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Slag viscosity is essential in high-temperature metallurgical processes. However, a slag viscosity model is difficult to exactly interpret as it has a strong nonlinear relation with its composition and temperature. In this paper, genetic programming (GP) was employed to derive a CaO-SiO2-Al2O3 slag viscosity equation. The equation was automatically described as a simple algebraic equation with the basicity and content of Al2O3 and temperature. The average relative error between the values obtained by the equation and the experimental data used for its derivation was as low as 17.1%. Computer simulations were performed to evaluate the accuracy of the derived viscosity equation and were then compared with many experimental viscosities and calculated values of other researchers. Slag compositions and temperatures for simulation calculations were the experimental data which were not used for deriving a viscosity equation. The results showed that the viscosity equation was relatively exact. The viscosities of CaO-SiO2-Al2O3 system slag could be simply and expediently predicted within the wide range of compositions and temperatures by using the derived viscosity equation.

ObjectivePreemptive thoracic endovascular aortic repair (TEVAR) has the potential to improve the prognosis of Stanford type B aortic dissection (TBAD), however it is important to determine whether it could be safely performed as a prophylactic treatment. This study aimed to determine the short- and long-term outcomes of preemptive TEVAR for uncomplicated TBAD with a small aortic aneurysm.DesignRetrospective multicenter analysis.MethodsWe analyzed 212 patients with medically treated uncomplicated subacute TBAD between July 2004 and October 2019 in two Japanese academic centers. The short- and long-term prognosis of patients who underwent preemptive TEVAR and the changes in aortic diameter over time after TEVAR were analyzed. Aorta-related complications, aortic-related death and postoperative complications were recorded and analyzed. Analysis was performed on an intension-to-treat basis.ResultsDuring follow-up, patients were divided into two groups: optimal medical treatment [OMT; n = 185 (87%)] and preemptive TEVAR [n = 27 (13%)]. In all cases, aortic enlargement was the reason for therapeutic intervention in the preemptive TEVAR group. Propensity score matching yielded a cohort of 27 control patients with OMT (group A) and 27 patients who underwent preemptive TEVAR (group B). Preoperative characteristics were similar between groups. In group B, only one patient developed type A dissection at a late stage and died from aortic rupture. Freedom from aortic-related death at 1/5/10 years was 100%/92%/92% in group B. Overall growth (mm/year) of max aorta was significantly smaller in the TEVAR group than in the control group (−3.7 ± 2.9 vs. 0.4 ± 5.6, p

Quando o adoecer provoca a transformação dos contextos de vida e seu consequente esvaziamento, seja por questões clínicas que limitam o cotidiano e/ou devido a dimensões psicossociais e espirituais, a implantação de ferramentas psicológicas nas unidades do Hospital, revestem-se em um importante recurso de ajuda, por resgatar capacidades, instigando recursos de enfrentamento do adoecer a pacientes e familiares. Em associação aos processos de avaliação e acompanhamento psicológico individual, temos oferecido processos preventivos nas Unidades de Infusões de nossa instituição, por apresentar a vantagem operacional de atingir um número maior de pacientes em tratamento e seus acompanhantes. As Unidades de Infusões constituem-se em espaços nos quais os comportamentos presentes podem ser experienciados e novos comportamentos experimentados, em consonância com a teoria de crise delineada pelo diagnóstico e tratamento oncológico. Este trabalho objetiva apresentar o Programa Correio Elegante, como processo integrado, planejado e sistematizado em Unidade de Infusões, em hospital de oncologia pediátrica. A atividade é desenvolvida semanalmente, nas Unidades de Infusões, alternando-se o período para maior abrangência dos participantes. No período de janeiro a junho de 2024, 93 cartas foram trocadas entre pacientes, familiares e equipes de saúde, com a participação de 52 pacientes. Dentre os acompanhantes houveram em sua maioria mães, seguido de pais, irmãos e avós. O Correio Elegante em Unidade de Infusões é um instrumento caracterizado como intervenção breve em seu formato, em tarefa que se pretende adaptativa e de suporte, utilizando técnica focal. Constatamos que por reunir pacientes e/ou acompanhantes em torno de uma mesma demanda, há um melhor entendimento e aceitação entre os participantes, a partir de suas próprias vivências. A curto prazo, essa coesão costuma propiciar melhores resultados psicológicos pois constata-se que as vivências advindas da troca de mensagens e cartas na Unidade, estimulam mecanismos de enfrentamento positivos, permitindo que os participantes vivenciem suas experiências do adoecer e hospitalização, de forma menos conflituosa, referenciando importante função preventiva de risco. Constatamos pelos conteúdos das mensagens que pacientes e familiares, reunidos em torno da dor psicológica do adoecer, sentem-se identificados e unidos, compartilham das mesmas angústias e esperanças, limitações e recomendações, complementando o clima de coesão e apoio necessário para o melhor enfrentamento do adoecer.

