bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Novel Production Model for Labour Productivity: Modular Construction Toolkit Design
Authors: Geiger Mark , Hock Daniel , Nübel Konrad
Published: November 2023

The building industry faces a number of prominent challenges in the coming period. In this article, we focus on productivity in construction, which lags behind other industries despite technological developments. There is an urgent need for more efficient production methods. In other words, the potential for increasing productivity in construction is enormous. As in other industries, the key to this lies in process orientation, process standardization, and digitization. Lean construction approaches offer innovative solutions here by aiming to maximize customer value while minimizing waste, applying the principles of lean production to construction processes. However, building products are distinct in nature. Efforts to standardize them have achieved partial success, but only within specific product categories and for certain customer needs. Most construction activities remain highly unique. An alternative solution lies in standardizing work processes and not the final product. By adopting this method, one can considerably decrease individuality in production without compromising the essential uniqueness of the building product. Consequently, it is crucial to gain a deeper understanding of the standardization of production processes and the dynamics within the construction sector. This article introduces a modular construction toolkit designed to standardize production processes at construction sites. This toolkit consists of a series of consistent process steps, each linked to a standard time metric. Using this classification, a production model is constructed from a select number of recurring processes, leading to an ontological representation of production. This modular approach allows diverse production processes to be compared based on productivity, as they are composed of consistent and comparable sub-processes. Such a comparison is crucial for continuous production optimization. This method also enables the pinpointing of the most wasteful processes across various construction sites. While the primary data generation use case is centred on special civil engineering (special foundation engineering), the core concepts can be applied to general building construction.
Synthesis of Aragonite Whiskers by Co-Carbonation of Waste Magnesia Slag and Magnesium Sulfate: Enhancing Microstructure and Mechanical Properties of Portland Cement Paste
Authors: Ye Junhao , Liu Songhui , Fang Jingrui , Zhang Haibo , Zhu Jianping , Guan Xuemao
Published: November 2023

This study focused on the synthesis of aragonite whiskers through a synergistic wet carbonation technology utilizing waste magnesia slag (MS) and magnesium sulfate (MgSO4), aiming to improve the microstructure and mechanical properties of ordinary Portland cement (OPC) paste. The influence of MgSO4 concentration on the wet carbonation process, phase composition, and microstructure of MS was investigated. Furthermore, the effect of incorporating carbonated MS (C-MS) on the mechanical properties and microstructure of Portland cement paste was evaluated. Results showed that appropriate MgSO4 concentrations favored aragonite whisker formation. A concentration of 0.075 M MgSO4 yielded 86.6% aragonite with high aspect ratio nanofibers. Incorporating 5% of this C-MS into OPC increased the seven-day compressive strength by 37.5% compared to the control OPC paste. The improvement was attributed to accelerated hydration and reduced porosity by the filling effect and microfiber reinforcement of aragonite whiskers. MS demonstrated good CO2 sequestration capacity during carbonation. This study provides an effective method to synthesize aragonite whiskers from waste MS and use it to enhance cementitious materials while reducing CO2 emissions, which is valuable for the development of a sustainable cement industry.
Temperature Response of Double-Layer Steel Truss Bridge Girders
Authors: Wang Shichao , Zhang Gang , Li Jie , Wang Yubo , Chen Bohao
Published: November 2023

Double-layer steel truss continuous girders are prone to significant temperature stress, deviation, torsion, and warping, thus causing adverse temperature structural responses, and also affecting the safety and durability of bridge structures. This paper presents an investigation on time-dependent characteristics in the temperature field and temperature response of double-layer steel truss continuous bridge girders, fully considering the shielding effect subjected to different solar radiation angles during the high-temperature season. The time-dependent thermal boundary conditions and support conditions provided for the steel truss bridge structure were determined. Subsequently, a thermal analysis model for the entire structure of double-layer steel truss continuous girders was established to attain the temperature distribution law. The research results show that significant differences occur in the position and temperature difference of temperature gradients exhibited in the vertical, horizontal, and longitudinal directions in the double-layer steel truss bridge structure. The temperature distribution pattern within the chord section is mainly influenced by the environmental temperature and solar radiation intensity, along with the heat exchange between different panels. Thereafter, a validated temperature gradient formula for the component section has been proposed. The time-dependent laws in structural displacement, stress, and rotation angle under daily temperature cycling conditions have been revealed, thereby providing a theoretical basis for the life cycle construction and safety maintenance of double-layer steel truss structure bridges.
Circular Maker Cities: Maker Space Typologies and Circular Urban Design
Authors: Elwakil Reham , Schroder Ingrid , Steemers Koen
Published: November 2023

Maker spaces can contribute significantly to the circular economy of cities; they demonstrate not only the economic potential of inner loop circularity, but also provide tangible evidence of spatial and social integration of production into the urban context. This paper presents findings from a typological analysis of 326 maker spaces in seven European cities, with a focus on selected exemplar case studies to reveal design characteristics, principles, and opportunities for circular city development. The research shows that circular economy principles of ‘reduce-reuse-recyle’ are aligned with maker spaces such as repair cafés, secondhand shops, and fab labs, but requires additional definition with respect to material flow and spaces for recycling to underpin circular making. In the context of cities, circularity is revealed by a spatial tightening of resource cycles that close the loops of product life cycles. Furthermore, urban maker spaces demonstrate social engagement and a relationship to local production that inherently includes maintenance, repair, reuse, and redistribution. This paper defines five maker typologies, presents exemplars of each from different urban contexts and posits hybrid design strategies for the transition to circular maker cities. Through the adoption of these findings into urban planning policy, it is possible accelerate circular urban production and close the sustainability gap between small-scale local and large-scale regional manufacturing.
On the Factors That Determine the Bond Behaviour of GFRP Bars to Concrete: An Experimental Investigation
Authors: Devaraj Rajeev , Olofinjana Ayodele , Gerber Christophe
Published: November 2023

