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Abstract Background Integration of symptom and palliative care for people with advanced cancer is established in many tumour types, but its role in people with hepatocellular carcinoma (HCC) has not been clearly defined. This study aims to evaluate the clinical and cost effectiveness of an intervention involving a suite of strategies designed to assess and treat palliative care symptoms and needs in adult outpatients with HCC attending four New South Wales (NSW) metropolitan tertiary hospitals. Methods This trial will use a pragmatic cluster-based randomised-controlled design, with ambulatory HCC services as the clusters. HCC patients will be recruited if they have Barcelona Clinical Liver Cancer (BCLC) stage A disease with active tumour or a current or prior diagnosis of BCLC stage B or C disease regardless of tumour activity. Patients with BCLC stage D disease will be excluded as palliative care is the standard of care (SOC) in this group. Cluster sites will be randomised to the study intervention or control where patients are managed according to SOC. All participants will complete the liver-specific Edmonton Symptom Assessment Scale (ESAS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at regular ambulatory clinic appointments. At intervention sites, patients scoring ≥ 5 on any liver-specific ESAS symptom will be referred to palliative care physicians for consultation. The primary clinical outcome will be improvement in all symptoms scored ≥ 5 on the liver-specific ESAS by 50% within 3 months and the primary implementation outcome will recording the liver-specific ESAS in ≥ 80% of all participants attending clinic appointments. Caregivers of patients enrolled in the trial will be invited to perform Carer Support Needs Assessment Tool at each appointment. Discussion This trial will inform if earlier palliative care involvement significantly reduces the symptom burden associated with HCC. If found to be effective, earlier implementation of palliative care consultation should be included in HCC treatment guidelines. Trial registration ACTRN12623000010695. Registered on September 1, 2023.

Abstract Bioassay-guided fractionation approach led to identification of two novel compounds; (4-(hydroxymethyl)-3-methoxy-1H-pyrazol (1) and mycalene (2), alongside with four known metabolites; octadecane (3), hexatriacontane (4), 1-heneicosanol (5) and heptatriacontanoic acid (6) from the Red Sea marine sponge Hemimycale sp. The ethyl acetate fraction showed a noticeable cytotoxic activity against the lung cancer cell line (A549) with IC50 value of 75.54 µg/ mL. Structural elucidation was achieved using a combination of 1D and 2D nuclear magnetic resonance (NMR) spectroscopy and high-resolution electrospray ionization-mass spectrometry (HR-ESI-MS). To elucidate the potential mechanism of action behind the cytotoxic effects against lung cancer, a multi-faceted approach combining in silico network pharmacology, experimental validation, and molecular docking studies were employed. Both compounds, designated as 1 and 2, demonstrated significant binding affinities to predicted target proteins, with docking scores of -4.789 and − 4.421 kcal/mol, respectively. These results lay the groundwork for further investigation into the therapeutic potential of these novel compounds from Hemimycale sp. as promising candidates for lung cancer treatment.

Energy Optimization in building design field now has been revolutionized due to AI and machine learning applications. Leveraging daylight to reduce artificial lighting consumption holds promise for significant energy savings, yet the nonlinear nature of daylight patterns poses challenges in prediction and optimization. This study proposes a novel approach to automated light shelf design using machine learning algorithms, specifically artificial neural networks (ANNs) such as recurrent neural networks (RNN) by long short term memory (LSTM), to accelerate daylighting simulation and optimization processes. The methodology employed two distinct approaches: Firstly, we employed the theoretical-analytical approach to explore methods for utilizing machine learning in natural lighting and light shelf parameters. Second, the practical and applied method involved creating a predictive model for designing the light shelf using appropriate AI and ML techniques. This model is based on an office geometry model at the El Arish weather file in Egypt, four-dimensional training room models with three internal zones-oriented south. Rhinoceros and Grasshopper, two parametric simulation tools, are used to normalize and optimize light shelf parameters like geometry cross-section, curvature surface, width, height position, depth, tilt angle, and reflectance materials. Then, the Galapagos plug-in and Colibri2 are used for dataset creation and optimization. The results demonstrate that automated light shelf operation has a significant impact on internal daylighting quality. RNNs enable rapid prediction of optimization models, reducing time consumption in the early design phase. ML facilitates decision-making by generating evaluative criteria from user-selected design options. RNNs were classified as good and bad and used LSTM to enhance prediction accuracy for efficient illuminance values metric in zones 1 and 2. Challenges include increasing the simulation procedure's efficiency. The results of model accuracy reached 99%. Hence, future research should prioritize resolving the previously identified concerns. In conclusion, this study underscores the importance of ML-driven approaches in early design phases to optimize building energy consumption and pave the way for sustainable architectural practices.