Potato plants have an important role in providing a source of carbohydrates for society. However, potato production is often threatened by various plant diseases, such as leaf disease, which can cause a decrease in yields. Identification of diseases on potato leaves is currently mostly done by farmers manually, so it is not always efficient and accurate. So the aim of this research is to identify diseases on potato leaves with artificial neural networks using the ELM (Extreme Learning Machine) approach and the GLCM (Gray Level Co-Occurrence Matrix) method for feature extraction. The GLCM approach functions to obtain texture features on objects by measuring how often certain pairs of pixel intensities appear together at various distances and directions in the image. Meanwhile, the ELM algorithm is used for image identification by adopting a one-time training method without iteration, which involves randomly determining weights and biases in hidden layers, thus allowing training to be carried out quickly and efficiently. Evaluation of the model by looking for the level of accuracy produces a value of 84.667%. The results show that the model developed is capable of accurate identification.

Abstract Objective In patients with stable hemodynamic status after an acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) after preoperative investigations can provide outcomes comparable to those of emergency surgery. However, no established guidelines exist regarding the preparation period before surgery. We report the results of the use of an inpatient cardiac rehabilitation program followed by CABG after an ACS to improve post-operative outcomes and prognosis after discharge. Methods From 2005 to 2017, 471 patients underwent either isolated or combined CABG at our institution, and of those, the 393 who received isolated CABG were included in the analysis. Twenty-seven patients (6.9%) were admitted with ACS and underwent preoperative rehabilitation before undergoing CABG, with a subsequent review of surgical morbidity and mortality rates. Propensity score matching yielded a cohort of 26 patients who underwent preoperative rehabilitation (group A) and 26 controls (group B). Preoperative characteristics were similar between groups. Results The completion rate of the rehabilitation program was 96.3%. All programs were conducted with inpatients, with an average length of stay of 23 ± 12 days. All patients completed in-bed exercises, and 85% completed out-of-bed exercises. The 30-day postoperative mortality was 0% in both groups A and B, and the rate of postoperative major adverse cardiac or cerebrovascular events at 12 months did not differ significantly between groups (7.7% vs 3.9%, respectively; p = 1.0). The duration of mechanical ventilation (1.3 ± 0.3 vs 1.5 ± 0.3 days, respectively; p = 0.633), length of intensive care unit stay (4.4 ± 2.1 vs 4.8 ± 2.3 days, respectively; p = 0.584) and length of hospital stay (25 ± 13 vs 22 ± 9 days, respectively; p = 0.378) did not differ significantly between groups. Conclusions No complications of preoperative rehabilitation were observed, suggesting that it is an acceptable option for patients who experience ACS and undergo CABG. These results are promising in offering more robust designs of future trials.

In Australia, antimicrobials are given an importance rating by the Australian Strategic and Technical Advisory Group on antimicrobial resistance. High importance antimicrobials are those essential for the treatment or prevention of infections in humans, where there are few or no treatment alternatives. In this study we consulted with experts from across human and animal health using the Delphi consensus-building process to establish the circumstances under which antimicrobials with high importance to human health could be used in animals in Australia. We used three rounds of online surveys. Group responses were provided to participants in each subsequent round to facilitate convergence of opinion. Consensus was defined as 80 % or more of respondents selecting the same option for a question. By the end of the third round, consensus was achieved on eight items. This included the use of high importance antimicrobials being appropriate if culture and sensitivity testing indicated the organism was resistant to low- and medium-rated antimicrobials that could be used to treat the case. If any high-importance antimicrobials are prescribed for animals there was also agreement that a clear indication for this use and justification for antimicrobial choice must be recorded in the medical history, along with the dose rate, route of administration, the duration and the time point for review of the condition and associated antimicrobial therapy.Appropriateness of use of high importance antimicrobials in critically ill animals where culture and sensitivity results are not available is still undefined. Further work is also required to establish which particular organisation should be notified of the use of high importance antimicrobials not registered for use in animals. The Delphi process was valuable in facilitating consensus amongst international experts from a broad range of health backgrounds and experience.

