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This study computationally examined the Richtmyer–Meshkov instability (RMI) evolution in a helium backward-triangular bubble immersed in monatomic argon, diatomic nitrogen, and polyatomic methane under planar shock wave interactions. Using high-fidelity numerical simulations based on the compressible Navier–Fourier equations based on the Boltzmann–Curtiss kinetic framework and simulated via a modal discontinuous Galerkin scheme, we analyze the complex interplay of shock-bubble dynamics. Key findings reveal distinct thermal non-equilibrium effects, vorticity generation, enstrophy evolution, kinetic energy dissipation, and interface deformation across gases. Methane, with its molecular complexity and higher viscosity, exhibits the highest levels of vorticity production, enstrophy, and kinetic energy, leading to pronounced Kelvin–Helmholtz instabilities and enhanced mixing. Conversely, argon, due to its simpler atomic structure, shows weaker deformation and mixing. Thermal non-equilibrium effects, quantified by the Rayleigh–Onsager dissipation function, are most significant in methane, indicating delayed energy relaxation and intense turbulence. This study highlights the pivotal role of molecular properties, specific heat ratio, and bulk viscosity in shaping RMI dynamics in polyatomic gases, offering insights on uses such as high-speed aerodynamics, inertial confinement fusion, and supersonic mixing. [ABSTRACT FROM AUTHOR]

When developing a distributed application, several issues need to be handled, and software components should include some mechanisms to make their execution resilient when network faults, delays, or tampering occur. For example, synchronous calls represent a too-tight connection between a client requesting a service and the service itself, whereby potential network delays or temporary server overloads would keep the client side hanging, exposing it to a domino effect. The proposed approach assists developers in dealing with such issues by providing an automatic tool that enhances a distributed application using simple blocking calls and makes it robust in the face of adverse events. The proposed devised solution consists in automatically identifying the parts of the application that connect to remote services using simple synchronous calls and substituting them with a generated customized snippet of code that handles potential network delays or faults. To accurately perform the proposed transformation, the devised tool finds application code statements that are data-dependent on the results of the original synchronous calls. Then, for the dependent statements, a solution involving guarding code, proper synchronization, and timeouts is injected. We experimented with the analysis and transformation of several applications and report a meaningful example, together with the analysis of the results achieved. [ABSTRACT FROM AUTHOR]

With the upgrade of aircraft and the increasingly harsh service environment, it is urgent to develop high-performance thermal structural materials. In this study, inspired by foliar and root water uptake of trees, we propose a one-step facile method to achieve an autonomous gradient in C/C–ZrC–SiC sharp leading edge composites. The gradual increase of SiC content from top to bottom is beneficial to improve the heat transfer capacity of the composites. After oxyacetylene ablation for 60 s, the mass and linear ablation rates of the samples with gradient structure are 0.83 mg/s and 0.5 μm/s, 35 % and 83 % lower than conventional samples. The composites with gradient structure of ZrC and SiC are favorable to the formation of a compact and smooth ZrO 2 oxide protective layer, which not only protects the composites from further penetration of O 2 , but also resists the mechanical denudation. The novel gradient structure composites with enhanced ablation resistance show a bright application prospect in next-generation thermal protection systems. [ABSTRACT FROM AUTHOR]

Introduction: Adnexal mass is a frequently encountered problem in gynecology practice. Although ultrasonography is our main tool in distinguishing endometrioma cases, there is a need for methods that will provide preoperative prediction, especially in rare cases. For this reason, we aimed to investigate the predictive value of CA-125 level, inflammatory markers, and malignancy index calculations in the diagnosis of endometrioma. Methods: In this study, 679 cases who were operated on, and diagnosed with an adnexal mass, at the Health Sciences University Haydarpaşa Numune Training and Research Hospital, Gynecology and Obstetrics Clinic, between 01.01.2010 and 30.06.2016, were retrospectively examined. The predictive value of CA-125, RMI, and inflammatory markers was investigated among these groups, which were divided into three groups: benign and malignant adnexal mass endometrioma patients. Results: In the comparison of the three groups, CA-125 value, malignancy risk index calculations, and some hematological markers were found to be statistically significantly higher. In the subgroup analysis for CA-125; It was found in the comparison of endometrioma and benign masses (p=0.000), in the comparison of benign and malignant masses (p=0.000), and the distinction between endometrioma and malignant masses (p=0.004). In the subgroup analysis for inflammatory markers, the NLR value was found to be significantly different in malignant and benign cases (p=0.000). The neutrophil count was significantly different in malignant and benign cases (p=0.005). Discussion and Conclusion: CA125 levels were found to be sensitive but not specific in the diagnosis of endometrioma. There is a need for studies on modeling in which new algorithms are developed in which TV-USG findings are combined with hematological markers. [ABSTRACT FROM AUTHOR]

Copyright of Acta Materiae Compositae Sinica is the property of Acta Materiea Compositae Sinica Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The ArdA DNA-mimic antirestriction proteins inhibit type I restriction−modification (RMI) systems by binding instead of DNA to RMI. The ArdA specificity to DNA methylation sites recognized by RMI complexes remains poorly understood; i.e., it is unclear whether a particular DNA site is mimicked by ArdA. The ardA genes were cloned from three Gram-positive bacteria: Agrobacterium tumefaciens, Pseudomonas monteilii, and Xanthomonas sp. Antirestriction activities of their products were tested against three Escherichia coli RMI systems differing in DNA recognition/methylation sites. Although similar structures were predicted for the ArdA proteins, the strong specificity to three RMI systems was observed. The results indicate that specific DNA sites may be imitated by DNA mimic ArdA proteins. [ABSTRACT FROM AUTHOR]

