Search

Abstract This research proposes the application of fractional‐order sliding mode control (FOSMC) at the primary controller level to improve the stability of an islanded microgrid by adjusting its voltage and frequency. The control strategies used in the microgrid are performed in two levels (primary and secondary) in the islanded mode. Practically, most previous studies have worked to improve the primary controller. Droop control is one of the most commonly used methods at the primary level and is adopted in this study as well. The sliding mode control (SMC) strategy is normally used to control linear equations. Thus, the non‐linear microgrid equations were transformed into some linear ones using the input‐output feedback linearization technique. Further, a fractional sliding surface was acquainted. The sliding surface and FOSMC were designed to reject system uncertainties and organize the voltage and frequency. Design parameters were chosen using the Lyapunov stability theorem. The validation of the proposed method using Simulink‐MATLAB confirms its effectiveness in enhancing level power sharing, regulating frequency, and maintaining voltage stability across the system.

Abstract Background Osteochondromas are the most common benign bone tumors occurring near the end of long bones. In this case report, we demonstrate the successful treatment of a proximal femoral osteochondroma in a pediatric patient excised through a dual medial and anterior approach with no hip dislocation. Case presentation We present the case of a white Arab 14-year-old boy with chronic hip pain and inability to ambulate. He failed conservative treatment and was referred to us after X-rays revealed two osseous masses. He was diagnosed with an intra-articular hip osteochondroma confirmed on magnetic resonance imaging and computed tomography scan. He was treated surgically with excision using two incisions: Smith-Petersen approach and Ferguson approach. Conclusion This case presents the successful resection of a symptomatic pediatric proximal femoral osteochondroma, using dual medial and anterior approaches without the need for hip dislocation. This was optimal for both the safety and accessibility of this unusual condition.

In this paper, a composite control strategy for improved off-grid configuration based on photovoltaic (PV array), a wind turbine (WT), and a diesel engine (DE) generator to achieve high performance while supplying nonlinear loads is investigated. To operate the WT efficiently under variable speed conditions and to obtain accurate and fast convergence to the maximum global operating point without a speed sensor, an iterative interpolation method is integrated with the perturbation and observation (P&O) technique. To ensure the balance of power in the system and to achieve the maximum power from the PV array without using any maximum power point tracking (MPPT) method, and ensuring stable operation during the disturbance, a double-loop control strategy for a two-switches buck-boost converter is developed. Furthermore, to protect the synchronous generator of the diesel generator (DG) from the 5th and 7th order-harmonics created by the connected nonlinear loads and to solve the issue of the filter resonance, the interfacing three-phase inverter is controlled using an improved synchronous-reference frame algorithm (SRF) with virtual impedance active damping. The presented work demonstrates effective and efficient control along with improved performance and cost-effective option as compared to the similar works reported in the literature. The performance of the presented off-grid configuration and its developed composite control strategy are tested using MATLAB/Simulink and validated through small-scale hardware prototyping.

Mining in Canada stands as one of the most energy-intensive sectors, playing a pivotal role as a significant provider of copper, nickel, and cobalt to the international market. Anticipated growth in the global population, coupled with the transition of several low-income economies to middle-income status, is poised to escalate the demand for essential raw materials. This surge in demand is expected to drive an increase in energy consumption across various stages of the Canadian mining industry, encompassing exploration, extraction, processing, and refining. Due to their geographical constraints, most Canadian mining operations rely heavily on fossil fuels such as diesel and heavy fuel. Considering the global shift towards decarbonization and the pursuit of net-zero emission targets, exploring avenues for adopting electrification solutions and integrating renewable energy technologies, particularly in sizable surface mines, is imperative. Within this context, our study delves into the challenges and prospects associated with infusing renewable energy technologies and embracing electrification alternatives within Canadian mining practices. This exploration encompasses a comprehensive review of pertinent literature comprising academic research, technical analyses, and data disseminated by international entities and experts. The findings underscore a prevalent trend wherein Canadian mining enterprises are prominently investing in robust electric truck fleets, particularly for heavy-duty operations. Additionally, incorporating renewable energy solutions is notably prevalent in remote sites with extended operational lifespans. However, an in-depth examination reveals that the most formidable hurdles encompass successfully integrating renewable energy sources and battery electric vehicles. Financial constraints, logistical intricacies, and the imperative to enhance research and development competencies emerge as pivotal challenges that demand strategic addressing.

