Electric Vehicle Charging Systems(EVCS)are increasingly vulnerable to cybersecurity threats as they integrate deeply into smart grids and Internet ofThings(IoT)environments,raising significant security challenges.Most...Electric Vehicle Charging Systems(EVCS)are increasingly vulnerable to cybersecurity threats as they integrate deeply into smart grids and Internet ofThings(IoT)environments,raising significant security challenges.Most existing research primarily emphasizes network-level anomaly detection,leaving critical vulnerabilities at the host level underexplored.This study introduces a novel forensic analysis framework leveraging host-level data,including system logs,kernel events,and Hardware Performance Counters(HPC),to detect and analyze sophisticated cyberattacks such as cryptojacking,Denial-of-Service(DoS),and reconnaissance activities targeting EVCS.Using comprehensive forensic analysis and machine learning models,the proposed framework significantly outperforms existing methods,achieving an accuracy of 98.81%.The findings offer insights into distinct behavioral signatures associated with specific cyber threats,enabling improved cybersecurity strategies and actionable recommendations for robust EVCS infrastructure protection.展开更多
This article delves into the analysis of performance and utilization of Support Vector Machines (SVMs) for the critical task of forest fire detection using image datasets. With the increasing threat of forest fires to...This article delves into the analysis of performance and utilization of Support Vector Machines (SVMs) for the critical task of forest fire detection using image datasets. With the increasing threat of forest fires to ecosystems and human settlements, the need for rapid and accurate detection systems is of utmost importance. SVMs, renowned for their strong classification capabilities, exhibit proficiency in recognizing patterns associated with fire within images. By training on labeled data, SVMs acquire the ability to identify distinctive attributes associated with fire, such as flames, smoke, or alterations in the visual characteristics of the forest area. The document thoroughly examines the use of SVMs, covering crucial elements like data preprocessing, feature extraction, and model training. It rigorously evaluates parameters such as accuracy, efficiency, and practical applicability. The knowledge gained from this study aids in the development of efficient forest fire detection systems, enabling prompt responses and improving disaster management. Moreover, the correlation between SVM accuracy and the difficulties presented by high-dimensional datasets is carefully investigated, demonstrated through a revealing case study. The relationship between accuracy scores and the different resolutions used for resizing the training datasets has also been discussed in this article. These comprehensive studies result in a definitive overview of the difficulties faced and the potential sectors requiring further improvement and focus.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)remains a significant public health concern in South Korea even though the incidence rates are declining.While medical travel for cancer treatment is common,its patterns and inf...BACKGROUND Hepatocellular carcinoma(HCC)remains a significant public health concern in South Korea even though the incidence rates are declining.While medical travel for cancer treatment is common,its patterns and influencing factors for patients with HCC are unknown.AIM To assess medical travel patterns and determinants and their policy implications among patients with newly diagnosed HCC in South Korea.METHODS This retrospective cohort study used the National Health Insurance Service database to identify patients with newly diagnosed HCC from 2013 to 2021.Medical travel was defined as receiving initial treatment outside one’s residential region.Patient characteristics and regional trends were analyzed,and factors influencing medical travel were identified using logistic regression analysis.RESULTS Among 64808 patients 52.4%received treatment in the capital.This proportion increased to 67.4%when including the surrounding metropolitan area.Medical travel was significantly more common among younger and wealthier patients.Patients with greater comorbidity burden or liver cirrhosis were less likely to travel.While geographic distance influenced travel patterns,high-volume academic centers in the capital attracted patients nationwide regardless of proximity.CONCLUSION This nationwide study highlighted the centralization of HCC care in the capital.This observation indicates that regional cancer hubs should be strengthened and promoted for equitable healthcare access.展开更多
BACKGROUND The early acquisition of skills required to perform hemostasis during endoscopy may be hindered by the lack of tools that allow assessments of the operator’s viewpoint.Understanding the operator’s viewpoi...BACKGROUND The early acquisition of skills required to perform hemostasis during endoscopy may be hindered by the lack of tools that allow assessments of the operator’s viewpoint.Understanding the operator’s viewpoint may facilitate the skills.AIM To evaluate the effects of a training system using operator gaze patterns during gastric endoscopic submucosal dissection(ESD)on hemostasis.METHODS An eye-tracking system was developed to record the operator’s viewpoints during gastric ESD,displaying the viewpoint as a circle.In phase 1,videos of three trainees’viewpoints were recorded.After reviewing these,trainees were recorded again in phase 2.The videos from both phases were retrospectively reviewed,and short clips were created to evaluate the hemostasis skills.Outcome measures included the time to recognize the bleeding point,the time to complete hemostasis,and the number of coagulation attempts.RESULTS Eight cases treated with ESD were reviewed,and 10 video clips of hemostasis were created.The time required to recognize the bleeding point during phase 2 was significantly shorter than that during phase 1(8.3±4.1 seconds vs 23.1±19.2 seconds;P=0.049).The time required to complete hemostasis during phase 1 and that during phase 2 were not significantly different(15.4±6.8 seconds vs 31.9±21.7 seconds;P=0.056).Significantly fewer coagulation attempts were performed during phase 2(1.8±0.7 vs 3.2±1.0;P=0.004).CONCLUSION Short-term training did not reduce hemostasis completion time but significantly improved bleeding point recognition and reduced coagulation attempts.Learning from the operator’s viewpoint can facilitate acquiring hemostasis skills during ESD.展开更多
The increased accessibility of social networking services(SNSs)has facilitated communication and information sharing among users.However,it has also heightened concerns about digital safety,particularly for children a...The increased accessibility of social networking services(SNSs)has facilitated communication and information sharing among users.However,it has also heightened concerns about digital safety,particularly for children and adolescents who are increasingly exposed to online grooming crimes.Early and accurate identification of grooming conversations is crucial in preventing long-term harm to victims.However,research on grooming detection in South Korea remains limited,as existing models trained primarily on English text and fail to reflect the unique linguistic features of SNS conversations,leading to inaccurate classifications.To address these issues,this study proposes a novel framework that integrates optical character recognition(OCR)technology with KcELECTRA,a deep learning-based natural language processing(NLP)model that shows excellent performance in processing the colloquial Korean language.In the proposed framework,the KcELECTRA model is fine-tuned by an extensive dataset,including Korean social media conversations,Korean ethical verification data from AI-Hub,and Korean hate speech data from Hug-gingFace,to enable more accurate classification of text extracted from social media conversation images.Experimental results show that the proposed framework achieves an accuracy of 0.953,outperforming existing transformer-based models.Furthermore,OCR technology shows high accuracy in extracting text from images,demonstrating that the proposed framework is effective for online grooming detection.The proposed framework is expected to contribute to the more accurate detection of grooming text and the prevention of grooming-related crimes.展开更多