It is becoming accepted that glass-fibre-reinforced polymer (GFRP) is a credible and effective replacement for steel in reinforced concrete (RC) to meet structural requirements whilst addressing durability concerns posed by steel over the long term. A better understanding of the bond behaviour between GFRP and concrete is essential for reliably and efficiently designing concrete structures with reinforced GFRP bars. This paper presents a parametric study of the bond behaviour of GFRP bars to concrete where the effects of the length, diameter, concrete strength, concrete cover thickness and rebar surface morphology of GFRP bars were investigated via a series of pull-out tests. The test results indicate that the bond strength of GFRP bars is predominantly influenced by their surface morphology, embedment length and diameter. On the other hand, the effects of concrete strength and cover thickness appear to have a limited impact on the bond strengths of GFRP rebars to concrete. It is shown that ribbed GFRP bars exhibit the highest bond energy of 89.4 Nmm and an average bond strength of 11.9 MPa. Moreover, the analysis of failure modes indicated the unique effect of GFRP surface morphology on failure mode. It is shown that 100% of ribbed GFRP failed due to concrete split, while 85% of sand-coated bars experienced failure due to bar slip. This examination of failure modes and their corresponding bond strengths provides a unique perspective on the bond behaviour between GFRP bars and concrete.
Cytogenetics Is a Science, Not a Technique! Why Optical Genome Mapping Is So Important to Clinical Genetic Laboratories
Authors: Smith Adam C. , Hoischen Alexander , Raca Gordana
Published: November 2023

Karyotyping is a technique that has been used in clinical cytogenetic laboratories for more than 40 years [...]
Combined Serum ALBUMIN with Neutrophil-to-Lymphocyte Ratio Predicts the Prognosis of Biliary Tract Cancer after Curative Resection
Authors: Chiu Tai-Jan , Liu Yueh-Wei , Yong Chee-Chien , Yin Shih-Min , Yeh Cheng-His , Chen Yen-Yang
Published: November 2023

Background: The mainstay treatment of biliary tract cancer is complete tumor resection. Prior to surgery, risk stratification may help to predict and plan treatment approaches. In this study, we investigated the possibility of combining serum albumin concentrations and neutrophil-to-lymphocyte ratios (NLR) to create a score as ANS to predict the prognoses of biliary tract cancer before surgery. Methods: This study retrospectively collected serum albumin concentration, neutrophil, and lymphocyte data measured in biliary tract cancer patients slated to receive complete tumor resections within two weeks before surgery. From January 2013 to December 2019, 268 biliary tract cancer patients who had received tumor resections at our hospital were categorized into 3 ANS groups: ANS = 0 (high albumin and low NLR), ANS = 1 (low albumin or high NLR), and ANS = 2 (low albumin and high NLR). Results: Five-year survival rates were 70.1%, 47.6%, and 30.8% in the ANS = 0, 1, and 2 groups, respectively. The median overall survival time for the ANS = 0 group could not be determined by the end of the study, while those for ANS = 1 and ANS = 2 groups were 54.90 months and 16.62 months, respectively. The results of our multivariate analysis revealed that ANS could be used as an independent predictor of overall and recurrent-free survival. A high ANS was also correlated with other poor prognostic factors. Conclusions: The ANS devised for this study can be used to predict postoperative survival in patients with BTC and to guide treatment strategies.
Higher Content but No Specific Activity in Gelatinase B (MMP-9) Compared with Gelatinase A (MMP-2) in Human Renal Carcinoma
Authors: Młynarczyk Grzegorz , Gudowska-Sawczuk Monika , Mroczko Barbara , Bruczko-Goralewska Marta , Romanowicz Lech , Tokarzewicz Anna
Published: November 2023

