bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Systemic Inflammation Index and Systemic Inflammatory Response Index on Predicting Acute Appendicitis Complications in Children Under Five Years Old
Authors: Özçelik Zerrin , Cesur İlknur Banlı , Parlakgümüş Cemal
Published: July 2024

Objective
The aim of our study is to determine the value of SII (Systemic Inflammation Index) and SIRI (Systemic Inflammatory Response Index), biomarkers whose usage has increased in recent years, in predicting acute appendicitis complications in children under five years old. Specifically, due to the difficulty in diagnosing and managing acute appendicitis in children under five, we aimed to investigate the usability of these indices in determining the risk of complications of acute appendicitis and in developing clinical management strategies.
Materials and Methods
The study was conducted with 178 patients who met the inclusion and exclusion criteria. The laboratory values, surgical notes, and pathology results of the cases were recorded from patient files and the automation system, and statistical analyses were performed.
Results
The laboratory values of Platelet, Monocyte, SIRI, CRP, and Procalcitonin in the complicated appendicitis group were higher compared to those in the simple appendicitis group (p = 0.046; p = 0.035; p = 0.042; p = 0.001; p = 0.001, respectively). According to the results of the ROC Curve test, the SIRI score had an AUC of 59%, sensitivity of 67.37%, and specificity of 54.43%, while the CRP value had the best diagnostic test performance in predicting complicated appendicitis with an AUC value of 64.3%, sensitivity of 63.54%, and specificity of 61.25%.
Conclusion
In our study evaluating SII and SIRI, we found that especially SIRI, along with CRP and procalcitonin, was higher in the complicated group. However, the predictive power of CRP for complications was greater than these indices. We believe that randomized controlled and larger studies should be conducted to evaluate the use of these new-generation markers in acute appendicitis.
The Relationship between Endolymphatic Hydrops Features and Hearing Loss in Bilateral Meniere's Disease
Authors: Liu XU , Wang Dan , Hsieh Yue-Lin , Shi Suming , Wang Wuqing
Published: July 2024

Background
This study aimed to investigate the relationship between the features of endolymphatic hydrops and hearing loss in patients with Bilateral Meniere's Disease.
Methods
A retrospective analysis was conducted on 77 patients diagnosed with Bilateral Meniere's Disease. The features of endolymphatic hydrops in the affected ear were evaluated through gadolinium-enhanced inner ear Magnetic resonance imaging. The Spearman correlation coefficient, paired t-tests, and Wilcoxon signed-rank tests were employed for data analysis.
Results
The analysis revealed a significant correlation between the degree of endolymphatic hydrops and hearing loss across all frequencies(0.125-8 kHz), including the cochlear, vestibular, and overall degree of endolymphatic hydrops. The strongest correlation between the overall degree of endolymphatic hydrops and hearing loss was observed at low frequencies (r = 0.571, p < 0.05), followed by mid-frequencies (r = 0.508, p < 0.05), and high-frequencies (r = 0.351, p < 0.05), with a correlation of r = 0.463, p < 0.05 for the staging of Meniere's disease. Affected Ears with endolymphatic hydrops both in the cochlea and vestibule exhibited more severe hearing loss and Meniere's disease staging compared to those with isolated endolymphatic hydrops within the same patient.
Conclusions
The features of endolymphatic hydrops in patients with Bilateral Meniere's Disease were found to correlate with the severity of hearing loss and the staging of Meniere's disease.
Adversarial Generation Method for Smart Contract Fuzz Testing Seeds Guided by Chain-Based LLM
Authors: Sun Jiaze , Yin Zhiqiang , Zhang Hengshan , Chen Xiang , Zheng Wei
Published: July 2024

With the rapid development of smart contract technology and the continuous expansion of blockchain application scenarios, the security issues of smart contracts have garnered significant attention. However, traditional fuzz testing typically relies on randomly generated initial seed sets. This random generation method fails to understand the semantics of smart contracts, resulting in insufficient seed coverage. Additionally, traditional fuzz testing often ignores the syntax and semantic constraints within smart contracts, leading to the generation of seeds that may not conform to the syntactic rules of the contracts and may even include logic that violates contract semantics, thereby reducing the efficiency of fuzz testing. To address these challenges, we propose a method for adversarial generation for smart contract fuzz testing seeds guided by Chain-Based LLM, leveraging the deep semantic understanding capabilities of LLM to assist in seed set generation. Firstly, we propose a method that utilizes Chain-Based prompts to request LLM to generate fuzz testing seeds, breaking down the LLM tasks into multiple steps to gradually guide the LLM in generating high-coverage seed sets. Secondly, by establishing adversarial roles for the LLM, we guide the LLM to autonomously generate and optimize seed sets, producing high-coverage initial seed sets for the program under test. To evaluate the effectiveness of the proposed method, 160 smart contracts were crawled from Etherscan for experimental purposes. Results indicate that using Chain-Based prompts to request LLM to generate fuzz testing seed sets improved instruction coverage by 2.63\% compared to single-step requests. The method of generating seed sets by establishing adversarial roles for the LLM reduced the time to reach maximum instruction coverage from 60 seconds to approximately 30 seconds compared to single-role methods. Additionally, the seed sets generated by the proposed method can directly trigger simple types of vulnerabilities (e.g., timestamp dependency and block number dependency vulnerabilities), with instruction coverage improvements of 3.3\% and 3.8\%, respectively.
Electromagnetic Inductive Coupling Analysis (EMICA): A new tool for imaging internal defects in carbon fiber composites
Authors: Finch Kevin , Long David C. , Ott Taylor , Spatafore Bradley , Biller Joshua R.
Published: July 2024