Slag viscosity is essential in high-temperature metallurgical processes. However, a slag viscosity model is difficult to exactly interpret as it has a strong nonlinear relation with its composition and temperature. In this paper, genetic programming (GP) was employed to derive a CaO-SiO2-Al2O3 slag viscosity equation. The equation was automatically described as a simple algebraic equation with the basicity and content of Al2O3 and temperature. The average relative error between the values obtained by the equation and the experimental data used for its derivation was as low as 17.1%. Computer simulations were performed to evaluate the accuracy of the derived viscosity equation and were then compared with many experimental viscosities and calculated values of other researchers. Slag compositions and temperatures for simulation calculations were the experimental data which were not used for deriving a viscosity equation. The results showed that the viscosity equation was relatively exact. The viscosities of CaO-SiO2-Al2O3 system slag could be simply and expediently predicted within the wide range of compositions and temperatures by using the derived viscosity equation. [ABSTRACT FROM AUTHOR]

Wild plants or weeds often become enemies or disturb the main cultivated plants. In its development, wild plants or weeds actually have ingredients that are beneficial to the body and can be used as medicine. However, many people still need knowledge about the types of weed plants that have medicinal properties, especially the leaves. The purpose of this research is to classify the image of weed leaves with medicinal properties based on color and texture characteristics with an artificial neural network using a Self-Organizing Map (SOM). To improve information in feature extraction, RGB and HSV color features are used as well as texture features with Gray Level Co-occurrence Matrix (GLCM). Furthermore, the results of feature extraction will be identified as groups or classes with the Self-Organizing Map (SOM) algorithm which divides the input pattern into several groups so that the network output is in the form of a group that is most similar to the input provided. The test produces a precision value of 91.11%, a recall value of 88.17% and an accuracy value of 89.44%. The results of the accuracy of the SOM model for image classification on medicinal weed leaves are in the good category.

Objective: Sorafenib and lenvatinib have been recommended as standard tyro sine kinase inhibitors (TKIs) for progressive radioiodine-refractory differentiated thyroid carcinoma (RR-DTC). However, their efficacy remains limited with unresolved drug resistance. Therefore, we conceived this open-label study based on real-world evidence to investigate the efficacy and safety of apatinib in patients wi th progressive RR-DTC. Methods: Off-label use of apatinib as either initial treatment or salvage treatment for sorafenib resistance was investigated. The primary endpoint was progression-free survival (PFS) and the secondary endpoints included objective r esponse rate (ORR), overall survival (OS), and safety. Results: For all 28 enrolled patients, the median PFS was 15.1 months, w ith an ORR of 69.6%. The median OS was not reached at the data cut-off. In det ail, the median PFS of 17.3 months and the ORR of 75% were determined in patients with TKI-naive RR-DTC (initial treatment group, n = 14). And, in patients with first-line sorafenib-resistant RR-DTC (salvage treatment group, n = 14), a median PFS of 12.0 months was reached, with an ORR of 45.5%. In the salvage treatment group, the media n OS from the start of apatinib administration was 20.6 months, reaching 89.1 month s from sorafenib treatment initiation. Adverse events at grade 3 or higher occur red in 64.3% of all subjects treated with apatinib. Conclusions: This study demonstrated that apatinib shows promise against RR- DTC with tolerable toxicity, representing a novel initial treatment for progressive RR-DTC and effective salvage treatment for RR-DTC resistant to sorafenib.