Gelatinases belong to a group of enzymes known as matrix metalloproteinases (MMPs). Gelatinases A and B (MMP-2 and MMP-9, respectively) are the enzymes with the highest ability to destroy collagen, primarily type IV collagen, which is an essential component of the base membrane. Hence, it can be assumed that they are involved, among other things, with the metastasis process of cancer. As a result, the objective of this study was to assess the presence, activity, and expression of selected gelatinases in human renal cancer. Healthy (n = 20) and clear-cell kidney cancer tissue samples (G2 n = 10, G3 n = 10) were analyzed. The presence and content of MMPs were measured using the Western blot and ELISA methods, respectively. The activity (actual and specific) was analyzed with a fluorimetric method. The presence of both investigated enzymes was demonstrated in the representative zymogram. MMP-9 showed the most intensive saturation. It has been observed that both gelatinases occur primarily in high molecular complexes in the human kidney, regardless of whether it is a control or tumor tissue. Both gelatinases were present in comparable amounts in healthy tissues of the kidney. MMP-9 showed a higher content than MMP-2 in both renal cancer grades, but we observed the enhanced activity of both gelatinases with an increase in the grade of renal cancer. A higher MMP-9 content and, on the other hand, lower specific activity in the cancer tissue suggest that MMP-9 is predominantly present in an inactive form in renal cancer. The higher activity of MMP-9 demonstrated using the zymography method may be a cause of different values of activity that depend on the phase of the carcinogenic process. The present study revealed changes in the tested gelatinases in healthy and cancerous tissues of renal cell carcinoma. Therefore, it can be concluded that matrix metalloproteinases 2 and 9 are enzymes directly involved in carcinogenesis, and hence, it seems that MMPs may have potential in the diagnosis and treatment of renal carcinoma.
Anticarcinogenic Potency of EF24: An Overview of Its Pharmacokinetics, Efficacy, Mechanism of Action, and Nanoformulation for Drug Delivery
Authors: Sazdova Iliyana , Keremidarska-Markova Milena , Dimitrova Daniela , Mitrokhin Vadim , Kamkin Andre , Hadzi-Petrushev Nikola , Bogdanov Jane , Schubert Rudolf , Gagov Hristo , Avtanski Dimiter , Mladenov Mitko
Published: November 2023

EF24, a synthetic monocarbonyl analog of curcumin, shows significant potential as an anticancer agent with both chemopreventive and chemotherapeutic properties. It exhibits rapid absorption, extensive tissue distribution, and efficient metabolism, ensuring optimal bioavailability and sustained exposure of the target tissues. The ability of EF24 to penetrate biological barriers and accumulate at tumor sites makes it advantageous for effective cancer treatment. Studies have demonstrated EF24’s remarkable efficacy against various cancers, including breast, lung, prostate, colon, and pancreatic cancer. The unique mechanism of action of EF24 involves modulation of the nuclear factor-kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathways, disrupting cancer-promoting inflammation and oxidative stress. EF24 inhibits tumor growth by inducing cell cycle arrest and apoptosis, mainly through inhibiting the NF-κB pathway and by regulating key genes by modulating microRNA (miRNA) expression or the proteasomal pathway. In summary, EF24 is a promising anticancer compound with a unique mechanism of action that makes it effective against various cancers. Its ability to enhance the effects of conventional therapies, coupled with improvements in drug delivery systems, could make it a valuable asset in cancer treatment. However, addressing its solubility and stability challenges will be crucial for its successful clinical application.
Development and Validation of a Clinical Prediction Model for Venous Thromboembolism Following Neurosurgery: A 6-Year, Multicenter, Retrospective and Prospective Diagnostic Cohort Study
Authors: Liu Deshan , Song Dixiang , Ning Weihai , Guo Yuduo , Lei Ting , Qu Yanming , Zhang Mingshan , Gu Chunyu , Wang Haoran , Ji Junpeng , Wang Yongfei , Zhao Yao , Qiao Nidan , Zhang Hongwei
Published: November 2023

Background: Based on the literature and data on its clinical trials, the incidence of venous thromboembolism (VTE) in patients undergoing neurosurgery has been 3.0%~26%. We used advanced machine learning techniques and statistical methods to provide a clinical prediction model for VTE after neurosurgery. Methods: All patients (n = 5867) who underwent neurosurgery from the development and retrospective internal validation cohorts were obtained from May 2017 to April 2022 at the Department of Neurosurgery at the Sanbo Brain Hospital. The clinical and biomarker variables were divided into pre-, intra-, and postoperative. A univariate logistic regression (LR) was applied to explore the 67 candidate predictors with VTE. We used a multivariable logistic regression (MLR) to select all significant MLR variables of MLR to build the clinical risk prediction model. We used a random forest to calculate the importance of significant variables of MLR. In addition, we conducted prospective internal (n = 490) and external validation (n = 2301) for the model. Results: Eight variables were selected for inclusion in the final clinical prediction model: D-dimer before surgery, activated partial thromboplastin time before neurosurgery, age, craniopharyngioma, duration of operation, disturbance of consciousness on the second day after surgery and high dose of mannitol, and highest D-dimer within 72 h after surgery. The area under the curve (AUC) values for the development, retrospective internal validation, and prospective internal validation cohorts were 0.78, 0.77, and 0.79, respectively. The external validation set had the highest AUC value of 0.85. Conclusions: This validated clinical prediction model, including eight clinical factors and biomarkers, predicted the risk of VTE following neurosurgery. Looking forward to further research exploring the standardization of clinical decision-making for primary VTE prevention based on this model.
Salvage Radical Prostatectomy for Recurrent Prostate Cancer: A Systematic Review (French ccAFU)
Authors: Saouli Amine , Ruffion Alain , Dariane Charles , Barret Eric , Fiard Gaëlle , Hankard Gaelle Fromont , Créhange Gilles , Roubaud Guilhem , Beauval Jean Baptiste , Brureau Laurent , Renard-Penna Raphaëlle , Gauthé Mathieu , Baboudjian Michael , Ploussard Guillaume , Rouprêt Morgan
Published: November 2023