This study focused on improving SiC-Ti 3 SiC 2 composites fabricated through reactive melt infiltration (RMI) using TiSi 2 alloy to optimize their microstructure, mechanical, and corrosion properties. The results indicated that achieving a balance between the carbon black content and the porosity of the preforms led to a decrease in residual TiSi 2 and an increase in the content of the MAX phase in the composites. The composite, derived from a SiC60-C40 preform with 35% porosity, contained 76 vol% SiC, 22 vol% Ti 3 SiC 2 , and 2 vol% TiSi 2. The "time window" based on two reactions specific to the TiSi 2 and C facilitates the creation of infiltration channels and the reduction of residual TiSi 2. With minimal residual TiSi2, the composite exhibited a flexural strength of 395 MPa, a fracture toughness of 5.24 MPa·m1/2, and maintained over 70% of its original strength after thermal shock below 1200ºC. Enhanced corrosion resistance was attributed to a protective MgTiO 3 layer. [ABSTRACT FROM AUTHOR]

C/C-HfC-ZrC (noted as CHZ) composites were prepared by a combined technique of polymer infiltration and pyrolysis (PIP) and reactive melt infiltration (RMI) to resist long-term ablation. The phase composition, microstructure and ablation properties of the composites were studied. Moderate HfC introduced by PIP cooperated with ZrC generated during RMI improved the ablation resistance of CHZ significantly, whose mass and linear ablation rates were only 0.544 mg/s and 0.107 μm/s, respectively, after ablation for 600 s (15 × 40 s) using oxyacetylene flame with a heat flux of 4.18 MW/m2. The excellent long-term ablation performance was attributed to the formation of a HfO 2 -ZrO 2 solid solution layer, which resisted the flame scouring and prevented the oxygen permeation. This work will provide some insight into long-term anti-ablation design and the combination of multiple techniques. [ABSTRACT FROM AUTHOR]

When developing a distributed application, several issues need to be handled, and software components should include some mechanisms to make their execution resilient when network faults, delays, or tampering occur. For example, synchronous calls represent a too-tight connection between a client requesting a service and the service itself, whereby potential network delays or temporary server overloads would keep the client side hanging, exposing it to a domino effect. The proposed approach assists developers in dealing with such issues by providing an automatic tool that enhances a distributed application using simple blocking calls and makes it robust in the face of adverse events. The proposed devised solution consists in automatically identifying the parts of the application that connect to remote services using simple synchronous calls and substituting them with a generated customized snippet of code that handles potential network delays or faults. To accurately perform the proposed transformation, the devised tool finds application code statements that are data-dependent on the results of the original synchronous calls. Then, for the dependent statements, a solution involving guarding code, proper synchronization, and timeouts is injected. We experimented with the analysis and transformation of several applications and report a meaningful example, together with the analysis of the results achieved.

Objectives: Inadequacy of effective sensitive and specific screening modalities results in late-stage diagnosis of ovarian cancer. Cancer Antigen-125 (CA-125) individually possesses limited specificity for differentiating adnexal masses. The present study aimed to evaluate the Human Epididymis Protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA), and Risk of Malignancy Index (RMI) for ameliorating sensitivity and specificity for differentiating benign from malignant adnexal masses. Materials and Methods: This study was conducted on 96 preoperative women with suspected adnexal mass (patients) and 48 healthy females without adnexal mass (controls) for the duration of 2 years. Both study participants were divided into two groups, pre-and postmenopausal. CA-125 and HE4 were done using commercially available kits. ROMA% and RMI were calculated. We validated their performances using histopathology as the gold standard. The statistical analysis was done using SPSS 21, Kruskal–Wallis, and Tukey's tests. The best cutoff points to best values of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were also evaluated. Statistical Analysis: The statistical analysis was done using SPSS 21. All study subjects were categorized based on menopausal status and final pathology of masses based on biopsy results into pre-and post-M and benign, malignant, and borderline masses groups, respectively. Comparisons were made between these by the Kruskal-Wallis test along with Tukey's test. For all of the statistical comparisons, a level of p < 0.05 was accepted as statistically significant and standard error was also calculated. Results: For differentiating benign from malignant masses in the premenopausal group, the sensitivity, specificity, PPV, NPV, and area under the curve (AUC) were 93.7%, 78.3%, 65.2%, 96.6%, 0.892 for CA-125; 87.5%, 83.7%, 70%, 93.9%, 0.926 for HE4; 93.7%, 70.2%, 57.6%, 96.2%, 0.927 for ROMA; and 68.7%, 86.4%, 68.7%, 86.5%, 0.916 for RMI. While in the postmenopausal group, the sensitivity, specificity, PPV, NPV, and AUC were 92.3%, 76.4%, 85.7%, 86.6%, 0.907 for CA-125; 78.5%, 94%, 95.6%, 80%, 0.955 for HE4; 92.3%, 94.1%, 96%, 88.8%, 0.968 for ROMA; and 88.4%, 88.2%, 92%, 83.3%, 0.943 for RMI. Conclusion: For differentiating benign from malignant masses more specifically in women with a suspected adnexal mass, ROMA and HE4 appear to be more effective than CA-125. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the diagnostic value of Ovarian-adnexal Reporting and Data System (O-RADS), and to compare it with Assessment of Different NEoplasias in the adnexa (ADNEX) model, subjective assessment (SA), and risk of malignancy index (RMI) in differentiating benign and malignant adnexal masses (AMs). Material and methods: Ultrasound characteristics of 445 patients included in the study were retrospectively analyzed and evaluated using diagnostic models. The diagnostic performances of ultrasound diagnostic models were measured by assessing, receiver-operating characteristic curves, sensitivities, positive predictive values, positive likelihood ratios, specificities, negative predictive values, and negative likelihood ratios. Kappa values were used to evaluate inter-reviewer agreement (IRA). Results: Of the 445 AMs, 265 were benign and 180 were malignant. The area under the curve (AUC) of O-RADS (0.941), ADNEX model (0.925), and SA (0.931) were higher than RMI (0.815) (all p < 0.05). The sensitivity of O-RADS (93.3%), ADNEX model (94.4%), and SA (96.1%) were higher than RMI (70.6%) (p > 0.05), and there was no statistical significance among them (p > 0.05). The specificity of O-RADS, ADNEX model, SA, and RMI was 90.2%, 90.6%, 90.2%, and 92.5%, respectively, with no statistical significance (p > 0.05). All four ultrasound diagnostic methods showed better IRA. Conclusions: O-RADS, ADNEX model and SA have better diagnostic value in differentiating benign and malignant AMs than RMI. [ABSTRACT FROM AUTHOR]

