Athens, a metropolis characterized by agglutination and compactness, but at the same time facing numerous urban and transport issues, saw its population swell during the 20th century which led to extensive urbanizatio...Athens, a metropolis characterized by agglutination and compactness, but at the same time facing numerous urban and transport issues, saw its population swell during the 20th century which led to extensive urbanization phenomena. This continued urbanization increases profoundly all urban activities with transportation being the key driver in energy consumption. Theories for sustainable cities prerequisite are the integration of a number of acts in order to reduce energy consumption, with mobility being the first consideration among others. The aim of this paper is to critically explore implemented policies and plans as well as forthcoming strategic plans in terms of sustainable mobility as imposed in large scale regeneration plans in contemporary Athens. Research focuses on strategic interventions since the 1980s, such as the Athenian Daktylios （ring road for circulation management） and its later adjustments, the upcoming pedestrianization and unification of the commercial triangle and its subsequent tram line extension as well as the notable implementation of the metropolitan cycling network. Moreover, the discussion takes into consideration the implications of the Greek economic crisis in mobility choices, as aimless travels have been reduced to a minimum, several cars have been abandoned and cyclists seem to tentatively claim some space in the urban environment. What will likely be the next day in the Athenian historic centre？ Considering the transformations that are expected in the immediate future, this research paper explores their potential to enhance urban environment, reduce climate change impacts and amplify resilience.展开更多
AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 yea...AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg),the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay.RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P＜0.008 and P＜0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3 %). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found.CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities.Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results.展开更多
Earth observation (EO) provides the opportunity for periodic and spatially detailed assessment of the state of the environment in urban areas. In this study, the potential of EO based indicators (EI) to assess the sta...Earth observation (EO) provides the opportunity for periodic and spatially detailed assessment of the state of the environment in urban areas. In this study, the potential of EO based indicators (EI) to assess the state of environment in the urban agglomeration of Athens (UAA) is examined. EO based indicators as used in the study, include land surface temperature, land use, land cover and aerosols distribution. The indicators are also related to the household density and population density, as extracted from census data, for the same area. Indicators are applied at the municipal scale and are also used to estimate an aggregate environmental indicator (AEI), at municipal scale, by integrating all indicators mentioned above in a GIS environment. It is found that the urban agglomeration of Athens is practically “dichotomized”, by being divided in a western and eastern area, with considerably different environmental conditions. Results are considered important for focused interventions supporting environmental urban planning, whereas they represent the high potential of EO based indicators to monitor and assess the state of the urban environment.展开更多
The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by ...The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.展开更多
Latest digital advancements have intensified the necessity for adaptive,data-driven and socially-centered learning ecosystems.This paper presents the formulation of a cross-platform,innovative,gamified and personalize...Latest digital advancements have intensified the necessity for adaptive,data-driven and socially-centered learning ecosystems.This paper presents the formulation of a cross-platform,innovative,gamified and personalized Learning Ecosystem,which integrates 3D/VR environments,as well as machine learning algorithms,and business intelligence frameworks to enhance learner-centered education and inferenced decision-making.This Learning System makes use of immersive,analytically assessed virtual learning spaces,therefore facilitating real-time monitoring of not just learning performance,but also overall engagement and behavioral patterns,via a comprehensive set of sustainability-oriented ESG-aligned Key Performance Indicators(KPIs).Machine learning models support predictive analysis,personalized feedback,and hybrid recommendation mechanisms,whilst dedicated dashboards translate complex educational data into actionable insights for all Use Cases of the System(Educational Institutions,Educators and Learners).Additionally,the presented Learning System introduces a structured Mentoring and Consulting Subsystem,thence reinforcing human-centered guidance alongside automated intelligence.The Platform’s modular architecture and simulation-centered evaluation approach actively support personalized,and continuously optimized learning pathways.Thence,it exemplifies a mature,adaptive Learning Ecosystem,supporting immersive technologies,analytics,and pedagogical support,hence,contributing to contemporary digital learning innovation and sociotechnical transformation in education.展开更多