Carbon fiber laminates enjoy a wide range of applications from innovative architectural design to aerospace and the safety overwrap for pressure vessels. In the case of carbon fiber overwrapped pressure vessels (COPVs), the overwrap thickness can vary from 6 mm (0.25 inch) for thin-walled COPV up to 25 mm (~ 1”) or more for thick walled COPV, depending on the vessel type. The failure mechanisms for carbon fiber are more complex than for metals and monitoring COPVs for defects or fatigue over their lifetime is further complicated by the thickness of the carbon fiber used. In this paper, we introduce a new technique, Electro-Magnetic-Inductive-Coupling-Analysis, or EMICA, which can detect damage inside thick carbon fiber laminate pieces. EMICA is based on the interaction of the repeating three-dimensional conducting structure of carbon fiber and low-frequency electromagnetic waves to highlight defects such as delamination and fiber disruptions, well below the laminate surface. In this paper, we demonstrate EMICA in flat carbon fiber laminates up to 12 mm (~ 0.5”) thick, made in-house, with known defects hidden through the thickness of the piece that cannot be detected via visual inspection.
Is fat quantification based on proton density fat fraction useful for differentiating renal tumor types?
Authors: Altay Canan , Akın Işıl Başara , Özgül Hakan Abdullah , Şen Volkan , Bozkurt Ozan , Tuna Emine Burçin , Yörükoğlu Kutsal , Seçil Mustafa
Published: July 2024

Purpose: This study retrospectively assessed the diagnostic accuracy of fat quantification based on PDFF for differentiating renal tumors.
Methods: In this retrospective study, 98 histologically confirmed clear cell renal cell carcinomas (RCCs), 35 papillary RCCs, 14 oncocytomas, 16 chromophobe RCCs, 10 lymphomas, 19 uroepithelial tumors, 10 lipid-poor angiomyolipomas (AMLs), and 25 lipid-rich AMLs were identified in 226 patients (127 males and 99 females) over 5 years. All patients underwent multiparametric kidney MRI. Demographic data were recorded, and PDFF values were independently reviewed by two radiologists blinded to pathologic results. MRI examinations were performed using a 1.5 T system. MRI-PDFF measurements were obtained from the solid parts of all renal tumors. Fat quantification was performed using a standard region of interest for each tumor, compared to histopathological diagnoses. Sensitivity and specificity analyses were performed to calculate the diagnostic accuracy for each histopathological tumor type. P-values < 0.05 were considered statistically significant.
Results: In all, 102 patients underwent partial nephrectomy, 70 patients underwent radical nephrectomy, and the remaining 54 had biopsies. Patient age (mean: 58.11 years; range: 18–87 years) and tumor size (mean: 29.5 mm; range: 14–147 mm) did not significantly differ across groups. All measurements exhibited good interobserver agreement. Clear cell RCCs presented a significantly higher fat ratio than other RCC types, uroepithelial tumors, lymphomas, and lipid-poor AMLs. Lipid-rich AMLs demonstrated a very high fat ratio.
Conclusion: MRI-PDFF facilitated accurate differentiation of clear cell RCCs from other renal tumors with high sensitivity and specificity.
The Rising Threat of Liver Cancer in Patients with Cirrhosis: Are Indeterminate Liver Nodules Cause for Concern? Real-world, long-term follow-up data
Authors: Yahia Yousef , Qasem Ma'mon , Abbarh Shahem , Saffo Husam , Obeidat Ibrahim M. , Barjas Haidar Hussein , Faisal Mohanad Mohammed , Halabiya Malik , Chandra Prem , Derbala Moutaz
Published: July 2024

Background:
Several studies have shown a higher risk of liver cancer from indeterminate liver nodules, but the exact occurrence and predictors of liver cancer in this group are still unclear. Our aim is to study the development of liver cancer in this population and identify any potential risk factors.
Methods:
This retrospective study evaluated cirrhotic patients with indeterminate liver nodules from 2013 to 2023.Data from electronic patient records was analyzed to assess the association between HCC and baseline factors.Subgroup exploratory analysis compared characteristics of patients with de novo HCC and those with nodule transformation HCC.
Results:
Out of 116 patients with liver nodules, 19 (16%) developed HCC in up to 7.5-year follow-up. Univariate Cox regression analysis showed a significant association between HCC incidence and smoking [hazard ratio (HR) 2.60, 95% Confidence Interval [CI] 1.01-6.74), nodule diameter exceeding 2cm (HR 5.41, 95% CI 1.45-20.18), and baseline LI-RADS score 3 (HR 3.78, 95% CI 1.36-19.52). Multivariate Cox regression analysis revealed significant independent associations with nodule diameters 1 cm to <2cm (adjusted HR 3.35, 95% CI 1.06-10.60) and greater than 2cm (adjusted HR 5.85, 95% CI 1.10-31.16), as well as with LI-RADS 3 lesions (adjusted HR 3.75, 95% CI 1.16-12.11) with adjusting other potential predictors and covariates.
Conclusion:
Our findings show a higher incidence of HCC in patients with indeterminate liver nodules, increasing over time and reaching 30% at seven years. Nodules larger than 1-2 cm or LI-RADS 3 lesions pose increased risk for HCC. Enhanced surveillance is necessary given the lack of clear management guidelines.
Cardiac Events Occurring after Allogeneic Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide. Study Conducted on Behalf of the GETH-TC
Authors: Salas Maria Queralt , Cascos Enric , López-García Alberto , Pérez Estefanía , Baile Mónica , Corral Lucía López , Pascual María , Luque Marta , Esqu Albert , Heras Inmaculada , Ormategi Itziar Oiartzabal , Marín Adolfo Sáez , Peña-Muñóz Felipe , Fernandez-Luis Sara , Domínguez-García Juan , Villar Sara , Girón Miguel Fernández de Sanmamed , González-Pinedo Leslie , Gonzalez-Rodriguez Ana Pilar , Torrado Tamara , Garcia-Mañó Lucia , Filaferro Silvia , Cedillo Ángel , Basalobre Pascual , Orti Guillermo , Jurado Manuel
Published: July 2024