Purpose: To measure the corneal sensitivity in patients with multiple sclerosis (MS), to compare it with normal values and to study its correlation with different disease characteristics. Methods: Corneal sensitivity of 28 MS patients was compared to corneal sensitivity of 28 age- and gender-matched normal controls. Corneal sensitivity was measured using the Cochet-Bonnet esthesiometer and was correlated to the duration, type and severity indexes of the disease. Results: Corneal sensitivity was comparable between both groups (P = 0.79). No statistically significant correlation was found between corneal sensitivity and the duration of MS (P = 0.55) nor the severity indexes of MS (expanded disability status scale [EDSS] P = 0.52, global multiple sclerosis severity score [MSSS] P = 0.64). Following subgroup analysis, only the primary progressive (PPMS) form of MS had a reduced corneal sensitivity with P = 0.023, while remittent-recurrent (RRMS), secondary progressive (SPMS), and clinically isolated (CIS) forms of MS did not have any reduction in the corneal sensitivity. “ROC curve analysis” showed an area under the curve of 0.48. Conclusion: In the exception of PPMS subtype, MS patients have similar corneal sensitivity in comparison to controls. Cochet-Bonnet esthesiometer does not seem to be a good diagnostic tool or a disease severity marker for patients with MS.

Low load is one of the most challenging combustion stages for a fixed-speed diesel electric generator. Due to incomplete combustion during this phase, a significant proportion of contaminants form inside the cylinder. This can lead to numerous chemical and mechanical harms to the diesel engine, resulting in friction, efficiency reduction, increased fuel consumption, and prematurely ending the generator’s life. These phenomena are qualified as underperformance, possibly due to a misfire and/or a low-efficiency value (air fuel–fuel ratio). Therefore, detecting and preventing underperformance and reducing its extended operation is crucial. This paper deals with the performance and emission analysis of a multicylinder fixed-speed diesel engine driving an electric generator (300 kW) fueled with ultra-low sulfur diesel (≤15 mg/kg) to provide energy in an isolated Canadian community. The tests were carried out according to ISO 3046-1:2002 standard in a remote site to identify clues that can prevent prolonged operation in underperformance. Among the tests conducted, emissions such as sulfur (S), carbon dioxide (CO2), nitrogen oxide (NOx), and exhaust gas temperature are considered the best indices for detecting the underperformance of a fixed-speed diesel–electric generator under very-low and low load (0–30%) with the following registered values: 18 ppm for S, 4% for CO2, 150 ppm for NOx, and 210 °C for the temperature.

Wind turbine icing has been the subject of intensive research over the past two decades, primarily focusing on applying computational fluid dynamics (CFD) to 2D airfoil simulations for parametric analysis. As a result of blades’ airfoils deformation caused by icing, wind turbines experience a considerable decrease in aerodynamic performance resulting in a substantial loss of productivity. Due to the phenomenon’s complexity and high computational costs, a fully 3D simulation of the entire iced-up rotating turbine becomes infeasible, especially when dealing with several scenarios under various operating and weather conditions. The Quasi-3D steady-state simulation is a practical alternative method to assess power loss resulting from ice accretion on wind turbine blades. To some extent, this approach has been employed in several published studies showing a capability to estimate performance degradation throughout the generation of power curves for both clean and iced wind turbines. In this paper, applying the Quasi-3D simulation method on wind turbine icing was subject to a survey and in-depth analysis based on a comprehensive literature review. The review examines the results of the vast majority of recently published studies that have addressed this approach, summarizing the findings and bringing together research in this area to conclude with clear facts and details that enhance research on the estimation of wind turbine annual power production loss due to icing.