Purpose:ATLAS is a cross-sectional study aiming to investigate environmental and genetic determinants of athletic performance in healthy Greek competitive athletes(CA).This article presents the study design,investigat...Purpose:ATLAS is a cross-sectional study aiming to investigate environmental and genetic determinants of athletic performance in healthy Greek competitive athletes(CA).This article presents the study design,investigates the muscle strength performance(MSP)of 289 adult and teenage CA,exercisers,and physically inactive individuals(PI),and proposes predictive models of MSP for adults.Methods:Muscle maximal,speed,and explosive strength(MMS/MSS/MES)at unilateral maximal concentric flexion and extension contraction(FC/EC)were evaluated using Biodex System 3 PRO^(TM)at 60°/s,180°/s,and 300°/s,while additional performance markers were assessed through field ergometric testing.Participants were interviewed about their lifestyle,dietary habits,physical activity,injury,and medical history.Body composition was assessed via bioelectrical impedance.gDNA was extracted from biochemical samples and then genotyped.Statistical analysis was conducted using IBM SPSS Statistics v21.0 and R.Results:Age,fitness,and sex impacted correlations of MSP with body composition and anthropometric measurements(p<0.05).Among CA,females outperformed males in accuracy(p<0.001)while,males outperformed females in anaerobic power,MSP,speed,and endurance(p<0.001).Adult CA outperformed exercisers and PI in MMS,MSS,and MES(p<0.05).Multiple linear regression models,with predictors age,FFM,body extremity,training load explained the majority of variation in MMS(R^(2)_(adj):71.4%–88.9%),MSS(R^(2)_(adj):64.8%–78.4%),and MES(R^(2)_(adj):52.7%–68.4%)at EC,FC,and their mean(p<0.001).Conclusions:Muscle-strengthening strategies should be customized according to individual fitness levels,body composition,and anthropometric measurements.The innovative sex-specific regression models assessing MMS,MSS,and MES at EC and FC provide a framework for personalizing rehabilitation and skill-specific training strategies.展开更多
N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory lo...N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory loss,behavioral abnormalities,and motor dysfunctions.Decades of research have significantly advanced our understanding of the pathophysiology underlying neurodegene rative diseases,including Alzheimer's disease(AD),Parkinson's disease,amyotrophic lateral sclerosis,and others.展开更多
Eucalyptus(Eucalyptus camaldulensis Dehnh.)is an important exotic species in northern Nigeria commonly used for poles and timber.Sustainable management of this resource would require quantifying its volume.Stem taper ...Eucalyptus(Eucalyptus camaldulensis Dehnh.)is an important exotic species in northern Nigeria commonly used for poles and timber.Sustainable management of this resource would require quantifying its volume.Stem taper equations are one of the main and most efficient methods for estimating stem volume to any merchantable limit of a species.There is currently no taper equation for Eucalyptus species in Nigeria.Therefore,this study developed taper equations for E.camaldulensis in northern Nigeria.Data for this study were obtained from a private plantation in Jalingo Local Government Area,Taraba State,Nigeria.68 trees were felled and sectioned into 1-m bolt across the stem to a merchantable limit of 5 cm,which were used as the fitting dataset.An additional 22 trees were felled and used to validate the taper equations for stem volume estimation.Seven taper equations were initially fitted to the dataset using nonlinear least squares.The best taper equation was then refitted using a nonlinear mixed-effects approach and calibrated using diameters of one to five sections from the butt end.The taper equations were numerically integrated to obtain the stem volume,which was compared with empirical volume equations.The result shows that the Kozak(Can J For Res 27(5):619-629.10.1139/x97-011,1997)equation,which included eight parameters,provided the best fit for predicting section diameters for under and over bark.The mixed-effects taper equation(NLME-TE)explained most stem diameter variations in the fitting dataset(pseudo-R2:0.986-0.987;RMSE:0.547-0.578 cm)without substantial residual trends.The validation showed that the prediction accuracy of the integrated NLME-TE improved as the number of sectional diameter measurements increased,with at least a 35%reduction in volume estimate error.For practical implementation,two calibration sectional diameter measurements taken from the butt end per tree are recommended.This approach would reduce measurement effort and cost while improving model performance.展开更多
Optimization is the key to obtaining efficient utilization of resources in structural design.Due to the complex nature of truss systems,this study presents a method based on metaheuristic modelling that minimises stru...Optimization is the key to obtaining efficient utilization of resources in structural design.Due to the complex nature of truss systems,this study presents a method based on metaheuristic modelling that minimises structural weight under stress and frequency constraints.Two new algorithms,the Red Kite Optimization Algorithm(ROA)and Secretary Bird Optimization Algorithm(SBOA),are utilized on five benchmark trusses with 10,18,37,72,and 200-bar trusses.Both algorithms are evaluated against benchmarks in the literature.The results indicate that SBOA always reaches a lighter optimal.Designs with reducing structural weight ranging from 0.02%to 0.15%compared to ROA,and up to 6%–8%as compared to conventional algorithms.In addition,SBOA can achieve 15%–20%faster convergence speed and 10%–18%reduction in computational time with a smaller standard deviation over independent runs,which demonstrates its robustness and reliability.It is indicated that the adaptive exploration mechanism of SBOA,especially its Levy flight–based search strategy,can obviously improve optimization performance for low-and high-dimensional trusses.The research has implications in the context of promoting bio-inspired optimization techniques by demonstrating the viability of SBOA,a reliable model for large-scale structural design that provides significant enhancements in performance and convergence behavior.展开更多
Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atheroscle...Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis,even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.Methods: We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127 000-km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography(CTCA).Results: The runner was asymptomatic, had a low ESC-SCORE2(3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein(a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.Conclusions: This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.展开更多
