Search

Lung cancer, a leading cause of cancer mortality, often involves epidermal growth factor receptor (EGFR) mutations, common in 17% of Caucasian and 40% of Asian non-small-cell lung cancer (NSCLC) patients. While the exon 19 deletion and L858R mutation are prevalent, rare variants like L833V/H835L are less understood. This case reports a 75-year-old female with NSCLC harboring L833V/H835L mutations. Initial imaging showed a right upper lobe mass and nodularity in the left upper lobe. Biopsy confirmed adenocarcinoma, and genomic analysis identified EGFR L833V/H835L mutations. Based on these findings, the patient was treated with osimertinib 160 mg daily, reduced to 80 mg due to side effects. After 3 months, positron emission tomography (PET) scans revealed significant tumor reduction, and brain metastasis remained stable. This case demonstrates the efficacy of osimertinib for rare EGFR mutations, aligning with literature suggesting its potential for managing such variants. Although large-scale trials are impractical due to the rarity of these mutations, this report adds valuable evidence supporting osimertinib’s use, highlighting the need for comprehensive genomic profiling in NSCLC.

Myelodysplastic syndrome (MDS) represents a spectrum of myeloid disorders occasionally linked to autoimmune diseases. Here, we present a case of a 60-year-old man demonstrating an unusual coexistence of MDS with warm-autoantibody autoimmune hemolytic anemia (wAIHA). Diagnostic evaluation, including positive direct antiglobulin testing, confirmed the autoimmune etiology of his anemia despite his low-risk MDS classification. Prompt initiation of prednisone therapy resulted in significant hematological and clinical improvement, allowing for a conservative management approach without transfusion requirements. This case underscores the importance of identifying the relationship between wAIHA and MDS, particularly in low-risk scenarios. Moreover, these findings suggest the efficacy of corticosteroids in managing autoimmune anemia in the context of concomitant wAIHA and MDS.

Many geological hazards are associated with ground deformations. Prompt and accurate detection and interpretation of ground deformation is therefore vital to geohazard mitigation. Multitemporal Interferometric Synthetic Aperture Radar (MT-InSAR) is an effective geodetic technique for monitoring ground deformation. However, accurate computation and interpretation of deformation using InSAR are often hindered by various errors and a lack of expert knowledge. We present a new advanced deep learning model based on a multi-task vision transformer (MT-ViT) to automatically detect, locate, and interpret deformation using single interferograms. To address the issue of limited training data in InSAR applications, the proposed model utilizes pre-trained weights from optical images and transfers them to a simulated InSAR dataset. Then real interferograms are used to fine-tune the weights in the network. An overall loss function is designed, which considers the classification and localization losses in the model. The effectiveness of the proposed model is demonstrated using both simulated and real InSAR datasets that contain either coseismic or volcanic deformation. The experimental results from the model are also compared with the state-of-the-art convolutional neural network (CNN) based techniques. The results show significant improvement in both the accuracy of the results and the computational efficiency over the CNN-based approaches. The MT-ViT model achieved 99.4 % classification accuracy, 54.1 % mean intersection over union (IOU), and 0.9 km localization accuracy. A comprehensive evaluation of the hyperparameters in training the MT-ViT model was carried out, which will inform future research in this direction. The research results highlight the promising capabilities of MT-ViT in near real-time deformation monitoring and automated deformation interpretation.

This paper aims to develop the recently introduced Spilt-Source Inverter (SSI) topology to improve its boosting characteristics. New SSI topologies with high voltage gain are introduced in this paper. The proposed converters square the basic SSI’s boosting factor by utilizing an additional inductor, capacitor, and two diodes. Thus, the proposed converters are called Quadratic-Boost (or Square-Boost) SSIs (QBIs or SBIs). Four different QBI topologies are presented. One with continuous input current (CC-QBI), and the other draws a discontinuous input current (DC-QBI) but with reduced capacitor voltage stresses. This paper also introduces the small-signal model of the CC-QBI using state variables perturbance. Based on this model, the closed-loop voltage and current control approach of the dc-boosting factor are designed. Moreover, a modified space vector modulation (MSVM) scheme is presented to reduce the input current ripples. To evaluate the performance of the proposed topologies, a comparative study between them and the other counterpart from different perspectives is introduced. It can be found that the CC-QBI topology has superior boosting characteristics when operating with low input voltage compared with their counterparts. It has a higher boosting capability, lower capacitor voltages, and semiconductor stresses, especially when high voltage gains are required. These merits make the proposed topologies convenient to the Photovoltaic and Fuel-Cell systems. Finally, the feasibility of the suggested topology and the introduced mathematical model is verified via simulation and experimental results, which show good accordance with the theoretical analysis.