The aim of this study was to systematically review the current evidence regarding the oncological and functional outcomes of salvage radical prostatectomy (sRP) for recurrent prostate cancer. A systematic review was conducted throughout September 2022 using the PubMed, Science Direct, Scopus, and Embase databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. A total of 55 studies (3836 patients) met our eligibility criteria. The vast majority of men included had radiation therapy (including brachytherapy) as their first-line treatment (n = 3240, 84%). Other first-line treatments included HIFU (n = 338, 9%), electroporation (n = 59, 2%), proton beam therapy (n = 54, 1.5%), cryotherapy (n = 34, 1%), focal vascular targeted photodynamic therapy (n = 22, 0.6%), and transurethral ultrasound ablation (n = 19, 0.5%). Median preoperative PSA, at the time of recurrence, ranged from 1.5 to 14.4 ng/mL. The surgical approach was open in 2300 (60%) cases, robotic in 1465 (38%) cases, and laparoscopic in 71 (2%) cases. Since 2019, there has been a clear increase in robotic versus conventional surgery (1245 versus 525 cases, respectively). The median operative time and blood loss ranged from 80 to 297 min and 75 to 914 mL, respectively. Concomitant lymph node dissection was performed in 2587 cases (79%). The overall complication rate was 34%, with a majority of Clavien grade I or II complications. Clavien ≥ 3 complications ranged from 0 to 64%. Positive surgical margins were noted in 792 cases (32%). The median follow-up ranged from 4.6 to 94 months. Biochemical recurrence after sRP ranged from 8% to 51.5% at 12 months, from 0% to 66% at 22 months, and from 48% to 59% at 60 months. The specific and overall survival rates ranged from 13.4 to 98% and 62 to 100% at 5 years, respectively. Urinary continence was maintained in 52.1% of cases. sRP demonstrated acceptable oncological outcomes. These results, after sRP, are influenced by several factors, and above all by pre-treatment assessment, including imaging, with the development of mpMRI and metabolic imaging. Our results demonstrated that SRP can be considered a suitable treatment option for selected patients, but the level of evidence remains low.
Cardiotoxicity Associated with Immune Checkpoint Inhibitors
Authors: Minegishi Shintaro , Horita Nobuyuki , Ishigami Tomoaki , Hibi Kiyoshi
Published: November 2023

Immune checkpoint inhibitors (ICIs) have shown significant efficacy in various cancers, including non-small cell lung cancer, small cell lung cancer, melanoma, classical Hodgkin lymphoma, head and neck squamous cell carcinoma, urothelial cancer, and renal cell carcinoma [...]
The Promise of Piperine in Cancer Chemoprevention
Authors: Benayad Salma , Wahnou Hicham , El Kebbaj Riad , Liagre Bertrand , Sol Vincent , Oudghiri Mounia , Saad El Madani , Duval Raphaël Emmanuel , Limami Youness
Published: November 2023

Cancer, characterized by the unregulated growth and dissemination of malignantly transformed cells, presents a significant global health challenge. The multistage process of cancer development involves intricate biochemical and genetic alterations within target cells. Cancer chemoprevention has emerged as a vital strategy to address this complex issue to mitigate cancer’s impact on healthcare systems. This approach leverages pharmacologically active agents to block, suppress, prevent, or reverse invasive cancer development. Among these agents, piperine, an active alkaloid with a wide range of therapeutic properties, including antioxidant, anti-inflammatory, and immunomodulatory effects, has garnered attention for its potential in cancer prevention and treatment. This comprehensive review explores piperine’s multifaceted role in inhibiting the molecular events and signaling pathways associated with various stages of cancer development, shedding light on its promising prospects as a versatile tool in cancer chemoprevention. Furthermore, the review will also delve into how piperine enhances the effectiveness of conventional treatments such as UV-phototherapy and TRAIL-based therapy, potentially synergizing with existing therapeutic modalities to provide more robust cancer management strategies. Finally, a crucial perspective of the long-term safety and potential side effects of piperine-based therapies and the need for clinical trials is also discussed.
Metal-Based Aerogels and Porous Composites as Efficient Catalysts: Synthesis and Catalytic Performance
Authors: Du Ran , Eychmüller Alexander
Published: November 2023

Faced with the threat of energy shortage and environment pollution in modern society, the development of efficient and cost-effective catalytic systems is becoming increasingly important [...]
Catalysis for CO2 Hydrogenation—What We Have Learned/Should Learn from the Hydrogenation of Syngas to Methanol
Authors: Yang Zixu , Guo Derun , Dong Shengbin , Wu Jiayi , Zhu Minghui , Han Yi-Fan , Liu Zhong-Wen
Published: November 2023

This short review provides an in-depth analysis of the achievements and further developments of the catalytic hydrogenation of carbon dioxide (CO2) to methanol from those that are worth learning about based on the transformation of syngas into methanol. We begin by exploring the environmental and energy-related implications of utilizing CO2 as a feedstock for methanol production by emphasizing its potential to mitigate greenhouse gas emissions and facilitate renewable energy integration. Then, different catalytic formulations focusing on precious metals, copper-based catalysts, and metal oxides are summarized, and insights into their advantages and limitations in the aspects of catalytic activity, selectivity, and stability are discussed. Precious metal catalysts, such as platinum and iridium, exhibit high activity but are cost-prohibitive, while copper-based catalysts present a promising and cost-effective alternative. Metal oxides are considered for their unique properties in CO2 activation. Mechanistic insights into reaction pathways are explored, with a particular emphasis on copper-based catalysts. Moreover, the complex steps involved in CO2 hydrogenation to methanol are discussed to shed light on the key intermediates and active sites responsible for catalysis, which is crucial for catalyst design and optimization. Finally, we stress the importance of ongoing research and development efforts to enhance catalyst efficiency, mechanistic comprehension, and process optimization. This review serves as a valuable resource for researchers, engineers, and policymakers working toward a more sustainable and carbon-neutral energy future. By harnessing CO2 as a carbon feedstock for methanol synthesis, we have the potential to address environmental concerns and advance the utilization of renewable energy sources, further contributing to the transition to a cleaner and more sustainable energy landscape.
Molecular Mechanisms Associated with Antifungal Resistance in Pathogenic Candida Species
Authors: Czajka Karolina M. , Venkataraman Krishnan , Brabant-Kirwan Danielle , Santi Stacey A. , Verschoor Chris , Appanna Vasu D. , Singh Ravi , Saunders Deborah P. , Tharmalingam Sujeenthar
Published: November 2023