Objective: We aimed to determine the efficacy of total arch replacement with stented elephant trunk by comparing it with hemiarch replacement with and without open stent graft for acute aortic dissection type 1. Methods: We reviewed records of 177 patients who underwent hemiarch replacement (HAR group) (concomitant open stent, 125) and 98 patients who underwent total arch replacement (TAR group) (concomitant stented elephant trunk, 91) for acute type 1 dissection. Compared with the TAR group, the HAR group was older (68.1 vs 60.9 years; P

Abstract Health intentions and behaviours are essential for improving the health of individuals and society. This study used cross-sectional data from 20,155 health checkup participants in the Yamagata study to identify factors associated with health intentions and behaviours. Information regarding the current level of health intentions and behaviours was collected using a baseline survey questionnaire. Participants were categorised into three groups: having no intention (no intention), having intentions to improve but not acting on them (intention), and already active (action). The associations between background factors and the presence/absence of health intentions and behaviours were assessed using logistic regression analysis. Of the participants, 35.4%, 37.7%, and 26.9% belonged to the no intention, intention, and action groups, respectively. Multivariate analysis revealed that the factors associated with health intentions were being young, being female, longer duration of education, higher body mass index and abdominal circumference, diabetes, and dyslipidaemia. The factors associated with health behaviours were being older and male, not consuming alcohol, not smoking, performing daily exercise, and having diabetes. These results indicate that health guidance considering background factors, including age, gender, education, and comorbidities, may be useful for effectively promoting health intentions and health behaviours in the Japanese population.

Epidermal growth factor receptor 2 (ERBB2) is commonly over-expressed in advanced or metastatic tissues of papillary thyroid cancer (PTC) with poor prognosis, while it remains unknown whether ERBB2 plays a role in the progression of PTC. Thus, we analyzed the data derived from online repositories, including TCGA, KEGG, GO, GeneMANIA, and STRING, to explore the relationship between ERBB2 expression and prognosis, tumor phenotypes of interest, and immune infiltrates in PTC. Compared to normal thyroid tissue, ERBB2 was up-regulated in PTC samples (p < 0.001); In comparison with the group with low expression of ERBB2, the group with high expression of ERBB2 had poorer progression-free interval in stage III/IV patients (p = 0.008) and patients aged >45 years (p = 0.019). The up-regulated ERBB2 was associated with iodine metabolism dysfunction, proliferation, metastasis, angiogenesis, and drug resistance. The expression of ERBB2 negatively correlated with enrichment scores of B cells (r = −0.176, p < 0.001), CD8+ T cells (r = −0.160, p < 0.001), cytotoxic cells (r = −0.219, p < 0.001), NK CD56dim cells (r = −0.218, p < 0.001), plasmacytoid dendritic cells (r = −0.267, p < 0.001), T cells (r = −0.164, p < 0.001), T follicular helper cells (r = −0.111, p = 0.012), gamma delta T cells (r = −0.105, p = 0.017), and regulatory T cells (r = −0.125, p = 0.005). In conclusion, ERBB2 may serve as a prognostic biomarker and an immunotherapeutic target in PTC, deserving further exploration.

Abstract Background Dairy products are known as health-promoting foods. This study prospectively examined the association between milk and yogurt intake and mortality in a community-based population. Methods The study population comprised of 14,264 subjects aged 40–74 years who participated in an annual health checkup. The frequency of yogurt and milk intake was categorized as none ( 1/day) intake. The association between yogurt and milk intake and total, cardiovascular, and cancer-related mortalities was determined using the Cox proportional hazards model. Results During the follow-up period, there were 265 total deaths, 40 cardiovascular deaths and 90 cancer-related deaths. Kaplan–Meier analysis showed that the total mortality in high/moderate/low yogurt intake and moderate/low milk intake groups was lower than that in none group (log-rank, P

Abstract Background The 12-item Short-Form Health Survey version 2 (SF-12v2), a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. No study to date has examined the measurement properties of the SF-12v2 in patients with lung cancer using Rasch analysis. The aim of this study was to extend the psychometric evaluations of the SF-12 within the lung cancer population to ensure its validity and reliability to assess the health status in this population. Methods Participants in the Victorian Lung Cancer Registry (VLCR) who completed the SF-12v2 between 2012 and 2016 were included in this study. The structural validity of the SF-12v2 was assessed using Rasch analysis. Overall fit to the Rasch measurement model was examined as well as five key measurement properties: uni-dimensionality, response thresholds, internal consistency, measurement invariance and targeting. Results A total of 342 participants completed the SF-12v2 three months following their lung cancer diagnosis. The SF-12 Physical Component Score (PCS-12) did not fit the overall Rasch measurement model (χ2 107.0; p