Spherical bubble oscillations are widely used to model cavitation phenomena in biomedical and naval hydrodynamic systems.During collapse,a sudden increase in surrounding pressure initiates the collapse of a cavitation...Spherical bubble oscillations are widely used to model cavitation phenomena in biomedical and naval hydrodynamic systems.During collapse,a sudden increase in surrounding pressure initiates the collapse of a cavitation bubble,followed by a rebound driven by the high internal gas pressure.While the ideal gas equation of state(EOS)is commonly used to describe the internal pressure and temperature of the bubble,it is limited in its capacity to capture molecular-level effects under highly compressed conditions.In the present study,we employ non-ideal EOS for the gas(the van der Waals EOS and its volume-limited case)to investigate bubble oscillations with a focus on energy redistribution.Bubble oscillation is modeled in two phases:collapse,described by the Keller−Miksis formulation,and rebound,where peak shock pressure is estimated using similitude-based relations.To assess the role of EOS in energy redistribution,we introduce a framework that quantifies energy components in the bubble−liquid system while conserving total energy,tailored to each EOS.Using this framework,we evaluate energy concentration,acoustic radiation,and shock propagation and statistically analyze their dependence on both the driving pressure and the EOS of gas.We statistically derive scaling relations of key bubble dynamics quantities,energy concentration and radiation,and shock pressure using the driving pressure ratio.This work provides a generalizable framework and set of scaling relations for predicting bubble dynamics and energy transfer,with potential applications in evaluating the impacts of cavitation phenomena in complex practical systems.展开更多
The advent of sixth-generation(6G)networks introduces unprecedented challenges in achieving seamless connectivity,ultra-low latency,and efficient resource management in highly dynamic environments.Although fifth-gener...The advent of sixth-generation(6G)networks introduces unprecedented challenges in achieving seamless connectivity,ultra-low latency,and efficient resource management in highly dynamic environments.Although fifth-generation(5G)networks transformed mobile broadband and machine-type communications at massive scales,their properties of scaling,interference management,and latency remain a limitation in dense high mobility settings.To overcome these limitations,artificial intelligence(AI)and unmanned aerial vehicles(UAVs)have emerged as potential solutions to develop versatile,dynamic,and energy-efficient communication systems.The study proposes an AI-based UAV architecture that utilizes cooperative reinforcement learning(CoRL)to manage an autonomous network.The UAVs collaborate by sharing local observations and real-time state exchanges to optimize user connectivity,movement directions,allocate power,and resource distribution.Unlike conventional centralized or autonomous methods,CoRL involves joint state sharing and conflict-sensitive reward shaping,which ensures fair coverage,less interference,and enhanced adaptability in a dynamic urban environment.Simulations conducted in smart city scenarios with 10 UAVs and 50 ground users demonstrate that the proposed CoRL-based UAV system increases user coverage by up to 10%,achieves convergence 40%faster,and reduces latency and energy consumption by 30%compared with centralized and decentralized baselines.Furthermore,the distributed nature of the algorithm ensures scalability and flexibility,making it well-suited for future large-scale 6G deployments.The results highlighted that AI-enabled UAV systems enhance connectivity,support ultra-reliable low-latency communications(URLLC),and improve 6G network efficiency.Future work will extend the framework with adaptive modulation,beamforming-aware positioning,and real-world testbed deployment.展开更多
BACKGROUND Liver cirrhosis is the late stage of hepatic fibrosis and is characterized by portal hypertension that can clinically lead to decompensation in the form of ascites,esophageal/gastric varices or encephalopat...BACKGROUND Liver cirrhosis is the late stage of hepatic fibrosis and is characterized by portal hypertension that can clinically lead to decompensation in the form of ascites,esophageal/gastric varices or encephalopathy.The most common sequelae associated with liver cirrhosis are neurologic and neuropsychiatric impairments labeled as hepatic encephalopathy(HE).Well established triggers for HE include infection,gastrointestinal bleeding,constipation,and medications.Alterations to the gut microbiome is one of the leading ammonia producers in the body,and therefore may make patients more susceptible to HE.AIM To investigate the relationship between the use of proton pump inhibitors(PPIs)and HE in patients with cirrhosis.METHODS This is a single center,retrospective analysis.Patients were included in the study with an admitting diagnosis of HE.The degree of HE was determined from subjective and objective portions of hospital admission notes using the West Haven Criteria.The primary outcome of the study was to evaluate the grade of HE in PPI users versus non-users at admission to the hospital and throughout their hospital course.Secondary outcomes included rate of infection,gastrointestinal bleeding within the last 12 mo,mean ammonia level,and model for end-stage liver disease scores at admission.RESULTS The HE grade at admission using the West Haven Criteria was 2.3 in the PPI group compared to 1.7 in the PPI nonuser group(P=0.001).The average length of hospital stay in PPI group was 8.3 d compared to 6.5 d in PPI nonusers(P=0.046).Twenty-seven(31.8%)patients in the PPI user group required an Intensive Care Unit admission during their hospital course compared to 6 in the PPI nonuser group(16.7%)(P=0.138).Finally,10(11.8%)patients in the PPI group expired during their hospital stay compared to 1 in the PPI nonuser group(2.8%)(P=0.220).CONCLUSION Chronic PPI use in cirrhotic patients is associated with significantly higher average West Haven Criteria for HE compared to patients that do not use PPIs.展开更多
BACKGROUND The undifferentiated-type(UDT)component profoundly affects the clinical course of early gastric cancers(EGCs).However,an accurate preoperative diagnosis of the histological types is unsatisfactory.To date,f...BACKGROUND The undifferentiated-type(UDT)component profoundly affects the clinical course of early gastric cancers(EGCs).However,an accurate preoperative diagnosis of the histological types is unsatisfactory.To date,few studies have investigated whether the UDT component within mixed-histological-type(MT)EGCs can be recognized preoperatively.AIM To clarify the histopathological characteristics of the endoscopically-resected MT EGCs for investigating whether the UDT component could be recognized preoperatively.METHODS This was a single-center retrospective study.First,we attempted to clarify the histopathological characteristics of the endoscopically-resected MT EGCs with emphasis on the UDT component.Histopathological examination investigated each lesion’s UDT component:(1)Whole mucosal layer occupation of the UDT component;(2)UDT component exposure to the surface of the mucosa;and(3)existence of a clear border between the differentiated-type and UDT components.Then,preoperative endoscopic images with magnifying endoscopy with narrowband imaging(ME-NBI)were examined to identify whether the endoscopic UDT component finding was recognizable within the area where it was present in the histopathological examination.The preoperative biopsy results and comparative relationships between endoscopic and histopathological findings were also examined.RESULTS In the histopathological examination,the whole mucosal layer occupation of the UDT component and exposure of the UDT component to the mucosal surface were observed in 67.3%(33/49)and 79.6%(39/49)of samples,respectively.A clear distinction of the border between the differentiated-type and UDT components could not be drawn in 65.3%(32/49)of MT lesions.In the endoscopic examination,the preoperative endoscopic images showed that only 24.5%(12/49)of MT EGCs revealed the UDT component within the area where it was present histopathologically.Histopathological UDT predominance was the single significant factor associated with the presence of the endoscopic UDT component finding(61.5%vs 11.1%,P=0.0009).Only 26.5%(13/49)of the lesions were diagnosed from the pretreatment biopsy as having a UDT component.Combined results of the pretreatment biopsy and ME-NBI showed the preoperative presence of the UDT component in 40.8%(20/49)of MT EGCs.CONCLUSION Recognition of a UDT component within MT EGCs is difficult even when pretreatment biopsy and ME-NBI are combined.Endoscopic resection plays a significant role in both treatment and diagnosis.展开更多