Brain tumor (BT) is a serious issue and potentially deadly disease that receives much attention. However, early detection and identification of tumor type and location are crucial for effective treatment and saving lives. Manual diagnoses are time-consuming and depend on radiologist experts; the increasing number of new cases of brain tumors makes it difficult to process massive and large amounts of data rapidly, as time is a critical factor in patients' lives. Hence, artificial intelligence (AI) is vital for understanding disease and its various types. Several studies proposed different techniques for BT detection and classification. These studies are on machine learning (ML) and deep learning (DL). The ML-based method requires handcrafted or automatic feature extraction algorithms; however, DL becomes superior in self-learning and robust in classification and recognition tasks. This research focuses on classifying three types of tumors using MRI imaging: meningioma, glioma, and pituitary tumors. The proposed DCTN model depends on dual convolutional neural networks with VGG-16 architecture concatenated with custom CNN (convolutional neural networks) architecture. After conducting approximately 22 experiments with different architectures and models, our model reached 100% accuracy during training and 99% during testing. The proposed methodology obtained the highest possible improvement over existing research studies. The solution provides a revolution for healthcare providers that can be used as a different disease classification in the future and save human lives. [ABSTRACT FROM AUTHOR]

In this work, we present a hydrocode Pagosa and explore the Richtmyer-Meshkov Instability (RMI) at an air/high explosive (HE) interface for the first time that is important but has not received much attention yet in the high explosive safety field. Thus, the presented Pagosa can be expected to predict the whole deflagration-to-detonation transition (DDT) process in future. In Pagosa, spatial discretization is implemented on cubic staggered grids by computing different variables at the vertex and the cell center, respectively, a special operator-splitting technique is employed to reduce the computational cost, and an artificial viscosity is added to handle the discontinuous shock waves in our simulations. To quantitatively evaluate the capability of Pagosa to solve these kinds of instabilities, the single mode Rayleigh-Taylor instability (RTI) and the multimode RMI at an air/SF 6 interface are first performed, respectively. The Pagosa results are compared with the related numerical solutions in the existing references and the experimental result. Moreover, a theoretical derivation of growth of RTI is also provided based on our numerical method. Subsequently, we explore the multi-mode RMI at an air/HE interface as well as the effects of several factors using Pagosa. Numerical results show that Pagosa is a powerful toolset to generate the right structures and the amplitude of RTI and RMI at an air/SF 6 interface. The solid HE can be penetrated by a strong shock wave and forms RMI deformations. The RMI at an air/HE interface behaves very different than at an air/SF 6 interface, periodic, decreased oscillation is observed due to material character, and is very sensitive to the initial simulation settings, that is, a tiny change in physical quantities will lead to a remarkable RMI structure, which is also observed in a shock bubble interaction [41]. The findings in this work are significant, and will present a new insight for the high explosive field. • An enhanced model Pagosa is presented with some special techniques. • Pagosa's capability to accurately capture the RTI at an air/SF 6 interface. • Pagosa's ability to accurately predict the RMI at an air/SF 6 interface. • The RMI at an air/HE interface is different from that at an air/SF 6 interface. • Effects of several factors on RMI at an air/HE interface. [ABSTRACT FROM AUTHOR]

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ArdB, ArdA, and Ocr proteins inhibit the endonuclease activity of the type I restriction-modification enzymes (RMI). In this study, we evaluated the ability of ArdB, ArdA, and Ocr to inhibit different subtypes of Escherichia coli RMI systems (IA, IB, and IC) as well as two Bacillus licheniformis RMI systems. Furthermore we explored, the antirestriction activity of ArdA, ArdB, and Ocr against a type III restriction-modification system (RMIII) EcoPI and BREX. We found that DNA- mimic proteins, ArdA and Ocr exhibit different inhibition activity, depending on which RM system tested. This effect might be linked to the DNA mimicry nature of these proteins. In theory, DNA-mimicmight competitively inhibit any DNA-binding proteins; however, the efficiency of inhibition depend on the ability to imitate the recognition site in DNA or its preferred conformation. In contrast, ArdB protein with an undescribedmechanismof action, demonstrated greater versatility against various RMI systems and provided similar antirestriction efficiency regardless of the recognition site. However, ArdB protein could not affect restriction systems that are radically different from the RMI such as BREX or RMIII. Thus, we assume that the structure of DNA-mimic proteins allows for selective inhibition of any DNA-binding proteins depending on the recognition site. In contrast, ArdB-like proteins inhibit RMI systems independently of the DNA recognition site. [ABSTRACT FROM AUTHOR]

Purpose This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs). Methods This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values. Results Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II). Conclusion The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.

ArdB, ArdA, and Ocr proteins inhibit the endonuclease activity of the type I restriction-modification enzymes (RMI). In this study, we evaluated the ability of ArdB, ArdA, and Ocr to inhibit different subtypes of Escherichia coli RMI systems (IA, IB, and IC) as well as two Bacillus licheniformis RMI systems. Furthermore we explored, the antirestriction activity of ArdA, ArdB, and Ocr against a type III restriction-modification system (RMIII) EcoPI and BREX. We found that DNA-mimic proteins, ArdA and Ocr exhibit different inhibition activity, depending on which RM system tested. This effect might be linked to the DNA mimicry nature of these proteins. In theory, DNA-mimic might competitively inhibit any DNA-binding proteins; however, the efficiency of inhibition depend on the ability to imitate the recognition site in DNA or its preferred conformation. In contrast, ArdB protein with an undescribed mechanism of action, demonstrated greater versatility against various RMI systems and provided similar antirestriction efficiency regardless of the recognition site. However, ArdB protein could not affect restriction systems that are radically different from the RMI such as BREX or RMIII. Thus, we assume that the structure of DNA-mimic proteins allows for selective inhibition of any DNA-binding proteins depending on the recognition site. In contrast, ArdB-like proteins inhibit RMI systems independently of the DNA recognition site.

