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Abstract Background In cervical cancer, accurate diagnosis of parametrial invasion (PMI) helps in determining the next step in management, either surgical resection or neoadjuvant therapy. Cervical cancer staging is still determined according to the clinical findings. But it is widely recognized that there are differences between clinical evaluation and the actual disease extent, particularly for PMI. In this prospective study, we investigate the relationship between clinical staging and magnetic resonance imaging (MRI) staging with post-management findings among patients with cervical cancer who underwent pre-treatment MRI, using fused T2-weighted image/diffusion-weighted imaging (T2/DWI). Results Based on examination under anesthesia (EUA), 80% of patients showed PMI, while fused T2/DWI was positive for PMI in 77.5% of patients. In all analyzed cases (40 females), MRI had sensitivity, specificity, and accuracy of 91%, 75%, and 87.5% compared to EUA. In the operated patients (24 females), MRI likewise had sensitivity, specificity, and accuracy of 81.3%, 87.5%, and 83%, respectively. In comparison with the postoperative results, the EUA showed higher sensitivity and accuracy than MRI (92.9% vs. 81.3%) and (83.3% vs. 79.2%), respectively, in the detection of PMI in operated cases. However, MRI was more specific in the PMI detection in cases with cervical cancer than EUA (75% vs. 70%). Conclusion MRI (with the aid of fused T2/DWI) improves the diagnostic performance for the PMI assessment in cases with cervical carcinoma. Therefore, MRI is helpful in choosing surgical candidates.

Smart contracts offer automation for various decentralized applications but suffer from vulnerabilities that cause financial losses. Detecting vulnerabilities is critical to safeguarding decentralized applications before deployment. Automatic detection is more efficient than manual auditing of large codebases. Machine learning (ML) has emerged as a suitable technique for vulnerability detection. However, a systematic literature review (SLR) of ML models is lacking, making it difficult to identify research gaps. No published systematic review exists for ML approaches to smart contract vulnerability detection. This research focuses on ML-driven detection mechanisms from various databases. 46 studies were selected and reviewed based on keywords. The contributions address three research questions: vulnerability identification, machine learning model approaches, and data sources. In addition to highlighting gaps that require further investigation, the drawbacks of machine learning are discussed. This study lays the groundwork for improving ML solutions by mapping technical challenges and future directions.

Objective The use of social media applications to disseminate information has substantially risen in recent decades. Spine and back pain-related hashtags have garnered several billion views on TikTok. As such, these videos, which share experiences, offer entertainment, and educate users about spinal surgery, have become increasingly influential. Herein, we assess the quality of spine surgery content TikTok from providers and patients. Methods Fifty hashtags encompassing spine surgery (“#spinalfusion,” “#scoliosissurgery,” and “#spinaldecompression”) were searched using TikTok’s algorithm and included. Two independent reviewers rated the quality of each video via the DISCERN questionnaire. Video metadata (likes, shares, comments, views, length) were all collected; type of content creator (musculoskeletal, layperson) and content category (educational, patient experience, entertainment) were determined. Results The overall DISCERN score was, on average, 24.4. #Spinalfusion videos demonstrated greater engagement, higher average likes (p = 0.02), and more comments (p < 0.001) compared to #spinaldecompression and #scoliosissurgery. #Spinaldecompression had the highest DISCERN score (p < 0.001), likely explained by the higher percentage of videos that were educational (p < 0.001) and created by musculoskeletal (MSK) professionals (p < 0.001). Compared to laypersons, MSK professionals had significantly higher quality videos (p < 0.001). Similarly, the educational category demonstrated higher quality videos (p < 0.001). Video interaction trended lower with MSK videos and educational videos had the lowest interaction of the content categories (likes: p = 0.023, comments: p = 0.005). Conclusion The quality of spine surgery videos on TikTok is low. As the influence of the new social media landscape governs how the average person consumes information, MSK providers should participate in disseminating high-quality content.

The jet pump is an artificial lift employed when the reservoir pressure declines and the well deviation increases. The use of computer well models for optimizing the oil well output has proven to be a successful strategy, and has helped increasing the efficiency and production of numerous wells. The objective of this study was to use a production optimization technique that achieves some improvements, and recommend approaches toward increasing the oil well production. The effects of the motive fluid flow rate and pressure on the oil production rate were investigated to determine the optimal injection rate and pressure on the performance of the deep well water-oil axial jet-pump. Additionally, the effects of the well-head pressure, water cut, and roughness of tubing on oil production of this jet pump type were investigated. The results revealed that the impact on the oil lift performance is significant. The oil production increased by 19.43%, and the optimal economic value for the injection rate and pressure for the GA-1A well are 744.44 BFPD and 2722.22 psig, respectively. In summary, increasing the tubing roughness decreased the well's total liquid production. Thus, maintaining the well integrity is a very important factor because not doing so can lower the productivity by up to 20%–25%.