This study aims to divide traffic into meaningful clusters （regimes） and to investigate their impact on accident likelihood and accident severity. Furthermore, the likelihood of pow- ered-two-wheelers （PTWs） invol...This study aims to divide traffic into meaningful clusters （regimes） and to investigate their impact on accident likelihood and accident severity. Furthermore, the likelihood of pow- ered-two-wheelers （PTWs） involvement in an accident is examined. To achieve the aims of the study, traffic and accident data during the period 2006-2011 from two major arterials in Athens were collected and processed. Firstly, a finite mixture cluster analysis was imple- mented to classify traffic into clusters. Afterwards, discriminant analysis was carried out in order to correctly assign new cases to the existing regimes by using a training and a testing set. Lastly, Bayesian logistic regression models were developed to investigate the impact of traffic regimes on accident likelihood and severity. The findings of this study suggest that urban traffic can be divided into different regimes by using average traffic occupancy and its standard deviation, measured by nearby upstream and downstream loop detectors. The results revealed potential hazardous traffic conditions, which are discussed in the paper. In general, high occupancy values increase accident likelihood, but tend to lead slight acci- dents, while PTWs are more likely to be involved in an accident, when traffic occupancy is high. Transitions from high to low occupancy also increase accident likelihood.展开更多
BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are e...BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.展开更多
BACKGROUND Gastric neuroendocrine tumors(G-NETs)are rare tumors originating from enterochromaffin-like cells,with an incidence of 0.4 per 100000 annually.There are three main types:(1)Type I,linked to chronic atrophic...BACKGROUND Gastric neuroendocrine tumors(G-NETs)are rare tumors originating from enterochromaffin-like cells,with an incidence of 0.4 per 100000 annually.There are three main types:(1)Type I,linked to chronic atrophic gastritis and hypergastrinemia,makes up 75%–80%of G-NETs;(2)Type II,associated with Zollinger-Ellison syndrome(ZES)and multiple endocrine neoplasia,comprises 5%;and(3)Type III,sporadic tumors with a higher metastatic potential,accounting for 15%–25%.Diagnosis involves endoscopy,biopsy,and histological examination.Additional methods include serum gastrin testing,immunohistochemistry,and imaging techniques such as computer tomography or magnetic resonance imaging for detecting metastasis.Type I treatment usually involves endoscopic resection(ER),with surgical resection for recurrence.Somatostatin analogs(SSAs)can reduce tumor size,and the prognosis is generally excellent.Type II treatment centers on surgical removal of the gastrinoma,with ER for smaller lesions and SSAs for symptom management.Type III requires surgical resection(partial or total gastrectomy)with lymph node dissection,and possibly chemotherapy.This type has a worse prognosis due to its aggressive nature.Emerging treatments like Peptide Receptor Radionuclide Therapy are promising for advanced cases,and ongoing research into immunotherapies is expanding future treatment options.Regular endoscopic follow-up is crucial to monitor for recurrence or metastasis across all types.Our literature review explores the current perspectives on G-NETs and highlights the importance of further research to improve diagnostic precision and treatment,particularly for those associated with less favorable cases.AIM To improve diagnostic precision and treatment,particularly for those associated with less favorable cases.METHODS A systematic search was conducted in PubMed,Scopus,and Web of Science until September 2024.Two independent reviewers screened titles,abstracts,and full texts for eligibility based on G-NET treatment in adults.Eligible studies included cohort studies,clinical trials,case series,and case reports,while in vitro,pediatric,and non-English studies were excluded.Relevant data were extracted independently,and disagreements were resolved through discussion.Study quality was assessed using appropriate tools.RESULTS G-NETs are rare,classified into three types:(1)Type I;(2)Type II;and(3)Type III.Type I G-NETs,often associated with chronic atrophic gastritis,are typically slow-growing and low-grade,with favorable outcomes following surgical resection.Type II G-NETs arise in hypergastrinemia conditions like multiple endocrine neoplasia and ZES,showing moderate malignancy risk.Type III G-NETs,the most aggressive and least common,present with distant metastases and poor prognosis.Diagnosis relies on endoscopy,imaging,and biomarkers like chromogranin A.Treatment varies by type,ranging from ER to aggressive surgery and chemotherapy for advanced cases.Regular follow-up is essential to monitor recurrence,particularly for type III G-NETs.CONCLUSION G-NETs require tailored diagnosis and treatment based on type and stage.Types I and II generally have better prognosis,while types III and IV are linked to poorer outcomes due to invasion and metastasis.Treatment strategies vary from ER for type I to extensive surgery for type III.Emerging therapies,like somatostatin analogs and peptide-receptor radionuclide therapies,show promise in advanced cases.Further research is essential to improve early diagnosis and treatment,particularly for high-risk lesions.展开更多
Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective to...Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.展开更多