Abstract Background Guidelines suggest that patients discontinue Clopidogrel at least 5 days prior to coronary artery bypass grafting (CABG). Those with acute coronary syndrome (ACS) are at high risk for myocardial infarction (MI) if not treated with dual antiplatelet therapy (DAPT). We sought to assess pre and post-operative outcomes of patients maintained on Clopidogrel and aspirin up to the time of surgery and compare them with those on aspirin alone. Methods From the cardiac surgery database, 240 patients were retrospectively registered between January and May 2017. There were 126 patients with ACS who underwent CABG on DAPT (Clopidogrel group [CG]) and 114 patients who underwent elective CABG on aspirin alone (control). The CG received intraoperative prophylactic platelet transfusion (PPT). Demographics, comorbidities, and laboratory data were prospectively entered at the time of surgery and were subsequently retrieved for analysis. Per and postoperative findings were identified and compared between both groups. Results The cohort consisted of 240 patients (mean age 61 years, 81.3% were male, SD ± 9.58). Patients in the CG were younger (Median 57 vs. 63, P-value 0.001), and with male predominance (86% versus 75%, P-value 0.028). In addition, they had less prevalence for diabetes and renal failure as compared to control (P-values 0.003, and 0.005, respectively). There were no significant differences between both groups in number of vessels grafts, duration of on-pump and aortic clamp. Hematologic laboratory data had also similar baseline values. The CG had similar bleeding rate, redo surgery and in-hospital death (P-values non-significant), however more infection and total hospital stay as compared to control (p-values 0.048 and 0.001). Conclusion Patients who are at increased risk for MI can be maintained on DAPT up to the time of CABG because surgery is safe when patients are offered PPT.

With stricter IMO regulations on CO2 taking effect in 2023 and ambitious goals to reduce carbon intensity by 2030, the maritime industry is scrambling to clean up its act. Conventional methods and equipment are now being reevaluated, upgraded or completely replaced. The difference between a short-term fix and a long-term sustainable option is how flexible vessels will be to use new energy sources or technology as they become viable. The review discusses the recent literature on renewable energy sources, technical and operational strategies for new and existing ships, technology maturity, and alternative fuels. It is found that the IMO’s targets can be met by combining two or three technologies, or via a radical technology shift which can provide innovative, high-efficiency solutions from an environmental and economic standpoint. It has also been noted that policies and enforcement are essential management instruments for mitigating the unfavourable environmental effects of marine transportation and directing the maritime industry toward sustainability on a regional, national, and international scale.

Nowadays, productivity challenges in modern manufacturing systems have been the driving force in generating energy-efficient technologies in every industry, including diesel–electric locomotives. The diesel–electric locomotive is one of the most widely used methods in rail transportation, especially in North America. More precisely, the evolution of the electric transmission has allowed the locomotive’s effective tractive effort to increase its diesel engine horsepower. In this paper, we study a new way to improve the energy efficiency of diesel–electric trains using photovoltaic solar panels. This solution is suitable for reducing greenhouse gas emissions of the diesel–electric locomotive system, particularly in cold climates. We explore the amount of energy produced by the PV solar panels and compare it with that produced by the auxiliary diesel-generator during a train’s journey. This comparison clarifies the actual percentage of energy that solar panels can cover. Thus, this paper presents a validation of feasibility and profitability as a function of the train’s specific operating conditions and the meteorological data associated with their routes. Based on the results, the minimum annual fuel reduction of auxiliary generators allowed using PV solar panels is above 50% in all cases and wagon classes, proving this solution’s feasibility. Regarding the comparison, case 3 (Sept-Îles to Schefferville) and case 4 (Luxor to Aswan) are the best, with over 100% of the energy provided by PV solar panels in all the wagons’ classes. The payback period ranges from 2.5 years to 9.1 years, while the CO2 emission reduction’s revenues range from $460 to $998 per year/wagon.

The energy efficiency of a renewable energy system is inextricably linked to the energy storage technologies used in conjunction with it. The most extensively utilized energy storage technology for all purposes is electrochemical storage batteries, which have grown more popular over time because of their extended life, high working voltage, and low self-discharge rate. However, these batteries cannot withstand the very low temperatures encountered in cold regions, even with these very promising technical characteristics. The cold northern temperatures affect the batteries’ electromotive force and thus decrease their storage capacity. In addition, they affect the conductivity of the electrolyte and the kinetics of electrochemical reactions, thus influencing the capacity and speed of electrons in the electrolyte. In this article, which is intended as a literature review, we first describe the technical characteristics of charge–discharge rate of different electrochemical storage techniques and their variations with temperature. Then, new approaches used to adapt these electrochemical storage techniques to cold climates are presented. We also conduct a comparative study between the different electrochemical storage techniques regarding their performance in the harsh climatic conditions of the Canadian North.

