project outcomes.

This study introduces a pioneering structural equation modeling (SEM)-based framework to assess BIM-DT adoption readiness in sustainable construction. The research’s approach delves into the intricate correlation between key success factors (KSFs) and sustainable parameters (SPs), fostering BIM-DT deployment. This interdisciplinary perspective provides a holistic understanding of the impact of KSFs on BIM-DT adoption. The research aims to identify KSFs and parameters, prioritize their relative weights for BIM-DT implementation, analyze KSFs and SPs correlations, and offer practical insights into the findings. The results revealed the importance of sustainability considerations in BIM-DT adoption, with cost optimization and resource management playing pivotal roles. The findings also revealed that the readiness of the organization to adopt the technology, availability of technology operators, availability of standards and codes for the new technology, availability of knowledge, skills, and competencies to adopt the technology, and availability of funds and financial investment are the top-ranked KSFs contributing to the successful adoption of BIM-DT.

Reinforced concrete bridges (RCBs) are essential elements of transportation infrastructure, necessitating ongoing inspection and maintenance to guarantee their durability and structural integrity. This research aims to develop an integrated framework for inspection and maintenance intervention in reinforced concrete bridges (RCB), leveraging the potential of as-is Bridge Information Modeling (BrIM). The methodology begins by converting 2D drawings into a 3D as-is BrIM model, facilitating a more accurate representation of the bridge’s current state. This is followed by creating a comprehensive bridge inventory, allowing for meticulous tracking of vital components and their condition. Subsequently, inspection data are acquired using advanced sensing technologies, enabling real-time data collection and analysis. Structural defects are modeled on the as-is BrIM model to enhance diagnostic capabilities, providing a visual representation of areas requiring intervention. The framework also makes it easier to create reports, ensuring that important information is efficiently shared with the right people. A thorough case study using a concrete bridge is used to show the effectiveness of the created framework. The BrIM framework’s potential to improve the bridge inspection and maintenance process was demonstrated by integrating inspection reporting with BrIM, which produced encouraging results. The research contribution to the body of knowledge is significant as the developed framework considerably enhances the administration of bridge inspection and maintenance procedures, resulting in greater efficacy by offering a thorough and clear picture of the bridge’s current state.

Background: Melanoma is the most aggressive skin cancer with ability to recur also after early‐stage tumor surgery. The aim was to identify early‐stage melanoma patients at high risk of recurrence using liquid biopsy, estimating of mutated BRAF ctDNA and the level of tumor marker S100B in plasma. Methods: Eighty patients were enrolled in the study. BRAF V600E mutation was determined in FFPE tissue and plasma samples using ultrasensitive ddPCR with pre‐amplification. The level of S100B was determined in plasma by immunoassay chemiluminescent method. Results: The best prediction of melanoma recurrence after surgery was observed in patients with combined high level of S100B (S100Bhigh) and ctDNA BRAFV600E (BRAFmut) in preoperative (57.1% vs. 12.5%, p = 0.025) as well as postoperative blood samples (83.3% vs. 14.3%, resp., p = 0.001) in comparison with low S100B and BRAF wild‐type. Similarly, patients with preoperative and postoperative S100Bhigh and BRAFmut experienced worse prognosis (DFI p = 0.05, OS p = 0.131 and DFI p = 0.001, OS = 0.001, resp.). Conclusion: We observed the benefit of the estimation of combination of S100B and ctDNA BRAFmut in peripheral blood for identification of patients at high risk of recurrence and unfavorable prognosis. Significance: There is still no general consensus on molecular markers for deciding the appropriateness of adjuvant treatment of early‐stage melanoma. We have shown for the first time that the combined determination of the ctDNA BRAFmut oncogene (liquid biopsy) and the high level of tumor marker S100B in pre‐ and postoperative plasma samples can identify patients with the worst prognosis and the highest risk of tumor recurrence. Therefore, modern adjuvant therapy would be appropriate for these patients with resectable melanoma, regardless of disease stage. [ABSTRACT FROM AUTHOR]

Simple Summary: There has recently been an interest in drugs that work across the pan-cancer spectrum and show antitumor activity based on biomarkers rather than histology. In this article, we discuss one of these biomarkers, NTRK fusions, which, if present, can predict sensitivity to treatment with inhibitors of the NTRK molecular pathway. Currently, there are three drugs that have been approved by the United States Food and Drug Administration (FDA) in patients with NTRK fusions, regardless of the tumor tissue of origin. These are larotrectinib, entrectinib, and repotrectinib. Herein, we discuss what NTRK fusions are and how to detect them, alongside data on each drug, from a clinical perspective. NTRK fusions are oncogenic drivers for multiple tumor types. Therefore, the development of selective tropomyosin receptor kinase (TRK) inhibitors, including larotrectinib and entrectinib, has been transformative in the context of clinical management, given the high rates of responses to these drugs, including intracranial responses in patients with brain metastases. Given their promising activity in pan-cancer cohorts, larotrectinib and entrectinib received U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) approval for tissue-agnostic indications in patients with advanced solid tumors harboring NTRK fusions. The safety profiles for both drugs are quite manageable, although neurotoxicity driven by the on-target inhibition of normal NTRK can be a concern. Also, on- and off-target resistance mechanisms can arise during therapy with TRK inhibitors, but they can be addressed with the use of combination therapy and next-generation TRK inhibitors. More recently, the FDA approved the use of repotrectinib, a second-generation TRK inhibitor, in patients with NTRK fusions, based on data suggesting clinical efficacy and safety, which could offer another tool for the treatment of NTRK-altered cancers. In this review, we summarize the current evidence related to the use of TRK inhibitors in the tissue-agnostic setting. We also elaborate on the safety profiles and resistance mechanisms from a practical perspective. [ABSTRACT FROM AUTHOR]