This study investigates the mineralogy and mineral-chemistry of a newly discovered Au-Ag-Bi-Te mineralization at the Aydindere Fe-Cu skarn deposit,within the Pontides Tectonic Unit,northeastern Turkey.The mineralizati...This study investigates the mineralogy and mineral-chemistry of a newly discovered Au-Ag-Bi-Te mineralization at the Aydindere Fe-Cu skarn deposit,within the Pontides Tectonic Unit,northeastern Turkey.The mineralization is developed in the skarn zone at the contact between Upper Cretaceous andesite-pyroclastic rocks and a Paleocene–Eocene I-type granitoid.The principal ore minerals of the Aydindere Fe-Cu deposit are oxides(magnetite),sulfides(pyrite-chalcopyritegalena-sphalerite),tellurides/sulfotellurides(tetradymite,hessite),sulfosalts(wittichenite,emplectite,aikinite) and native gold-electrum.Skarn minerals include anhydrous phases(garnet) formed in a prograde stage and hydrous phases(amphibole,epidote,chlorite),which were formed in a retrograde stage in association with quartz,adularia,apatite and late calcite.Sulfides,tellurides and sulfosalts are introduced during the retrograde stage.The Au-Ag-Bi-Te mineralization was detected for the first time within the western ore body of the Aydindere deposit,and occurs in calcite-bearing sulfide bodies that cut magnetite-garnet-amphibole-epidote skarns with magnetite ores of different grade,including massive magnetite.Chlorite geothermometry indicates formation of the Au-Ag-BiTe mineralization at temperatures between 300 and 250 ℃,during the retrograde skarn evolution.Assuming the temperature is ~275 ℃,logfS_(2) =-10.5 to-13,logfO_(2) =-37 to-33,and logf Te2 values range from approximately-12 to-8.5 were estimated.The available mineralogical and geological data(presences of magnetite,oxidized-type tellurides/sulfotellurides,and andraditic garnets,and absence of pyrrhotite and arsenopyrite) suggest that Aydindere is an oxidized Au-bearing skarn deposit.The discovery of Au-Ag-Bi-Te mineralization at Aydindere increases its productivity and requires more detailed exploration in the deposit for precious(Au,Ag) and critical(Bi,Te) metals.展开更多
Cholangiocarcinoma(CCA)is a highly aggressive and heterogeneous malignancy arising from the epithelial cells of the biliary tract.The limitations of the current methods in the diagnosis of CCA highlight the urgent nee...Cholangiocarcinoma(CCA)is a highly aggressive and heterogeneous malignancy arising from the epithelial cells of the biliary tract.The limitations of the current methods in the diagnosis of CCA highlight the urgent need for new,accurate tools for early cancer detection,better prognostication and patient monitoring.Liquid biopsy(LB)is a modern and non-invasive technique comprising a diverse group of methodologies aiming to detect tumour biomarkers from body fluids.These biomarkers include circulating tumour cells,cell-free DNA,circulating tumour DNA,RNA and extracellular vesicles.The aim of this review is to explore the current and potential future applications of LB in CCA management,with a focus on diagnosis,prognostication and monitoring.We examine both its significant potential and the inevitable limitations associated with this technology.We conclude that LB holds considerable promise,but further research is necessary to fully integrate it into precision oncology for CCA.展开更多
Azoospermia is characterized by the absence of sperm in the ejaculate and is categorized into obstructive azoospermia(OA)and nonobstructive azoospermia(NOA).For men with NOA,testicular sperm extraction(TESE)is the onl...Azoospermia is characterized by the absence of sperm in the ejaculate and is categorized into obstructive azoospermia(OA)and nonobstructive azoospermia(NOA).For men with NOA,testicular sperm extraction(TESE)is the only method to obtain sperm for assisted reproductive technology(ART).Given the rarity of these sperm and the unpredictable success of subsequent retrieval attempts,cryopreservation of microdissection-TESE-obtained sperm is essential.Effective cryopreservation prevents the need for repeated surgical procedures and supports future ART attempts.After first delving into the physiological and molecular aspects of sperm cryopreservation,this review aims to examine the current methods and devices for preserving small numbers of sperm.It presents conventional freezing and vitrification techniques,evaluating their respective strengths and limitations in effectively preserving rare sperm,and compares the efficacy of using fresh versus cryopreserved testicular sperm.展开更多
Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligen...Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.展开更多
Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting...Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.展开更多
Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards f...Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.展开更多
文摘Athens, a metropolis characterized by agglutination and compactness, but at the same time facing numerous urban and transport issues, saw its population swell during the 20th century which led to extensive urbanization phenomena. This continued urbanization increases profoundly all urban activities with transportation being the key driver in energy consumption. Theories for sustainable cities prerequisite are the integration of a number of acts in order to reduce energy consumption, with mobility being the first consideration among others. The aim of this paper is to critically explore implemented policies and plans as well as forthcoming strategic plans in terms of sustainable mobility as imposed in large scale regeneration plans in contemporary Athens. Research focuses on strategic interventions since the 1980s, such as the Athenian Daktylios （ring road for circulation management） and its later adjustments, the upcoming pedestrianization and unification of the commercial triangle and its subsequent tram line extension as well as the notable implementation of the metropolitan cycling network. Moreover, the discussion takes into consideration the implications of the Greek economic crisis in mobility choices, as aimless travels have been reduced to a minimum, several cars have been abandoned and cyclists seem to tentatively claim some space in the urban environment. What will likely be the next day in the Athenian historic centre？ Considering the transformations that are expected in the immediate future, this research paper explores their potential to enhance urban environment, reduce climate change impacts and amplify resilience.