Abstract This study examined the composition, distribution, and origins of rare, Noble, and fissionable elements for the first time in black sand deposits from the Northern Delta coastal region. The findings showed that among the elements under investigation, Fe, Ti, Mn, and Sn had the greatest mean levels, while Hf, Cd, and As had the lowest mean amounts. According to the study's elemental composition, black sand is thought to have economic worth for Ti, Zr, Hf, Sn, Ag, and W. The Zr, Co, Cd, Cu, Hf, V, W, and Zn correlation points to the same source origin. It is clear that the accessory mineral composition in the sediments under study especially the heavy ones controls the geochemical patterns of trace elements. The trace element concentrations of interest show a pattern of element variability related to the mineralogy of the sands, as indicated by the principal component analysis and cluster analysis. To explore and exploit heavy minerals in the research region, the study's findings are important.

Alkaline metals and hydrogen titanates are of great interest for possible applications. The soda ash and Rosetta ilmenite ore concentrate briquette were investigated. The kinetic of formation of sodium titanate was studied in the temperature range 700°C to 900°C.

Abstract Background Therapeutic options for early-stage hepatocellular carcinoma (HCC) in individual patients can be limited by tumor and location, liver dysfunction and comorbidities. Many patients with early-stage HCC do not receive curative-intent therapies. Stereotactic ablative body radiotherapy (SABR) has emerged as an effective, non-invasive HCC treatment option, however, randomized evidence for SABR in the first line setting is lacking. Methods Trans-Tasman Radiation Oncology Group (TROG) 21.07 SOCRATES-HCC is a phase II, prospective, randomised trial comparing SABR to other current standard of care therapies for patients with a solitary HCC ≤ 8 cm, ineligible for surgical resection or transplantation. The study is divided into 2 cohorts. Cohort 1 will compromise 118 patients with tumors ≤ 3 cm eligible for thermal ablation randomly assigned (1:1 ratio) to thermal ablation or SABR. Cohort 2 will comprise 100 patients with tumors > 3 cm up to 8 cm in size, or tumors ≤ 3 cm ineligible for thermal ablation, randomly assigned (1:1 ratio) to SABR or best other standard of care therapy including transarterial therapies. The primary objective is to determine whether SABR results in superior freedom from local progression (FFLP) at 2 years compared to thermal ablation in cohort 1 and compared to best standard of care therapy in cohort 2. Secondary endpoints include progression free survival, overall survival, adverse events, patient reported outcomes and health economic analyses. Discussion The SOCRATES-HCC study will provide the first randomized, multicentre evaluation of the efficacy, safety and cost effectiveness of SABR versus other standard of care therapies in the first line treatment of unresectable, early-stage HCC. It is a broad, multicentre collaboration between hepatology, interventional radiology and radiation oncology groups around Australia, coordinated by TROG Cancer Research. Trial registration anzctr.org.au, ACTRN12621001444875, registered 21 October 2021.

Seaweeds or marine algae with their three main taxa are recognized as a potential pot for numerous products. This has been imperative to valorize their components at an industrial scale in the context of the sustainability goals of the United Nations (UN). Biorefinery approaches have been attempted for several decades to produce bioactive, biofuels, fine chemicals, and nutritional products from seaweeds. However, with the recent UN goals, climatic changes, and the global economic situation, it is essential to assess all the production processes involved concerning several factors. Numerous steps are performed following algae collection, including optimization of downstream processing (e.g., drying, extraction, and purification), in addition to suitable preservation to maintain products’ integrity till their usage. Moreover, breakthroughs in biotechnologies and the biological sciences are also targeted to achieve the goals of the blue circular bioeconomy which focuses on renewable resources of foods, drug discovery, and energy, while preserving the ocean ecosystem. Hence, the current article provided new insights into the various processes to valorize marine algae in the frame of circular bioeconomy and sustainability concepts.

Abstract Background Nanotechnology has demonstrated its vital significance in all aspects of daily life. Our research was conducted to estimate the potential of primed seed with chitosan nanoparticles in seed growth and yield by inducing plant secondary metabolism of Pancratium maritimum L. one of the important medicinal plants. Petri dish and pot experiments were carried out. Seeds of Pancratium maritimum L. were soaked in Nano solution (0.1, 0.5, 1 mg/ ml) for 4, 8, 12 h. Germination parameters (germination percentage, germination velocity, speed of germination, germination energy, germination index, mean germination time, seedling shoot and root length, shoot root ratio, seedling vigor index, plant biomass and water content), alkaloids and antioxidant activity of Pancratium maritimum L. were recorded and compared between coated and uncoated seeds. Results Our results exhibited that chitosan nanopriming had a positive effect on some growth parameters, while it fluctuated on others. However, the data showed that most germination parameters were significantly affected in coated seeds compared to uncoated seeds. GC-MS analysis of Pancratium maritimum L. with different nanopriming treatments showed that the quantity of alkaloids decreased, but the amount of pancratistatin, lycorine and antioxidant content increased compared with the control. Conclusions Applying chitosan nanoparticles in priming seeds might be a simple and effective way to improve the quantity of secondary metabolites of Pancratium maritimum L. valuable medicinal plant.