In a context of energy abundance for industrial applications, industrial systems are exploited with minimal attention to their actual energy consumption requirements to meet the loads imposed on them. As a result, most of them are used at maximal capacity, regardless of the varying operational conditions. First, the paper studies pneumatic conveying systems and thoroughly reviews previously published work. Then, we overview simulations and operating data of the experimental parameters and their effects on the flow characteristics and transport efficiency. Finally, we summarize with a conclusion and some suggestions for further work. The primary goal of this study is to identify the parameters that influence the energy consumption of industrial dust collector systems. It is differentiated from previously published overviews by being concentrated on wood particles collection systems. The results will permit a better selection of an appropriate methodology or solution for reducing an industrial system’s power requirements and energy consumption through more precise control. The anticipated benefits are not only on power requirement and energy consumption but also in reducing greenhouse gas emissions. This aspect shows more impacts in regions that rely on electricity supplied by thermal power stations, especially those that use petrol or coal.

Rail transport, specifically diesel–electric trains, faces fundamental challenges in reducing fuel consumption to improve financial performance and reduce GHG emissions. One solution to improve energy efficiency is the electric brake regenerative technique. This technique was first applied on electric trains several years ago, but it is still considered to improve diesel–electric trains efficiency. Numerous parameters influence the detailed estimation of brake regenerative technique performance, which makes this process particularly difficult. This paper proposes a simplified energetic approach for a diesel–electric train with different storage systems to assess these performances. The feasibility and profitability of using a brake regenerative system depend on the quantity of energy that can be recuperated and stored during the train’s full and partial stop. Based on a simplified energetic calculation and cost estimation, we present a comprehensive and realistic calculation to evaluate ROI, net annual revenues, and GHG emission reduction. The feasibility of the solution is studied for different train journeys, and the most significant parameters affecting the impact of using this technique are identified. In addition, we study the influence of electric storage devices and low temperatures. The proposed method is validated using experimental results available in the literature showing that this technique resulted in annual energy savings of 3400 MWh for 34 trains, worth USD 425,000 in fuel savings.

Connected objects are deployed all over the world. Thus, they are contributing to improving communications. In urban areas, technological challenges are gradually being overcome, and advances in this area are exponential. Unfortunately, isolated territories such as northern Quebec do not beneficiate from this technological progress. Yet, northern Quebec relies on abundant natural resources, with notably its huge hydroelectric dams and iron mines, and therefore, the region’s economic life revolves essentially around the exploitation of these resources and is heavily reliant on rail transportation. However, according to Transport Canada, 1246 railroad accidents were reported in 2019 to the Transportation Safety Board (TSB). Thirty-eight people described as trespassers lost their lives, and five railroad employees were fatally injured. In this context, we present the implementation of a security system in an isolated environment for employees intervening on the railroad track to warn them of the imminent arrival of a train. Due to the context of the isolated environment, i.e., without an electrical network, without internet, and without an LTE network, a solution for employees has been developed using a Zigbee telecommunication system and a connected watch. A case study on a train operating in a remote and isolated area in northern Quebec is presented to validate the performance of the proposed system based on an open-source and customizable solution.

Noise-induced hearing loss leads to anatomic and physiologic changes in primary auditory cortex (A1) and the adjacent dorsal rostral belt (RB). Since acetylcholine is known to modulate plasticity in other cortical areas, changes in A1 and RB following noise damage may be due to changes in cholinergic receptor expression. We used [ 3 H]scopolamine and [ 18 F]flubatine binding to measure muscarinic acetylcholine receptor (mAChR) and nicotinic acetylcholine receptor (nAChR) expression, respectively, in guinea pig A1 and RB 3 weeks following unilateral, left ear noise exposure, and a temporary threshold shift in hearing. [ 3 H]Scopolamine binding decreased in right A1 and RB (contralateral to noise) compared to sham controls across all cortical layers. [ 18 F]Flubatine binding showed a nonsignificant upward trend in right A1 following noise but only significantly increased in right RB and 2 layers of left RB (ipsilateral to noise). This selective response may ultimately influence cortical plasticity and function. The mechanism(s) by which cholinergic receptors are altered following noise exposure remain unknown. However, these data demonstrate noise exposure may differentially influence mAChRs that typically populate interneurons in A1 and RB more than nAChRs that are traditionally located on thalamocortical projections and provide motivation for cholinergic imaging in clinical patient populations of temporary or permanent hearing loss.