Although biologically targeted therapies based on key oncogenic mutations have made significant progress in the treatment of locally advanced or metastatic thyroid cancer, the challenges of drug resistance are urging us to explore other potentially effective targets. Herein, epigenetic modifications in thyroid cancer, including DNA methylation, histone modifications, non-coding RNAs, chromatin remodeling and RNA alterations, are reviewed and epigenetic therapeutic agents for the treatment of thyroid cancer, such as DNMT (DNA methyltransferase) inhibitors, HDAC (histone deacetylase) inhibitors, BRD4 (bromodomain-containing protein 4) inhibitors, KDM1A (lysine demethylase 1A) inhibitors and EZH2 (enhancer of zeste homolog 2) inhibitors, are updated. We conclude that epigenetics is promising as a therapeutic target in thyroid cancer and further clinical trials are warranted.

As the aging process is springing up around the whole world, the problem of sit-to-stand (STS) for the elderly has become the focal point of older people themselves, their families, and society. The key challenge in solving this problem is developing and applying the technology of auxiliary robots for standing up and auxiliary stands. The research is not only to find the appropriate fundamentals from a healthcare perspective in the center of gravity movement (COM) curve of the elderly during STS but also to meet the psychological needs of the elderly during STS in a comfortable, pleasant, and safe way. To obtain the skeleton tracking technology used in this study, we used the Vicon optical motion capture system and automatic moving target indicator (AMTI) 3-D force measuring table to obtain a COM curve of the elderly during STS. The stationary process, speed, and sitting posture analysis during STS were combined in this paper to seek a solution to the psychological needs of the elderly. The analysis is conducted with the integration of medicine, engineering, art, and science into this research. Finally, a movement curve and related dynamic parameters that can truly reflect the STS of the elderly are obtained, and the discussion is provided. The research result can provide theoretical and technical support for the later development of auxiliary robots for standing up and auxiliary stands technology products, so that the elderly can STS comfortably, happily, and safely with the assistance of human–robot interaction.

In China, cultivation of the craftsmanship spirit is strongly advocated, but little attention is devoted to whether and how “working for the family” promotes heritage of this spirit. A configuration model of family motivation and organizational learning is proposed and expounded. Fuzzy set qualitative comparative analysis (fsQCA) was used to further explore the conditional configuration. The results show that the fitting family motivation to organizational learning is important for promoting heritage of the craftsmanship spirit. There are two paths that promote efficient heritage of this spirit: the institution-led path and the motivation-driven interpretation-led path. For the institution-led path, when apprentices have strong institution learning ability, the anterior-cause condition involves low family motivation, but this factor plays a weak role in promoting efficient heritage of the craftsmanship spirit. In a configuration consisting of intuition, interpretation, integration and institution, family motivation becomes irrelevant, which explains the phenomenon that organizational learning behavior reinforcement leads to a lack of family motivation. For the motivation-driven interpretation-led path, even without regular and institutionalized learning behaviors in the organization, the core conditions of high family motivation and high explanation learning, together with low intuition learning and low integration learning, will promote efficient heritage of the craftsmanship spirit.

Abstract Background Social support, defined as the exchange of support in social relationships, plays a vital role in maintaining healthy behavior and mitigating the effects of stressors. This study investigated whether functional aspect of social support is related to 5-year mortality in health checkup participants. Methods This study recruited 16,651 subjects (6797 males, 9854 females). Social support was evaluated using five-component questions: Do you have someone 1) whom you can consult when you are in trouble? 2) whom you can consult when your physical condition is not good? 3) who can help you with daily homework? 4) who can take you to hospital when you don’t feel well? and 5) who can take care of you when you are ill in bed? The association between the component of social support and all-cause and cardiovascular mortality was examined using Cox proportional hazard analysis. Results The percentage of subjects without social support components was 7.7–15.0%. They were more likely to be male, non-elderly, and living alone. During the follow-up period, there were 166 all-cause and 38 cardiovascular deaths. Cox proportional analysis adjusted for confounders showed that only the lack of support for transportation to hospital was significantly associated with all-cause (hazard ratio [HR] 2.01, 95% confidence interval [CI] 1.26–3.05) and cardiovascular mortality (HR 3.30, 95% CI 1.41–6.87). These associations were stronger in males than females. Conclusion This study showed that the lack of social support for transportation to the hospital was independently associated with all-cause and cardiovascular mortality in a community-based population.