Porous carbonaceous preforms, made from graphite and silicon carbide (SiC) powders, with varying graphite powder mass fractions and particle sizes, were infiltrated at 1500 °C and 1700 °C by Si-8 at. pct Zr alloy to produce dense Si-Zr-SiC composites. The experiments were performed in a graphite chamber vacuum furnace at 10 − 2 mbar. The most desirable results were obtained for preforms composed of a mixture of graphite and SiC powders, with preforms containing 15–20 % mass fraction of graphite and infiltrated at 1500 °C. The banding of the Zr-rich phase observed in the cross-sections of SiC-C pre- forms infiltrated by the Si-Zr alloy may help in decoding the reactive infiltration process with binary alloys. [ABSTRACT FROM AUTHOR]

A correct diagnosis of any ovarian mass is essential to ensure that patients receive the right treatment. A number of scoring systems have been set up to make diagnosis easier. The aim of this study is to evaluate and compare the accuracy and limitations of three different diagnostic methods, IOTA Simple Rules, ADNEX Model, and RMI. In our prospective study, we investigated patients with ovarian pathology admitted for surgery to the Obstetrics and Gynaecology Clinic I, Târgu Mures, in 2022. All patients underwent vaginal ultrasound examination before surgery. The diagnostic scoring systems mentioned above were used for the clinical evaluation of the ovarian screenings, which were compared with the results of the histological specimens obtained during surgery. We applied the IOTA Simple Rules method to our patients, in 111 out of the total 127 cases (87.41%). The sensitivity of the method was 91.67% and the specificity was 89.66%. The ADNEX Model and RMI provided interpretable results in all cases. The first method had a sensitivity of 89.19% and a specificity of 86.67%, while the second one had a sensitivity of 75.68% and a specificity of 88.89%. All three of the tested methods are simple to use and have good efficacy. However, the results of RMI are strongly influenced by the serum CA-125 level, which makes the IOTA Simple Rules and the ADNEX Model more reliable. [ABSTRACT FROM AUTHOR]

Es un honor presentar el más reciente número de la Revista de Medicina e Investigación Universidad Autónoma del Estado de México, una ventana abierta hacia la diversidad de la investiga-ción médica que surge de distintas latitudes. Como catedrático de Bioingeniería médica, me complace destacar cómo esta edición aborda una amplia gama de temas, todos ellos contribuyendo de manera significativa al avance de la medicina y la atención sanitaria.

The current work presents simultaneous, high-speed measurements at 60,000 fields per second of velocity and mole fraction using particle image velocimetry (PIV) and planar laser induced acetone-fluorescence in a Richtmyerâ€"Meshkov instability of an inclined interface (Atwood number, At  = 0.22). Specifically, around 2 ms of temporal evolution of the vortex structures and their associated scalar modes immediately following the interface-reshock interaction is presented. Two initial interface conditions are discussedâ€"(a) a sharp, inclined ‘single mode’ interface and (b) a ‘multi-mode’ interface where small perturbations are imposed on the single mode case. A 2D wavelet decomposition of the scalar flow field shows a highly intermittent distribution of small-scale variance throughout the interface even at late times. These are correlated strongly with the vortex structures and local turbulence intensity, where each small-scale scalar mode is sandwiched between two co-rotating vortex structures. This indicates that the interstitial regions between the vortices are significant hotspots of entrainment, which is then dispersed by the induced, counter-flow velocity fields. The multimode case demonstrates similar organization at large scales, while the scalar field is much more homogeneous at smaller scales. These observations highlight the importance of capturing the early time vortex evolution to accurately estimate any late time intermittency, especially where deposition of intense vorticity on sharp interfaces is present. [ABSTRACT FROM AUTHOR]

The usage of digital and intelligent healthcare applications on mobile devices has grown progressively. These applications are generally distributed and access remote healthcare services on the user's applications from different hospital sources. These applications are designed based on client–server architecture and different paradigms such as socket, remote procedure call, and remote method invocation (RMI). However, these existing paradigms do not offer a security mechanism for healthcare applications in distributed mobile-fog-cloud networks. This paper devises a blockchain-socket-RMI-based framework for fine-grained healthcare applications in the mobile-fog-cloud network. This study introduces a new open healthcare framework for applied research purposes and has blockchain-socket-RMI abstraction level classes for healthcare applications. The goal is to meet the security and deadline requirements of fine-grained healthcare tasks and minimize execution and data validation costs during processing applications in the system. This study introduces a partial proof of validation (PPoV) scheme that converts the workload into the hash and validates it among mobile, fog, and cloud nodes during offloading, execution, and storing data in the secure form. Simulation discussions illustrate that the proposed blockchain-socket-RMI minimizes the processing and blockchain costs and meets the security and deadline requirements of fine-grained healthcare tasks of applications as compared to existing frameworks in work. [ABSTRACT FROM AUTHOR]