Tumor‐agnostic therapies represent a paradigm shift in oncology by altering the traditional means of characterizing tumors based on their origin or location. Instead, they zero in on specific genetic anomalies responsible for fueling malignant growth. The watershed moment for tumor‐agnostic therapies arrived in 2017, with the US Food and Drug Administration's historic approval of pembrolizumab, an immune checkpoint inhibitor. This milestone marked the marriage of genomics and immunology fields, as an immunotherapeutic agent gained approval based on genomic biomarkers, specifically, microsatellite instability‐high or mismatch repair deficiency (dMMR). Subsequently, the approval of NTRK inhibitors, designed to combat NTRK gene fusions prevalent in various tumor types, including pediatric cancers and adult solid tumors, further underscored the potential of tumor‐agnostic therapies. The US Food and Drug Administration approvals of targeted therapies (BRAF V600E, RET fusion), immunotherapies (tumor mutational burden ≥10 mutations per megabase, dMMR) and an antibody‐drug conjugate (Her2‐positive–immunohistochemistry 3+ expression) with pan‐cancer efficacy have continued, offering newfound hope to patients grappling with advanced solid tumors that harbor particular biomarkers. In this comprehensive review, the authors delve into the expansive landscape of tissue‐agnostic targets and drugs, shedding light on the rationale underpinning this approach, the hurdles it faces, presently approved therapies, voices from the patient advocacy perspective, and the tantalizing prospects on the horizon. This is a welcome advance in oncology that transcends the boundaries of histology and location to provide personalized options. [ABSTRACT FROM AUTHOR]

A self‐healable hydrogel for advanced authentication applications was successfully developed. In the presence of an aqueous solution of ammonium hydroxide as a cheap passivating agent, the hydrothermal carbonization of cellulose diacetate extracted from rice straw yielded nitrogen‐doped carbon dots (NdCD) in a straightforward and ecologically beneficial manner. NdCD achieved a maximum quantum yield of 25.11%. Self‐healing biocomposite inks with different emission properties were created by using different concentrations of NdCD nanoparticles (NPs). In order to create a transparent layer of NdCD@PLA hydrogel, stamps were used to press homogenous films onto paper surfaces. Polylactic acid (PLA) hydrogel was embedded with NPs of NdCD. Self‐healing security hydrogel inks are highly durable. The NdCD@PLA hydrogel is efficiently self‐healable at room temperature. The current NdCD@PLA hydrogel can attach to different surfaces, such as glasses, plastics, and papers. The self‐healable nanobiocomposite was photostable when exposed to UV light. Under UV light, NdCD‐containing nanobiocomposite inks have a bluish color, as proved by both colorimetric parameters and fluorescence spectra. The morphological properties of NdCD were studied by transmission electron microscopy to suggest a particle diameter of 10–15 nm. The morphology of the fluorescent prints was analyzed using a number of different analytical methods. The hydrogel rheology and the mechanical performance of printed papers were tested. The printed films showed excitation and fluorescence bands at 401 and 488 nm, respectively. The present smart ink shows significant promise as a potential industrial production technique to simply produce anti‐counterfeiting prints. Highlights: Rice straws were used to prepare nitrogen‐doped carbon dots with a quantum yield of 25.11%.Self‐healable polylactic acid hydrogel was immobilized with N‐doped carbon dots (10–15 nm).Transparent printed films shifted in color to blue (488 nm) when excited at 401 nm.Ultraviolet‐stimulated photochromic authentication prints were prepared.Printed paper demonstrated non‐cytotoxicity, high photostability, and durability. [ABSTRACT FROM AUTHOR]

To investigate lacrimal gland malignancies' incidence and survival rates in the USA between 1995 and 2018. Incidence and survival data from the North American Association of Central Cancer Registries of lacrimal gland malignancies between 1996 and 2018 were extracted and analyzed. This study analyzed data pertaining to 3620 patients (females 56.7%, n = 2051). A sizable number of patients were 60–79 years of age (45.1%, n = 1633), with a substantial majority being of the non-Hispanic white ethnicity (82.9%, n = 3002). A little above half of patients (52.1%, n = 1886) had presented with a localized disease. Lymphomas represented 59.3% (n = 2146) of lacrimal gland malignancies, while 37% (n = 1339) were carcinomas. The cumulative age-adjusted incidence rate per million was 0.53 for all malignancies, 0.31 for lymphomas, and 0.2 for carcinomas. While the annual crude incidence rate showed a significant steady increase (average annual change of 1.24%; P <.05), age-adjusted rates did not show a similar trend. The five- and 10-year relative survival rates were 88.64 months (95% confidence interval (CI): 85.81–90.93) and 80.26 months (95%CI: 76.21–83.7), respectively. Older age, non-lymphoma tumors, and advanced stage at diagnosis were significantly associated with worse outcomes. Relative survival rates did not show significant changes from 1995 to 2018, irrespective of gender, race or treatment received. Early detection and localized tumor management can improve survival outcomes for patients with lacrimal gland malignancies. Further research is needed to understand these malignancies' risk profiles and develop more effective treatment strategies. [ABSTRACT FROM AUTHOR]