This multicenter study investigates the incidence and predictors of cardiac events (CE) following allo-HCT with PTCY in 453 AML patients. CE occurred in 67 (14.3%) patients within a median of 81 days (IQR: 13-380), with day 100 and 5-year cumulative incidences of 8.2% and 15.3%. Early (first 100 days) and late CE occurred at rates of 8.2% and 6.2%. The most prevalent CE were heart failure (n=21, 32.8%), arrhythmia (n=17, 26.6%), and pericardial complications (n=16, 25%). The proportions of patients older than 50 years (73.4% vs. 59.4%, P=0.032), with hypertension (34.9% vs. 18.3%, P=0.001), dyslipidemia (26.6% vs. 11.1%, P=0.001), and undergoing haplo-HCT (70.3% vs. 55.8%, P=0.029) were higher in patients with CE. However, the multivariate regression analysis revealed that only hypertension (HR 2.02, P=0.015) and dyslipidemia (HR 2.20, P=0.015) were predictors for CE, with no differences according to donor type (haplo-HCT vs. others: HR 1.49, P=0.151). Among the 64 patients with CE, the mortality rate was 10.9%. Notably, the diagnosis of CE negatively impacted NRM (HR 2.40, P=0.013) and OS (HR 1.79, P=0.014), underscoring necessity of aggressively treating cardiovascular risk factors, and implementing post-transplant cardiac monitoring protocols to prevent these complications.
A Novel Method for Enhancing the Identification of Attacks in Wireless Sensor Networks via Improved Naive Bayes
Authors: Nithiyananda N. , Rajesh M. , Rodrigues Joel J. P. C.
Published: July 2024

Using feature weighting based on Jensen-Shannon divergence and inverse category frequency (ICF), this research introduces JINB, an improved Naive Bayes (NB) classifier, so that network intrusion detection can be more precise. The technique uses the JINB algorithm for network event classification after feature weights are determined according to their situational importance. By utilising the NSL-KDD dataset, we were able to validate the algorithm's performance, which showed considerable enhancements in detection accuracy, decreased false alarm rates, and efficient real-time processing. When compared experimentally to other algorithms, like OAA, SVM, IBT, HNB, and XLSTM, JINB proves to be the most effective in identifying different forms of attacks in WSNs without sacrificing energy economy. The findings show that JINB is an efficient, accurate, and cost-effective way to identify intrusions in networks in real-time.
Complex mechanical properties of 3D micro-metric pantographic metamaterials fabricated by two-photon polymerization
Authors: Barchiesi Emilio , Mavrikos Stefanos , Giorgio Ivan , Grigoropoulos Costas , Farsari Maria , dell’Isola Francesco , Zyla Gordon
Published: July 2024

Mechanical metamaterials consist of specially engineered features designed to tailor and enhance the mechanical properties of their constituent materials. In this context, 2D pantographic fabrics have gained attention for their unique deformation behavior, providing remarkable resilience and damage tolerance. This study explores micro-metric metamaterials with 3D pantographic motifs, aiming to transfer these properties to small scales. 3D micro-metric structures were designed using 2D pantographic fabrics arranged in multiple layers, each featuring unit cells with quasi-perfect pivots. Relatively large specimens of 3D micro-metric pantographs, measuring 158μm x 250 μm x 450 μm, were fabricated using two-photon polymerization in various configurations. These specimens were mechanically characterized through in-situ scanning electron microscopy microindentation under conditions of cyclic deformation. Structural failures were subsequently assessed via helium-ion microscopy. The 3D micro-metric pantographs exhibited complex mechanical properties, some aligning with those of 2D pantographic fabrics, while new properties, such as a dissipative response and softening, were identified. Nonetheless, the 3D micro-metric pantographs demonstrated great resilience against deformation and enhanced resistance to undesired out-of-plane motions, indicating their potential for novel applications in advanced engineering fields. Additionally, the findings can potentially lead to optimizing and enriching theoretical models describing the mechanical behavior of pantographic metamaterials.
Fake News in the Social Media of the Trans-Baikal Territory: The War Against the Axiology of Society
Authors: Myasnikova Tsyrigma Ts. ,   Transbaikal State University, Safronova Olga V. , Tolstokulakova Yulia V. ,   Transbaikal State University,   Transbaikal State University
Published: July 2024