Cyclin-dependent kinases (CDK2, CDK4, CDK6), cyclin D1, cyclin E1 and phosphorylated retinoblastoma (pRB1) are key regulators of the G1/S cell cycle checkpoint and may influence platinum response in ovarian cancers. CDK2/4/6 inhibitors are emerging targets in ovarian cancer therapeutics. In the current study, we evaluated the prognostic and predictive significance of the CDK2/4/6–cyclin D1/E1–pRB1 axis in clinical ovarian cancers (OC). The CDK2/4/6, cyclin D1/E1 and RB1/pRB1 protein expression were investigated in 300 ovarian cancers and correlated with clinicopathological parameters and patient outcomes. CDK2/4/6, cyclin D1/E1 and RB1 mRNA expression were evaluated in the publicly available ovarian TCGA dataset. We observed nuclear and cytoplasmic staining for CDK2/4/6, cyclins D1/E1 and RB1/pRB1 in OCs with varying percentages. Increased nuclear CDK2 and nuclear cyclin E1 expression was linked with poor progression-free survival (PFS) and a shorter overall survival (OS). Nuclear CDK6 was associated with poor OS. The cytoplasmic expression of CDK4, cyclin D1 and cyclin E1 also has predictive and/or prognostic significance in OCs. In the multivariate analysis, nuclear cyclin E1 was an independent predictor of poor PFS. Tumours with high nuclear cyclin E1/high nuclear CDK2 have a worse PFS and OS. Detailed bioinformatics in the TCGA cohort showed a positive correlation between cyclin E1 and CDK2. We also showed that cyclin-E1-overexpressing tumours are enriched for genes involved in insulin signalling and release. Our data not only identified the prognostic/predictive significance of these key cell cycle regulators but also demonstrate the importance of sub-cellular localisation. CDK2 targeting in cyclin-E1-amplified OCs could be a rational approach.

Objective To analyze the usage of floor-mounted robot in minimally invasive lumbar fusion. Methods Patients who underwent minimally invasive lumbar fusion for degenerative pathology using floor-mounted robot (ExcelsiusGPS) were included. Pedicle screw accuracy, proximal level violation rate, pedicle screw size, screw-related complications, and robot abandonment rate were analyzed. Results Two hundred twenty-nine patients were included. Most surgeries were primary single-level fusion. Sixty-five percent of surgeries had intraoperative computed tomography (CT) workflow, 35% had preoperative CT workflow. Sixty-six percent were transforaminal lumbar interbody fusion, 16% were lateral, 8% were anterior, and 10% were a combined approach. A total of 1,050 screws were placed with robotic assistance (85% in prone position, 15% in lateral position). Postoperative CT scan was available for 80 patients (419 screws). Overall pedicle screw accuracy rate was 96.4% (prone, 96.7%; lateral, 94.2%; primary, 96.7%; revision, 95.3%). Overall poor screw placement rate was 2.8% (prone, 2.7%; lateral, 3.8%; primary, 2.7%; revision, 3.5%). Overall proximal facet and endplate violation rates were 0.4% and 0.9%. Average diameter and length of pedicle screws were 7.1 mm and 47.7 mm. Screw revision had to be done for 1 screw (0.1%). Use of the robot had to be aborted in 2 cases (0.8%). Conclusion Usage of floor-mounted robotics for the placement of lumbar pedicle screws leads to excellent accuracy, large screw size, and negligible screw-related complications. It does so for screw placement in prone/lateral position and primary/revision surgery alike with negligible robot abandonment rates.

Abstract Background Children with cerebral palsy (CP) have motor deficits caused by spasticity, weakness, contractures, diminished selective motor control (SMC), and poor balance. The purpose of the current study was to evaluate the influence of mirror feedback on lower extremity selective motor control and balance in children with hemiplegic cerebral palsy. Understanding the relationship between SMC and balance will help children with hemiplegic CP receive more appropriate therapies. Methods Forty-seven children of both sexes diagnosed with hemiplegic CP participated in the study. Group1 (Gr1 - control group) received conventional physical therapy training while group 2 (Gr2 - intervention group) received conventional physical therapy training in addition to bilateral lower extremity mirror therapy (MT). The primary outcome measure used was Selective Control Assessment of Lower Extremity scale (SCALE), while the secondary outcome measure was the Pediatric Balance Scale (PBS). Results There were significant differences in Selective Control Assessment of Lower Extremity Scale (SCALE) and Pediatric Balance Scale (PBS) between both groups in favor of Gr2. After treatment, both groups improved significantly, yet Gr2 outperformed Gr1 by a large margin. Conclusion Mirror therapy may be a useful addition to home-based motor interventions for children with hemiplegic CP due to its relative simplicity, low cost, and high patient adherence. Additionally, it may help children improve their selective motor skills and balance. Trial registration Current Controlled Trials using African Clinical Trials Registry website with ID number PACTR202105604636415 retrospectively registered on 21/01/202.