文摘AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg),the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay.RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P＜0.008 and P＜0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3 %). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found.CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities.Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results.
文摘Earth observation (EO) provides the opportunity for periodic and spatially detailed assessment of the state of the environment in urban areas. In this study, the potential of EO based indicators (EI) to assess the state of environment in the urban agglomeration of Athens (UAA) is examined. EO based indicators as used in the study, include land surface temperature, land use, land cover and aerosols distribution. The indicators are also related to the household density and population density, as extracted from census data, for the same area. Indicators are applied at the municipal scale and are also used to estimate an aggregate environmental indicator (AEI), at municipal scale, by integrating all indicators mentioned above in a GIS environment. It is found that the urban agglomeration of Athens is practically “dichotomized”, by being divided in a western and eastern area, with considerably different environmental conditions. Results are considered important for focused interventions supporting environmental urban planning, whereas they represent the high potential of EO based indicators to monitor and assess the state of the urban environment.
文摘The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.
文摘Latest digital advancements have intensified the necessity for adaptive,data-driven and socially-centered learning ecosystems.This paper presents the formulation of a cross-platform,innovative,gamified and personalized Learning Ecosystem,which integrates 3D/VR environments,as well as machine learning algorithms,and business intelligence frameworks to enhance learner-centered education and inferenced decision-making.This Learning System makes use of immersive,analytically assessed virtual learning spaces,therefore facilitating real-time monitoring of not just learning performance,but also overall engagement and behavioral patterns,via a comprehensive set of sustainability-oriented ESG-aligned Key Performance Indicators(KPIs).Machine learning models support predictive analysis,personalized feedback,and hybrid recommendation mechanisms,whilst dedicated dashboards translate complex educational data into actionable insights for all Use Cases of the System(Educational Institutions,Educators and Learners).Additionally,the presented Learning System introduces a structured Mentoring and Consulting Subsystem,thence reinforcing human-centered guidance alongside automated intelligence.The Platform’s modular architecture and simulation-centered evaluation approach actively support personalized,and continuously optimized learning pathways.Thence,it exemplifies a mature,adaptive Learning Ecosystem,supporting immersive technologies,analytics,and pedagogical support,hence,contributing to contemporary digital learning innovation and sociotechnical transformation in education.
文摘Purpose:ATLAS is a cross-sectional study aiming to investigate environmental and genetic determinants of athletic performance in healthy Greek competitive athletes(CA).This article presents the study design,investigates the muscle strength performance(MSP)of 289 adult and teenage CA,exercisers,and physically inactive individuals(PI),and proposes predictive models of MSP for adults.Methods:Muscle maximal,speed,and explosive strength(MMS/MSS/MES)at unilateral maximal concentric flexion and extension contraction(FC/EC)were evaluated using Biodex System 3 PRO^(TM)at 60°/s,180°/s,and 300°/s,while additional performance markers were assessed through field ergometric testing.Participants were interviewed about their lifestyle,dietary habits,physical activity,injury,and medical history.Body composition was assessed via bioelectrical impedance.gDNA was extracted from biochemical samples and then genotyped.Statistical analysis was conducted using IBM SPSS Statistics v21.0 and R.Results:Age,fitness,and sex impacted correlations of MSP with body composition and anthropometric measurements(p<0.05).Among CA,females outperformed males in accuracy(p<0.001)while,males outperformed females in anaerobic power,MSP,speed,and endurance(p<0.001).Adult CA outperformed exercisers and PI in MMS,MSS,and MES(p<0.05).Multiple linear regression models,with predictors age,FFM,body extremity,training load explained the majority of variation in MMS(R^(2)_(adj):71.4%–88.9%),MSS(R^(2)_(adj):64.8%–78.4%),and MES(R^(2)_(adj):52.7%–68.4%)at EC,FC,and their mean(p<0.001).Conclusions:Muscle-strengthening strategies should be customized according to individual fitness levels,body composition,and anthropometric measurements.The innovative sex-specific regression models assessing MMS,MSS,and MES at EC and FC provide a framework for personalizing rehabilitation and skill-specific training strategies.