Background: Traditional tumor markers such as cancer antigen 15.3 (CA15.3) and carcinoembryonic antigen (CEA) exhibit limited clinical utility in breast cancer due to their lack of sensitivity and specificity, particularly for detecting low-volume tumors. Other serum markers, such as nestin, may offer more promise. This study aimed to assess the clinical significance of serum nestin and CA15.3 in breast cancer patients.Method: This case-control study enrolled 80 normal control females and 80 females with breast cancer. Serum samples were collected from both control and breast cancer groups. The serum nestin and CA15.3 levels were measured in all samples using enzyme-linked immunosorbent assay (ELISA) kits.Results: The serum levels of nestin and CA15.3 were found to be significantly elevated in the breast cancer patient group compared with the control group. Preoperative serum nestin levels exceeding 9.9 ng/ml demonstrated a substantial odds ratio of 27 (confidence interval: 4.57-159.67; P = 0.0003). In receiver operating characteristic curve analysis, serum nestin exhibited the highest significant area under the curve at 85.2% (P < 0.001), followed by serum CA15.3 at 70% (P = 0.021). Post-surgery serum nestin levels significantly decreased compared with pre-surgery levels (P = 0.045).Conclusion: Serum nestin outperforms serum CA15.3 in diagnosing breast cancer patients. Elevated serum nestin levels may represent a significant risk factor for the development of breast cancer. Furthermore, serum nestin can monitor the effects of surgery, whereas none of the assessed biomarkers exhibit a significant role in monitoring the effects of chemotherapy on breast cancer patients.

Abstract The crude extract of Hemimycale sp. marine sponge was evaluated as a cytotoxic drug against different cell lines; whereas it exhibited promising selective activity toward the breast cancer cell line only with IC50 value 199.6 ± 0.00512 µg/ml. Moreover, its cytotoxic activity against the breast cancer cell line was reevaluated upon forming total extract-loaded niosomes. This revealed an IC50 value of 44.35 ± 0.011128 µg/ml, indicating the potential contribution of niosomes in boosting cell penetration and activity as a result. Owing to highlight the bioactive constituents responsible for the cytotoxic activity, metabolomics profiling of Hemimycale sp. was performed using liquid chromatography coupled with high-resolution electrospray ionization mass spectrometry (LC-HR-ESI-MS) revealing tentative identification of phytoconstituents clusters like as, diterpenes, sesterterpenes and sterols. Additionally, the cytotoxic activity of the crude extract was explained on the molecular level, whereas the dereplicated compounds were evaluated in silico against the Epidermal Growth Factor Receptor tyrosine kinase (EGFR). The sesterterpenoid derivatives phorbaketal A acetate (12) and secoepoxy ansellone A (13) together with mycalol-522 (17) showed the best binding energy.

Real-time localization is a crucial task in various applications, such as automatic vehicles (AV), robotics, and smart city. This study proposes a framework for map-aided LiDAR-inertial localization, with the objective of accurately estimating the trajectory in a point clouds map. The proposed framework addresses the localization problem through a factor graph optimization (FGO), enabling the fusion of homogenous measurements for sensor fusion and designed absolute and relative constraints. Specifically, the framework estimates the light detection and ranging (LiDAR) odometry by leveraging inertial measurement unit (IMU) and registering corresponding featured points. To eliminate the accumulative error, this paper employs a ground plane distance and a map matching error to constraint the positioning error along the trajectory. Finally, local odometry and constraints are integrated using a FGO, including LiDAR odometry, IMU pre-integration, and ground constraints, map matching constraints, and loop closure. Experimental results were evaluated on an open-source dataset, UrbanNav, with an overall localization accuracy of 2.29 m (root mean square error, RMSE).