The relevance of the research is caused by the necessity of studying the phenomenon of fakeness, which has become the main problem in the information-psychological warfare against our country. Mass distribution of deliberately false information inevitably transforms the spiritual and moral values of society. Thus, the purpose of the research is to study this phenomenon in social media in the context of the influence on the fundamental values of society based on the content analysis of specialized Internet resources that are dedicated to reveal fakes and distributed in the Transbaikal Territory.The authors of the research have studied the phenomenon of fakes in the practice of modern social media. Based on the content analysis of the telegram channel "War against fakes. Zabaikalye", communities "Lapsha media", "Chita", "Zabaikalye. Oh i Novosti", "Politjoystick", "Notes from the East", "Nochnoi K", "CHITAGRAM Chita / News / Road Accident", the specificity of fake information in the Trans-Baikal Territory is determined with a focus on the subject of false information disseminated at the federal level. In total, 1980 posting contents published by these media resources were studied for the period from February 27, 2022 to May 3, 2023. The authors of the article relied on a discursive analysis, which helped to reveal specific unreliable content of materials and relate them with the agenda. The authors also used the sociocultural approach which was focused on the values that contribute to national identity values and make it possible to reveal the degree of influence of fake news on the traditional values of modern Russian society. The descriptive-analytical method helped with the theoretical understanding and systematization of the information about unreliable content. Based on the research, the authors came to the conclusion that the dissemination of false information is aimed at discrediting the main institutions of statehood – state authority, the army, as well as the foundations of the social structure – unity, catholicity, spirituality. Under influence of fake cases, Russian society is going through depreciation of traditional values such as patriotism, catholicity, spirituality, love, non-covetousness.
First Russian Circumnavigation and Colonization of Russian America (1803–1806)
Authors:   Institute of History of St. Petersburg State University, Li Xuan Li Xuan
Published: July 2024

The article analyzes the organization, implementation and impact of the first Russian circumnavigation from 1803 to 1806 from the point of view of Russian America. The Great Northern Expedition discovered Bering Island, the Aleutian Islands and Alaska, laying the foundation for the Russian colonization of the North Pacific Ocean. Subsequently, hunters and fur traders went east through Siberia to the northern Pacific Ocean to hunt for fur animals, they developed the fur trade and founded colonial settlements. In 1803, the Russian government and the Russian-American Company jointly planned and undertook Russia’s first circumnavigation. Russia’s only overseas colony, Russian America, was one of the main travel destinations. Neva, headed by Yu. F. Lysianskyi, stayed in the colonies from July 1804 to September 1805. N. P. Rezanov, manager of the Russian-American Company and chief secretary of the Governing Senate, who visited Japan on Nadezhda, also visited Russian America from May 1805 to July 1806. The sailors stopped the war initiated by the Tlingits in Russian America, eliminated the shortcomings of the policy of the Russian-American Company regarding the natives, developed education in the colonies and established trade from Russian America to California. These activities not only consolidated colonial rule, strengthened Russia’s military power in the North Pacific, and promoted the trade of the Russian-American Company but also heralded the gradual strengthening of government control over the overseas colonies and had a lasting and profound effect on the colonization of Russian America.
Accumulation and Histochemical Localization of Cadmium in Hemp (Cannabis sativa L.) Leaf and Root Tissue
Authors: Nash Amanda O. M. , Joshee Nirmal , Sherman Samantha , Lessl Jason T. , Coolong Timothy
Published: July 2024

As anthropogenic activities have facilitated the spread of heavy metals into the environment, plants have been identified that may have the ability to tolerate exposure to high levels of these metals. Industrial hemp (Cannabis sativa L.) has been suggested as potentially having the ability to accumulate elevated concentrations of some contaminants from soils, including cadmium (Cd), a heavy metal that has been linked to serious health risks to humans. Therefore, there is an interest to document the ability of hemp to tolerate exposure to Cd to determine if there is a risk when products for medicinal consumption are made from the hemp plant. The objectives of this study were to perform histochemical localization of Cd at the cellular level and document potential changes in plant tissues in response to hemp exposure. Plants were grown in hydroponic solutions for 4 weeks and then exposed to either 0 or 10 mg·L−1 Cd for 17 days and harvested. There were no differences in dry weights (dw) of leaves, stems, and roots among treated and control 17 days after treatment (DAT). However, plants exposed to 10 mg·L−1 Cd had Cd concentrations of 1448.0 mg·kg−1 dw in roots and 23.2 mg·kg−1 dw in leaves at 17 DAT, whereas Cd was not detected in roots or leaves of control plants. On staining with dithizone, Cd was primarily localized in leaf epidermis, mesophyll, and trichomes, and in root rhizodermis, cortex, and pericycle in hemp plants exposed to 10 mg·L−1 Cd. Image analysis was able to further quantify these results based on area stained. Our results suggest that Cd is primarily accumulated throughout hemp roots, with lesser amounts translocated to the leaves, where it may be localized in the epidermis and trichomes.
Delighting customers: Evaluating service quality and customer satisfaction of self-checkout users in sports retail
Authors: Ingale Kavita , Paliwal Manisha , Jha Suchita , Masarrat Ghazal , Kodlekere Suchitra , Shedge Shreya
Published: July 2024