Simple Summary: Diagnosing ovarian cancer (OC) accurately helps triage patients to receive anticancer treatment and appropriate cancer surgery. We conducted a systematic review and meta-analysis evaluating models combining clinical information, biomarkers, and ultrasound to identify the most accurate test. Our review investigated 58 studies (30,121 patients, 9061 OC cases) and compared the standard of care test in the UK, Risk of Malignancy index I (RMI I) against risk of ovarian malignancy (ROMA) and Assessment of Different NEoplasias in the adnexa (ADNEX). Compared to RMI I, in pre-menopausal women, ROMA and ADNEX identified more cancers correctly (increased sensitivity) but increased the number of women classified as having cancer when they did not have cancer (reduced specificity). In post-menopausal women, ROMA identified more cancers than RMI I with similar specificity, whilst ADNEX identified the most cancers overall but with least specificity. Consideration should be given as to whether RMI I should be replaced by ROMA or ADNEX as the standard of care test for OC. Background: Ovarian cancer (OC) is a diagnostic challenge, with the majority diagnosed at late stages. Existing systematic reviews of diagnostic models either use inappropriate meta-analytic methods or do not conduct statistical comparisons of models or stratify test performance by menopausal status. Methods: We searched CENTRAL, MEDLINE, EMBASE, CINAHL, CDSR, DARE, Health Technology Assessment Database and SCI Science Citation Index, trials registers, conference proceedings from 1991 to June 2019. Cochrane collaboration review methods included QUADAS-2 quality assessment and meta-analysis using hierarchical modelling. RMI, ROMA or ADNEX at any test positivity threshold were investigated. Histology or clinical follow-up was the reference standard. We excluded screening studies, studies restricted to pregnancy, recurrent or metastatic OC. 2 × 2 diagnostic tables were extracted separately for pre- and post-menopausal women. Results: We included 58 studies (30,121 patients, 9061 cases of ovarian cancer). Prevalence of OC ranged from 16 to 55% in studies. For premenopausal women, ROMA at a threshold of 13.1 (+/−2) and ADNEX at a threshold of 10% demonstrated significantly higher sensitivity compared to RMI I at 200 (p < 0.0001) 77.8 (72.5, 82.4), 94.9 (92.5, 96.6), and 57.1% (50.6 to 63.4) but lower specificity (p < 0.002), 92.5 (90.0, 94.4), 84.3 (81.3, 86.8), and 78.2 (75.8, 80.4). For postmenopausal women, ROMA at a threshold of 27.7 (+/−2) and AdNEX at a threshold of 10% demonstrated significantly higher sensitivity compared to RMI I at a threshold of 200 (p < 0.001) 90.4 (87.4, 92.7), 97.6 (96.2, 98.5), and 78.7 (74.3, 82.5), specificity of ROMA was comparable, whilst ADneX was lower, 85.5 (81.3, 88.9), 81.3 (76.9, 85.0) (p = 0.155), compared to RMI 55.2 (51.2, 59.1) (p < 0.001). Conclusions: In pre-menopausal women, ROMA and ADNEX offer significantly higher sensitivity but significantly decreased specificity. In post-menopausal women, ROMA demonstrates significantly higher sensitivity and comparable specificity to RMI I, ADNEX has the highest sensitivity of all models, but with significantly reduced specificity. RMI I has poor sensitivity compared to ROMA or ADNEX. Choice between ROMA and ADNEX as a replacement test will depend on cost effectiveness and resource implications. [ABSTRACT FROM AUTHOR]

The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the decision to refer is made at general hospitals with a low ovarian cancer prevalence. We assessed accuracies of HE4 in differentiating benign or borderline from malignant tumors in patients presenting with an ovarian mass at general hospitals. Patients with an ovarian mass were prospectively included between 2017 and 2021 in nine general hospitals. HE4 and CA125 were preoperatively measured and the risk of malignancy index (RMI) was calculated. Histological diagnosis was the reference standard. We included 316 patients, of whom 195 had a benign, 39 had a borderline and 82 had a malignant ovarian mass. HE4 had the highest AUC of 0.80 (95%CI 0.74–0.86), followed by RMI (0.71, 95%CI 0.64–0.78) and CA125 (0.69, 95%CI 0.62–0.75). Clinical setting significantly influenced biomarker performances. Applying age-dependent cut-off values for HE4 resulted in a better performance than one cut-off. Addition of HE4 to RMI resulted in a 32% decrease of unnecessary referred patients, while the number of correctly referred patients remained the same. HE4 is superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals. The addition of HE4 to the RMI improved HE4 alone. Although, there is still room for improvement, HE4 can guide referral decisions in patients with an ovarian mass to an oncology hospital. • HE4 was superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals • The addition of HE4 to RMI improved the performance of HE4 alone • Combined HE4 and RMI had a 32% higher specificity than RMI while sensitivities were similar • Clinical setting significantly influences biomarker performances in predicting malignancy in patients with an ovarian mass [ABSTRACT FROM AUTHOR]

Present-day intelligent healthcare applications offer digital healthcare services to users in a distributed manner. The Internet of Healthcare Things (IoHT) is the mechanism of the Internet of Things (IoT) found in different healthcare applications, with devices that are attached to external fog cloud networks. Using different mobile applications connecting to cloud computing, the applications of the IoHT are remote healthcare monitoring systems, high blood pressure monitoring, online medical counseling, and others. These applications are designed based on a client–server architecture based on various standards such as the common object request broker (CORBA), a service-oriented architecture (SOA), remote method invocation (RMI), and others. However, these applications do not directly support the many healthcare nodes and blockchain technology in the current standard. Thus, this study devises a potent blockchain-enabled socket RPC IoHT framework for medical enterprises (e.g., healthcare applications). The goal is to minimize service costs, blockchain security costs, and data storage costs in distributed mobile cloud networks. Simulation results show that the proposed blockchain-enabled socket RPC minimized the service cost by 40%, the blockchain cost by 49%, and the storage cost by 23% for healthcare applications. [ABSTRACT FROM AUTHOR]

In this work, the mechanisms leading to the pore closure in reactive melt infiltration (RMI) of carbon by pure silicon and a near eutectic Si-8 at-pct Zr alloy at 1500 and 1700 °C under vacuum were studied. Various geometrical configurations of microchannels were fabricated via laser ablation of glassy carbon plates. The micron size capillary channels allowed simplifying the complicated porosity distribution in the infiltration of powder or fibres based porous preform while keeping the physical dimensions in the range of where the physical phenomenon of pore closure takes place. The extent of infiltration was analysed by means of X-ray radiography. For RMI of pure Si, the widely accepted decrease in capillary radius by the formation of a solid state SiC layer by the reaction of liquid Si and C was observed, but did not lead to closure and it is hence not the infiltration limiting step in channels as small as 10 μm. However, in the case of the Si-Zr alloy infiltration, another mechanism of pore closure was observed, namely the precipitation of zirconium silicides at the infiltration front, due to Zr enrichment in the alloy by the continuous consumption of Si for the formation of SiC. [ABSTRACT FROM AUTHOR]