Candidiasis is a highly pervasive infection posing major health risks, especially for immunocompromised populations. Pathogenic Candida species have evolved intrinsic and acquired resistance to a variety of antifungal medications. The primary goal of this literature review is to summarize the molecular mechanisms associated with antifungal resistance in Candida species. Resistance can be conferred via gain-of-function mutations in target pathway genes or their transcriptional regulators. Therefore, an overview of the known gene mutations is presented for the following antifungals: azoles (fluconazole, voriconazole, posaconazole and itraconazole), echinocandins (caspofungin, anidulafungin and micafungin), polyenes (amphotericin B and nystatin) and 5-fluorocytosine (5-FC). The following mutation hot spots were identified: (1) ergosterol biosynthesis pathway mutations (ERG11 and UPC2), resulting in azole resistance; (2) overexpression of the efflux pumps, promoting azole resistance (transcription factor genes: tac1 and mrr1; transporter genes: CDR1, CDR2, MDR1, PDR16 and SNQ2); (3) cell wall biosynthesis mutations (FKS1, FKS2 and PDR1), conferring resistance to echinocandins; (4) mutations of nucleic acid synthesis/repair genes (FCY1, FCY2 and FUR1), resulting in 5-FC resistance; and (5) biofilm production, promoting general antifungal resistance. This review also provides a summary of standardized inhibitory breakpoints obtained from international guidelines for prominent Candida species. Notably, N. glabrata, P. kudriavzevii and C. auris demonstrate fluconazole resistance.
Mechanisms of Activation of Brain’s Drainage during Sleep: The Nightlife of Astrocytes
Authors: Postnov Dmitry , Semyachkina-Glushkovskaya Oxana , Litvinenko Elena , Kurths Jürgen , Penzel Thomas
Published: November 2023

The study of functions, mechanisms of generation, and pathways of movement of cerebral fluids has a long history, but the last decade has been especially productive. The proposed glymphatic hypothesis, which suggests a mechanism of the brain waste removal system (BWRS), caused an active discussion on both the criticism of some of the perspectives and our intensive study of new experimental facts. It was especially found that the intensity of the metabolite clearance changes significantly during the transition between sleep and wakefulness. Interestingly, at the cellular level, a number of aspects of this problem have been focused on, such as astrocytes–glial cells, which, over the past two decades, have been recognized as equal partners of neurons and perform many important functions. In particular, an important role was assigned to astrocytes within the framework of the glymphatic hypothesis. In this review, we return to the “astrocytocentric” view of the BWRS function and the explanation of its activation during sleep from the viewpoint of new findings over the last decade. Our main conclusion is that the BWRS’s action may be analyzed both at the systemic (whole-brain) and at the local (cellular) level. The local level means here that the neuro-glial-vascular unit can also be regarded as the smallest functional unit of sleep, and therefore, the smallest functional unit of the BWRS.
Evaluating the Efficacy of ChatGPT in Navigating the Spanish Medical Residency Entrance Examination (MIR): Promising Horizons for AI in Clinical Medicine
Authors: Guillen-Grima Francisco , Guillen-Aguinaga Sara , Guillen-Aguinaga Laura , Alas-Brun Rosa , Onambele Luc , Ortega Wilfrido , Montejo Rocio , Aguinaga-Ontoso Enrique , Barach Paul , Aguinaga-Ontoso Ines
Published: November 2023

The rapid progress in artificial intelligence, machine learning, and natural language processing has led to increasingly sophisticated large language models (LLMs) for use in healthcare. This study assesses the performance of two LLMs, the GPT-3.5 and GPT-4 models, in passing the MIR medical examination for access to medical specialist training in Spain. Our objectives included gauging the model’s overall performance, analyzing discrepancies across different medical specialties, discerning between theoretical and practical questions, estimating error proportions, and assessing the hypothetical severity of errors committed by a physician. Material and methods: We studied the 2022 Spanish MIR examination results after excluding those questions requiring image evaluations or having acknowledged errors. The remaining 182 questions were presented to the LLM GPT-4 and GPT-3.5 in Spanish and English. Logistic regression models analyzed the relationships between question length, sequence, and performance. We also analyzed the 23 questions with images, using GPT-4’s new image analysis capability. Results: GPT-4 outperformed GPT-3.5, scoring 86.81% in Spanish (p < 0.001). English translations had a slightly enhanced performance. GPT-4 scored 26.1% of the questions with images in English. The results were worse when the questions were in Spanish, 13.0%, although the differences were not statistically significant (p = 0.250). Among medical specialties, GPT-4 achieved a 100% correct response rate in several areas, and the Pharmacology, Critical Care, and Infectious Diseases specialties showed lower performance. The error analysis revealed that while a 13.2% error rate existed, the gravest categories, such as “error requiring intervention to sustain life” and “error resulting in death”, had a 0% rate. Conclusions: GPT-4 performs robustly on the Spanish MIR examination, with varying capabilities to discriminate knowledge across specialties. While the model’s high success rate is commendable, understanding the error severity is critical, especially when considering AI’s potential role in real-world medical practice and its implications for patient safety.
Preparation and Testing of Anti-Corrosion Properties of New Pigments Containing Structural Units of Melamine and Magnesium Cations (Mg2+)
Authors: Kohl Miroslav , Alafid Fouzy , Boštíková Karolína , Krejčová Anna , Slang Stanislav , Řezníček Dominik , Hrdina Radim , Kalendová Andréa
Published: November 2023