基金supported by the National Institute on Aging(Nos.AG000723 and AG000578)(to VAB)the Fondation Sante(No.19656),Greece 2.0+1 种基金the National Recovery and Resilience Plan’s flagship program TAEDR-0535850the European Research Council(No.101077374-Synapto Mitophagy)(to KP)。
文摘N umerous neurological disorders negatively impact the nervous system,either through loss of neurons or by disrupting the normal functioning of neural networks.These impairments manifest as cognitive defects,memory loss,behavioral abnormalities,and motor dysfunctions.Decades of research have significantly advanced our understanding of the pathophysiology underlying neurodegene rative diseases,including Alzheimer's disease(AD),Parkinson's disease,amyotrophic lateral sclerosis,and others.
文摘Eucalyptus(Eucalyptus camaldulensis Dehnh.)is an important exotic species in northern Nigeria commonly used for poles and timber.Sustainable management of this resource would require quantifying its volume.Stem taper equations are one of the main and most efficient methods for estimating stem volume to any merchantable limit of a species.There is currently no taper equation for Eucalyptus species in Nigeria.Therefore,this study developed taper equations for E.camaldulensis in northern Nigeria.Data for this study were obtained from a private plantation in Jalingo Local Government Area,Taraba State,Nigeria.68 trees were felled and sectioned into 1-m bolt across the stem to a merchantable limit of 5 cm,which were used as the fitting dataset.An additional 22 trees were felled and used to validate the taper equations for stem volume estimation.Seven taper equations were initially fitted to the dataset using nonlinear least squares.The best taper equation was then refitted using a nonlinear mixed-effects approach and calibrated using diameters of one to five sections from the butt end.The taper equations were numerically integrated to obtain the stem volume,which was compared with empirical volume equations.The result shows that the Kozak(Can J For Res 27(5):619-629.10.1139/x97-011,1997)equation,which included eight parameters,provided the best fit for predicting section diameters for under and over bark.The mixed-effects taper equation(NLME-TE)explained most stem diameter variations in the fitting dataset(pseudo-R2:0.986-0.987;RMSE:0.547-0.578 cm)without substantial residual trends.The validation showed that the prediction accuracy of the integrated NLME-TE improved as the number of sectional diameter measurements increased,with at least a 35%reduction in volume estimate error.For practical implementation,two calibration sectional diameter measurements taken from the butt end per tree are recommended.This approach would reduce measurement effort and cost while improving model performance.
文摘Optimization is the key to obtaining efficient utilization of resources in structural design.Due to the complex nature of truss systems,this study presents a method based on metaheuristic modelling that minimises structural weight under stress and frequency constraints.Two new algorithms,the Red Kite Optimization Algorithm(ROA)and Secretary Bird Optimization Algorithm(SBOA),are utilized on five benchmark trusses with 10,18,37,72,and 200-bar trusses.Both algorithms are evaluated against benchmarks in the literature.The results indicate that SBOA always reaches a lighter optimal.Designs with reducing structural weight ranging from 0.02%to 0.15%compared to ROA,and up to 6%–8%as compared to conventional algorithms.In addition,SBOA can achieve 15%–20%faster convergence speed and 10%–18%reduction in computational time with a smaller standard deviation over independent runs,which demonstrates its robustness and reliability.It is indicated that the adaptive exploration mechanism of SBOA,especially its Levy flight–based search strategy,can obviously improve optimization performance for low-and high-dimensional trusses.The research has implications in the context of promoting bio-inspired optimization techniques by demonstrating the viability of SBOA,a reliable model for large-scale structural design that provides significant enhancements in performance and convergence behavior.
文摘Background and purpose: Lifelong endurance exercise is generally associated with cardiovascular health benefits.However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis,even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.Methods: We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127 000-km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography(CTCA).Results: The runner was asymptomatic, had a low ESC-SCORE2(3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein(a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.Conclusions: This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.