Digitalization has transformed dynamics across all fields, and technology has completely changed the customer experience. One prominently utilized technology in offline retail is self-checkout services. The present study intends to investigate the attributes that influence people to use self-checkout services and assess their impact on service quality and customer satisfaction. Drawn from Dabholkar’s attribute-based model, the study employs a positivist approach to test the conceptual framework. After the preliminary survey of 330 respondents, it identified ninety-nine consumers who had used the self-service check-out facility. The data collected were analyzed using a multi-variate technique – Partial Least Squares Structural Equation Modeling (PLS-SEM) – owing to the small sample size requirement. All independent variables taken for the study positively affect the service quality. Customer perception of control, ease of use, reliability, enjoyment, speed, adventure, and openness positively affect service quality. It was noted that ease of use, with a variance value of 2.451, and openness to experience, with a variance value of 2.437, show the importance of determining independent variables with service quality. The study findings reported that service quality is primarily influenced by ease of use, enjoyment, and openness to experience. It underlines that some retail customers will likely feel frustrated rather than enjoy the self-service technology, perceiving it as less reliable. The study suggests incorporating openness to experience and adventure shopping in retail outlets that can enhance consumer satisfaction and loyalty. Adopting an immersive and interactive shopping experience will ultimately improve the perception of service quality and customer happiness.
Immune Checkpoint Inhibitors in first versus second line of metastatic non-small cell lung cancer: Real-World Overall Survival
Authors: Yudin D. I. , Laktionov К. К. , Breder V. V. , Sarantseva K. A. , Reutova E. V.
Published: July 2024

Introduction. Although immuneand targeted therapy have become successful in recent years, platinum-based chemotherapy continues to have a place in the up-front treatment for metastatic non-small cell lung cancer (NSCLC).

Aim. Tо evaluate the overall survival (OS) of patients with metastatic NSCLC who were treated with immune checkpoint inhibitors either as first-line or second-line treatment in clinical practice in Russia.

Materials and methods. Using real-world database, we retrospectively selected 232 patients with metastatic NSCLC without driving mutations. Of these patients, 82 received chemoimmunotherapy as the initial treatment (group 1) and 150 patients were treated with platinum–based chemotherapy followed by immunotherapy as the second line (group 2). Multivariate subgroup analyses were performed. The median time from the start of treatment to data cut off was 38.4 months.

Results. The median OS was the same in the first and second group, 21.0 months (14.4–27.6; 95% CI) and 22.4 months (17.6–27.19; 95% CI); estimated 3-year OS was 40% and 36.6%, respectively. The hazard ratio (HR) for patients in the immunochemotherapy group was 1.02 (0.72–1.44; 95% CI) compared with patients who received second-line immunotherapy. In multivariate analysis, non-compliance with basic inclusion criteria in clinical trials (ECOG 2–3, serious intercurrent illness, active infection, chronic infection, corticosteroids need) (HR = 1.71 (1.21–2.4; 95% CI), the liver metastasis (HR = 1.76 (1.09–2.84; 95% CI) and gender (male vs. female HR = 1.68 (1.04–2.71; 95% DI) were significantly associated with the shorter OS.

Conclusions. The overall survival in patients who received immunotherapy in the second line of treatment did not differ from the results of treatment for the patients after immuno-chemotherapy in the first line. The crucial is the receiving of immunotherapy regardless of the line. Failure to meet the criteria of inclusion in clinical trials significantly worsens the long-term outcomes.
Own experience of using combination therapy in the first line of treatment of metastatic renal cell carcinoma
Authors: Ustinova T. V. , Chanaeva A. Yu. , Paichadze A. A. , Levshakova A. V. , Bolotina L. V. , Ivanykina V. M. , Fedenko A. A.
Published: July 2024

Renal cell carcinoma is one of the most common diseases in oncourology. The leading morphological variation of renal cell carcinoma today is the light-cell subtype, which is determined in 80% of cases. Despite the intensity of diagnostic methods, almost 1/3 of patients with kidney cancer have distant metastases during initial examination, which causes extremely high mortality rates from this oncopathology. Standard chemotherapy schemes with the inclusion of fluoropyrimidines and antitumor antibiotics, cytokine therapy using interleukin-2 and interferon α only slightly prolonged the life of patients, while causing pronounced toxic-anemic adverse events. The appearance of tyrosine kinase inhibitors has allowed us to obtain really significant results in the treatment of metastatic renal cell carcinoma. The next step in the treatment of renal cell carcinoma was the registration by the US FDA in April 2018 of a combination of immuno-oncological drugs ipilimumab and nivolumab for the treatment of metastatic renal cell carcinoma. Afterwards, combinations of immune checkpoint inhibitors with targeted drugs were registered, which not only significantly increased the life expectancy of patients, but also reduced the incidence of adverse events of antitumor therapy. This article provides clinical examples demonstrating the effectiveness of the combination of pembrolizumab and axitinib in the treatment of patients with metastatic renal cell carcinoma.
Approaches to the treatment of oligometastatic melanoma in the era of immunotargeted therapy
Authors: Ledin E. V. , Stolyarov V. I.
Published: July 2024

Oligometastatic disease is a term that describes the state of a tumor between a localized tumor and a disseminated process, when all detected tumor lesions are accessible to local action. The concept of oligometastatic disease in advanced cutaneous melanoma has existed since the 1970–1980s, and the role of metastasectomy of solitary lesion is approved in the treatment strategy for this disease. However, the role of local methods before the introduction of modern systemic therapy was quite modest due to the aggressive and often primary disseminated course of the disease. The introduction of immunotherapy and modern targeted therapy in the treatment of metastatic melanoma has significantly increased the number of patients meeting the criteria for oligometastatic disease with the possibility of metastasectomy. Currently, there is no clear algorithm or specific sequence for combining systemic treatment methods with surgical and other local methods. Conditional neoadjuvant immunotherapy is being actively discussed even for primary resectable melanoma metastases; this concept is based on the higher effectiveness of immunotherapy in the presence of tumor tissue in the body and already has practical confirmation from recent studies. In determining the tactics for oligometastatic melanoma, a multidisciplinary approach is extremely important, including a balanced assessment of possible local surgical options, the use of radiotherapy and mandatory systemic disease control. By successfully applying and combining these approaches, it is possible to achieve outstanding success in controlling the disease in a significant proportion of patients. This review provides an analysis of the main and most important works on systemic and surgical treatment of oligometastatic melanoma.
Long-term outcomes of durvalumab after chemoradiotherapy in locally advanced non-small cell lung cancer in Russia
Authors: Yudin D. I. , Laktionov К. К. , Moiseenko F. V. , Ponomarenko D. M. , Сhernykh M. V. , Chubenko V. A. , Levchenko N. V. , Kozlov V. V. , Stepanova E. О. , Khagazheeva M. N. , Yukalchuk D. Yu.
Published: July 2024