This paper deals with the properties and testing of newly prepared organic pigments based on melamine cyanurate containing magnesium or zinc cations depending on their composition and anticorrosive properties in model coatings. Organic pigments based on melamine cyanurate with Mg2+ in the form of a complex differing in the ratio of melamine and cyanurate units were prepared. Furthermore, a pigment based on melamine citrate with magnesium cation Mg2+, a pigment based on melamine citrate with magnesium cation, and a pigment based on melamine cyanurate with zinc cation were prepared. The properties of Mg-containing organic pigments were also compared with those of selected magnesium-containing inorganic oxide-type pigments. The above-synthesized pigments were characterized by inductively coupled plasma-optical emission spectroscopy, elemental analysis, scanning electron microscopy, and X-ray diffraction. In addition, the basic parameters that are indicative of the applicability of the pigments in the binders of anti-corrosion coatings were determined. The anti-corrosive properties of the tested pigments were verified after application to the epoxy-ester resin-based paint binder in three different concentrations: at pigment volume concentrations of 0.10%, 0.25%, and 0.50%. The anticorrosive effectiveness of pigmented organic coatings was verified by cyclic corrosion tests in a salt electrolyte fog (NaCl + (NH4)2SO4) in an atmosphere containing SO2 and by the electrochemical technique of linear polarization. Finally, the effect of the structure of the pigments on the mechanical resistance of the organic coatings was investigated. The results obtained showed that the new organic pigments exhibit anticorrosive properties, and at the same time, differences in performance were found depending on the structure of the pigments tested. Specifically, the results of cyclic corrosion tests and the electrochemical technique of linear polarization clearly demonstrated that synthesized pigments of the organic type based on melamine cyanurate containing magnesium or zinc cations ensure the anti-corrosion efficiency of the tested organic coatings. The highest anti-corrosion efficiency was achieved by the system pigmented with synthesized melamine cyanurate with magnesium cation (C12H16MgN18O6), whose anti-corrosion efficiency was comparable to the anti-corrosion efficiency of the tested inorganic pigment MgFe2O4, which was prepared by high-temperature solid-phase synthesis. In addition, these organic coatings achieved high mechanical resistance after being tested using the most used standardized mechanical tests.
Analysis of Interlayer Crack Propagation and Strength Prediction of Steel Bridge Deck Asphalt Pavement Based on Extended Finite Element Method and Cohesive Zone Model (XFEM–CZM) Coupling
Authors: Zhu Chen , Li Weiwei , Wang Hongchang
Published: November 2023

The extended finite element method (XFEM) was employed for the computational modeling of internal defects within a bond layer. Furthermore, a cohesive zone model (CZM) was implemented to characterize the behavior of the bond layer in response to interactions at both the bond layer/steel plate and bond layer/asphalt paving layer interfaces. The coupling of XFEM and CZM was used for a comprehensive analysis of crack propagation within the bond layer as well as the assessment of phenomena associated with interfacial debonding and delamination. The feasibility and accuracy of the XFEM–CZM coupling method were verified by comparing it with the virtual crack closure technique (VCCT), CZM, XFEM–VCCT, and experiments. A double cantilever beam experimental model was established to simulate the process of interlayer-type cracks expanding from the inside of the bond layer to the interface between the bond layer and the upper and lower layers, causing debonding. This was undertaken to analyze the damage failure mechanism of interlayer-type cracks in asphalt paving layers of steel bridge decks; to discuss the impacts of the initial crack length, the interface stiffness, the interface strength, and the thickness of the bond layer on the performance of the overall interlayer bond strength; and to carry out the significance analysis. The results showed that the initial crack length, interface stiffness, and bond layer thickness had different effects on the expansion path of interlayer cracks. The interlayer strength decreased with an increase in the initial crack length and interface stiffness, increased with an increase in the interface strength, and decreased with an increase in the thickness of the bond layer. The interface stiffness had the most significant effect on the strength.
Type-II GaSe/MoS2 van der Waals Heterojunction for High-Performance Flexible Photodetector
Authors: Wang Shuai , Tang Xiaoqiu , Alim Ezimetjan , Sun Xingdong , Wei Zheng , Tao Hualong , Wen Yang , Wu Sumei , Cai Yongqing , Wang Yingying , Liang Yao , Zhang Zhihua
Published: November 2023