As the complexity of flight missions continues to increase,sending a timely warning or providing assistance to pilots helps to reduce the probability of operational errors and flight accidents.Monitoring pilots’physi...As the complexity of flight missions continues to increase,sending a timely warning or providing assistance to pilots helps to reduce the probability of operational errors and flight accidents.Monitoring pilots’physiological data,real-time evaluation of mission load is a feasible technical way to achieve this.In this paper,a set of flight tasks including aircraft control,humancomputer interaction and mental arithmetic tests are designed to simulate five mission loads at different flight difficulty levels.A sensitivity analysis method based on a comprehensive test is proposed to select a set of sensitive physiological factors.Then,based on the SVM hierarchical combination classification method,the pilot mission load real-time evaluation model is established.The test results show significant differences in EMG,respiration rate(abdomen),heart rate,blood oxygen saturation,pupil area,fixation duration,number of fixations,and saccades.The high accuracy obtained from experiments proved that the proposed real-time evaluation model is applicable to meet the requirements of real working environments.The findings can provide methodological references for mission load evaluation research in other fields.展开更多
Mobile Edge Computing(MEC)assists clouds to handle enormous tasks from mobile devices in close proximity.The edge servers are not allocated efficiently according to the dynamic nature of the network.It leads to process...Mobile Edge Computing(MEC)assists clouds to handle enormous tasks from mobile devices in close proximity.The edge servers are not allocated efficiently according to the dynamic nature of the network.It leads to processing delay,and the tasks are dropped due to time limitations.The researchersfind it difficult and complex to determine the offloading decision because of uncertain load dynamic condition over the edge nodes.The challenge relies on the offload-ing decision on selection of edge nodes for offloading in a centralized manner.This study focuses on minimizing task-processing time while simultaneously increasing the success rate of service provided by edge servers.Initially,a task-offloading problem needs to be formulated based on the communication and pro-cessing.Then offloading decision problem is solved by deep analysis on taskflow in the network and feedback from the devices on edge services.The significance of the model is improved with the modelling of Deep Mobile-X architecture and bi-directional Long Short Term Memory(b-LSTM).The simulation is done in the Edgecloudsim environment,and the outcomes show the significance of the proposed idea.The processing time of the anticipated model is 6.6 s.The following perfor-mance metrics,improved server utilization,the ratio of the dropped task,and number of offloading tasks are evaluated and compared with existing learning approaches.The proposed model shows a better trade-off compared to existing approaches.展开更多
Foot ulcers are common complications of diabetes mellitus and substantially increase the morbidity and mortality due to this disease.Wound care by regular monitoring of the progress of healing with clinical review of ...Foot ulcers are common complications of diabetes mellitus and substantially increase the morbidity and mortality due to this disease.Wound care by regular monitoring of the progress of healing with clinical review of the ulcers,dressing changes,appropriate antibiotic therapy for infection and proper offloading of the ulcer are the cornerstones of the management of foot ulcers.Assessing the progress of foot ulcers can be a challenge for the clinician and patient due to logistic issues such as regular attendance in the clinic.Foot clinics are often busy and because of manpower issues,ulcer reviews can be delayed with detrimental effects on the healing as a result of a lack of appropriate and timely changes in management.Wound photographs have been historically useful to assess the progress of diabetic foot ulcers over the past few decades.Mobile phones with digital cameras have recently revolutionized the capture of foot ulcer images.Patients can send ulcer photographs to diabetes care professionals electronically for remote monitoring,largely avoiding the logistics of patient transport to clinics with a reduction on clinic pressures.Artificial intelligence-based technologies have been developed in recent years to improve this remote monitoring of diabetic foot ulcers with the use of mobile apps.This is expected to make a huge impact on diabetic foot ulcer care with further research and development of more accurate and scientific technologies in future.This clinical update review aims to compile evidence on this hot topic to empower clinicians with the latest developments in the field.展开更多
As an established spatial analytical tool,Geographically Weighted Regression(GWR)has been applied across a variety of disciplines.However,its usage can be challenging for large datasets,which are increasingly prevalen...As an established spatial analytical tool,Geographically Weighted Regression(GWR)has been applied across a variety of disciplines.However,its usage can be challenging for large datasets,which are increasingly prevalent in today’s digital world.In this study,we propose two high-performance R solutions for GWR via Multi-core Parallel(MP)and Compute Unified Device Architecture(CUDA)techniques,respectively GWR-MP and GWR-CUDA.We compared GWR-MP and GWR-CUDA with three existing solutions available in Geographically Weighted Models(GWmodel),Multi-scale GWR(MGWR)and Fast GWR(FastGWR).Results showed that all five solutions perform differently across varying sample sizes,with no single solution a clear winner in terms of computational efficiency.Specifically,solutions given in GWmodel and MGWR provided acceptable computational costs for GWR studies with a relatively small sample size.For a large sample size,GWR-MP and FastGWR provided coherent solutions on a Personal Computer(PC)with a common multi-core configuration,GWR-MP provided more efficient computing capacity for each core or thread than FastGWR.For cases when the sample size was very large,and for these cases only,GWR-CUDA provided the most efficient solution,but should note its I/O cost with small samples.In summary,GWR-MP and GWR-CUDA provided complementary high-performance R solutions to existing ones,where for certain data-rich GWR studies,they should be preferred.展开更多
BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are important as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.In the s...BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are important as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.In the surveillance of very small HCC nodules(≤2 cm in maximum diameter,Barcelona clinical stage 0),we demonstrated that the tumor markers alpha-fetoprotein and PIVKA-Ⅱare not so useful.Therefore,we must survey with imaging modalities.The superiority of magnetic resonance imaging(MRI)over ultrasound(US)to detect HCC was confirmed in many studies.Although enhanced MRI is now performed to accurately diagnose HCC,in conventional clinical practice for HCC surveillance in liver diseases,unenhanced MRI is widely performed throughout the world.While,MRI has made marked improvements in recent years.AIM To make a comparison of unenhanced MRI and US in detecting very small HCC that was examined in the last ten years in patients in whom MRI and US examinations were performed nearly simultaneously.METHODS In 394 patients with very small HCC nodules,those who underwent MRI and US at nearly the same time(on the same day whenever possible or at least within 14 days of one another)at the first diagnosis of HCC were selected.The detection rate of HCC with unenhanced MRI was investigated and compared with that of unenhanced US.RESULTS The sensitivity of unenhanced MRI for detecting very small HCC was 95.1%(97/102,95%confidence interval:90.9-99.3)and that of unenhanced US was 69.6%(71/102,95%confidence interval:60.7-78.5).The sensitivity of unenhanced MRI for detecting very small HCC was significantly higher than that of unenhanced US(P<0.001).Regarding the location of HCC in the liver in patients in whom detection by US was unsuccessful,S7-8 was identified in 51.7%.CONCLUSION Currently,unenhanced MRI is a very useful tool for the surveillance of very small HCC in conventional clinical follow-up practice.展开更多
BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are relevant as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.AIM To ex...BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are relevant as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.AIM To examine the impact of the tumor marker alpha-fetoprotein(AFP)or PIVKA-II in detecting very small HCC nodules(≤2 cm in maximum diameter,Barcelona stage 0)in the large number of very small HCC.The difference in the behavior of these tumor markers in HCC development was also examined.METHODS A total of 933 patients with single-nodule HCC were examined.They were subdivided into 394 patients with HCC nodules≤2 cm in maximum diameter and 539 patients whose nodules were>2 cm.The rates of patients whose AFP and PIVKA-II showed normal values were examined.RESULTS The positive ratio of the marker PIVKA-II was significantly different(P<0.0001)between patients with nodules≤2 cm in diameter and those with nodules>2 cm,but there was no significant difference in AFP(P=0.4254).In the patients whose tumor was≤2 cm,50.5%showed normal levels in AFP and 68.8%showed normal levels in PIVKA-II.In 36.4%of those patients,both AFP and PIVKA-II showed normal levels.The PIVKA-II-positive ratio was markedly increased with an increase in the tumor size.In contrast,the positivity in AFP was increased gradually and slowly.CONCLUSION In the surveillance of very small HCC nodules(≤2 cm in diameter,Barcelona clinical stage 0)the tumor markers AFP and PIVKA-II are not so useful.展开更多
BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCT...BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.展开更多
BACKGROUND The oral nucleos(t)ide analogue,entecavir(ETV)was demonstrated to reduce the rate of hepatocellular carcinoma(HCC)in patients with hepatitis B virus(HBV)-associated liver cirrhosis.However,the reduction of ...BACKGROUND The oral nucleos(t)ide analogue,entecavir(ETV)was demonstrated to reduce the rate of hepatocellular carcinoma(HCC)in patients with hepatitis B virus(HBV)-associated liver cirrhosis.However,the reduction of HCC differs in various regions of the world.AIM To investigate the reduction of HCC development due to ETV therapy by metaanalysis.METHODS We surveyed the differences in HCC development following ETV treatment based on published articles using PubMed(2004-2019).RESULTS The regions with the most marked reduction in HCC development due to ETV therapy were Spain(1.0%/year)and Canada(Southern part,1.3%/year),and the most ineffective areas were South Korea(3.6%-3.8%/year),China(3.3%/year),Taiwan(2.4%-3.1%/year),and Hong Kong(2.8%/year).Following ETV administration,the incidence of HCC in genotype D regions(1.89%±0.28%/year,mean±SE)was significantly lower than that in genotype C regions(2.91%±0.24%/year,P<0.01).With regard to the initial HBV-DNA level,in genotype C patients(average:5.61 Log10IU/mL)this was almost the same as that in genotype D patients(average:5.46 Log10IU/mL).Moreover,there was no association between the prevalence ratio of HBV and the incidence of HCC on ETV treatment.CONCLUSION The effectiveness of ETV in preventing HCC development in HBV-associated liver cirrhosis is genotype-dependent.展开更多
With the rapid evolution of Internet technology,fog computing has taken a major role in managing large amounts of data.The major concerns in this domain are security and privacy.Therefore,attaining a reliable level of...With the rapid evolution of Internet technology,fog computing has taken a major role in managing large amounts of data.The major concerns in this domain are security and privacy.Therefore,attaining a reliable level of confidentiality in the fog computing environment is a pivotal task.Among different types of data stored in the fog,the 3D point and mesh fog data are increasingly popular in recent days,due to the growth of 3D modelling and 3D printing technologies.Hence,in this research,we propose a novel scheme for preserving the privacy of 3D point and mesh fog data.Chaotic Cat mapbased data encryption is a recently trending research area due to its unique properties like pseudo-randomness,deterministic nature,sensitivity to initial conditions,ergodicity,etc.To boost encryption efficiency significantly,in this work,we propose a novel Chaotic Cat map.The sequence generated by this map is used to transform the coordinates of the fog data.The improved range of the proposed map is depicted using bifurcation analysis.The quality of the proposed Chaotic Cat map is also analyzed using metrics like Lyapunov exponent and approximate entropy.We also demonstrate the performance of the proposed encryption framework using attacks like brute-force attack and statistical attack.The experimental results clearly depict that the proposed framework produces the best results compared to the previous works in the literature.展开更多
In this article,the rheology of Ferro-fluid over an axisymmetric heated disc with a variable magnetic field by considering the dispersion of hybrid nanoparticles is considered.The flow is assumed to be produced by the...In this article,the rheology of Ferro-fluid over an axisymmetric heated disc with a variable magnetic field by considering the dispersion of hybrid nanoparticles is considered.The flow is assumed to be produced by the stretching of a rotating heated disc.The contribution of variable thermophysical properties is taken to explore themomentum,mass and thermal transportation.The concept of boundary layermechanismis engaged to reduce the complex problem into a simpler one in the form of coupled partial differential equations system.The complex coupled PDEs are converted into highly nonlinear coupled ordinary differential equations system(ODEs)and the resulting nonlinear flow problem is handled numerically.The solution is obtained via finite element procedure(FEP)and convergence is established by conducting the grid-independent survey.The solution of converted dimensionless problem containing fluid velocity,temperature and concentration field is plotted against numerous involved emerging parameters and their impact is noted.From the obtained solution,it is monitored that higher values of magnetic parameter retard the fluid flow and escalating values of Eckert number results in to enhance temperature profile.Ferro-fluid flow and heat energy for the case of the Yamada Ota hybrid model are higher than for the case of the Hamilton Crosser hybrid model.Developing a model is applicable to the printing process,electronic devices,temperature measurements,engineering process and food-making process.The amount of mass species is reduced vs.incline impacts of chemical reaction and Schmidt parameter.展开更多
BACKGROUND It is generally accepted that the incidence of hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-associated patients is higher than that in hepatitis B virus(HBV)-associated patients.The reason why thi...BACKGROUND It is generally accepted that the incidence of hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-associated patients is higher than that in hepatitis B virus(HBV)-associated patients.The reason why this difference in the incidence of HCC occurs in patients with HBV and HCV infections remains unclear.We report the possibility that the contributing power of inflammation,which is the main risk factor for developing HCC,may be different with HBV and HCV infections.AIM To investigate this,we surveyed the hazard ratio of inflammation for HCC development which was identified by serum alanine aminotransferase(ALT)levels between patients with HBV and HCV infections.METHODS The PubMed database was searched(2001-2021)for studies published in English regarding the incidence of HCC identifying 8924 HBV-and 7376 HCV-infected patients.From these studies,interferon-treated patients with both HBV and HCV infections were excluded.Furthermore,in HBV patients,those administered nucleos(t)ide analogues were excluded,and in HCV patients,those administered direct acting antivirals were also excluded.Studies citing hazard ratios of HCC regarding inflammation(serum elevated alanine aminotransferase levels)were selected.Finally,there were 14 studies of HBV-infected patients and 8 studies of HCV-infected patients.We calculated the hazard ratio in patients in an inflammatory state(serum ALT levels were above the normal range).RESULTS In the 14 studies of HBV patients,the average hazard ratio(HR)of elevated ALT for developing HCC was 2.74[1.98-3.77]and that in the 8 studies of HCV-infected patients was 5.51[3.08-9.83].The HR of inflammation for HCC development in HCV-associated liver diseases is about twice that in HBV-associated liver diseases.HR in HCV-infected patients was significantly(P=0.0391)higher than that in HBV-infected patients.In hepatitis B patients,the abnormal range adopted was 28-45 IU/L,and in hepatitis C patients,it was 20-50 IU/L.It was demonstrated that the abnormal ALT levels adopted in hepatitis B and C patients were very similar in this series.CONCLUSION The difference in the incidence of HCC development between HBV and HCV patients may depend on the difference in the hazard risk of ALT between HBV and HCV infections.展开更多
文摘Electric Vehicle Charging Systems(EVCS)are increasingly vulnerable to cybersecurity threats as they integrate deeply into smart grids and Internet ofThings(IoT)environments,raising significant security challenges.Most existing research primarily emphasizes network-level anomaly detection,leaving critical vulnerabilities at the host level underexplored.This study introduces a novel forensic analysis framework leveraging host-level data,including system logs,kernel events,and Hardware Performance Counters(HPC),to detect and analyze sophisticated cyberattacks such as cryptojacking,Denial-of-Service(DoS),and reconnaissance activities targeting EVCS.Using comprehensive forensic analysis and machine learning models,the proposed framework significantly outperforms existing methods,achieving an accuracy of 98.81%.The findings offer insights into distinct behavioral signatures associated with specific cyber threats,enabling improved cybersecurity strategies and actionable recommendations for robust EVCS infrastructure protection.