Owing to their dependency of weather conditions, distributed generation systems are integrated with utility grid through power converters. This paper proposes an isolated three-phase based flyback-inverter (TBFBI) that can be used as a central-type inverter for grid-tied PV applications. To alleviate DC-current ripples at the input side, the proposed inverter utilizes only a single LC-filter with small passive elements size, which reduces the system footprint and cost. Mathematical modeling of the TBFBI in addition to its control technique is presented in detail. Compared with other differential based converters, the proposed control technique is designed considering the least number of control loops and required sensors by using terminal voltage estimation strategy. Continuous-modulation-scheme (CMS) combined with static-linearization strategy (SLS) is utilized to diminish the low-order odd harmonics. In addition, harmonic compensation technique is utilized to eliminate negative-sequence harmonic component (NSHC) from the grid-injected currents. Also, identical three single-phase high-frequency transformers (HFTs) are designed based-on ferrite and nanocrystalline cores to compare the inverter operating efficiency. The TBFBI is experimentally validated via laboratory prototype-based 200 V, 1.6 kW, and switching frequency of 50 kHz. Experimental results of 1.6 kW power flow show that THD of the grid current is 3.95%, peak-to-peak current ripple at the input DC-side is 2.1% of the average DC input current that matches the IEEE-1547 standards for grid-tied PV applications.

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies used in the treatment of solid and hematologic malignancies. Immune checkpoint inhibitors target the T-cell deactivation system via the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) receptor, programmed cell death protein 1 (PD-1) receptor, and programmed cell death ligand 1 (PD-L1). As a result, the activated T-cell enhances the host tumor response. However, even with their essential clinical benefits, ICIs are associated with a broad spectrum of adverse effects that can be generalized or tissue-specific inflammatory responses known as immune-related adverse events (irAEs). The most common dermatologic toxicity manifests mainly as maculopapular rash and pruritus. Understanding the complexity of immune-mediated response and the importance of clinical histopathologic correlation in recognizing irAEs allows for appropriate intervention and patient care due. We present the case of a 71-year-old African American male diagnosed with a large-cell poorly differentiated neuroendocrine tumor in the gastroesophageal junction of the stomach with mediastinal lymphadenopathy. He was treated with carboplatin, etoposide, and atezolizumab for 4 cycles. However, he developed vitiligo while on maintenance atezolizumab, which is rarely seen with atezolizumab use. Despite the improving clinical outcomes in oncology with ICIs, their adverse effects should not be ignored. When promptly recognized and treated, patients on ICI monotherapy may not need treatment interruption or discontinuation.

Wind energy is considered one of the most important alternative energy sources for generating electricity. But the stochastic nature of wind, leads to use the distribution function to present the wind system. The two-parameter Weibull distribution is often used in the wind speed presentation. The two-parameter Weibull distribution has scale and shape parameters that are important in wind energy applications, thus selecting the optimum method for estimation them is important. The unpredictability in wind speed leads to uncertainty in devolved power which leads to difficult system operation. In this study, two novel artificial intelligence (AI) methods called Mayfly algorithm (MA) and Aquila Optimizer (AO) are used for calculating the Weibull distribution parameters. Results are compared with four classical numerical methods called the Maximum likelihood approach, Energy pattern factor method, Graphical method, and Empirical method. The two AI methods prove superiority and robustness for evaluating two-parameter of Weibull distribution as they give lower errors and higher correlation coefficients. Moreover, to prove the accuracy of the MA method in solving the optimal power flow (OPF) problem, single and multi-objective OPF is applied on a standard IEEE-30 bus system to minimize fuel cost, power loss, thermal unit emissions, and voltage security index (VSI), and results are compared with other metaheuristic methods. The results prove the validity and robustness of the MA method in solving the OPF problem. Then, single and multi-objective stochastic optimal power flow (SCOPF) is applied to modified IEEE-30 which contains two wind farms to minimize total generation cost, power loss, thermal unit emission, and VSI. The fuzzy-based Pareto front technique is utilized in multi-objective optimization (MOO) to obtain the best compromise point solution. The objective function of SCOPF considers reserve cost for overestimation and penalty cost for underestimation of wind energy. Finally, this paper studies the effect of changing Weibull parameters, penalty cost coefficient, and reverse cost coefficient in wind energy generation cost. The proposed MA method could be valuable to system operators as a decision-making aid when dealing with hybrid power systems.