In recent years, two-dimensional (2D) type-II van der Waals (vdW) heterojunctions have emerged as promising candidates for high-performance photodetectors. However, direct experimental evidence confirming the enhancement of photoelectric properties by the heterojunction’s type and structure remains scarce. In this work, we present flexible photodetectors based on individual GaSe and MoS2, as well as a vertically stacked type-II GaSe/MoS2 vdW heterojunction on polyethylene terephthalate (PET) substrate. These devices demonstrate outstanding responsivities and rapid response speeds, ensuring stable and repeatable light detection. It is notable that the GaSe/MoS2 heterojunction photodetector exhibits the highest on-off ratio and fastest response speed, attributed to the formation of type-II band alignment. Furthermore, the GaSe/MoS2 heterojunction photodetector maintains robust stability even in a bent state, highlighting remarkable flexibility. This work exemplifies the type-II vdW heterojunctions in enhancing photoelectric properties through direct in-situ experimentation, laying the groundwork for practical applications of 2D flexible photodetectors.
Clinicopathological Features of Non-Small Cell Lung Carcinoma with BRAF Mutation
Authors: Ambrosini-Spaltro Andrea , Rengucci Claudia , Capelli Laura , Chiadini Elisa , Calistri Daniele , Bennati Chiara , Cravero Paola , Limarzi Francesco , Nosseir Sofia , Panzacchi Riccardo , Valli Mirca , Ulivi Paola , Rossi Giulio
Published: November 2023

(1) Background: BRAF mutations affect 4–5% of lung adenocarcinomas. This study aimed to analyze the clinicopathological features of lung carcinomas with BRAF mutations, focusing on V600E vs. non-V600E and the presence of co-mutations. (2) Methods: All BRAF-mutated lung carcinomas were retrieved from a molecular diagnostic unit (the reference unit for four different hospitals). The samples were analyzed using next-generation sequencing. Statistical analyses included log-rank tests for overall survival (OS) and progression-free survival (PFS). (3) Results: In total, 60 BRAF-mutated lung carcinomas were retrieved: 24 (40.0%) with V600E and 36 (60.0%) with non-V600E mutations, and 21 (35.0%) with other co-mutations and 39 (65.0%) with only BRAF mutations. Survival data were available for 54/60 (90.0%) cases. Targeted therapy was documented in 11 cases. Patients with V600E mutations exhibited a better prognosis than patients with non-V600E mutations (p = 0.008 for OS, p = 0.018 for PFS); this was confirmed in PFS (p = 0.036) when considering only patients who received no targeted therapy. Patients with co-mutations displayed no prognostic difference compared to patients carrying only BRAF mutations (p = 0.590 for OS, p = 0.938 for PFS). (4) Conclusions: BRAF-mutated lung carcinomas with V600E (40.0%) had a better prognosis than those without V600E. Concomitant co-mutations (35.0%) did not affect the prognosis.
The Contribution of Mediastinal Transbronchial Nodal Cryobiopsy to Morpho-Histological and Molecular Diagnosis
Authors: Velasco-Albendea Francisco Javier , Cruz-Rueda Juan José , Gil-Belmonte María Jesús , Pérez-Rodríguez Álvaro , López-Pardo Andrés , Agredano-Ávila Beatriz , Lozano-Paniagua David , Nievas-Soriano Bruno José
Published: November 2023

(1) Background: endobronchial ultrasound-guided mediastinal transbronchial cryo-node biopsy, previously assisted by fine-needle aspiration, is a novel technique of particular interest in the field of lung cancer diagnosis and is of great utility for extrathoracic tumor metastases, lymphomas, and granulomatous diseases. An integrated histological and molecular diagnosis of small samples implies additional difficulty for the pathologist. Additionally, emerging tumor biomarkers create the need to search for new approaches to better manage the tissue sample; (2) Methods: An analytical observational study of 32 mediastinal node cryobiopsies is carried out in 27 patients (n = 27). Statistical analysis using the t-student and Wilcoxon signed-rank tests for paired data is performed with SPSS 26 and R Statistical software. The significance level is established at p < 0.05; (3) Results: cryobiopsies were valid for diagnosis in 25 of 27 patients, with a maximum average size of 3.5 ± 0.7 mm. A total of 18 samples (66.67%) were positive for malignancy and 9 (33.33%) were benign. The tumor percentage measured in all neoplastic samples was greater than 30%. The average DNA and RNA extracted in nine non-small cell lung cancer cases was 97.2 ± 22.4 ng/µL and 26.6 ± 4.9 ng/µL, respectively; (4) Conclusions: the sample size obtained from an endobronchial ultrasound-guided mediastinal transbronchial cryo-node biopsy facilitates the morphological and histo-architectural assessment of inflammatory and neoplastic pathology. It optimizes molecular tests in the latter due to more tumor cells, DNA, and RNA.
Refractory Bilateral Tubo-Ovarian Abscesses in a Patient with Iatrogenic Hypogammaglobulinemia
Authors: Klein Elizabeth J. , Almaghlouth Nouf K. , Weigel Gabriela , Farmakiotis Dimitrios , Hardy Erica
Published: November 2023