文摘This article delves into the analysis of performance and utilization of Support Vector Machines (SVMs) for the critical task of forest fire detection using image datasets. With the increasing threat of forest fires to ecosystems and human settlements, the need for rapid and accurate detection systems is of utmost importance. SVMs, renowned for their strong classification capabilities, exhibit proficiency in recognizing patterns associated with fire within images. By training on labeled data, SVMs acquire the ability to identify distinctive attributes associated with fire, such as flames, smoke, or alterations in the visual characteristics of the forest area. The document thoroughly examines the use of SVMs, covering crucial elements like data preprocessing, feature extraction, and model training. It rigorously evaluates parameters such as accuracy, efficiency, and practical applicability. The knowledge gained from this study aids in the development of efficient forest fire detection systems, enabling prompt responses and improving disaster management. Moreover, the correlation between SVM accuracy and the difficulties presented by high-dimensional datasets is carefully investigated, demonstrated through a revealing case study. The relationship between accuracy scores and the different resolutions used for resizing the training datasets has also been discussed in this article. These comprehensive studies result in a definitive overview of the difficulties faced and the potential sectors requiring further improvement and focus.
基金Supported by Dong-A University Research Fund,No.20230598.
文摘BACKGROUND Hepatocellular carcinoma(HCC)remains a significant public health concern in South Korea even though the incidence rates are declining.While medical travel for cancer treatment is common,its patterns and influencing factors for patients with HCC are unknown.AIM To assess medical travel patterns and determinants and their policy implications among patients with newly diagnosed HCC in South Korea.METHODS This retrospective cohort study used the National Health Insurance Service database to identify patients with newly diagnosed HCC from 2013 to 2021.Medical travel was defined as receiving initial treatment outside one’s residential region.Patient characteristics and regional trends were analyzed,and factors influencing medical travel were identified using logistic regression analysis.RESULTS Among 64808 patients 52.4%received treatment in the capital.This proportion increased to 67.4%when including the surrounding metropolitan area.Medical travel was significantly more common among younger and wealthier patients.Patients with greater comorbidity burden or liver cirrhosis were less likely to travel.While geographic distance influenced travel patterns,high-volume academic centers in the capital attracted patients nationwide regardless of proximity.CONCLUSION This nationwide study highlighted the centralization of HCC care in the capital.This observation indicates that regional cancer hubs should be strengthened and promoted for equitable healthcare access.
基金Supported by the Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research,No.23K11902.
文摘BACKGROUND The early acquisition of skills required to perform hemostasis during endoscopy may be hindered by the lack of tools that allow assessments of the operator’s viewpoint.Understanding the operator’s viewpoint may facilitate the skills.AIM To evaluate the effects of a training system using operator gaze patterns during gastric endoscopic submucosal dissection(ESD)on hemostasis.METHODS An eye-tracking system was developed to record the operator’s viewpoints during gastric ESD,displaying the viewpoint as a circle.In phase 1,videos of three trainees’viewpoints were recorded.After reviewing these,trainees were recorded again in phase 2.The videos from both phases were retrospectively reviewed,and short clips were created to evaluate the hemostasis skills.Outcome measures included the time to recognize the bleeding point,the time to complete hemostasis,and the number of coagulation attempts.RESULTS Eight cases treated with ESD were reviewed,and 10 video clips of hemostasis were created.The time required to recognize the bleeding point during phase 2 was significantly shorter than that during phase 1(8.3±4.1 seconds vs 23.1±19.2 seconds;P=0.049).The time required to complete hemostasis during phase 1 and that during phase 2 were not significantly different(15.4±6.8 seconds vs 31.9±21.7 seconds;P=0.056).Significantly fewer coagulation attempts were performed during phase 2(1.8±0.7 vs 3.2±1.0;P=0.004).CONCLUSION Short-term training did not reduce hemostasis completion time but significantly improved bleeding point recognition and reduced coagulation attempts.Learning from the operator’s viewpoint can facilitate acquiring hemostasis skills during ESD.
基金supported by the IITP(Institute of Information&Communications Technology Planning&Evaluation)-ITRC(Information Technology Research Center)grant funded by the Korean government(Ministry of Science and ICT)(IITP-2025-RS-2024-00438056).
文摘The increased accessibility of social networking services(SNSs)has facilitated communication and information sharing among users.However,it has also heightened concerns about digital safety,particularly for children and adolescents who are increasingly exposed to online grooming crimes.Early and accurate identification of grooming conversations is crucial in preventing long-term harm to victims.However,research on grooming detection in South Korea remains limited,as existing models trained primarily on English text and fail to reflect the unique linguistic features of SNS conversations,leading to inaccurate classifications.To address these issues,this study proposes a novel framework that integrates optical character recognition(OCR)technology with KcELECTRA,a deep learning-based natural language processing(NLP)model that shows excellent performance in processing the colloquial Korean language.In the proposed framework,the KcELECTRA model is fine-tuned by an extensive dataset,including Korean social media conversations,Korean ethical verification data from AI-Hub,and Korean hate speech data from Hug-gingFace,to enable more accurate classification of text extracted from social media conversation images.Experimental results show that the proposed framework achieves an accuracy of 0.953,outperforming existing transformer-based models.Furthermore,OCR technology shows high accuracy in extracting text from images,demonstrating that the proposed framework is effective for online grooming detection.The proposed framework is expected to contribute to the more accurate detection of grooming text and the prevention of grooming-related crimes.