Background/Aim: Ovarian cancer is the second most common gynecologic malignancy worldwide and is the deadliest among gynecological cancers. It is important that this cancer, which is usually diagnosed in advanced stages, is referred to a gynecologist oncologist without delay. An ideal screening method does not yet exist. Although CA 125 is still the most used tumor marker, it cannot detect early-stage ovarian cancer. Also, CA 125 is not specific for ovarian malignancy. Therefore, new serum markers, such as HE4, and more complex algorithms, like ROMA and RMI, have emerged. Here we evaluate the preoperative potential of patients with adnexal mass to have a malignant or benign mass with morphological index, CA 125, HE4, RMI, and ROMA tests. Methods: This study is a prospective cohort study. A power analysis was done before starting the study. The sample size was at least 80 when the Type I error was set at 0.05, and the confidence interval was 95%. We included into the study 84 patients admitted to our clinic because of pelvic mass and underwent operation between March 2016 and October 2018. To homogenize the benign and malignant groups, 42 patients were collected from each group. CA 125 and HE4 levels of the samples were studied by the electrochemiluminescence method. ROMA and RMI values were calculated, and the data were entered into SPSS. Data were analyzed using SPSS 22.0 statistical package program. Results: Each of the CA 125 (P = 0.002), HE4 (P < 0.001), morphological index (P < 0.001), ROMA (P < 0.001), and RMI (P < 0.001) tests has been successful in differentiating malignant masses from benign masses. In the malignant-benign differentiation of adnexal masses preoperatively, CA 125 was the test with the lowest sensitivity, and RMI had the highest sensitivity. However, in the ROC analysis, the morphological index has a higher area under the curve. Conclusion: Although CA 125 is still the most frequently used marker in the preoperative evaluation of adnexal masses, it has low specificity and sensitivity, especially in premenopausal patients. The use of new tumor markers (e.g., HE4) and other algorithms (e.g., ROMA and RMI) is supported by our findings and the literature. However, here we show that an expert ultrasonographic evaluation with morphological index alone could be effective. [ABSTRACT FROM AUTHOR]

Introduction: To detect the morphological parameters of ovarian masses and the accuracy of the risk of malignancy index (RMI) in diagnosing ovarian malignancy. Material and methods: 264 women in 3 groups (reproductive, premenopausal, and postmenopausal) presented with ovarian masses and scheduled for surgery were included in this study. The participants’ preoperative RMI was compared to the postoperative histology (gold standard) to detect the accuracy of RMI in diagnosing ovarian malignancy. Results: The incidence of malignant and benign ovarian tumours in the reproductive group was 9.1% and 90.9%, respectively, while it was 35.2% and 64.8%, respectively, in the premenopausal group, and 35.2%, and 64.8%, respectively, in the postmenopausal group. The incidence of malignant ovarian tumours was significantly higher in the premenopausal (35.2%) and postmenopausal (35.2%) groups compared to the reproductive group (9.1%), (p = 0.0008, and p = 0.0008, respectively). The receiver operating characteristic curve showed that RMI at cut-off value > 247.5 had 82.9% sensitivity, 100% specificity, 100% positive predictive value (PPV), and 98.1% negative predictive value (NPV) in diagnosing ovarian malignancy in the 3 studied groups (AUC 0.955, p < 0.001). There was significant positive correlation between the participants’ age, and RMI (p = 0.001), and between participants’ cancer antigen-125 (CA-125) and RMI (p < 0.0001) in the ovarian malignancy group. Conclusions: The multimodal RMI is an effective tool for primary evaluation of suspected ovarian masses. Risk malignancy index at cut-off value > 247.5 had the best performance (82.9% sensitivity, 100% specificity, 100% PPV, and 98.1% NPV) in diagnosing ovarian malignancy in the 3 studied groups. There was significant positive correlation between participants’ age, and RMI, and between participants’ CA-125 and RMI, in the studied malignant ovarian tumours. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine if the risk of malignancy index (RMI 2) can distinguish between benign and malignant adnexal masses in the women with adnexal masses. Methods: This is a prospective observational study conducted over a period of two years from 2012 to 2014. A total of 100 cases of adnexal mass were selected using purposive sampling technique. Information regarding age, parity, menstrual status, history of previous surgery and symptoms were noted. RMI 2 was calculated for each patient. Statistical analysis was done using SPSS software version 21. Results: Majority (60%) of the women were in the perimenopausal or menopausal age group (40-60 years). Majority of the patients ie 62% had levels of CA-125 above100U/l, 16% had levels between 35-100U/l and 22% had levels

Introducción. El objetivo de la investigación fue resolver para Cuba los mapas mineragé- nicos a escala 1:250000 de las regolitas de meteorización y de las estructuras geotectóni- cas, así como un nomenclador universal de las rocas de la meteorización, investigándose todo el país en 2015-2019 según proyecto I+D “Mapa Mineragénico de Cuba”. Fase I (Código 613490) y Fase II (Código 613740) del Programa de Ciencia, Tecnología e Innovación de In- terés Nacional: Caracterización Integral de la Geología de Cuba, cuyos resultados componen esta propuesta. Métodos. Se comenzó por la búsqueda bibliográfica con retrospectiva hasta 1807, seguida por trabajos geológicos, geofísicos, litológicos, petrográficos, mineralógicos y químico-analíticos para Fe, Ni, Co, Si, Al, Mg, Cr, Mn, Ti, Ba, Cu, Pb, Zn, Sr, Li, Sn, V, Ca, Y, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu; 130 DRX mineralógicas; 3768 km de itinerarios, toma y documentación de 744 muestras y 523 mediciones espectrométricas de U, Th, K con el espectrómetro RS-230 BGO Super-Spec. Resultados. Dos mapas mineragénicos: de la meteorización y general de RMI a escala 1:250000 de Cuba, y un nomenclador universal para clasificación y sistemática de rocas de la meteorización. Se tipificaron y categorizaron los escenarios geotectónicos y tipos de regolitas de meteorización por su productividad y potencialidad en recursos minerales (RMI y metalíferos), aportando cartografías tectónico-li- tológicas y mineragénicas a escala 1:250000 de Cuba basado en tectónica global, resultados demandados por el Servicio Geológico de Cuba y útiles para diversos objetivos y ramas de la Economía, la Docencia y la Investigación Científica del país