Smart objects are deployed globally, contributing to improved communications and the growth of industrial systems’ performances. Unfortunately, isolated territories are generally excluded from this progress. Remote areas in Canada are no exception. Thus, about two hundred thousand people are living in isolated regions in Canadian territory. The development of these communities is slowed down not only by an outdated energy supply, but they are also dependent on telecommunication systems not fully deployed in those regions, thus contributing to the amplification of those populations’ isolation. Furthermore, the magnetic field in some regions of the planet and very often in isolated areas undergoes partial or total absorption, known as white areas, making the propagation of the signal very delicate. As a part of this article, a state of the art of telecommunication solutions available in an isolated environment is applied with a critical analysis based on several criteria. It shows the ability to use an original approach based on a captive balloon. Despite the proposed solution’s feasibility, several challenges need to be addressed before formally adopting it. These challenges include: (i) controlling the height of the balloon; (ii) stabilization of the balloon; and (iii) powering the system. The list of references given at the end of the paper should offer aids for the industry and for researchers working in this field.

Tinnitus, or phantom sound perception, leads to increased spontaneous neural firing rates and enhanced synchrony in central auditory circuits in animal models. These putative physiologic correlates of tinnitus to date have not been well translated in the brain of the human tinnitus sufferer. Using functional near-infrared spectroscopy (fNIRS) we recently showed that tinnitus in humans leads to maintained hemodynamic activity in auditory and adjacent, non-auditory cortices. Here we used fNIRS technology to investigate changes in resting state functional connectivity between human auditory and non-auditory brain regions in normal-hearing, bilateral subjective tinnitus and controls before and after auditory stimulation. Hemodynamic activity was monitored over the region of interest (primary auditory cortex) and non-region of interest (adjacent non-auditory cortices) and functional brain connectivity was measured during a 60-second baseline/period of silence before and after a passive auditory challenge consisting of alternating pure tones (750 and 8000Hz), broadband noise and silence. Functional connectivity was measured between all channel-pairs. Prior to stimulation, connectivity of the region of interest to the temporal and fronto-temporal region was decreased in tinnitus participants compared to controls. Overall, connectivity in tinnitus was differentially altered as compared to controls following sound stimulation. Enhanced connectivity was seen in both auditory and non-auditory regions in the tinnitus brain, while controls showed a decrease in connectivity following sound stimulation. In tinnitus, the strength of connectivity was increased between auditory cortex and fronto-temporal, fronto-parietal, temporal, occipito-temporal and occipital cortices. Together these data suggest that central auditory and non-auditory brain regions are modified in tinnitus and that resting functional connectivity measured by fNIRS technology may contribute to conscious phantom sound perception and potentially serve as an objective measure of central neural pathology.

Tinnitus is the phantom perception of sound in the absence of an acoustic stimulus. To date, the purported neural correlates of tinnitus from animal models have not been adequately characterized with translational technology in the human brain. The aim of the present study was to measure changes in oxy-hemoglobin concentration from regions of interest (ROI; auditory cortex) and non-ROI (adjacent nonauditory cortices) during auditory stimulation and silence in participants with subjective tinnitus appreciated equally in both ears and in nontinnitus controls using functional near-infrared spectroscopy (fNIRS). Control and tinnitus participants with normal/near-normal hearing were tested during a passive auditory task. Hemodynamic activity was monitored over ROI and non-ROI under episodic periods of auditory stimulation with 750 or 8000 Hz tones, broadband noise, and silence. During periods of silence, tinnitus participants maintained increased hemodynamic responses in ROI, while a significant deactivation was seen in controls. Interestingly, non-ROI activity was also increased in the tinnitus group as compared to controls during silence. The present results demonstrate that both auditory and select nonauditory cortices have elevated hemodynamic activity in participants with tinnitus in the absence of an external auditory stimulus, a finding that may reflect basic science neural correlates of tinnitus that ultimately contribute to phantom sound perception.