Purpose – This paper aims to address socio-spatial challenges facing the sustainable regeneration of the 19th-century historic covered Attaba market. One of the few remaining historic market buildings in Cairo. Understanding these challenges is crucial as there is a pressing need for these buildings to be included in the national heritage regeneration policies that would foster their role as sustainable socio-economic urban nuclei within the city center. Design/methodology/approach – The paper detects the socio-spatial transformation of the Attaba market through the comparison of archival material. This is supported by observations on the current socio-spatial aspects of the market including forms of interactions, conflicts and interventions of various user groups. A number of 30 semi-structured interviews with traders of the Attaba market were conducted inside the market, along with in-depth observations carried out between 2016 and 2018. Finally, information about local policies toward the market is obtained through interviews with local officials currently managing the market, namely, the Egyptian Endowment Authority and Cairo Governorate. Findings – The findings reveal a lack of clear regeneration policy and a complete absence of public participation in decision-making. These factors erode the crucial role these markets play in revitalizing the city’s socio-economic strength and threaten their tangible and intangible values. Originality/value – The paper focuses on one of the understudied building types that, however, represent key opportunities for the sustainable development of their contexts. The paper proposes a framework that can be applied to regenerate the Attaba market and its surroundings. When tested, the framework can be also adjusted and applied to the other historic covered markets in Cairo.

Breast cancer is the most common cancer diagnosed in women in North America. Hormone receptor positive (HR+) and HER2 negative (HER2−) breast cancers account for at least 60% to 70% of all breast cancer cases. They usually metastasize to lymph nodes, bones, liver, lungs, and brain. Urinary bladder is a very unusual site for metastatic HR+/HER2− breast cancer and occurs in only 2% of all metastatic disease. In this article, we present a case of a 63-year-old female with locally advanced breast cancer who underwent mastectomy, adjuvant chemotherapy, radiation, and hormonal therapy. She was in remission for almost 17 years and subsequently presented with hematuria and lower abdominal pain. Cystoscopy was performed, which showed evidence of bladder wall thickening. Histopathology showed metastatic HR+/HER2− breast cancer consistent with her history of breast primary. Imaging studies did not show any other evidence of metastatic disease. She was started on cyclin D kinase 4/6 inhibitor, palbociclib, in combination with an aromatase inhibitor, letrozole. This is an exceedingly rare case of HR+ and HER2− breast cancer with metastasis to the urinary bladder. The late onset of recurrence with bladder metastasis makes this case very unique and to our knowledge only few similar cases have been reported in the literature.

In this paper, an autonomous exercise generation system based of fuzzy logic approach is presented. This work attempts to close a gap in the design of a completely autonomous robotic rehabilitation system that can recommend exercises to patients based on their data, such as shoulder range of motion (ROM) and muscle strength, from a pre-set library of exercises. The input parameters are fed into a system that uses Mamdani-style fuzzy logic rules to process them. In medical applications, the rationale behind decision making is a sophisticated process that involves a certain amount of uncertainty and ambiguity. In this instance, a fuzzy-logic-based system emerges as a viable option for dealing with the uncertainty. The system’s rules have been reviewed by a therapist to ensure that it adheres to the relevant healthcare standards. Moreover, the system has been tested with a series of test data and the results obtained ensures the proposed idea’s feasibility.

A series of six complexes [n‐Bu2Sn(L1)]⋅S (S=Benzene/toluene, mixed/partial) (1), [Ph2Sn(L1)]n⋅S (S=Benzene) (2), [Bz2Sn(L1)] (3), [n‐Bu2Sn(L2)]n (4), [Ph2Sn(L2)] (5) and [Bz2Sn(L2)] (6) were synthesized using diorganotin(IV) oxide precursors and two new bis‐Schiff bases containing N2O2 donor atoms. The Schiff bases, H2L1 and H2L2, were prepared by reacting ethane‐1,2‐diamine or benzene‐1,2‐diamine with 2‐hydroxy‐5‐(pyridin‐3‐yldiazenyl)benzaldehyde in absolute ethanol. Compounds 1–6 were characterized by IR and NMR spectroscopies, as well as by solid‐state single‐crystal X‐ray diffraction (except for 3 and 6). In all the complexes the bis‐Schiff bases occupy the equatorial positions and the R groups are in axial sites. However, while 1 and 5 are discrete molecules where the tin atoms adopt distorted octahedral geometries, 2 and 4 are monoperiodic polymers with the metal cations in pentagonal bipyramidal environments. Although solid state crystallographic results revealed asymmetrical molecular configurations, solution NMR studies proved symmetric arrangements for all the compounds. Tin NMR spectroscopy confirmed that all complexes are six‐coordinate in solution, despite variations in solid‐state coordination. Further analysis using Hirshfeld surface and fingerprint plots provided insights into intermolecular interactions in compounds 1, 2, 4, and 5. This comprehensive study underscores the structural diversity and solution‐state dynamics of organotin(IV) complexes synthesized using novel Schiff bases. [ABSTRACT FROM AUTHOR]