Genital mycoplasmas are sexually transmitted Mollicutes with a high prevalence of urogenital tract colonization among females of reproductive age. Current guidelines recommend against routine screening for these organisms, since their role in the pathogenesis of pelvic inflammatory disease and tubo-ovarian abscesses (TOAs) remains unclear. However, genital mycoplasmas harbor pathogenic potential in immunocompromised hosts, especially patients with hypogammaglobulinemia. It is important to identify such infections early, given their potential for invasive spread and the availability of easily accessible treatments. We present a young adult female with multiple sclerosis and iatrogenic hypogammaglobulinemia, with refractory, bilateral pelvic inflammatory disease and TOAs due to Ureaplasma urealyticum, identified as a single pathogen via three distinct molecular tests. To our knowledge, this is the second case of TOAs caused by U. urealyticum in the literature, and the first diagnosed by pathogen cell-free DNA metagenomic next-generation sequencing in plasma.
An Open-Source Graphical User Interface-Embedded Automated Electrocardiogram Quality Assessment: A Balanced Class Representation Approach
Authors: Elgendi Mohamed , van der Bijl Kirina , Menon Carlo
Published: November 2023

The rise in cardiovascular diseases necessitates accurate electrocardiogram (ECG) diagnostics, making high-quality ECG recordings essential. Our CNN-LSTM model, embedded in an open-access GUI and trained on balanced datasets collected in clinical settings, excels in automating ECG quality assessment. When tested across three datasets featuring varying ratios of acceptable to unacceptable ECG signals, it achieved an F1 score ranging from 95.87% to 98.40%. Training the model on real noise sources significantly enhances its applicability in real-life scenarios, compared to simulations. Integrated into a user-friendly toolbox, the model offers practical utility in clinical environments. Furthermore, our study underscores the importance of balanced class representation during training and testing phases. We observed a notable F1 score change from 98.09% to 95.87% when the class ratio shifted from 85:15 to 50:50 in the same testing dataset with equal representation. This finding is crucial for future ECG quality assessment research, highlighting the impact of class distribution on the reliability of model training outcomes.
Multi-Asymmetric Irradiation Method Using a Ring Array to Obtain an Emission-Capable LED Beam Power Effect to Observe Cancer Removal Status in a Surgical Microscope
Authors: Lee Seon Min , Yoon Kicheol , Lee Sangyun , Ryu Seung Yeob , Kim Kwang Gi
Published: November 2023

The light emitting diodes (LEDs) used in surgical fluorescence microscopes have weak power, to induce fluorescence emission. The LED induces fluorescence emission throughout a lesion due to its large beam width; however, the beam irradiation intensity is not uniform within the beam width, resulting in a fluorescence emission induction difference. To overcome this problem, this study proposes an asymmetric irradiation array for supplying power uniformly throughout the beam width of the LED and increasing the intensity of the LED. To increase the irradiation power of the LEDs, a multi-asymmetric irradiation method with a ring-type array structure was used. The LED consisted of eight rings, and the space between the LEDs, the placement position, and the placement angle were analyzed to devise an experimental method using 3D printing technology. To test the irradiation power of the LED, the working distance (WD) between the LED and target was 30 cm. The bias voltage of the LED for irradiating the light source was 5.0 V and the measured power was 4.63 mW. The brightness (lux) was 1153 lx. Consequently, the LED satisfied the fluorescence emission induction conditions. The diameter of the LED-irradiated area was 9.5 cm. Therefore, this LED could be used to observe fluorescent emission-guided lesions. This study maximized the advantages of LEDs with optimal conditions for fluorescence emission by increasing the beam width, irradiation area, and energy efficiency, using a small number of LEDs at the maximum WD. The proposed method, optimized for fluorescence expression-induced surgery, can be made available at clinical sites by mass producing them through semiconductor processes.
A Study on the Factors and Prediction Model of Triple-Negative Breast Cancer for Public Health Promotion
Authors: Nam Young-Hee
Published: November 2023

This study was conducted to identify the risk causes and predictive models based on the clinical features of patients with breast cancer classified as triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (non-TNBCs) using Korean cancer statistics. A total of 2045 cases that underwent three types of hormone receptor tests were obtained from Korean cancer data in 2016. Research data were analyzed with the software SPSS Ver. 26.0. TNBC and non-TNBCs accounted for 12.4% and 87.6% of the data, respectively. Tubular and lobular tumors occurred most frequently in the external quadrant of the breast (C50.4–C50.5; 43.1%). Compared to non-TNBCs, the incidence of TNBC was the most common in patients under the age of 39 (19.5%), followed by those over the age of 70 (17.3%). Tumors larger than 2 cm accounted for 16.0%, which was higher than the number of tumors smaller than 2 cm. Cases in stage IV cancer represented 21.7% of the data. Additionally, 21.0% of the patients were in the SEER stage of distant metastasis, which was the most prevalent SEER (surveillance, epidemiology, and end outcomes) stage. Neoadjuvant therapy was administered more frequently, with a rate of 24.1%. In the logistic regression and decision-making tree model, the variables that affected TNBC were age, differentiation grade, and neoadjuvant therapy. The predictive accuracies of logistic regression and decision-making tree models were 87.8% and 87.6%, respectively. In a decision-marking tree model, the differentiation grades of TNBC affect neoadjuvant therapy, and neoadjuvant therapy affects the cancer stage. Therefore, in order to promote the health of breast cancer patients, it is urgent to apply an intensive early health check-up program for those in their 40s and 50s with a high prevalence of TNBC. For patients with breast cancer, in TNBC cases, except for poorly differentiated cases, neoadjuvant therapy must be applied first at all differentiation grades. The establishment of a policy system is necessary for the success of this process.