Introduction. The results of the PACIFIC trial have changed the standards of care for the patients with unresectable stage III nonsmall cell lung cancer (NSCLC). However, many patients in our clinical practice do not meet the inclusion criteria of PACIFIC trial.

Aim. To evaluate the long-term outcomes for this approach in real clinical practice in Russia.

Materials and мethods. This real-world observational retrospective multicenter study analyzed clinical outcomes in 100 patients with unresectable stage III NSCLC after concurrent or sequential chemoradiotherapy (CRT). The overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meyer method. Multivariate subgroups analysis was performed as well. The median follow-up time was 22.7 months.

Results. There were 96% patients with ECOG/WHO performance status 0 or 1 in our study. Most of the patients were treated by sequential CRT (76%). Median time of durvalumab start from the end of CRT was 34 days. Patients received durvalumab for a median 10 months. The estimated median progression-free survival (PFS) and overall survival (OS) were 14.3 months (11.8–16.7, 95% CI) and 29 months (18.7–39.2, 95% CI), respectively. The estimated 1-year and 2-year rates for OS and for PFS were 90.4%, 62.8% and 59.1%, 35%, respectively. In multivariate analysis, a smoking history (HR = 0.21 (0.10–0.45; 95% CI) and concurrent CRT (HR = 0.3 (0.12–0.74; 95%CI) were associated with better PFS. The smoking history was significantly associated with a better OS (HR = 0.29 (0.10–0.76; 95% CI)) as well.

Conclusions. There is a difference between the real-world outcomes for patients with unresectable stage III NSCLC in Russia and the PACIFIC trial. Sequential CRT is the most frequent treatment option for locally advanced unresectable NSCLC in Russia, and estimated OS and PFS are shorter than in the PACIFIC clinical trial. A paradigm shift in chemoradiotherapy to the concurrent and personalized approach could change the current situation.
Lung cancer associated with an activating mutation in the 14th exon of the MET gene
Authors: Kuzmina V. A. , Reutova E. V. , Laktionov K. K. , Ardzinba M. A.
Published: July 2024

In recent years, the active search and development of new therapeutic agents for a prognostically unfavourable group of patients with disseminated non-small cell lung cancer (NSCLC) has continued. Studies show that the occurrence of lung cancer can be associated with mutations of driver genes such as EGFR, ALK, ROS1, BRAF, KRAS, RET, MET, HER2, NTRK1/2/3, etc., in the normal processes of growth, proliferation, differentiation. The discovery of targeting drugs with high activity against certain mutations has led to a paradigm opening of therapeutic approaches and continued prognosis in serious disease. The presence of activating mutations predetermines the clinical and morphological profile of the patient. One of the random mutations – MET mutation with exon 14 skipping (METex14) is observed, as a rule, in patients of older age group, with disseminated tumour process, more aggressive course of the disease and poor prognosis with chemotherapy alone. This case provides an opportunity for long-term disease control while maintaining satisfactory quality of life in an elderly patient with NSCLC associated with METex14 mutations, as well as providing a major role and method for obtaining next-generation value for personalisation of therapy and new insights into the scientific targets and the future use of molecules to them.
The evolution of treatment for advanced cervical cancer: from cisplatin monotherapy to immuno-oncology combinations
Authors: Rumyantsev A. A. , Letuchikh A. N.
Published: July 2024

Cervical cancer is one of the most common malignant tumors in Russia. Despite the high cure rates with local treatment approaches (eg, surgery or radiothearapy) at early stages of the disease, metastatic cervical cancer portends an unfavorable prognosis. The incidence and mortality rates over the last 10 years remain at a consistently high level. The backbone of treatment for metastatic cervical cancer is platinum-based combinations – the cytototic combination of paclitaxel and cisplatin (or carboplatin) being a standard-of-care treatment for patients with metastatic disease. However, chemotherapy alone failed to achieve satisfactory long-term treatment outcomes – the expected life expectancy with chemotherapeutic drugs rarely exceeds 12 months. One of the most fruitful directions in the treatment of metastatic cervical cancer to date is immunotherapy – in particular, pembrolizumab, a PD-1 pathway inhibitor – one of the key checkpoints of the immune response control. This review article highlights historical and recent achievements in metastatic cervical cancer treatment. It highlights the development of anticancer medications for advanced or metastatic cervical cancer, including targeted antiangiogenic therapy, immunotherapy, and the latest research data on the effectiveness of combining these classes of drugs with standard cytotoxic chemotherapy to achieve the best treatment outcomes.
The role of G-CSF in the prevention of cytostaticassociated adverse events during antitumor drug therapy
Authors: Menshikov K. V. , Nasretdinov A. F. , Sultanbaeva N. I. , Lipatov O. N. , Musin Sh. I. , Menshikova I. A. , Volkov A. A. , Galimov Sh. N. , Sultanbaev A. V.
Published: July 2024