基金supported by Institute of Information&Communications Technology Planning&Evaluation(IITP)grant funded by the Korea government(MSIT)(No.RS-2022-00155966Artificial Intelligence Convergence Innovation Human Resources Development(EwhaWomans University)).
文摘Spherical bubble oscillations are widely used to model cavitation phenomena in biomedical and naval hydrodynamic systems.During collapse,a sudden increase in surrounding pressure initiates the collapse of a cavitation bubble,followed by a rebound driven by the high internal gas pressure.While the ideal gas equation of state(EOS)is commonly used to describe the internal pressure and temperature of the bubble,it is limited in its capacity to capture molecular-level effects under highly compressed conditions.In the present study,we employ non-ideal EOS for the gas(the van der Waals EOS and its volume-limited case)to investigate bubble oscillations with a focus on energy redistribution.Bubble oscillation is modeled in two phases:collapse,described by the Keller−Miksis formulation,and rebound,where peak shock pressure is estimated using similitude-based relations.To assess the role of EOS in energy redistribution,we introduce a framework that quantifies energy components in the bubble−liquid system while conserving total energy,tailored to each EOS.Using this framework,we evaluate energy concentration,acoustic radiation,and shock propagation and statistically analyze their dependence on both the driving pressure and the EOS of gas.We statistically derive scaling relations of key bubble dynamics quantities,energy concentration and radiation,and shock pressure using the driving pressure ratio.This work provides a generalizable framework and set of scaling relations for predicting bubble dynamics and energy transfer,with potential applications in evaluating the impacts of cavitation phenomena in complex practical systems.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(RS-2025-00559546)supported by the IITP(Institute of Information&Coummunications Technology Planning&Evaluation)-ITRC(Information Technology Research Center)grant funded by the Korea government(Ministry of Science and ICT)(IITP-2025-RS-2023-00259004).
文摘The advent of sixth-generation(6G)networks introduces unprecedented challenges in achieving seamless connectivity,ultra-low latency,and efficient resource management in highly dynamic environments.Although fifth-generation(5G)networks transformed mobile broadband and machine-type communications at massive scales,their properties of scaling,interference management,and latency remain a limitation in dense high mobility settings.To overcome these limitations,artificial intelligence(AI)and unmanned aerial vehicles(UAVs)have emerged as potential solutions to develop versatile,dynamic,and energy-efficient communication systems.The study proposes an AI-based UAV architecture that utilizes cooperative reinforcement learning(CoRL)to manage an autonomous network.The UAVs collaborate by sharing local observations and real-time state exchanges to optimize user connectivity,movement directions,allocate power,and resource distribution.Unlike conventional centralized or autonomous methods,CoRL involves joint state sharing and conflict-sensitive reward shaping,which ensures fair coverage,less interference,and enhanced adaptability in a dynamic urban environment.Simulations conducted in smart city scenarios with 10 UAVs and 50 ground users demonstrate that the proposed CoRL-based UAV system increases user coverage by up to 10%,achieves convergence 40%faster,and reduces latency and energy consumption by 30%compared with centralized and decentralized baselines.Furthermore,the distributed nature of the algorithm ensures scalability and flexibility,making it well-suited for future large-scale 6G deployments.The results highlighted that AI-enabled UAV systems enhance connectivity,support ultra-reliable low-latency communications(URLLC),and improve 6G network efficiency.Future work will extend the framework with adaptive modulation,beamforming-aware positioning,and real-world testbed deployment.
文摘BACKGROUND Liver cirrhosis is the late stage of hepatic fibrosis and is characterized by portal hypertension that can clinically lead to decompensation in the form of ascites,esophageal/gastric varices or encephalopathy.The most common sequelae associated with liver cirrhosis are neurologic and neuropsychiatric impairments labeled as hepatic encephalopathy(HE).Well established triggers for HE include infection,gastrointestinal bleeding,constipation,and medications.Alterations to the gut microbiome is one of the leading ammonia producers in the body,and therefore may make patients more susceptible to HE.AIM To investigate the relationship between the use of proton pump inhibitors(PPIs)and HE in patients with cirrhosis.METHODS This is a single center,retrospective analysis.Patients were included in the study with an admitting diagnosis of HE.The degree of HE was determined from subjective and objective portions of hospital admission notes using the West Haven Criteria.The primary outcome of the study was to evaluate the grade of HE in PPI users versus non-users at admission to the hospital and throughout their hospital course.Secondary outcomes included rate of infection,gastrointestinal bleeding within the last 12 mo,mean ammonia level,and model for end-stage liver disease scores at admission.RESULTS The HE grade at admission using the West Haven Criteria was 2.3 in the PPI group compared to 1.7 in the PPI nonuser group(P=0.001).The average length of hospital stay in PPI group was 8.3 d compared to 6.5 d in PPI nonusers(P=0.046).Twenty-seven(31.8%)patients in the PPI user group required an Intensive Care Unit admission during their hospital course compared to 6 in the PPI nonuser group(16.7%)(P=0.138).Finally,10(11.8%)patients in the PPI group expired during their hospital stay compared to 1 in the PPI nonuser group(2.8%)(P=0.220).CONCLUSION Chronic PPI use in cirrhotic patients is associated with significantly higher average West Haven Criteria for HE compared to patients that do not use PPIs.
文摘BACKGROUND The undifferentiated-type(UDT)component profoundly affects the clinical course of early gastric cancers(EGCs).However,an accurate preoperative diagnosis of the histological types is unsatisfactory.To date,few studies have investigated whether the UDT component within mixed-histological-type(MT)EGCs can be recognized preoperatively.AIM To clarify the histopathological characteristics of the endoscopically-resected MT EGCs for investigating whether the UDT component could be recognized preoperatively.METHODS This was a single-center retrospective study.First,we attempted to clarify the histopathological characteristics of the endoscopically-resected MT EGCs with emphasis on the UDT component.Histopathological examination investigated each lesion’s UDT component:(1)Whole mucosal layer occupation of the UDT component;(2)UDT component exposure to the surface of the mucosa;and(3)existence of a clear border between the differentiated-type and UDT components.Then,preoperative endoscopic images with magnifying endoscopy with narrowband imaging(ME-NBI)were examined to identify whether the endoscopic UDT component finding was recognizable within the area where it was present in the histopathological examination.The preoperative biopsy results and comparative relationships between endoscopic and histopathological findings were also examined.RESULTS In the histopathological examination,the whole mucosal layer occupation of the UDT component and exposure of the UDT component to the mucosal surface were observed in 67.3%(33/49)and 79.6%(39/49)of samples,respectively.A clear distinction of the border between the differentiated-type and UDT components could not be drawn in 65.3%(32/49)of MT lesions.In the endoscopic examination,the preoperative endoscopic images showed that only 24.5%(12/49)of MT EGCs revealed the UDT component within the area where it was present histopathologically.Histopathological UDT predominance was the single significant factor associated with the presence of the endoscopic UDT component finding(61.5%vs 11.1%,P=0.0009).Only 26.5%(13/49)of the lesions were diagnosed from the pretreatment biopsy as having a UDT component.Combined results of the pretreatment biopsy and ME-NBI showed the preoperative presence of the UDT component in 40.8%(20/49)of MT EGCs.CONCLUSION Recognition of a UDT component within MT EGCs is difficult even when pretreatment biopsy and ME-NBI are combined.Endoscopic resection plays a significant role in both treatment and diagnosis.
