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In this study, an experimental study was carried out to determine the effects of adding different amounts of graphene oxide (GO) on engine characteristics to a single-cylinder diesel engine operating with 30% sesame oil (SO) + 70% diesel fuel mixture. After that, an optimization was carried out with response surface methodology (RSM) to determine optimum operating conditions at different engine loads. Experimental results showed that GO nanoparticle is a good addition for diesel–biodiesel blends to enhance the performance and reduce emissions. The most appropriate amount of GO is between 75 ppm and 100 ppm for the performance characteristics. The optimal amount of GO for power is 75 ppm, while for brake-specific fuel consumption (BSFC) and exhaust gas temperature (EGT) it is 100 ppm. In addition, the maximum GO amount of 100 ppm is the most suitable for carbon monoxide (CO) and hydrocarbon (HC), and 75 ppm GO amount is the most appropriate for nitrogen oxides (NOx). On the other hand, optimization results revealed that 100 ppm GO at 1950 W load was optimum conditions for all responses. The responses that emerged under optimum conditions were 1746.77 W, 968.73 g/kWh, 259.8 ⁰C, 0.0603%, 23.13 ppm and 185.61 ppm for power, BSFC, EGT, CO, HC, and NOx, respectively. According to the validation study, the error between the optimum and experimental results is 4.69% maximum. According to the findings of study, it can be concluded that the RSM model can successfully model a single-cylinder diesel engine and thus save time, and money.

Background: Over one-third of the U.S. population is exposed to unsafe levels of ozone (O3). Dietary supplementation with fish oil (FO) or olive oil (OO) has shown protection against other air pollutants. This study evaluates potential cardiopulmonary benefits of FO or OO supplementation against acute O3 exposure in young healthy adults. Methods: Forty-three participants (26 ± 4 years old; 47% female) were randomized to receive 3 g/day of FO, 3 g/day OO, or no supplementation (CTL) for 4 weeks prior to undergoing 2-hour exposures to filtered air and 300 ppb O3 with intermittent exercise on two consecutive days. Outcome measurements included spirometry, sputum neutrophil percentage, blood markers of inflammation, tissue injury and coagulation, vascular function, and heart rate variability. The effects of dietary supplementation and O3 on these outcomes were evaluated with linear mixed-effect models. Results: Compared with filtered air, O3 exposure decreased FVC, FEV1, and FEV1/FVC immediately post exposure regardless of supplementation status. Relative to that in the CTL group, the lung function response to O3 exposure in the FO group was blunted, as evidenced by O3-induced decreases in FEV1 (Normalized CTL −0.40 ± 0.34 L, Normalized FO −0.21 ± 0.27 L) and FEV1/FVC (Normalized CTL −4.67 ± 5.0 %, Normalized FO −1.4 ± 3.18 %) values that were on average 48% and 70% smaller, respectively. Inflammatory responses measured in the sputum immediately post O3 exposure were not different among the three supplementation groups. Systolic blood pressure elevations 20-h post O3 exposure were blunted by OO supplementation. Conclusion: FO supplementation appears to offer protective effects against lung function decrements caused by acute O3 exposure in healthy adults.

In this study a series of pyrazole-3,4-dicarboxamide (3–10) derivatives bearing sulfonamide moiety were synthesized starting from 1-(3-nitrophenyl)-5-phenyl-1H-pyrazole-3,4-dicarboxylic acid (1). The structures of synthesized molecules were characterized by FT-IR, 1H NMR, 13C NMR, and elemental analysis methods. Human carbonic anhydrase isoenzymes (hCA I and hCA II) were purified separately from erythrocyte cells by the Sepharose-4B-L-tyrosine-sulfanilamide affinity column chromatography and inhibitory effects of newly synthesized sulfonamides on esterase activities of these isoenzymes have been studied as in vitro. The Ki values of compounds were found in the range of 0.056–110.400 μM for hCA I and 0.057–533.400 μM for hCA II. Compound 4 has the highest inhibitory effect for hCA I and hCA II while compound 5 showed lowest inhibition. The structure–activity relationships for the inhibition of these isoforms with the pyrazole-sulfonamides reported here were also elucidated. Keywords: Pyrazole, Pyrazole-3,4-dicarboxamide, Synthesis, Reduction, Carbonic anhydrase, Enzyme inhibition

Background: Ischemia–reperfusion injury causes various severe morphological and functional changes in diabetic patients. To date, numerous antidiabetic and antioxidant agents have been used for treatment of the disease-related changes. Objectives: We aimed to examine effective therapeutic doses or doses of berberine against renal ischemia/reperfusion injury (IRI) in a streptozotocin (STZ)-induced diabetic rat model by histopathological and biochemical analysis. Methods: Thirty male Sprague Dawley rats were treated with STZ injection for the development of diabetes, and divided into the following groups: STZ-induced diabetic group (STZ); IRI-induced diabetic group (STZ + IRI); 50 mg/kg berberine (BRB) treated diabetic group after inducing IRI (STZ + IRI + BRB1); 100 mg/kg BRB treated diabetic group after IRI (STZ + IRI + BRB2); 150 mg/kg BRB treated diabetic group after IRI (STZ + IRI + BRB3). Bilateral renal ischemia model was applied for 45 min, then reperfusion was allowed for 14 days in STZ-induced diabetic rats. Renal injury was detected histopathologically. Blood urea nitrogen (BUN), creatinine and lactate dehydrogenase (LDH) levels were measured in serum using the ELISA method. Total antioxidant status (TAS) and total oxidant status (TOS) of renal tissue was studied by spectrophotometric assay. Oxidative stress index (OSI) was calculated as TOS-to-TAS ratio. Tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), Na+/K+-ATPase (sodium pump), and Ca2+-ATPase (calcium ATPase) enzyme levels were measured in tissues using the ELISA method. Anti-apoptotic Bax and pro-apoptotic Bcl-2 protein levels were detected by Western blot analysis. All data were evaluated statistically. Results: The highest histopathological score was detected in the STZ + IRI group compared to the other group. BRB administration at the doses of 100 mg/kg and 150 mg/kg markedly improved renal injury. BUN and creatinine levels significantly increased in the STZ + IRI group compared to the STZ group (p