基金supported by the special fund for research grants of NTUA for PhD studies
文摘This study aims to divide traffic into meaningful clusters （regimes） and to investigate their impact on accident likelihood and accident severity. Furthermore, the likelihood of pow- ered-two-wheelers （PTWs） involvement in an accident is examined. To achieve the aims of the study, traffic and accident data during the period 2006-2011 from two major arterials in Athens were collected and processed. Firstly, a finite mixture cluster analysis was imple- mented to classify traffic into clusters. Afterwards, discriminant analysis was carried out in order to correctly assign new cases to the existing regimes by using a training and a testing set. Lastly, Bayesian logistic regression models were developed to investigate the impact of traffic regimes on accident likelihood and severity. The findings of this study suggest that urban traffic can be divided into different regimes by using average traffic occupancy and its standard deviation, measured by nearby upstream and downstream loop detectors. The results revealed potential hazardous traffic conditions, which are discussed in the paper. In general, high occupancy values increase accident likelihood, but tend to lead slight acci- dents, while PTWs are more likely to be involved in an accident, when traffic occupancy is high. Transitions from high to low occupancy also increase accident likelihood.
文摘BACKGROUND Pubic ramus fractures are generally considered fragility fractures in the elderly population,commonly deriving from a low-impact fall.Treatment is ordinarily conservative and hemodynamic complications are exceedingly infrequent.Notwithstanding,patients with copious comorbidities should be carefully monitored for potential vascular injury.CASE SUMMARY This case report presents the management of a 75-year-old male patient with a history of diabetes mellitus and arterial hypertension who was admitted to the emergency room with a superior pubic ramus fracture.The patient experienced a significant drop in hematocrit and hemoglobin levels post-admission,necessi-tating urgent intervention.A computed tomography angiography revealed active bleeding,leading to the embolization of the medial femoral branch.The patient was stabilized hemodynamically and was discharged after 15 days,with recom-mendations for home-based follow-up care.CONCLUSION This report denotes the various challenges and strategies in managing simple fractures that are treated conservatively,but need prompt monitoring for occult vascular injuries that can be fatal.
文摘BACKGROUND Gastric neuroendocrine tumors(G-NETs)are rare tumors originating from enterochromaffin-like cells,with an incidence of 0.4 per 100000 annually.There are three main types:(1)Type I,linked to chronic atrophic gastritis and hypergastrinemia,makes up 75%–80%of G-NETs;(2)Type II,associated with Zollinger-Ellison syndrome(ZES)and multiple endocrine neoplasia,comprises 5%;and(3)Type III,sporadic tumors with a higher metastatic potential,accounting for 15%–25%.Diagnosis involves endoscopy,biopsy,and histological examination.Additional methods include serum gastrin testing,immunohistochemistry,and imaging techniques such as computer tomography or magnetic resonance imaging for detecting metastasis.Type I treatment usually involves endoscopic resection(ER),with surgical resection for recurrence.Somatostatin analogs(SSAs)can reduce tumor size,and the prognosis is generally excellent.Type II treatment centers on surgical removal of the gastrinoma,with ER for smaller lesions and SSAs for symptom management.Type III requires surgical resection(partial or total gastrectomy)with lymph node dissection,and possibly chemotherapy.This type has a worse prognosis due to its aggressive nature.Emerging treatments like Peptide Receptor Radionuclide Therapy are promising for advanced cases,and ongoing research into immunotherapies is expanding future treatment options.Regular endoscopic follow-up is crucial to monitor for recurrence or metastasis across all types.Our literature review explores the current perspectives on G-NETs and highlights the importance of further research to improve diagnostic precision and treatment,particularly for those associated with less favorable cases.AIM To improve diagnostic precision and treatment,particularly for those associated with less favorable cases.METHODS A systematic search was conducted in PubMed,Scopus,and Web of Science until September 2024.Two independent reviewers screened titles,abstracts,and full texts for eligibility based on G-NET treatment in adults.Eligible studies included cohort studies,clinical trials,case series,and case reports,while in vitro,pediatric,and non-English studies were excluded.Relevant data were extracted independently,and disagreements were resolved through discussion.Study quality was assessed using appropriate tools.RESULTS G-NETs are rare,classified into three types:(1)Type I;(2)Type II;and(3)Type III.Type I G-NETs,often associated with chronic atrophic gastritis,are typically slow-growing and low-grade,with favorable outcomes following surgical resection.Type II G-NETs arise in hypergastrinemia conditions like multiple endocrine neoplasia and ZES,showing moderate malignancy risk.Type III G-NETs,the most aggressive and least common,present with distant metastases and poor prognosis.Diagnosis relies on endoscopy,imaging,and biomarkers like chromogranin A.Treatment varies by type,ranging from ER to aggressive surgery and chemotherapy for advanced cases.Regular follow-up is essential to monitor recurrence,particularly for type III G-NETs.CONCLUSION G-NETs require tailored diagnosis and treatment based on type and stage.Types I and II generally have better prognosis,while types III and IV are linked to poorer outcomes due to invasion and metastasis.Treatment strategies vary from ER for type I to extensive surgery for type III.Emerging therapies,like somatostatin analogs and peptide-receptor radionuclide therapies,show promise in advanced cases.Further research is essential to improve early diagnosis and treatment,particularly for high-risk lesions.