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Overall structure of KAMAT pump station and RMI pump station which have high domestic market share were introduced. Key technologies in terms of deceleration system, hydraulic system, lubrication system, protection system and control system were comprehensively compared and analyzed. Their respective advantages and disadvantages were summarized, and their improvement directions were pointed out: for KAMAT pump station, processing technology and quality of gear shaft, as well as hydraulic system structure should be improved; for RMI pump station, crankshaft strength of deceleration system should be strengthened, and high-pressure seal module design of hydraulic system and arrangement of suction and discharge valve plug seat should be improved.

Abstract Ovarian cancer is the 5th leading cause of death for women with cancer worldwide. In more than 70% of cases, it is only diagnosed at an advanced stage. Our study aims to give an update on the biological markers for diagnosing ovarian cancer, specifically HE4, CA 125, RMI and ROMA algorithms. Serum CA125 assay has low sensitivity in the early stages and can be increased in certain conditions such as menstruation or endometriosis. The level of HE4 is overexpressed in ovarian tumors. Its specificity is 94% and its level is not affected by endometriosis cysts. The combined measures of CA125 and HE4 have proved to be highly efficient with an area under the curve (AUC) of up to 0.96. Furthermore, this combined measure of CA125 can correct the variations in HE4 which are due to smoking or contraception combining estrogen plus progestin. While the specificity of RMI sometimes reaches 92%, the rather low AUC of 0.86 does not make it the best diagnostic tool. The specificity of ROMA is lower than HE4 (84% compared to 94%). To date, the most efficient biological diagnostic tool to diagnose ovarian cancer is the combination of CA125 and HE4.

Adnexal masses are a common finding in women, with 20% of them developing at least one pelvic mass during their lifetime. There are more than 30 different subtypes of adnexal tumours, with multiple different subcategories, and the correct characterisation of the pelvic masses is of paramount importance to guide the correct management. On that basis, different algorithms and scoring systems have been developed to guide the clinical assessment. The first scoring system implemented into the clinical practice was the Risk of Malignancy Index, which combines ultrasound evaluation, menopausal status, and serum CA-125 levels. Today, current guidelines regarding female patients with adnexal masses include the application of International Ovarian Tumours Analysis simple rules, logistic regression model 1 (LR1) and LR2, OVERA, cancer ovarii non-invasive assessment of treating strategy, and assessment of Different Neoplasias in the adnexa. In this scenario, the choice of the scoring system for the discrimination between benign and malignant ovarian tumours can be complex when approaching patients with adnexal masses. This review aims to summarise the available evidence regarding the different scoring systems to provide a complete overview of the topic. [ABSTRACT FROM AUTHOR]

The Bloom syndrome complex is a DNA damage repair machine. It consists of several protein components which are functional in isolation, but interdependent in cells for the maintenance of accurate homologous recombination. Mutations to any of the genes encoding these proteins cause numerous physical and developmental markers as well as phenotypes of genome instability, infertility, and cancer predisposition. Here we review the published structural and biochemical data on each of the components of the complex: the helicase BLM, the type IA topoisomerase TOP3A, and the OB-fold-containing RMI and RPA subunits. We describe how each component contributes to function, interacts with each other, and the DNA that it manipulates/repairs. The Bloom syndrome complex is essential in cells for the maintenance of accurate DNA repair and suppression of cancer. Here, Bythell-Douglas and Deans review the published structural and biochemical data on each of the components of the Bloom syndrome complex. They discuss how the subunits combine in a molecular machine that regulates multiple steps of homologous recombination. [ABSTRACT FROM AUTHOR]

Objectives: In order to improve the early diagnosis of ovarian cancer (OC), we evaluated human epididymis secretory protein 4 (HE4), the risk of malignancy index (RMI), the risk of ovarian malignancy algorithm (ROMA), and the Copenhagen Index (CPH-I) in their ability to predict the risk of adnexal masses being malignant, and in discriminating between serous and mucinous ovarian tumors. Methods: A study consisting of 509 patients who were diagnosed with benign, borderline, and malignant adnexal tumors was conducted. We analyzed the values of HE4, RMI, ROMA, and CPH-I. In addition, CA125, CEA, CA125/CEA ratio, CA199, and CA125/CA199 ratio were also assessed to determine their predictive values to diagnoses serous or mucinous ovarian tumors. Results: To differentiate between benign and borderline ovarian tumors, we evaluated RMI and CPH-I scores which showed high AUC (0.7593, and 0.7128, respectively), but neither of them showed both high sensitivity and specificity. When discriminating benign and malignant tumors, RMI and CPH-I performed the best for premenopausal women; whereas ROMA and HE4 performed the best for postmenopausal women. Patients with values above the cutoff for CA125 (>328.3 U/mL), CA125/CEA (>82.26), and CA125/CA199 (> 5.633), were more likely to be diagnosed with serous carcinoma. Whereas those with higher values for CEA (> 3.7 μg/L) and CA199 (>27.81 ng/mL) were more likely to have a mucinous carcinoma. Conclusion: RMI and CPH-I for premenopausal women, ROMA and RMI for postmenopausal women were reliable indicators to differentiate between women with benign versus malignant tumors. In addition, the ratios CA125/CEA and CA125/CA199 could be used to distinguish serous from mucinous ovarian carcinomas. [ABSTRACT FROM AUTHOR]