In this study, we explore the volatility structure of BIST 100 index returns through Markov Regime Switching VAR model in the domain of credit risk indicators of Turkey. Also, July 2016 coup attempt has been added to the model, to examine its impact on the volatility. According to the results, Asset Swap spread displays better performance than other two credit risk indicators in signaling. Markov Regime Switching results demonstrate that while BIST 100 return volatility is not affected by credit risk in low volatility regime, in high volatility regime, CDS, ASW and ZV spreads have a significant impact on the volatility. This effect, however, can be omitted due to its very low coefficient. Finally, it is seen that July 2016 coup attempt and following operations did not cause any increase in BIST 100 return volatility. Keywords: CDS spread, Asset swap spread, Zero-volatility spread, Credit risk, Political risk, JEL classification: D72, F59, P16, G32

Drug use is associated with increased sexual risk behaviors. We examined whether decreases in drug use risk are associated with reduction in HIV-related sex risk behaviors among adults. Data was from a cohort of participants (n = 574) identified by drug use screening in a randomized trial of brief intervention for drug use in an urban primary care setting. Inverse probability of treatment weighted (IPTW) logistic regression models were used to examine the relationship between decreases in drug use risk and sex-related HIV risk behavior reduction from study entry to six months. Weights were derived from propensity score modeling of decreases in drug use risk as a function of potential confounders. Thirty seven percent of the study participants (213/574) reported a decrease in drug use risk, and 7% (33/505) reported decreased sex-related HIV risk behavior at the six-month follow-up point. We did not detect a difference in reduction of risky sexual behaviors for those who decreased drug use risk (unadjusted: OR 1.32, 95% CI 0.65–2.70; adjusted OR [AOR] 1.12, 95% CI 0.54–2.36). Adults who screened positive for high drug use risk had greater odds of reducing sex risk behavior in unadjusted analyses OR 3.71, 95% CI 1.81–7.60; but the results were not significant after adjusting for confounding AOR 2.50, 95% CI 0.85–7.30). In this primary care population, reductions in HIV sex risk behaviors have complex etiologies and reductions in drug use risk do not appear to be an independent predictor of them. Keywords: Sex risk behavior, Unprotected sex, Drug use, HIV/AIDS

Cystic pheochromocytoma is a very rare entity.Preoperative diagnosis is difficult because clinical, biochemical and radiologic findings are usually not consistent with a pheochromocytoma.Open surgery is traditionally the gold standard to avoid cyst rupture.we present a case of a 6 cm cystic pheochromocytoma treated by laparoscopy.

In this study, we analyze the effects of internal political risk on the Turkish stock market in the period of 2001–2014. Empirical analyses are conducted through various methods to obtain breaks and regimes in the return volatilities of the BIST100 index. According to the results, while the number of breaks has increased in recent years, the risk level of recent periods is significantly lower than the early regimes, and the risk level trend for all regimes show a negative slope. In conclusion, the Turkish stock market responds to political events, but according to our results, not as significantly as in the past.

Hippocampal hyperactivity has been proposed as a biomarker in schizophrenia. However, there is a debate whether the CA1 or the CA2/3 subfield is selectively affected. We studied 15 schizophrenia patients and 15 matched healthy control subjects with 3T steady state, gadolinium-enhanced, absolute cerebral blood volume (CBV) maps, perpendicular to the long axis of the hippocampus. The subfields of the hippocampal formation (subiculum, CA1, CA2/3, and hilus/dentate gyrus) were manually segmented to establish CBV values. Comparing anterior CA1 and CA2/3 CBV between patients and controls revealed a significant subfield-by-diagnosis interaction. This interaction was due to the combined effect of a trend of increased CA1 CBV (p = .06) and non-significantly decreased CA2/3 CBV (p = 0.14) in patients relative to healthy controls. These results support the emerging hypothesis of increased hippocampal activity as a biomarker of schizophrenia and highlight the importance of subfield-level investigations.

Human exposure to particulate matter (PM) is a global environmental health concern. Zinc (Zn2+) is a ubiquitous respiratory toxicant that has been associated with PM health effects. However, the molecular mechanism of Zn2+ toxicity is not fully understood. H2O2 and Zn2+ have been shown to mediate signaling leading to adverse cellular responses in the lung and we have previously demonstrated Zn2+ to cause cellular H2O2 production. To determine the role of Zn2+-induced H2O2 production in the human airway epithelial cell response to Zn2+ exposure. BEAS-2B cells expressing the redox-sensitive fluorogenic sensors HyPer (H2O2) or roGFP2 (EGSH) in the cytosol or mitochondria were exposed to 50 µM Zn2+ for 5 min in the presence of 1 µM of the zinc ionophore pyrithione. Intracellular H2O2 levels were modulated using catalase expression either targeted to the cytosol or ectopically to the mitochondria. HO-1 mRNA expression was measured as a downstream marker of response to oxidative stress induced by Zn2+ exposure. Both cytosolic catalase overexpression and ectopic catalase expression in mitochondria were effective in ablating Zn2+-induced elevations in H2O2. Compartment-directed catalase expression blunted Zn2+-induced elevations in cytosolic EGSH and the increased expression of HO-1 mRNA levels. Zn2+ leads to multiple oxidative effects that are exerted through H2O2-dependent and independent mechanisms.

Squamous cell carcinoma of the eyelid is a rare but severe tumor that causes functional and aesthetic damage and poses a significant threat to life through metastatic spread. It typically affects elderly individuals with fair skin and often develops from pre-existing lesions. Diagnosis is confirmed by biopsy. Imaging, using CT and MRI, is critical for assessing local and distant extension, guiding treatment, and monitoring progress. Primary treatment is surgical, aiming for complete resection and restoration of eyelid function, with radiotherapy or chemo-radiotherapy considered for metastatic cases on an individual basis. This report presents a case of unusual localization of eyelid SCC metastasis, showing the importance of performing a cross sectional imaging, particularly a CT NCAP, for distant extension assessment.