Diarrheal illness, frequently associated with fecal-oral transmission, is one of the leading causes of death worldwide. It is commonly preventable through the implementation of safe water practices. This experiment concerns how to best implement safe water practices in a quasi-permanent refugee camp setting with limited ability for structural changes. Specifically, we explore how health promotion activities that help identify target groups for hygiene interventions can play a role in disease prevention. An anonymous survey was conducted at the United Nations Relief and Works Agency Health Clinic in the Kulandia refugee camp to assess the safe water and personal hygiene practices. Demographic and social characteristics, accessible water and personal hygiene characteristics, and gastrointestinal (GI) burden for individuals and their households were assessed. A total of 96 individuals were enrolled; 62 females and 34 males. Approximately 58% of the sample had soap available and washed hands before and after eating and when preparing food. Piped water was the main source of drinking water (62%), while 31% of our sample utilized tanker-trucks. 93% of participants had access to toilet facilities, with 86% of these facilities being private households. 55% practice extra water hygiene measures on their household drinking water source. 51.3% considered vendor cleanliness when they were buying food. 51% had received formal health education. 68.8% had been taught by their parents, but only 55.2% were teaching their children and 15.6% had consistent access to a health professional for hygiene inquiries. Individual variables and hygiene practices associated with lower rates of diarrheal illnesses included having water piped into the home, proper hand washing, adequate soap availability, proper consideration of vendor cleanliness, higher income, levels of education, health hygiene education, and having access to healthcare professions to discuss hygiene related matters. This is the first study to assess the water and personal hygiene practices at the Kulandia refugee ramp. This study demonstrates that hygiene education and better practices are closely associated with the rate at which individuals and households suffer from diarrheal illnesses within the Kulandia refugee camp. There are significant hygiene deficits in the camp, which likely result from a lack of formal hygiene education and a lack of awareness concerning the connection between diarrheal illness and hygiene. With respect to practices, our results elucidate several areas where basic, communal programming – including lessons on appropriate hand washing and food preparation – will likely improve hygiene practices and decrease overall GI burden.