Uncontrolled hydrogen/air explosions pose a central problem in nuclear and process plant safety research. The Richtmyer–Meshkov Instability (RMI) can be an important contributing factor to flame acceleration and subsequently the deflagration-to-detonation transition. In this context, the RMI is caused by the interaction of a sharp pressure gradient, generated by a shock wave and the density gradient at a flame surface. This interaction leads to the production of baroclinic torque at the flame surface, which causes flame wrinkling. For this work, compressible direct numerical simulations of a shock wave, interacting with a perturbed statistically planar flame in a premixed medium, are conducted. After the first interaction with the flame, a second instance of shock–flame interaction (re-shock) is observed, caused by the reflection of the shock wave from an adiabatic wall on the right-hand side of the domain. The influence of the chemical reaction, shock strength, as well as initial flame surface disturbance on the flame surface area A f and mixing width δ m , are investigated. It is found that the chemical reaction has a large impact on the development of A f and δ m , as it partly smoothens emerging wrinkled structures on the flame surface for the present thermochemistry. The maximum reached A f is hereby reduced by about 50 % compared to cases without chemical reaction. A comparison of the development of δ m over time with predictions from an analytical model shows good agreement for the linear portion of the instability (short time frame after shock interaction). The model then fails to predict the decrease of δ m in the non-linear part of the model, due to the smoothing effects of the chemical reaction. The influence of the initial flame disturbance on the development of the flame surface area and mixing width shows a strong dependence on the selected disturbance wavenumber k 0 . The maximum achievable flame surface area is inversely proportional to k 0 in the investigated range. Increasing the shock Mach number and therefore increasing the pressure gradient showed a strong impact on the development of the RMI. After the first shock interaction, numerous fresh gas funnels are created, reaching into the burned gas. Therefore, when the re-shock interaction occurs, the shock will interact with an increased and more irregular flame surface. In addition, the flame thickness is reduced by about 50 % upon each shock interaction, due to flame compression and increase in the pressure level from the shock wave. Both effects will lead to distinct spikes in the baroclinic torque production over time upon flame interaction with the re-shock and result in a strong increase of A f and δ m . [ABSTRACT FROM AUTHOR]

Background: It is unclear whether EDSS is responsive to disability worsening in advanced MS. Objective: To explore the dynamics of disability worsening in persons with advanced-stage MS (EDSS ≥5.5) using three disability worsening definitions (EDSS, Rivermead Mobility Index (RMI), 9-Hole Peg Test (9-HPT)). Methods: EDSS-, RMI- and 9-HPT-based disability worsening were assessed over a minimum of two years in a cohort of 286 persons with advanced MS attending inpatient rehabilitation using Kaplan-Meier Curves and multivariable Cox regression. Furthermore, the correspondence between EDSS-, RMI- and 9-HPT-based disability worsening was analyzed. Results: Disability progression was observed in 49% (9-HPT), 52% (EDSS) and 53% (RMI), with 9-HPT-based worsening slightly lagging behind. The Multiple Sclerosis Severity Score (MSSS) was the only consistent factor predicting disability worsening based on all three definitions (EDSS: hazard ratio 1.48 [1.30;1.68]; RMI: 1.12 [0.99;1.27]; 9-HPT: 1.36 [1.18;1.57]). Correspondence between EDSS and the other definitions (9-HPT and RMI) was 44.3% and 55.7% at time of EDSS progression and 65.1% and 72.5% overall, respectively. Conclusion: In persons with advanced-stage MS, half still developed disability worsening in different functional systems over a median of 6 years. MSSS seems a valid predictor for disability worsening in all three outcome measures in advanced MS. [ABSTRACT FROM AUTHOR]

Background: Ovarian malignancy is the second most common gynecological malignancy. It is the most lethal gynecologic cancer as many women with ovarian cancer present with late stages of disease. The search for an ideal screening test for ovarian cancer has been going on for quite some time. RMI is a scoring system that is derived from a formula that combines menopausal status with serum cancer antigen 125 (CA-125) values and ultrasound variables of low complexity. Aim: To calculate RMI of adnexal masses and correlate it with final histopathological diagnosis so as to determine the significance of RMI score in diagnosis of ovarian malignancy. Materials and methods: A prospective cohort study was conducted of 48 women with an adnexal mass referred to a teaching hospital and managed surgically. RMI3 was calculated in all the cases and correlated with the intraoperative findings and histopathology. Results: RMI 3 had a sensitivity of 100%, a specificity of 91.89%, a positive predictive value of 78.57%, and negative predictive value of 100% in diagnosing epithelial ovarian malignancy. RMI was more accurate than CA125 alone in distinguishing malignant from benign masses. Conclusion: RMI is a standardized, easily reproducible, and relatively inexpensive, highly reliable procedure available even in low resource settings with good sensitivity, specificity, positive predictive value and negative predictive value in detecting epithelial ovarian malignancy. [ABSTRACT FROM AUTHOR]

The trend today to ever increasing modelling sophistication demands that much more attention be paid by practitioners to achieving better appreciation and characterization of geology and rockmass variability, so that rock–structure interaction effects can be analysed more realistically in better calibrated models. This paper is thus directed towards focussing attention on risk-based geological characterization as basis for helping modellers and designers improve calibration of their models. A sequential approach of appropriate input parameter refinement is outlined as a path forward methodology for consistently achieving maximum reliability in modelling. Processes that are needed for identifying key controlling geological structural features and rockmass domain characteristics that may be critical influences on true rockmass behaviour are explored so that rationalization steps can be followed in model building to ensure that actual behaviour drivers are not only properly represented, but are reliably characterized through rigorous calibration. Suggestions for the use of the observational and quantitative GSI charts at various scales appropriate to specific geological domains are presented as a means for achieving such calibration. Illustration is then given of how quantification can be achieved of rock quality variability throughout the complete range of rock competence, from intact pseudo-homogeneous high strength rockmasses subject to brittle spalling, through blocky, folded or foliated rockmasses, where kinematic controls are typically of paramount importance, through to completely degraded, fault process core zones and saprolites, where material matrix strength almost entirely dominates behaviour. Guidelines are given for suggested ranges of classification applicability for use with the Hoek–Brown failure criterion. [ABSTRACT FROM AUTHOR]