This study addresses the crucial challenge of monitoring the State of Health (SOH) of Lithium-Ion Batteries (LIBs) in response to the escalating demand for renewable energy systems and the imperative to reduce CO2 emissions. The research introduces deep learning (DL) models, namely Encoder-Long Short-Term Memory (E-LSTM) and Convolutional Neural Network-LSTM (CNN–LSTM), each designed to forecast battery SOH. E-LSTM integrates an encoder for dimensionality reduction and an LSTM model to capture data dependencies. CNN–LSTM, on the other hand, employs CNN layers for encoding followed by LSTM layers for precise SOH estimation. Significantly, we prioritize model explainability by employing a game-theoretic approach known as SHapley Additive exPlanations (SHAP) to elucidate the output of our models. Furthermore, a method based on pattern mining was developed, synergizing with the model, to identify patterns contributing to abnormal SOH decrease. These insights are presented through informative plots. The proposed approach relies on the battery dataset from the Massachusetts Institute of Technology (MIT) and showcases promising results in accurately estimating SOH values, in which the E-LSTM model outperformed the CNN–LSTM model with a Mean Absolute Error (MAE) of less than 1%.

Spray cooling is an effective method and thus finds many applications, including thermal management and energy production. In this regard, spray cooling with flat sprays is particularly crucial in applications with space constraints, as it efficiently dissipates heat while conforming to limited spatial requirements. Flat sprays ensure a wide yet uniform distribution of coolant, making it ideal for cooling systems in compact and densely packed environments. Motivated by these advantages, in this study, we performed an experimental study on the effect of major flat spray parameters, which are the spray flow rate (160 mL/min), spray upstream pressure (2.5 and 5.0 bars), spray angle (0, 30, and 90°), spray distance (3 and 10 cm), spray temperature (23 and 61 °C) and wall heat flux (10–100 W/cm2), on the two-phase heat transfer performance. According to the results, unlike full cone nozzles, the spray distance enhances heat transfer. While the cooling rate increased with the upstream pressure, the inlet temperature had a deteriorating effect on the heat transfer performance of the system. The results also indicated that the heat transfer rate decreased with the spray angle. The spray angle-induced effect on the system performance diminished with the spray pressure and temperature. The obtained results were used to develop two correlations for single phase and nucleate boiling heat transfer in flat sprays. The findings of this study suggest that flat sprays, with their significantly lower flow rates compared to full spray cone nozzles, effectively meet the requirements for direct thermal management by offering precise control, reduced fluid consumption, and enhanced efficiency.

Background: This in vivo study evaluated the effect of graphene oxide and graphite coatings, coupled with the micro-arc oxidation (MAO) surface roughening technique, known for their mechanical strength, chemical stability, and antibacterial properties. The main objective was to assess the degree of improvement in osseointegration of titanium implants resulting from these interventions. Materials and methods: In this study, 32 female rats were utilized and randomly allocated into four groups (n = 8 each): machined surface titanium implants (control), those roughened by the MAO method, those coated with graphene oxide-doped MAO, and those with a graphite-doped MAO coating. Titanium implants were surgically placed in the right tibia of the rats. Rats undergoing no additional procedures during the 4-week experimental period were sacrificed at the end. Then, the implants and surrounding bone tissues were separated and embedded in acrylic blocks for reverse torque analysis. Using a digital torque device, the rotational force was applied to all samples using a hex driver and racquet until implant separation from the bone occurred, with the corresponding values recorded on the digital display. Then, statistical analysis was performed to analyze the data. Results: No statistically significant difference between the groups was observed in the biomechanical bone–implant connection levels (N/cm) (P = 0.268). Post-hoc tests were not required because no discernible differences were identified between the groups. Conclusion: Within the scope of this study, implants treated with the MAO method, along with those coated with graphene oxide- and graphite-doped MAO method, did not exhibit significant superiority in terms of osseointegration compared to machined surface titanium implants.

Pneumosinus dilatans (PSD) is an abnormal dilatation and enlargement of one or more paranasal sinuses, extending beyond the anatomic bony boundaries, without defect or thinning of its bony walls. It is documented by only a few reports. Usually asymptomatic, it is in general found incidentally on imaging. It is important for radiologists to recognize the diagnosis and rule out eventual associated conditions such as meningiomas, orbital tumors, arachnoid cysts, and fibrous dysplasia. We report the case of PSD diagnosed incidentally in a 51-year-old female patient who presented to the emergency department with confusion.

Lithium-ion batteries play a crucial role in powering various applications, including Electric Vehicles (EVs), underscoring the importance of accurately estimating their State Of Health (SOH) throughout their operational lifespan. This paper introduces two novel models: a Transformer (TOPS-SoH) and a Long Short-Term Memory based (LSTM-OSoH) for One-shot Prediction of SOH. The LSTM-OSoHexcels in accuracy, achieving a Masked Mean Absolute Error (MMAE) of less than 0.01 for precise SOH estimation, while the TOPS-SoHdemonstrates simplicity and efficiency, with accuracy comparable to state-of-the-art models. The TOPS-SoHmodel also offers additional interpretability by providing insights into the attention scores between inputs and outputs, highlighting the cycles used for estimation. These models were trained using the MIT battery dataset, with auto-encoders employed to reduce the dimensionality of the input data. Additionally, the models’ effectiveness was validated against a Bidirectional LSTM (BiLSTM) baseline, demonstrating superior performance in terms of lower MMAE, MMSE, and MAPE values, making them highly suitable for integration into Battery Management Systems (BMS). These findings contribute to advancing SOH estimation up to the End Of Life (EOL), which is crucial for ensuring the reliability and longevity of lithium-ion batteries in diverse applications.

Alfa fiber-reinforced self-compacting mortars (SCMs) offer enhanced workability. Thus, the potential of combining natural Alfa fibers and ground granulated blast furnace slag (GBFS) to optimize the rheological and mechanical properties was ascertained. The effect of fibers and GBFS on the properties of SCMs after treatment with linseed oil and NaOH was also evaluated. Partial substitution of cement by slag (10 % and 30 %.) was achieved. Mini cone spreading, V-funnel flow tests as well as compressive and bending tests at 7 days and 28 days were performed on the prepared mixtures. For optimization and predictive purposes, both Taguchi optimization and Artificial Neural Network modeling were employed. Our results indicated that, according to Taguchi experimental design, the use of 1 % fiber in the initial mixture achieved a good distribution within the paste and improved flexural strength. In addition, the treatment of fibers with NaOH actually improved the structure and bonding surface. Fiber content and GBFS replacements achieved the desired rheological and mechanical characteristics. Prediction of both compressive and flexural strengths was successfully achieved by an accurate application of machine a learning algorithm based on six inputs, one hidden layer and four outputs. The combined ANN-Taguchi approach provided accurate predictions of SCM performances and identified a robust mix-design that was less prone to fluctuations in the initial material properties. Alfa fibers and GBFS promoted both fresh and hardened properties. This study demonstrated the effectiveness ML and statistical optimization in developing high-performance, sustainable-SCMs with superior workability and strengths, making them ideal for various construction applications.