Background: Single-incision laparoscopic cholecystectomy (SILC) is a minimally invasive procedure designed to minimize the number and size of the incisions needed for cholecystectomy. Titanium clips are traditionally used to close the cystic duct and artery. Although it is considered safe, dislodgement can result in bleeding and biliary leakage. Using LigaSure for duct sealing is still controversial. The aim of this study was to evaluate the safety and feasibility of using LigaSure to close the cystic duct during SILC. Methods: A prospective study over two years was conducted at the General Surgery Department, Mansoura University Hospital, on 102 patients, 51 in each group. They underwent SILC using LigaSure (Group 1) or titanium clips (Group 2) to control the cystic duct and artery. Results: The data analyzed included demographic data, operative time, intra- and postoperative complications, postoperative pain, and hospital stay. The operative time was significantly shorter in LigaSure group (68.5 ± 9.8 versus 72.9 ± 10.6 minutes in the clips group, P.03). There was no significant difference between the two groups regarding postoperative bile leak or bleeding. However, two cases in Group 1 and four cases in Group 2 were converted to multiple port laparoscopic cholecystectomy; this was statistically nonsignificant. Postoperative pain and hospital stay showed no significant difference between the two groups. Two patients in each group developed port-site incisional hernia. Conclusions: Clipless SILC using LigaSure is a feasible and safe procedure with acceptable morbidity with shorter operative time than SILC using clips. Nevertheless, the risk of port-site incisional hernia should be explained to the patients. [ABSTRACT FROM AUTHOR]

The novel hydrosoluble silver coordination polymer [Ag(NO3)(μ-1κN;2κN′,N″-TPMOH)]n (1) (TPMOH = tris(1H-pyrazol-1-yl)ethanol) was obtained and characterized. While single crystal X-ray diffraction analysis of compound 1 disclosed an infinite 1D helical chain structure in the solid state, NMR analysis in polar solvents confirmed the mononuclear nature of compound 1 in solution. Compound 1 and the analogue [Ag(μ-1κN;2κN′,N″-TPMS)]n (2) (TPMS = tris(1H-pyrazol-1-yl)methane sulfonate) were evaluated with regard to their antimicrobial activities towards the Gram-negative Escherichia coli, Pseudomonas aeruginosa, and Burkholderia contaminans, the Gram-positive Staphylococcus aureus, and the fungal species Candida albicans and Candida glabrata. Compound 1 exhibited minimal inhibitory concentration (MIC) values ranging from 2 to 7.7 µg/mL towards the tested Gram-negative bacteria, 18 µg/mL towards the Gram-positive S. aureus, and 15 and 31 µg/mL towards C. albicans and C. glabrata, respectively. Compound 2 was less effective towards the tested bacteria, with MIC values ranging from 15 to 19.6 µg/mL towards the Gram-negative bacteria and 51 µg/mL towards S. aureus; however, it was more effective against C. albicans and C. glabrata, with MIC values of about 6 µg/mL towards these fungal species. The toxicity of compounds 1 and 2 was assessed by evaluating the survival of the Caenorhabditis elegans model organism to concentrations of up to 100 µg/mL. The value of 50% lethality (LD50) could only be estimated as 73.2 µg/mL for compound 1 at 72 h, otherwise LD50 was >100 µg/mL for both compounds 1 and 2. These results indicate compounds 1 and 2 as novel silver complexes with interesting antimicrobial properties towards bacterial and fungal pathogens. [ABSTRACT FROM AUTHOR]

We present the synthesis and characterization of two monometallic coordination polymers, [Co(L)2(H2O)2]n (Co-CP) and [Ni(L)2(H2O)2]n (Ni-CP), alongside a heterobimetallic counterpart, CoNi-CP, derived from an amide-based multifunctional pro-ligand 4-(pyrimidin-5-ylcarbamoyl)benzoic acid (HL), and discussed their electrocatalytic activity in the oxygen evolution reaction (OER). The CPs were characterized using various techniques, including elemental analysis, IR spectroscopy, X-ray diffraction, and thermal and powder XRD analyses. The low-cost amide-functionalized transition metal pristine coordination polymers Co-CP and Ni-CP were demonstrated to catalyze the OER in alkaline media, surpassing the benchmark IrO2 electrocatalyst performance. The heterometallic coordination polymer (CoNi-CP) displayed a lower Tafel slope value (and thus, faster kinetics) and higher long-term durability compared to its monometallic counterparts, Co-CP and Ni-CP. The results obtained show a pristine transition metal heterobimetallic coordination polymer as a lowcost electrocatalyst of great promise and high performance for OER catalysis in alkaline media. [ABSTRACT FROM AUTHOR]