基金co-supported by the Aeronautical Science Foundation of China(No.2020Z023053002)the National Natural Science Foundation of China(No.61305133。
文摘As the complexity of flight missions continues to increase,sending a timely warning or providing assistance to pilots helps to reduce the probability of operational errors and flight accidents.Monitoring pilots’physiological data,real-time evaluation of mission load is a feasible technical way to achieve this.In this paper,a set of flight tasks including aircraft control,humancomputer interaction and mental arithmetic tests are designed to simulate five mission loads at different flight difficulty levels.A sensitivity analysis method based on a comprehensive test is proposed to select a set of sensitive physiological factors.Then,based on the SVM hierarchical combination classification method,the pilot mission load real-time evaluation model is established.The test results show significant differences in EMG,respiration rate(abdomen),heart rate,blood oxygen saturation,pupil area,fixation duration,number of fixations,and saccades.The high accuracy obtained from experiments proved that the proposed real-time evaluation model is applicable to meet the requirements of real working environments.The findings can provide methodological references for mission load evaluation research in other fields.
文摘Mobile Edge Computing(MEC)assists clouds to handle enormous tasks from mobile devices in close proximity.The edge servers are not allocated efficiently according to the dynamic nature of the network.It leads to processing delay,and the tasks are dropped due to time limitations.The researchersfind it difficult and complex to determine the offloading decision because of uncertain load dynamic condition over the edge nodes.The challenge relies on the offload-ing decision on selection of edge nodes for offloading in a centralized manner.This study focuses on minimizing task-processing time while simultaneously increasing the success rate of service provided by edge servers.Initially,a task-offloading problem needs to be formulated based on the communication and pro-cessing.Then offloading decision problem is solved by deep analysis on taskflow in the network and feedback from the devices on edge services.The significance of the model is improved with the modelling of Deep Mobile-X architecture and bi-directional Long Short Term Memory(b-LSTM).The simulation is done in the Edgecloudsim environment,and the outcomes show the significance of the proposed idea.The processing time of the anticipated model is 6.6 s.The following perfor-mance metrics,improved server utilization,the ratio of the dropped task,and number of offloading tasks are evaluated and compared with existing learning approaches.The proposed model shows a better trade-off compared to existing approaches.
文摘Foot ulcers are common complications of diabetes mellitus and substantially increase the morbidity and mortality due to this disease.Wound care by regular monitoring of the progress of healing with clinical review of the ulcers,dressing changes,appropriate antibiotic therapy for infection and proper offloading of the ulcer are the cornerstones of the management of foot ulcers.Assessing the progress of foot ulcers can be a challenge for the clinician and patient due to logistic issues such as regular attendance in the clinic.Foot clinics are often busy and because of manpower issues,ulcer reviews can be delayed with detrimental effects on the healing as a result of a lack of appropriate and timely changes in management.Wound photographs have been historically useful to assess the progress of diabetic foot ulcers over the past few decades.Mobile phones with digital cameras have recently revolutionized the capture of foot ulcer images.Patients can send ulcer photographs to diabetes care professionals electronically for remote monitoring,largely avoiding the logistics of patient transport to clinics with a reduction on clinic pressures.Artificial intelligence-based technologies have been developed in recent years to improve this remote monitoring of diabetic foot ulcers with the use of mobile apps.This is expected to make a huge impact on diabetic foot ulcer care with further research and development of more accurate and scientific technologies in future.This clinical update review aims to compile evidence on this hot topic to empower clinicians with the latest developments in the field.
基金supported by National Key Research and Development Program of China[grant num-ber 2021YFB3900904]the National Natural Science Foundation of China[grant numbers 42071368,U2033216,41871287].
文摘As an established spatial analytical tool,Geographically Weighted Regression(GWR)has been applied across a variety of disciplines.However,its usage can be challenging for large datasets,which are increasingly prevalent in today’s digital world.In this study,we propose two high-performance R solutions for GWR via Multi-core Parallel(MP)and Compute Unified Device Architecture(CUDA)techniques,respectively GWR-MP and GWR-CUDA.We compared GWR-MP and GWR-CUDA with three existing solutions available in Geographically Weighted Models(GWmodel),Multi-scale GWR(MGWR)and Fast GWR(FastGWR).Results showed that all five solutions perform differently across varying sample sizes,with no single solution a clear winner in terms of computational efficiency.Specifically,solutions given in GWmodel and MGWR provided acceptable computational costs for GWR studies with a relatively small sample size.For a large sample size,GWR-MP and FastGWR provided coherent solutions on a Personal Computer(PC)with a common multi-core configuration,GWR-MP provided more efficient computing capacity for each core or thread than FastGWR.For cases when the sample size was very large,and for these cases only,GWR-CUDA provided the most efficient solution,but should note its I/O cost with small samples.In summary,GWR-MP and GWR-CUDA provided complementary high-performance R solutions to existing ones,where for certain data-rich GWR studies,they should be preferred.
基金The study was reviewed and approved by the Ethics Committee of Yokohama Municipal Citizen's Hospital Institutional Review Board(Approval No.21-02-01).
文摘BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are important as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.In the surveillance of very small HCC nodules(≤2 cm in maximum diameter,Barcelona clinical stage 0),we demonstrated that the tumor markers alpha-fetoprotein and PIVKA-Ⅱare not so useful.Therefore,we must survey with imaging modalities.The superiority of magnetic resonance imaging(MRI)over ultrasound(US)to detect HCC was confirmed in many studies.Although enhanced MRI is now performed to accurately diagnose HCC,in conventional clinical practice for HCC surveillance in liver diseases,unenhanced MRI is widely performed throughout the world.While,MRI has made marked improvements in recent years.AIM To make a comparison of unenhanced MRI and US in detecting very small HCC that was examined in the last ten years in patients in whom MRI and US examinations were performed nearly simultaneously.METHODS In 394 patients with very small HCC nodules,those who underwent MRI and US at nearly the same time(on the same day whenever possible or at least within 14 days of one another)at the first diagnosis of HCC were selected.The detection rate of HCC with unenhanced MRI was investigated and compared with that of unenhanced US.RESULTS The sensitivity of unenhanced MRI for detecting very small HCC was 95.1%(97/102,95%confidence interval:90.9-99.3)and that of unenhanced US was 69.6%(71/102,95%confidence interval:60.7-78.5).The sensitivity of unenhanced MRI for detecting very small HCC was significantly higher than that of unenhanced US(P<0.001).Regarding the location of HCC in the liver in patients in whom detection by US was unsuccessful,S7-8 was identified in 51.7%.CONCLUSION Currently,unenhanced MRI is a very useful tool for the surveillance of very small HCC in conventional clinical follow-up practice.