Intracellular redox homeostasis in the airway epithelium is closely regulated through adaptive signaling and metabolic pathways. However, inhalational exposure to xenobiotic stressors such as secondary organic aerosols (SOA) can alter intracellular redox homeostasis. Isoprene hydroxy hydroperoxide (ISOPOOH), a ubiquitous volatile organic compound derived from the atmospheric photooxidation of biogenic isoprene, is a major contributor to SOA. We have previously demonstrated that exposure of human airway epithelial cells (HAEC) to ISOPOOH induces oxidative stress through multiple mechanisms including lipid peroxidation, glutathione oxidation, and alterations of glycolytic metabolism. Using dimedone-based reagents and copper catalyzed azo-alkynyl cycloaddition to tag intracellular protein thiol oxidation, we demonstrate that exposure of HAEC to micromolar levels of ISOPOOH induces reversible oxidation of cysteinyl thiols in multiple intracellular proteins, including GAPDH, that was accompanied by a dose-dependent loss of GAPDH enzymatic activity. These results demonstrate that ISOPOOH induces an oxidative modification of intracellular proteins that results in loss of GAPDH activity, which ultimately impacts the dynamic regulation of the intracellular redox homeostatic landscape in HAEC.

The aim of this study is to comparatively analyze the performance of machine learning (ML) algorithms for modeling soil salinity using field-based electrical conductivity (EC) data and Landsat-8 OLI satellite images with derived environmental covariates. We also aim to interpret and explain the ML models with and without over-sampling methods using Shapley (SHAP) values, an explainable ML approach that has not yet been utilized for soil salinity estimation tasks as an ML problem. We investigate two case study areas from western and southeastern Lake Urmia Playas (LUP) in the Northwest of Iran. Our study uses 26 environmental covariates, two ML models, namely extreme gradient boosting (XGBoost) and random forest (RF), and two over-sampling methods: synthetic minority over-sampling technique (SMOTE) and random over-sampling (ROS). Results indicate that XGBoost performs better compared to RF in terms of both R2 and RMSE. Additionally, the visual interpretation of soil salinity maps demonstrated the superiority of XGBoost. SMOTE produced superior results than ROS and no over-sampling test cases. Finally, SHAP analysis illustrated that vegetation indices made a greater contribution to the soil salinity prediction in the West LUP, while visible bands contributed more in the Southeast LUP Region.

Cyberloafing is the use of (e.g. smartphones, tablets, laptops, and the Internet) for purposes other than work related reasons during work hours. Although cyberloafing in the workplace has been widely investigated, there is relatively a small number of studies on cyberloafing behaviors in educational settings, which refer to students' tendencies to use technology for non-class-related purposes during lectures. The goal of the current study is to determine how frequently and for what purposes speech and language therapy (SLT) students at Biruni University engage in cyberloafing during lectures. In this quantitative study, The Cyberloafing Scale was administered to 264 undergraduate students (235 female; 27 male; 2 preferred not to disclose). The results revealed that SLT students’ cyberloafing behavior was very high. However, there is no statistically significant difference between the gender variable and the overall mean score for cyberloafing. There is a statistically significant difference between genders in gaming/gambling subscale favoring males and in shopping subscale favoring females. Further studies should be conducted to analyze cyberloafing behavior in health education.

Ortner's syndrome refers to vocal cord paralysis resulting from compression of the left recurrent laryngeal nerve by abnormal mediastinal vascular structures. We present a case of an 89-year-old man who was an active smoker, with a clinical history of hypertension, who presented hoarseness of voice with chronic evolution. Neck and Thoracoabdominal CT angiography was performed revealing a thrombosed aneurysm of the aortic arch.

Congenital duodenal obstruction is a common cause of bowel obstruction. It is relatively easy to diagnose in the neonatal period. However, if the obstruction is due to a duodenal diaphragm, diagnosis may be delayed until later in infancy or even adulthood, depending on the size of the aperture in the diaphragm. Congenital duodenal obstruction may be associated with other gastrointestinal and biliary anomalies. The association of a duodenal diaphragm and a partial annular pancreas is a rare clinical entity. We present an unusual case of late presentation of duodenal diaphragm with partial annular pancreas in a 10-year-old girl with a 3-month history of abdominal distension and vomiting. The plain abdominal X-ray showed the classic picture of a double bubble. The CT images showed narrowing of the third duodenal portion and dilatation of the stomach and duodenum. The pancreatic tissue incompletely surrounded the second part of the duodenum. Intraoperatively, both the duodenal diaphragm and the partial annular pancreas were confirmed. Excision of the diaphragm and duodenoplasty were performed. A duodenal diaphragm should be suspected in patients with a history of abdominal distension and vomiting, even in late childhood. Associated gastrointestinal and biliary anomalies should always be excluded.

The aim of this study was to evaluate the effects of three disinfection solutions on the amount of monomers released from resin nanoceramic CAD/CAM blocks using high performance liquid chromatography (HPLC). Forty resin nanoceramic CAD/CAM (Cerasmart, GC, Japan) samples (12x14 × 2 mm) were divided into four groups; each group was disinfected using one of four solutions (Group 1: no disinfectant; Group 2: 70 % ethanol; Group 3: 2 % glutaraldehyde; and Group 4: 1 % sodium hypochlorite) for 5 min. Analysis of residual monomers (UDMA and Bis-EMA) amounts was performed using an HPLC instrument (Dionex Ultimate 3000, Thermo Fisher Scientific). After 30 days, the amounts of monomers found were as follows: 14.54 ppm for Group 1; 9.28 ppm for Group 2; 10.60 ppm for Group 3; and 2.76 ppm for Group 4 (the smallest monomer amount) (p