In the middle of the last century, the discovery of a number of cytotoxic agents was an incredible achievement in the treatment of malignant tumors. However, their use was limited by adverse events, primarily the development of myelosuppression. The occurrence of neutropenia is associated with frequent and extremely dangerous events that do not allow timely initiation of a new cycle of therapy and increases risk of infectious complications. Over the years, many attempts have been made to develop optimal management tactics for patients receiving cytotoxic therapy, including antibiotic therapy, the use of nonspecific myelopoiesis modulators, and even blood transfusions. With the advent of granulocyte precursor maturation stimulators in 1983, the situation has improved greatly. Filgrastim and its bioanalogues, registered later, made it possible to reconsider approaches to the use of intensified chemotherapy regimens. It has become possible to control the incidence of neutropenia using only subcutaneous forms of granulocyte colony-stimulating factors (GCSF). The article presents a clinical observation of the use of filgrastim in neoadjuvant therapy of early breast cancer. Filgrastim not only helped to cope with the development of newly diagnosed febrile neutropenia, but during continued treatment it prevented the development of adverse events. The administration of GCSF allowed timely completion of treatment with a complete pathological response, providing the patient with better survival prognosis.
Analisis Keruntuhan Bendungan Cipanas Kabupaten Sumedang Melalui Simulasi HEC-RAS dan InaSAFE
Authors: Tinambunan Calvin Orniel , Dian Sisinggih  , Runi Asmaranto
Published: July 2024

Bendungan Cipanas Terletak di Kabupaten Sumedan merupakan salah satu bendungan yang direncanakan akan selesai pada tahun 2022 Bendungan Cipanas memiliki tampungan efektif sebesar 81 juta m3. Tujuan dari penelitian ini adalah untuk mengetahui besarnya debit banjir rancangan maksimum di daerah tangkapan air Bendungan Cipanas, memperkirakan sebaran banjir akibat runtuhnya Bendungan Cipanas berdasarkan simulasi HEC-RAS dan tingkat bahayanya, menentukan klasifikasi dan memperkirakan kerusakan ekonomi yang disebabkan oleh runtuhnya Bendungan Cipanas berdasarkan InaSAFE. Pada studi ini dilakukan analisis debit banjir rancangan menggunakan metode HSS Nakayasu dan Snyder. Hasil dari analisis ini didapatkan debit PMF menggunakan HSS nakayasu sebesar 1346,844 m3/detik. Berdasarkan simulasi HEC-RAS dari ketiga skenario tersebut, diperoleh sebaran terluas genangan banjir akibat keruntuhan Bendungan Cipanas seluas 534.010 km2 yaitu pada kondisi piping atas. Berdasarkan luasan sebaran banjir dan ketinggian maksimum banjir yang disimulasikan pada aplikasi InaSAFE, keruntuhan Bendungan Cipanas tergolong sebagai bahaya tingkat tinggi. Perkiraan kerugian ekonomi akibat keruntuhan Bendungan Cipanas berdasarkan simulasi InaSAFE sebesar Rp. 797,090,878,500,00.
Studi Penilaian Indeks Kinerja Irigasi Dan Angka Kebutuhan Nyata Operasi Dan Pemeliharaan (Aknop) Pada Daerah Irigasi Kali Biru Kecamatan Ngajum Kabupaten Malang
Authors: Gozali Bayu Achmad , Runi Asmaranto  , Very Dermawan
Published: July 2024

Daerah Irigasi Kali Biru memiliki bangunan pengambilan yang terletak pada Kecamatan Ngajum Kabupaten Malang. Ada 2 titik pengambilan pada bangunan tersebut, yang menjadi saluran Primer Ubalan (110 ha) dan saluran Primer Baba’an (66 ha). Hasil inventarisasi yang dilakukan pada tahun 2022, terdapat 26 titik kerusakan pada saluran yang diakibatkan oleh 1 sedimen dan 25 kerusakan lining saluran. Untuk indeks kinerja irigasi dari Daerah Irigasi Kali Biru mendapatkan nilai sebesar 78,66% (Kondisi Sedang) dengan aspek prasarana fisik sebesar 39,00%, aspek produktivitas tanam 13,83%, aspek sarana penunjang O&P sebesar 7,15%, aspek organisasi dan personalia sebesar 10,93%, aspek dokumentasi sebesar 3,30%, dan aspek perkumpulan petani pemakai air sebesar 4,45%. Perhitungan prioritas Daerah Irigasi Kali Biru dengan menggunakan metode peringkat dimana mengurutkan dari besaran nilai aset terendah ke tertinggi. Sehingga didapatkan hasil dimana 9 aset dengan kondisi sedang, 21 aset dalam kondisi baik, dan 40 dalam kondisi baik sekali. Dengan penanganan rehabilitasinya didapatkan 9 aset membutuhkan pemeliharaan berkala bersifat perbaikan, 21 aset membutuhkan pemeliharaan berkala bersifat perawatan, dan 40 aset cukup dilakukan pemeliharaan rutin. Perhitungan AKNOP didapatkan sebesar  Rp. 322.235.852,00 dengan Rp. 63.312.860,00 untuk biaya operasi dan Rp. 258.922.992,00 untuk biaya pemeliharaan.
Implementation of Kalman Filter With Pi-Controller for Temperature Sensor in Fish Pond Monitoring System
Authors: Wardah Alfalah  , Varlenda Sarma Quraini  , Nabilah Qurrotuayun
Published: July 2024