Abnormally high expression of aryl hydrocarbon receptor (AhR) has been implicated in dedifferentiation of radioiodine-refractory papillary thyroid cancer (RR-PTC). This study aimed to evaluate the differentiation effect of AhR antagonist in PTC, and to explore the potential mechanism of it. Results showed that AhR antagonists promoted differentiation of PTC, as shown as increase in 125I uptake and Na/I symporter (NIS) expression level. CircRNA microarray in K1 cells treated with StemRegenin 1(SR1) revealed that hsa_circ_0006741 (circSH2B3) was down-regulated in SR1 treated K1 cells. Downregulation of circSH2B3 increased 125I uptake and NIS expression levels. CircSH2B3 acted as an endogenous sponge of hsa-miR-4640-5p and modulated IGF2BP2 expression. IGF2BP2 overexpression induced dedifferentiation of PTC, while silencing IGF2BP2 accelerated differentiation of PTC cells. Rescue studies showed that the dedifferentiation activity of AhR was modulated by the circSH2B3/miR-4640-5p/IGF2BP2 axis. Our findings confirmed for the first time that AhR antagonists promote differentiation of PTC via inhibiting the circSH2B3/miR-4640-5p/IGF2BP2 axis, offering a novel therapeutic approach and a potential marker for differentiation of PTC.

Radioiodine remnant ablation (RRA) was previously demonstrated to be a safe and effective alternative to completion thyroidectomy for patients with differentiated thyroid cancer (DTC). However, its side effects have not been fully investigated, particularly in patients with lobectomy. We reported a young euthyroidal female who underwent RRA post lobectomy and lymph node dissection for papillary thyroid cancer, whose post-ablation 131I-whole-body scan accidentally showed diffuse radioiodine distribution on chest-mimicking pulmonary metastases. Immediately-added single-photon emission computed tomography/computed tomography (SPECT/CT), nevertheless, revealed a 131I-accumulating swollen left thyroid lobe and emerging pleural effusion, which relieved after short-term treatment with prednisone. In summary, acute pleural effusion ascribed to RRA-induced thoracic duct compression was reported for the first time. 131I-lobectomy-induced pleural effusion could be precisely diagnosed by SPECT/CT and efficiently manipulated via treating radiation thyroiditis with the short-term administration of corticosteroid.

Background: To optimize [18F] 9-fluoropropyl-(+)-dihydrotetrabenazine (18F-FP-(+)-DTBZ) purification via solid-phase extraction (SPE) with combined cartridges to facilitate its widespread clinical application.Methods: A modified SPE purification method, employing Sep-Pak PS-2 and Sep-Pak C18 cartridges, was used for the preparation of 18F-FP-(+)-DTBZ. This method was compared to the purification method of high-pressure liquid chromatography (HPLC) and SPE with one cartridge, following quality control test and positron emission tomography (PET) imaging in healthy volunteers and patients with parkinsn's disease (PD).Results: A SPE purification method integrating Sep-Pak PS-2 and Sep-Pak C18 cartridges was implemented successfully. The retention time of 18F-FP-(+)-DTBZ purified by HPLC, SPE with Sep-Pak PS-2, SPE with Sep-Pak C18, and SPE with combined use of Sep-Pak PS-2 and Sep-Pak C18 cartridges was 8.7, 8.8, 8.7, and 8.9 min, respectively. Fewest impurity peak was detected in 18F-FP-(+)-DTBZ purified by the SPE with combined use of Sep-Pak PS-2 and Sep-Pak C18 cartridges. This modified SPE purification method provided a satisfactory radiochemical yield of 29 ± 1.8% with radiochemical purity >99% and shortened synthesis time to 27 min. The brain uptake of 18F-FP-(+)-DTBZ purified by the modified SPE was comparable to that purified by HPLC in both healthy volunteers and PD patients.Conclusions: A SPE method integrating Sep-Pak PS-2 and Sep-Pak C18 cartridges for purification of 18F-FP-(+)-DTBZ may be highly suited to automatic synthesis for routine clinical applications, as it provides excellent radiochemical purity, high yield as well as operational simplicity.