Introduction: Lipopolysaccharide (Lps) is an essential component responsible for the virulence of gram-negative bacteria. Lps can cause damage to many organs, including the heart, kidneys, and lungs. Dexpanthenol (Dex) is an agent that exhibits anti-oxidative and anti-inflammatory effects and stimulates epithelialization. In this study, we aimed to investigate the effects of Dex on Lps-induced cardiovascular toxicity. Methods: Rats were divided into four groups: control, Lps (5 mg/kg, intraperitoneal), Dex (500 mg/kg, intraperitoneal), and Lps + Dex. The control group received saline intraperitoneally (i.p.) once daily for three days. The Lps group received saline i.p. once daily for three days and a single dose of Lps i.p. was administered on the third day. The Dex group received Dex i.p. once daily for three days and saline on the third day. The Lps + Dex group received Dex i.p. once daily for three days and a single dose of Lps i.p. on the third day. Heart and aortic tissues were taken for biochemical, histopathological, immunohistochemical, and genetic analysis. Results: Lps injection caused histopathological changes in both heart and aortic tissues and significantly increased total oxidant status and oxidative stress index levels. Interleukin-6, and Tumor necrosis factor-α mRNA expressions were significantly altered in heart and aorta, likely do to the anti-inflammatory and antioxidative effects of Dex. Furthermore, Dex affected Caspase-3 and Hypoxia-inducible factor 1-α staining patterns. Conclusions: Our results show that Dex treatment has a protective effect on Lps-induced cardiac and endothelial damage in rats by reducing inflammation, oxidative stress, and apoptosis.

Federated Learning (FL) is a type of distributed deep learning framework in which multiple devices train a local model using local data, and the gradients of the local model are then sent to a central server that aggregates them to create a global model. This type of framework is ideal where data privacy is of utmost importance because the data never leave the local device. However, a major concern in FL is ensuring the data quality of local training data. Since there is no control over the local training data, ensuring that the local model is trained on clean data becomes challenging. A model trained on poor-quality data can have a significant impact on its accuracy. In this paper, we propose a decentralized approach using blockchain to ensure local model data quality. We use miners to validate each local model by checking its accuracy against a secret testing dataset. This is done using a smart contract that the miners invoke during the mining process. The local model is aggregated with the global model only if it passes a preset accuracy threshold. We test our proposed method on two datasets: the Brain Tumor Classification dataset from Kaggle, comprised of 7000 MRI images divided into two classes (Tumor/No Tumor), and the Medical MNIST dataset, which includes 58,954 images classified into six different classes: AbdomenCT, BreastMRI, ChestCT, Chest X-ray, Hand X-ray, and HeadCT. Our results show that our method outperforms the original FL approach in all experiments.

Simulation-based medical education is becoming a cornerstone in health education. Simulators are commonly expensive and not available in developing countries.We propose a very low-cost simulator that any educator can realize. We describe here the steps to follow to develop this proposed simulator.

ABSTRACT: Heavy selection for growth in turkeys has led to a decay in leg soundness and walking ability. In this study, different models and traits were used to investigate the genetic relationships between body weight (BW) and walking ability (WA) in a turkey population. The data consisted of BW and WA traits collected on 276,059 male birds. Body weight was measured at 12 and 20 wk and WA at 20 wk of age. For WA, birds were scored based on a 1 (bad) to 6 (good) grading system. Due to the small number of records with scores 5 and 6, birds with WA scores of 4, 5, and 6 were grouped together resulting in only 4 classes. Additionally, a binary classification of WA (scores 1 and 2 = Similarly, an estimate of the genetic correlation between WA and BW at 20 wk was −0.45, indicating a more pronounced class 1; scores 3, 4, 5, and 6 = class 2) was evaluated. The inheritability estimates of WA ranged between 0.25 and 0.27 depending on the number of classes. The Heritability of BW at 12 and 20 wk was 0.44 and 0.51, respectively. The genetic correlation between WA and BW at 12 wk was around −0.35, indicating that heavy birds tend to have poor WA. antagonistic relationship between BW and WA. The genetic correlation between BW at 12 and 20 wk was positive and high (0.80). The residual correlation between WA and BW at 12 and 20 wk of age was −0.07 and −0.02, respectively. The residual correlation between body weight traits was 0.57. Similar results were observed when a binary classification was adopted for WA. The probability of an individual with a given genetic merit expressing a certain class of WA was determined for different fixed effect designations. Predictive probabilities clearly showed that birds when hatched in the winter would have a small chance to exhibit good WA phenotypes.

Dual active bridge DC-DC converters (DAB) are one of the bidirectional converters and mainly used in electric vehicles and micro grids. With the increasing number of electric vehicles in use, and the increasing amount of batteries in these vehicles and rapidly spanning micro grids, the importance of DAB converters has increased and they are expected to be smaller in size and operate at higher power levels. The reduction in size has increased the importance of power density and efficiency, which are two significant parameters of DAB circuits. One of the methods to increase efficiency and power density is to increase the switching frequency. However, with the increase at the switching frequency, electromagnetic interference (EMI) in the DAB circuit also increases.In this manuscript, the change in the EMI values emitted by conduction, according to the phase shift modulation methods at DAB converters are evaluated. Also the effect of type of MOSFETs on conducted EMI is examined. Prototypes of the DAB converters by using Si and SiC MOSFETs with power rating of 1 kW are designed and developed. Switching frequency of converter is 25 kHz and leakage inductance is determined 81uH and 75uH. Si based circuit is operated with %88.5 efficiency. SiC based circuit is also operated with %88 efficiency. The designed circuits are operated using the phase shift modulations SPS and DPS. Conducted emission noise emitted by these circuits are analyzed by dividing them into common mode and difference mode noises. It has been observed that the EMI value when using SPS method is 15–20 dBµV lower than the EMI when using DPS method. The relationship between the measured noises and the efficiency of the circuits was observed.

Introduction: Amidst a surge in HIV and hepatitis C virus (HCV) infections in persons who use drugs, medications that effectively prevent HIV and treat opioid use disorder and HCV remain underutilized. Methods: We developed a 6-month peer recovery coaching intervention (brief motivational interviewing followed by weekly virtual or in-person coaching) and collected data on uptake of medications for opioid use disorder (MOUD), HIV pre-exposure prophylaxis (PrEP), and HCV treatment. The primary outcomes were intervention acceptability and feasibility. Results: At a Boston substance use disorder bridge clinic, we enrolled 31 HIV-negative patients who used opioids. Participants reported high intervention satisfaction at 6 months (95% “satisfied” or “very satisfied”). At study completion, 48% of the participants were on MOUD, 43% who met CDC guidelines were on PrEP, and 22% with HCV were engaged with treatment. Conclusions: A peer recovery coaching intervention is feasible and acceptable, with positive preliminary findings regarding MOUD, PrEP and HCV treatment uptake.