The research aims to determine monitoring the temperature in fish ponds is crucial for successful cultivation, especially in tropical climates that often experience hot weather. This study proposes an approach using the Kalman Filter method and PI (Proportional-Integral-Derivative). Aside from that, to controller to improve the accuracy of monitoring the temperature in fish ponds. Integration with the Firebase Realtime Database allows for real-time data monitoring. Testing was conducted by comparing the DS18B20 temperature sensor without a filter with three variations of the Kalman Filter and PI controller. The results show that using Kalman Filter 3 with the PI controller resulted in a significant reduction in error and noise compared to using Kalman Filter alone. In conclusion, the integration of the Kalman Filter and PI controller with the Firebase Realtime Database can improve the accuracy of monitoring the temperature in fish ponds and has positive implications for increasing efficiency and fish welfare.
Adaptive Bounding Box Coordinate Adjustment on License Plate Character Detection Using Machine Learning
Authors: Ahmad Taufiq Musaddid
Published: July 2024

Effective law enforcement, including the use of the ANPR (Automatic Number Plate Recognition) system, is essential for reducing the number of road traffic accidents. ANPR involves plate localization, character segmentation, and recognition to build a minimum system. This study aims to improve a character segmentation method using a detection approach to address issues like noisy or modified plates. We propose an adaptive improvement on an established sliding window technique, by integrating a CNN (Convolutional Neural Network) for bounding box coordinate adjustment to handle various plate conditions. The proposed method was tested on 280 license plate images and improved the average IoU (Intersection over Union) from 0.4811 to 0.8980. Hence, the recall and precision of the model could be improved to increase any character recognition performance.
Design and Implementation of a Student Counting and Monitoring System in a Laboratory Using Human Tracking Method with OpenCV and TensorFlow
Authors: Nancy Febriani Taek  , Arya Sony
Published: July 2024

Laboratories serve as crucial facilities supporting practical activities, with a recommended maximum of 20 students, necessitating periodic monitoring to count the dynamic number of students within. The system utilizes the COCO dataset labeled ”person,” involving an approach with entry and exit preference lines, ID identification implementation, and object detection models YOLO v3 Tiny and Faster R-CNN ResNet50. The main system components, Raspberry Pi 3 Model B+, Raspberry Pi Camera 5 MP (f/1.3), and Raspberry Pi 7-inch Touch Display, are integrated for processing, real-time video recording, and image display functions. Test and evaluation results reveal that YOLO v3 Tiny achieves an 88.24% accuracy for entry counting and 75% for entry-exit counting, with an average processing rate of 4.89 FPS, while Faster R-CNN ResNet50 demonstrates lower accuracy, reaching 70.59% and 45.83%, with an average processing rate of 0.58 FPS.
A Participatory Model for Cocreating Accessible Rehabilitation Technology for Stroke Survivors: User-Centered Design Approach
Authors: Kerr Andrew , Grealy Madeleine , Slachetka Milena , Wodu Chioma Obinuchi , Sweeney Gillian , Boyd Fiona , Colville David , Rowe Philip
Published: July 2024

Background

Globally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users’ needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process.

Objective

This study aims to present the participatory cocreation model that has been developed from our center and illustrate the approach with 2 cases studies.

Methods

The model is built around user participation in an intensive rehabilitation program (2-hour sessions, 2‐5 times per week, and 8-week duration), supervised by qualified therapists but delivered exclusively through commercial and prototype technology. This provides participants (chronic stroke survivors with movement and/or speech disability) with a rich experience of rehabilitation technology, enabling them to provide truly informed feedback, as well as creating an observatory for the research team. This process is supported by short-term focus groups for specific product development and a longer-term advisory group to consider broader issues of adoption and translation into everyday health care.

Results

Our model has been active for 3 years with 92 (92%) out of 100 participants completing the program. Five new technologies have evolved from the process with further ideas logged for future development. In addition, it has led to a set of cocreated protocols for technology-enriched rehabilitation, including recruitment, outcome measures, and intervention structure, which has allowed us to replicate this approach in an acute hospital ward.

Conclusions

Suboptimal rehabilitation limits recovery from health conditions. Technology offers the potential support to increase access to recommended levels of rehabilitation but needs to be designed to suit end users and not just their impairment. Our cocreation model, built around participation in an intensive, technology-based program, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.
Contrasting the performance of mainstream Large Language Models in Radiology Board Examinations (Preprint)
Authors: Wei Boxiong
Published: July 2024

BACKGROUND

Artificial Intelligence advancements have enabled Large Language Models to significantly impact radiology education and diagnostic accuracy.

OBJECTIVE

This study evaluates the performance of mainstream Large Language Models, including GPT-4, Claude, Bard, Tongyi Qianwen, and Gemini Pro, in radiology board exams.

METHODS

A comparative analysis of 150 multiple-choice questions from radiology board exams without images was conducted. Models were assessed on accuracy in text-based questions categorized by cognitive levels and medical specialties using chi-square tests and ANOVA.

RESULTS

GPT-4 achieved the highest accuracy (83.3%), significantly outperforming others. Tongyi Qianwen also performed well (70.7%). Performance varied across question types and specialties, with GPT-4 excelling in both lower-order and higher-order questions, while Claude and Bard struggled with complex diagnostic questions.

CONCLUSIONS

GPT-4 and Tongyi Qianwen show promise in medical education and training. The study emphasizes the need for domain-specific training datasets to enhance large models' effectiveness in specialized fields like radiology.