文摘Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.
文摘This study investigates the mineralogy and mineral-chemistry of a newly discovered Au-Ag-Bi-Te mineralization at the Aydindere Fe-Cu skarn deposit,within the Pontides Tectonic Unit,northeastern Turkey.The mineralization is developed in the skarn zone at the contact between Upper Cretaceous andesite-pyroclastic rocks and a Paleocene–Eocene I-type granitoid.The principal ore minerals of the Aydindere Fe-Cu deposit are oxides(magnetite),sulfides(pyrite-chalcopyritegalena-sphalerite),tellurides/sulfotellurides(tetradymite,hessite),sulfosalts(wittichenite,emplectite,aikinite) and native gold-electrum.Skarn minerals include anhydrous phases(garnet) formed in a prograde stage and hydrous phases(amphibole,epidote,chlorite),which were formed in a retrograde stage in association with quartz,adularia,apatite and late calcite.Sulfides,tellurides and sulfosalts are introduced during the retrograde stage.The Au-Ag-Bi-Te mineralization was detected for the first time within the western ore body of the Aydindere deposit,and occurs in calcite-bearing sulfide bodies that cut magnetite-garnet-amphibole-epidote skarns with magnetite ores of different grade,including massive magnetite.Chlorite geothermometry indicates formation of the Au-Ag-BiTe mineralization at temperatures between 300 and 250 ℃,during the retrograde skarn evolution.Assuming the temperature is ~275 ℃,logfS_(2) =-10.5 to-13,logfO_(2) =-37 to-33,and logf Te2 values range from approximately-12 to-8.5 were estimated.The available mineralogical and geological data(presences of magnetite,oxidized-type tellurides/sulfotellurides,and andraditic garnets,and absence of pyrrhotite and arsenopyrite) suggest that Aydindere is an oxidized Au-bearing skarn deposit.The discovery of Au-Ag-Bi-Te mineralization at Aydindere increases its productivity and requires more detailed exploration in the deposit for precious(Au,Ag) and critical(Bi,Te) metals.
文摘Cholangiocarcinoma(CCA)is a highly aggressive and heterogeneous malignancy arising from the epithelial cells of the biliary tract.The limitations of the current methods in the diagnosis of CCA highlight the urgent need for new,accurate tools for early cancer detection,better prognostication and patient monitoring.Liquid biopsy(LB)is a modern and non-invasive technique comprising a diverse group of methodologies aiming to detect tumour biomarkers from body fluids.These biomarkers include circulating tumour cells,cell-free DNA,circulating tumour DNA,RNA and extracellular vesicles.The aim of this review is to explore the current and potential future applications of LB in CCA management,with a focus on diagnosis,prognostication and monitoring.We examine both its significant potential and the inevitable limitations associated with this technology.We conclude that LB holds considerable promise,but further research is necessary to fully integrate it into precision oncology for CCA.
文摘Azoospermia is characterized by the absence of sperm in the ejaculate and is categorized into obstructive azoospermia(OA)and nonobstructive azoospermia(NOA).For men with NOA,testicular sperm extraction(TESE)is the only method to obtain sperm for assisted reproductive technology(ART).Given the rarity of these sperm and the unpredictable success of subsequent retrieval attempts,cryopreservation of microdissection-TESE-obtained sperm is essential.Effective cryopreservation prevents the need for repeated surgical procedures and supports future ART attempts.After first delving into the physiological and molecular aspects of sperm cryopreservation,this review aims to examine the current methods and devices for preserving small numbers of sperm.It presents conventional freezing and vitrification techniques,evaluating their respective strengths and limitations in effectively preserving rare sperm,and compares the efficacy of using fresh versus cryopreserved testicular sperm.
文摘Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.
文摘Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.
文摘Hepatocellular carcinoma(HCC)remains a leading cause of cancer-related mortality worldwide,necessitating innovative treatment strategies.Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC;however,advances in imaging and minimally invasive techniques have improved patient selection and outcomes.Additionally,the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC.This review highlights the efficacy of agents such as tyrosine kinase inhibitors,alongside emerging options like immune checkpoint inhibitors,which have shown promise in clinical trials.Furthermore,the role of locoregional therapies,including ablation in the setting of combined treatment,transar-terial chemoembolization and transarterial radioembolization with flow catheters,cone-beam computed tomo-graphy and 4D navigation guidance,is examined in the context of bridging therapies for patients awaiting surgical intervention.The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes.Future directions for HCC treatment are discussed,including the potential of novel biomarkers in prognosis and treatment response.This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.