While redox processes play a vital role in maintaining intracellular homeostasis by regulating critical signaling and metabolic pathways, supra-physiological or sustained oxidative stress can lead to adverse responses or cytotoxicity. Inhalation of ambient air pollutants such as particulate matter and secondary organic aerosols (SOA) induces oxidative stress in the respiratory tract through mechanisms that remain poorly understood. We investigated the effect of isoprene hydroxy hydroperoxide (ISOPOOH), an atmospheric oxidation product of vegetation-derived isoprene and a constituent of SOA, on intracellular redox homeostasis in cultured human airway epithelial cells (HAEC). We used high-resolution live cell imaging of HAEC expressing the genetically encoded ratiometric biosensors Grx1-roGFP2, iNAP1, or HyPer, to assess changes in the cytoplasmic ratio of oxidized glutathione to reduced glutathione (GSSG:GSH), and the flux of NADPH and H2O2, respectively. Non-cytotoxic exposure to ISOPOOH resulted in a dose-dependent increase of GSSG:GSH in HAEC that was markedly potentiated by prior glucose deprivation. ISOPOOH-induced increase in glutathione oxidation were accompanied by concomitant decreases in intracellular NADPH. Following ISOPOOH exposure, the introduction of glucose resulted in a rapid restoration of GSH and NADPH, while the glucose analog 2-deoxyglucose resulted in inefficient restoration of baseline GSH and NADPH. To elucidate bioenergetic adaptations involved in combatting ISOPOOH-induced oxidative stress we investigated the regulatory role of glucose-6-phosphate dehydrogenase (G6PD). A knockout of G6PD markedly impaired glucose-mediated recovery of GSSG:GSH but not NADPH. These findings reveal rapid redox adaptations involved in the cellular response to ISOPOOH and provide a live view of the dynamic regulation of redox homeostasis in human airway cells as they are exposed to environmental oxidants.

Cigarette smoking remains as a major preventable cause of morbidity and mortality around the world. Smoking causes many diseases and use of tobacco products is known to have detrimental effects on the user, leading to the causation of numerous adverse health outcomes.Evaluation of the user's risk following cessation of tobacco products has shown to vary with the affected organ, reflecting the temporal dynamics of the underlying disease processes. The potential utility of biomarkers for smoking cessation can provide a measure of the damage from use of tobacco products and the impact on affected organs after cessation of tobacco products.For this review we focus on three common sets of diseases for which there are potential biomarkers of improved health within a relatively short period of time after smoking cessation: cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), and oral disease. For each set of diseases, we provide an overview including disease burden and epidemiology; a discussion of disease process/pathogenesis; potential biomarkers of improved health after smoking cessation with examples of their application; and future directions.

Introduction: Surgical treatment options are limited for nasopharyngeal cancer for many reasons including epidemiological and histological properties, proximity to important structures, heavy lymphatic drainage, and the difficulty in ensuring a safe surgical margin; therefore primary treatment is generally radiotherapy and chemotherapy. With current radiotherapy technology, oncological success has been increased and the quality of life of patients during the post- radiotherapy period is improved. Objective: The role of magnetic resonance imaging and positron emission-computed tomography in the follow-up of recurrent nasopharyngeal cancer patients who were initially treated with radiotherapy was evaluated with respect to histopathological findings. Methods: A total of 110 patients with nasopharyngeal cancer who had received radiotherapy were included in the study. Patients who were suspected to have recurrence according to endoscopic nasopharyngeal examination and magnetic resonance imaging findings were requested to undergo positron emission-computed tomography. Biopsies were taken from 40 patients who had suspicious lesions in positron emission-computed tomography images. These patients’ age, gender, presence/absence of contrast enhancement on magnetic resonance imaging, the SuvMax values of nasopharyngeal and neck lesions, T/N phases at initial diagnosis, histopathological recurrence, and history of neck dissection were assessed. Results: Recurrence was observed in 8 patients (20.0%). Among these, 4 (10.0%) had recurrence at the nasopharynx and 4 (10.0%) at the neck. Patients with recurrence were found to be of older age, male gender, advanced T/N phase, contrast enhancement on magnetic resonance imaging, and higher nasopharyngeal and neck SuvMax values in positron emission-computed tomography. However, these differences were not statistically significant. Only the history of neck dissection was significantly more common among those with recurrence (p

ABSTRACT: Objective: To compare the effectiveness of different mask types in limiting the dispersal of coughed air. Method: The Schlieren method with a single curved mirror was used in this study. Coughed air has a slightly higher temperature than ambient air, which generates a refractive index gradient. A curved mirror with a radius of curvature of 10 m and a diameter of 60 cm was used. The spread of the cough wavefront was investigated among five subjects wearing: (1) no mask; (2) a single surgical mask; (3) a double surgical mask; (4) a cloth mask; (5) a valveless N95 mask; and (6) a valved N95 mask. Results: All mask types reduced the size of the contaminated region significantly. The percentage reduction in the cross-sectional area of the contaminated region for the same mask types on different subjects revealed by normalized data suggests that the fit of a mask plays an important role. Conclusions: No significant difference in the spread of coughed air was found between the use of a single surgical mask or a double surgical mask. Cloth masks may be effective, depending on the quality of the cloth. Valved N95 masks exclusively protect the user. The fit of a mask is an important factor to minimize the contaminated region.

Introduction: Fitted filtration performance of an N95 respirator may benefit from differing levels of instructions. Methods: Using a modified Occupational Safety and Health Administration fit test protocol, we measured fitted filtration efficiency for an N95 respirator in 21 screened, healthy participants given 4 levels of escalating instruction: (1) uninstructed (baseline), (2) written/pictorial manufacturer instructions, (3) step-by-step video demonstration, and (4) staff instruction (visual inspection of respirator fit and verbal suggestions to adjust when applicable). Results: Baseline fitted filtration efficiency was not significantly different between participants with or without previous experience of N95 use. Clear improvements in fitted filtration efficiency were observed progressing from baseline (average=86.1%) to manufacturer paper instructions (93.3%), video instructions (97.5%), and post staff intervention (98.3%). Baseline fitted filtration efficiency values were significantly lower than those after video instruction (p

Disposable facemasks are a primary tool to prevent the transmission of SARS-COV-2 during the COVID-19 pandemic. However, plastic waste generated from their disposal represents a significant environmental problem that can be reduced by maximizing the service life of disposable masks. We evaluated the effect of repeated wearing on the fitted filtration efficiency (FFE) of N95, KF94, KN95, and procedure/surgical masks. The FFEs of masks were compared following extended wearing with and without washing. Results reveal that most disposable facemasks can retain a high level of their baseline FFE after extended wearing, even after 40 h of wearing. Laundering disposable masks degraded FFE in some instances. We conclude that the durability of disposable facemask performance is considerably longer than their intended single use indication, suggesting that reusing disposable masks is a safe means of reducing plastic waste in the environment.