This research proposes the application of fractional‐order sliding mode control (FOSMC) at the primary controller level to improve the stability of an islanded microgrid by adjusting its voltage and frequency. The control strategies used in the microgrid are performed in two levels (primary and secondary) in the islanded mode. Practically, most previous studies have worked to improve the primary controller. Droop control is one of the most commonly used methods at the primary level and is adopted in this study as well. The sliding mode control (SMC) strategy is normally used to control linear equations. Thus, the non‐linear microgrid equations were transformed into some linear ones using the input‐output feedback linearization technique. Further, a fractional sliding surface was acquainted. The sliding surface and FOSMC were designed to reject system uncertainties and organize the voltage and frequency. Design parameters were chosen using the Lyapunov stability theorem. The validation of the proposed method using Simulink‐MATLAB confirms its effectiveness in enhancing level power sharing, regulating frequency, and maintaining voltage stability across the system. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate clinical outcomes and prognostic factors in non-metastatic oral cavity squamous cell carcinoma (OCSCC) patients who underwent surgery with or without adjuvant therapy. Methods: From 2007 and 2018, 116 patients were analyzed. The primary endpoint was overall survival (OS), and secondary endpoints were disease-free survival (DFS), local failure (LF), regional failure (RF), and distant metastases (DM). Kaplan-Meier method and log-rank test assessed survival outcomes, while Cox proportional hazard tests analyzed prognostic factors. Results: Median patient age was 53 years, most were smokers (93.5%) and males (62.9%). Predominant subsite was the oral tongue (58.6%). Treatment included surgery alone (16.4%), adjuvant radiotherapy (46.6%), or adjuvant concurrent chemoradiotherapy (CCRT) (37%). The median follow-up time was 45.9 months. There were significant differences between groups in terms of gender (P=0.028) and RT dose (P=0.01). The 3-year OS, DFS, LF, RF and DM for the entire cohort were 60.9%, 55.1%, 20.11%, 8.43%, and 17.13%, respectively. Surgery alone yielded higher 3-year OS (81.4%) than adjuvant RT (70%) or adjuvant CCRT (41.4%), (p=0.012). Adjuvant CCRT correlated with higher LF compared to adjuvant RT and surgery alone groups (p=0.029). Lymphovascular invasion (LVI) impacted OS (HR=2.034, p=0.0498) and DM (HR=3.380, p=0.0132), while higher tumor grade increased DM likelihood (HR=8.477, p=0.0379). Conclusions: This study reports OCSCC patient outcomes in Jordan across different treatment modalities. Adjuvant CCRT correlated with higher LF rates, and LVI impacted OS and DM, aligning with existing OCSCC treatment literature. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the clinicopathological features of oropharyngeal cancer patients in Jordan based on their HPV status. Sixty-nine biopsies from two hospitals were included. Tissue microarrays were prepared from formalin-fixed paraffin-embedded (FFPE) specimens and stained with antibodies for CDKN2A/P16, EGFR, PI3K, PTEN, AKT, pS473AKT, PS2mTOR, and TIMAP. The cohort was divided according to P16 expression. Chi-square test and survival analyses were employed to evaluate the variations among the study variables and determine the prognostic factors, respectively. P16 expression was found in 55.1% of patients; however, there was no significant association between P16 expression and the patients' clinicopathological features. The Kaplan–Meier test revealed that smoking in P16-positive group and younger age (< 58 years) negatively impacted disease-free survival (DFS) (P = 0.04 and P = 0.003, respectively). Multivariate Cox regression test indicated that smoking, age, PI3K, and AKT were negative predictors of DFS (P = 0.021, P = 0.002, P = 0.021, and P = 0.009, respectively), while TIMAP was a positive predictor (P = 0.045). Elevated P16 expression is found in more than half of the patients' specimens. DFS is negatively affected by younger age and the combined effect of smoking and P16 overexpression. TIMAP is overexpressed in P16-positive oropharyngeal cancer, and it is a favorable predictor of DFS. [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatocellular carcinoma (HCC) is a common cancer and a leading cause of cancer-related deaths worldwide. However, HCC can be effectively treated in selected cases, with liver transplantation representing one of the limited options for potential cure. Unfortunately, many patients are ineligible for liver transplantation either due to an advanced tumor at initial diagnosis or due to disease progression while awaiting liver transplantation. Our review discusses the role of systemic therapies as a bridging treatment to liver transplantation, thereby enabling more HCC patients to undergo potentially curative liver transplantation. Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths. Classically, liver transplantation (LT) can be curative for HCC tumors within the Milan criteria. Bridging strategies to reduce the dropouts from LT waiting lists and/or to downstage patients who are beyond the Milan criteria are widely utilized. We conducted a literature-based review to evaluate the role of systemic therapies as a bridging treatment to liver transplantation (LT) in HCC patients. Tyrosine kinase inhibitors (TKIs) can be used as a systemic bridging therapy to LT in patients with contraindications for locoregional liver-directed therapies. Immune checkpoint inhibitor (ICI) treatment can be utilized either as a monotherapy or as a combination therapy with bevacizumab or TKIs prior to LT. Acute rejection after liver transplantation is a concern in the context of ICI treatment. Thus, a safe ICI washout period before LT and cautious post-LT immunosuppression strategies are required to reduce post-LT rejections and to optimize clinical outcomes. Nevertheless, prospective clinical trials are needed to establish definitive conclusions about the utility of systemic therapy as a bridging modality prior to LT in HCC patients. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate real-world (rw) outcomes of immunotherapy (IO) for advanced stage NSCLC at King Hussein Cancer Center (KHCC) in Jordan. Methods: Advanced stage NSCLC patients who received IO at KHCC between 2017 and 2022 were included. The data were retrospectively collected. PFS and OS were estimated for patients with ECOG performance status (ECOG PS) 0-1. Cox regression analyzed predictors of OS in first-line (1L) IO, regardless of performance status. Results: The total number of patients included was 244. Out of those, 160 (65%), 67 (28%), and 17 (7%) patients received IO as 1L, second-line (2L), or third-line or beyond (3L or beyond), respectively. The median age for all patients was 59 years. Male were 88%, and 77% were smokers. The median follow-up time was 12.5 months. The median PFS and OS for 1L IO were 7 [95% CI 5.8 - 10.3] and 11.8 [95% CI 8.8 - 14.4], months, respectively. In the first 3 months after starting 1L IO, 34/160 (21%) patients had died. For those who survived beyond 3 months after starting 1L IO, the median PFS and OS were 11.3 [95% CI 8.3 - 16.5] and 15.4 [95% CI 13.2 - 21] months, respectively. In the Cox regression model of 1L IO patients with any performance status, ECOG PS 2 was predictive of worse OS compared to ECOG PS 0-1 (p= 0.005). Conclusion: This real-world study of advanced-stage NSCLC patients treated with immunotherapy at KHCC reveals outcomes that fall short of those anticipated from clinical trials. The inclusion of Middle Eastern patients in lung cancer trials is essential to ensure adequate representation of various ethnicities in clinical research. [ABSTRACT FROM AUTHOR]