文摘BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are relevant as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.AIM To examine the impact of the tumor marker alpha-fetoprotein(AFP)or PIVKA-II in detecting very small HCC nodules(≤2 cm in maximum diameter,Barcelona stage 0)in the large number of very small HCC.The difference in the behavior of these tumor markers in HCC development was also examined.METHODS A total of 933 patients with single-nodule HCC were examined.They were subdivided into 394 patients with HCC nodules≤2 cm in maximum diameter and 539 patients whose nodules were>2 cm.The rates of patients whose AFP and PIVKA-II showed normal values were examined.RESULTS The positive ratio of the marker PIVKA-II was significantly different(P<0.0001)between patients with nodules≤2 cm in diameter and those with nodules>2 cm,but there was no significant difference in AFP(P=0.4254).In the patients whose tumor was≤2 cm,50.5%showed normal levels in AFP and 68.8%showed normal levels in PIVKA-II.In 36.4%of those patients,both AFP and PIVKA-II showed normal levels.The PIVKA-II-positive ratio was markedly increased with an increase in the tumor size.In contrast,the positivity in AFP was increased gradually and slowly.CONCLUSION In the surveillance of very small HCC nodules(≤2 cm in diameter,Barcelona clinical stage 0)the tumor markers AFP and PIVKA-II are not so useful.
文摘BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.
基金Supported by the Kanagawa Association of Medical and Dental Practitioners.
文摘BACKGROUND The oral nucleos(t)ide analogue,entecavir(ETV)was demonstrated to reduce the rate of hepatocellular carcinoma(HCC)in patients with hepatitis B virus(HBV)-associated liver cirrhosis.However,the reduction of HCC differs in various regions of the world.AIM To investigate the reduction of HCC development due to ETV therapy by metaanalysis.METHODS We surveyed the differences in HCC development following ETV treatment based on published articles using PubMed(2004-2019).RESULTS The regions with the most marked reduction in HCC development due to ETV therapy were Spain(1.0%/year)and Canada(Southern part,1.3%/year),and the most ineffective areas were South Korea(3.6%-3.8%/year),China(3.3%/year),Taiwan(2.4%-3.1%/year),and Hong Kong(2.8%/year).Following ETV administration,the incidence of HCC in genotype D regions(1.89%±0.28%/year,mean±SE)was significantly lower than that in genotype C regions(2.91%±0.24%/year,P<0.01).With regard to the initial HBV-DNA level,in genotype C patients(average:5.61 Log10IU/mL)this was almost the same as that in genotype D patients(average:5.46 Log10IU/mL).Moreover,there was no association between the prevalence ratio of HBV and the incidence of HCC on ETV treatment.CONCLUSION The effectiveness of ETV in preventing HCC development in HBV-associated liver cirrhosis is genotype-dependent.
基金This work was supprted by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2022R151),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘With the rapid evolution of Internet technology,fog computing has taken a major role in managing large amounts of data.The major concerns in this domain are security and privacy.Therefore,attaining a reliable level of confidentiality in the fog computing environment is a pivotal task.Among different types of data stored in the fog,the 3D point and mesh fog data are increasingly popular in recent days,due to the growth of 3D modelling and 3D printing technologies.Hence,in this research,we propose a novel scheme for preserving the privacy of 3D point and mesh fog data.Chaotic Cat mapbased data encryption is a recently trending research area due to its unique properties like pseudo-randomness,deterministic nature,sensitivity to initial conditions,ergodicity,etc.To boost encryption efficiency significantly,in this work,we propose a novel Chaotic Cat map.The sequence generated by this map is used to transform the coordinates of the fog data.The improved range of the proposed map is depicted using bifurcation analysis.The quality of the proposed Chaotic Cat map is also analyzed using metrics like Lyapunov exponent and approximate entropy.We also demonstrate the performance of the proposed encryption framework using attacks like brute-force attack and statistical attack.The experimental results clearly depict that the proposed framework produces the best results compared to the previous works in the literature.
文摘In this article,the rheology of Ferro-fluid over an axisymmetric heated disc with a variable magnetic field by considering the dispersion of hybrid nanoparticles is considered.The flow is assumed to be produced by the stretching of a rotating heated disc.The contribution of variable thermophysical properties is taken to explore themomentum,mass and thermal transportation.The concept of boundary layermechanismis engaged to reduce the complex problem into a simpler one in the form of coupled partial differential equations system.The complex coupled PDEs are converted into highly nonlinear coupled ordinary differential equations system(ODEs)and the resulting nonlinear flow problem is handled numerically.The solution is obtained via finite element procedure(FEP)and convergence is established by conducting the grid-independent survey.The solution of converted dimensionless problem containing fluid velocity,temperature and concentration field is plotted against numerous involved emerging parameters and their impact is noted.From the obtained solution,it is monitored that higher values of magnetic parameter retard the fluid flow and escalating values of Eckert number results in to enhance temperature profile.Ferro-fluid flow and heat energy for the case of the Yamada Ota hybrid model are higher than for the case of the Hamilton Crosser hybrid model.Developing a model is applicable to the printing process,electronic devices,temperature measurements,engineering process and food-making process.The amount of mass species is reduced vs.incline impacts of chemical reaction and Schmidt parameter.
文摘BACKGROUND It is generally accepted that the incidence of hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-associated patients is higher than that in hepatitis B virus(HBV)-associated patients.The reason why this difference in the incidence of HCC occurs in patients with HBV and HCV infections remains unclear.We report the possibility that the contributing power of inflammation,which is the main risk factor for developing HCC,may be different with HBV and HCV infections.AIM To investigate this,we surveyed the hazard ratio of inflammation for HCC development which was identified by serum alanine aminotransferase(ALT)levels between patients with HBV and HCV infections.METHODS The PubMed database was searched(2001-2021)for studies published in English regarding the incidence of HCC identifying 8924 HBV-and 7376 HCV-infected patients.From these studies,interferon-treated patients with both HBV and HCV infections were excluded.Furthermore,in HBV patients,those administered nucleos(t)ide analogues were excluded,and in HCV patients,those administered direct acting antivirals were also excluded.Studies citing hazard ratios of HCC regarding inflammation(serum elevated alanine aminotransferase levels)were selected.Finally,there were 14 studies of HBV-infected patients and 8 studies of HCV-infected patients.We calculated the hazard ratio in patients in an inflammatory state(serum ALT levels were above the normal range).RESULTS In the 14 studies of HBV patients,the average hazard ratio(HR)of elevated ALT for developing HCC was 2.74[1.98-3.77]and that in the 8 studies of HCV-infected patients was 5.51[3.08-9.83].The HR of inflammation for HCC development in HCV-associated liver diseases is about twice that in HBV-associated liver diseases.HR in HCV-infected patients was significantly(P=0.0391)higher than that in HBV-infected patients.In hepatitis B patients,the abnormal range adopted was 28-45 IU/L,and in hepatitis C patients,it was 20-50 IU/L.It was demonstrated that the abnormal ALT levels adopted in hepatitis B and C patients were very similar in this series.CONCLUSION The difference in the incidence of HCC development between HBV and HCV patients may depend on the difference in the hazard risk of ALT between HBV and HCV infections.