Background: Exposure to ambient air pollution is associated with increased cardiovascular morbidity and mortality. Circulating microRNAs (miRNAs) may mediate cardiovascular effects of exposure to air pollution. This study aims to investigate whether circulating miRNAs mediate the associations between short-term human exposure to ambient air pollution and cardiovascular biomarkers. Methods: Twenty-four healthy adults residing in the Research Triangle area of North Carolina, USA were enrolled between December 2016 and July 2019. Circulating miRNAs, protein, and lipid biomarkers were assessed repeatedly for 3 sessions separated by at least 7 days. Linear mixed-effects models were used to assess the associations between air pollutant concentrations obtained from nearby air quality monitoring stations and miRNAs controlling for covariates including omega-3 index, relative humidity, and temperature. miRNAs that were significantly altered were then matched with protein or blood lipid biomarkers using either Ingenuity Pathway Analysis or a literature search. A mediation analysis was performed to test the statistical significance of miRNA’s mediating effects between exposure to air pollution and cardiovascular biomarkers. Results: Short-term exposure to ambient fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) was associated with changes in 11, 9, and 24 circulating miRNAs, respectively. Pathway analysis showed that several miRNAs including miR-125b-5p, miR-144–5p, miR-26a-5p, and miR-34a-5p may mediate the effects of air pollutant exposure on the changes of downstream protein / lipid biomarkers including serum amyloid A (SAA), C-reactive protein (CRP), soluble vascular adhesive molecules 1 (sICAM1), total cholesterol, and high-density lipoproteins (HDL). Mediation analysis showed that only miR-26a-5p significantly mediated air pollutant (PM2.5 and NO2)-induced effects on blood CRP and total cholesterol levels. For example, 34.1% of PM2.5–associated changes in CRP were significantly mediated by miR-26a-5p at lag4 [indirect effects, 0.06 (0.02, 0.10), P = 0.005]. Similarly, the proportions of indirect effects of miR-26a-5p on the association between NO2 exposure and CRP were 46.8% at lag2 [0.06 (0.02, 0.11), P = 0.003], 61.2% at lag3 [0.05 (0.00, 0.09), P = 0.04], and 30.8% at 5-day moving average [0.06 (0.02, 0.10), P = 0.01]. In addition, omega-3 index may be a significant modifying factor of the mediated effects of miRNAs. Conclusions: This study demonstrates that short-term exposure to ambient PM2.5, O3, and NO2 was associated with specific circulating miRNAs, and some of which may mediate their effects on the downstream inflammation and blood lipid markers.

This study investigated the potential use of metalworking (cutting) fluid as an surface additive in the production of medium density fiberboard (MDF). The cutting fluid was sprayed on the mat surface of the fiberboard at different loading levels, of 3.5 g/m2, 7 g/m2, and 14 g/m2 (5 wt% or 10 wt% concentration levels) before the hot pressing. Some physical and mechanical properties of the resulting MDF specimens were carried out according to European standards. The bending strength and bending modulus, internal bond strength improved with the addition of the cutting fluid into the surface layers while the thickness swelling and water absorption decreased. This might be related to the fact that there was no hydrophobic chemical used in the production. The improvement in the adhesive bond between the fibers may be explained by the enhanced heat transfer from surface to the core layer of the MDF. The formaldehyde emission of the MDFs decreased with the incorporation of the cutting fluid. It was estimated that the crosslinking of the UF resin increased due to the higher thermal conductivity of the cutting fluid. The preliminary findings of the present study showed that the cutting fluid used in the metal industry could be efficiently used as surface additive in the production of the MDF.

Exposure to respirable air particulate matter (PM2.5) in ambient air is associated with morbidity and premature deaths. A major source of PM2.5 is the photooxidation of volatile plant-produced organic compounds such as isoprene. Photochemical oxidation of isoprene leads to the formation of hydroperoxides, environmental oxidants that lead to inflammatory (IL-8) and adaptive (HMOX1) gene expression in human airway epithelial cells (HAEC). To examine the mechanism through which these oxidants alter intracellular redox balance, we used live-cell imaging to monitor the effects of isoprene hydroxyhydroperoxides (ISOPOOH) in HAEC expressing roGFP2, a sensor of the glutathione redox potential (EGSH). Non-cytotoxic exposure of HAEC to ISOPOOH resulted in a rapid and robust increase in EGSH that was independent of the generation of intracellular or extracellular hydrogen peroxide. Our results point to oxidation of GSH through the redox relay initiated by glutathione peroxidase 4, directly by ISOPOOH or indirectly by ISOPOOH-generated lipid hydroperoxides. We did not find evidence for involvement of peroxiredoxin 6. Supplementation of HAEC with polyunsaturated fatty acids enhanced ISOPOOH-induced glutathione oxidation, providing additional evidence that ISOPOOH initiates lipid peroxidation of cellular membranes. These findings demonstrate that ISOPOOH is a potent environmental airborne hydroperoxide with the potential to contribute to oxidative burden of human airway posed by inhalation of secondary organic aerosols.

Introduction: Stroke is a public health problem worldwide. Community stroke knowledge is crucial to guide the prevention approach. We aimed to evaluate the level of stroke knowledge among the visitors to Emergency Centres (ECs) in the southern region of Tunisia concerning factors of risk, symptoms, and treatment of stroke. Methods: A multicenter cross-sectional survey about stroke knowledge; conducted in five ECs for 10 days. All the visitors to these ECs were invited to participate in this survey. In each center, one investigator had to conduct the questionnaire. We used the stroke knowledge test (SKT). Results: We enrolled 839 participants aged at 44 ± 7 years and with an M/F sex-ratio at 0.9. Relatives and mass media were the most reported sources of information about stroke. In 32.3% of cases, the participants had a university schooling level. The upper quartile had an SKT score of 55% or over (n = 247; 29.4%). The SKT score was significantly higher in young, female participants, in rural centers, with a university level of schooling and with no reported chronic diseases. Receiving information about stroke through the medium of television or via relatives was an independent predictor of a high SKT score compared with other knowledge sources. Conclusion: This study emphasises the urgent need for improving the population's knowledge about stroke in Tunisia. These findings may reflect the lack of government policies for education and training on stroke. A national educating program is necessary to implement to increase stroke knowledge.

Very recently, Yang, Abdel-Aty and Cattani (2019) introduced a new and intersting fractional derivative operator with non-singular kernel involving Rabotnov fractional-exponential function. In this paper, we present a general framework of the homotopy perturbation transform method (HPTM) for analytic treatment of time fractional partial differential equations in the sense of Yang-Abdel-Aty-Cattani. As applications, time fractional wave equations involving Yang-Abdel-Aty-Cattani fractional derivatives are solved. The solutions are obtained in the form of series involving Prabhakar functions.

This endeavour provides a new instance of understanding the velocity of a particle in Brownian motion, using the Fokker-Plank equation. Our treatment is based on the new mathematical tool invoked by Yang-Abdel-Aty-Cattani (YAC) to solve the fractional derivative on Fokker-Plank equation. The HPTM and RPSMs, are used to obtain the solution in terms of Prabhakar function. Numerical examples to extend these ideas and to establish the capability and truthfulness of the proposed method, which makes use of YAC-fractional derivative, is also briefly sketched.

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. This indicates the importance of chest trauma among all traumas. Blunt chest trauma is usually caused by motor vehicle accident, falling from height, blunt instrument injury and physical assault. As a result of chest trauma, many injuries may occur, such as pulmonary injuries, and these require urgent intervention. Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial injuries. Following these injuries, patients may present with a simple dyspnea or even respiratory arrest. For such patient, it is important to understand the treatment logic and to take a multidisciplinary approach to treat the pulmonary and chest wall injuries. This is because only 10% of thoracic trauma patients require surgical operation and the remaining 90% can be treated with simple methods such as appropriate airway, oxygen support, maneuvers, volume support and tube thoracostomy. Adequate pain control in chest trauma is sometimes the most basic and best treatment. With definite diagnosis, the morbidity and mortality can be significantly reduced by simple treatment methods.

Intra-vesical foreign bodies can be of variable nature and etiology, their introduction can be voluntary or not. The motivations most frequently associated with the presence of foreign bodies within the bladder are of a sexual or erotic nature. Various objects have been inserted into the bladder and many patients fail to remove them themselves and are very embarrassed to seek medical advice, which is the origin of a clinical picture which is most often atypical which occurs in a patient particular terrain.

Urachal villous adenoma is a rare entity. We aimed to share a case of a giant villous adenoma that was treated surgically. Surgery was uneventful and flow up was normal.

Isolated shwannoma of the urinary bladder is a very rare entity. We report a case of a shwannoma of the bladder that was diagnosed by an MRI and confirmed by histopathology after the patient underwent TURB.

Renal cell carcinoma (RCC) is rare in children and is usually found in late children. We present a case of a 14 year-old boy who presented with right lumbar pain. CT-scan showed a tumor in the upper pole of the right kidney measuring 15 cm. He underwent radical nephrectomy and histopathologic examination revealed RCC. No adjuvant therapy was given. After three years and half, there is no evidence of recurrence.

Giant adrenal cysts represent rare clinical entities that are usually discovered incidentally. Here, we describe a patient who presented with nonspecific upper abdominal left pain. Imaging studies revealed a huge left adrenal cyst. Routine laboratory tests and endocrine function tests were all normal. The patient underwent surgery, and the cyst was completely removed with total adrenalectomy. Histological examination revealed a benign epithelial adrenal cyst.The postoperative course was uneventful and the patient had no evidence of recurrence during a 3-year follow-up. We discuss the diagnosis and management of adrenal cysts.

Despite theadvancements in surgical reconstructive techniques for bladder exstrophy-epispadias complex, urinary incontinence represents a major problem that affects the quality of life. Bladder augmentation associated to Mitrofanoff external continent urinary diversion (ECUD) constitute for some surgeon the best solution for the management of bladder exstrophyallowing to achieve continence and to preserve renal function.

Background: There is a lack of information as to which molecular processes, present at diagnosis, favor tumour escape from standard-of-care treatments in cervical cancer (CC). RAIDs consortium (www.raids-fp7.eu), conducted a prospectively monitored trial, [BioRAIDs (NCT02428842)] with the objectives to generate high quality samples and molecular assessments to stratify patient populations and to identify molecular patterns associated with poor outcome. Methods: Between 2013 and 2017, RAIDs collected a prospective CC sample and clinical dataset involving 419 participant patients from 18 centers in seven EU countries. Next Generation Sequencing has so far been carried out on a total of 182 samples from 377 evaluable (48%) patients, allowing to define dominant genetic alterations. Reverse phase protein expression arrays (RPPA) was applied to group patients into clusters. Activation of key genetic pathways and protein expression signatures were tested for associations with outcome. Findings: At a median follow up (FU) of 22 months, progression-free survival rates of this FIGO stage IB1-IV population, treated predominantly (87%) by chemoradiation, were65•4% [CI95%: 60•2-71.1]. Dominant oncogenic alterations were seen in PIK3CA (40%), while dominant suppressor gene alterations were seen in KMT2D (15%) and KMT2C (16%). Cumulative frequency of loss-of-function (LOF) mutations in any epigenetic modulator gene alteration was 47% and it was associated with PIK3CA gene alterations in 32%. Patients with tumours harboring alterations in both pathways had a significantly poorer PFS. A new finding was the detection of a high frequency of gains of TLR4 gene amplifications (10%), as well as amplifications, mutations, and non-frame-shift deletions of Androgen receptor (AR) gene in 7% of patients. Finally, RPPA protein expression analysis defined three expression clusters. Interpretation: Our data suggests that patient population may be stratified into four different treatment strategies based on molecular markers at the outset. Fund: European Union's Seventh Program grant agreement No 304810. Keywords: Bioraids study, Prospective database, Cervical cancers, Whole exome sequencing, Reverse phase protein array, Epigenetics pathways, PI3KCA, Patient stratification