The coexistence of mixed numerologies with OFDM introduces significant inter-numerology interference (INI) due to high out-of-band emission (OOBE). This interference worsens with increasing offset between numerologies, negatively impacting system performance. To address this issue, this paper proposes the use of a Hybrid Waveforms (HW) technique to mitigate the effects of INI in mixed-numerology systems. Specifically, f-OFDM, UFMC, and WOLA waveforms are employed instead of OFDM to suppress OOBE for users with higher numerology. The effectiveness of the proposed technique is evaluated using the Vienna 5G link-level simulator. Simulation results demonstrate that utilizing f-OFDM, UFMC, and WOLA waveforms for higher numerology users is more efficient in reducing INI compared to OFDM. By implementing the proposed framework, user throughput increases and Bit Error Rate (BER) decreases. Among the hybrid waveforms, f-OFDM proves to be the most effective, providing the highest throughput and the lowest BER when compared to UFMC, WOLA, and OFDM. For instance, in the case of f-OFDM, when the power of the second user is ten times that of the first user, the user BER in the uplink can be reduced by 63.3%, and its throughput can be increased by 47.3%. Similarly, in the downlink, the user BER can be reduced by 60.9%, and its throughput can be increased by 43%. These improvements are observed when comparing against the traditional system (OFDM), where the first user uses a subcarrier spacing of 15 kHz and the second user uses a 60 kHz spacing with a 180 kHz guard band.

PurposeIn this cohort study, 5-year data from the Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry (ie, CONFIRM) were examined to identify associations of baseline aspirin and statin use with mortality, major adverse cardiovascular events (MACE), and myocardial infarction (MI) in individuals without substantial (≥50%) stenosis.Materials and methodsIn this prospective cohort study, all participants in the registry underwent coronary CT angiography and were classified as having no detectable coronary plaque or having nonobstructive coronary artery disease (CAD) (1%-49% stenosis). Participants with obstructive (≥50%) stenosis were excluded from analysis. The study commenced in June 2003 and was completed in March 2016. All unadjusted and risk-adjusted analyses utilized the Cox proportional hazard model with hospital sites modeled using shared frailty.ResultsA total of 6386 participants with no detectable plaque or with nonobstructive CAD were included (mean age, 56.0 years ± 13.3 [SD], 52% men). The mean follow-up period was 5.66 years ± 1.10. Nonobstructive CAD (n = 2815, 44% of all participants included in the study) was associated with a greater risk of all-cause mortality (10.6% [298 of 2815] vs 4.8% [170 of 3571], P < .001) compared to those without CAD (n = 3571, 56%). Baseline aspirin and statin use was documented for 1415 and 1429 participants, respectively, with nonobstructive CAD, and for 1560 and 1565 participants without detectable plaque, respectively. In individuals with nonobstructive CAD, baseline aspirin use was not associated with a reduction in MACE (10.9% [102 of 936] vs 14.7% [52 of 355], P = .06), all-cause mortality (9.6% [95 of 991] vs 10.9% [46 of 424], P = .468), or MI (4.4% [41 of 936] vs 6.2% [22 of 355], P = .18). On multivariate risk-adjusted analysis, baseline statin use was associated with a lower rate of MACE (hazard ratio, 0.59; 95% CI: 0.40, 0.87; P = .007). Neither therapy improved clinical outcomes for participants with no detectable plaque.ConclusionIn participants with nonobstructive CAD, baseline use of statins, but not of aspirin, was associated with improved clinical outcomes. Neither therapy was associated with benefit in participants without plaque.Keywords: Aspirin, Statin, Coronary Artery Disease, CT Angiography, Nonobstructive Coronary Artery DiseaseClinical trial registration no. NCT01443637 Supplemental material is available for this article. © RSNA, 2022See also the commentary by Canan and Navar in this issue.

Abstract Background A missed abortion is a spontaneous abortion in which the embryo or fetus has already died but has remained in the uterus for days or weeks with a closed cervical ostium. Termination of pregnancy could be achieved either by surgical evacuation or medical or expectant management. Letrozole is a third-generation aromatase inhibitor. According to many recent studies, letrozole given for three days before the administration of misoprostol was more effective than misoprostol alone at inducing abortion. Our study compared the efficacy of various letrozole regimens (10 mg/d for three days and a single dose of 20 mg) combined with misoprostol vs. misoprostol alone in inducing abortion. To find the most efficient regimen of letrozole administered before misoprostol to induce an abortion. Methodology This prospective, parallel, three-arm, single-blinded, allocation-concealed randomized controlled trial was conducted in Sohag Teaching Hospital in Upper Egypt. We randomly divided 105 patients with anembryonic missed abortion (up to 63 days gestation) with no history of medical disorders or a history of allergies to misoprostol or letrozole into three equal groups (a single-dose letrozole group, a multiple-dose letrozole group, and a misoprostol-only group). The complete abortion rate, incomplete abortion rate, failure to abort rate, and induction-to-abortion interval were all collected. All statistical calculations were performed using the computer program SPSS (Statistical Package for the Social Science, SPSS Inc., Chicago, IL, USA). Results The complete abortion rate was significantly higher in the single-dose letrozole and multiple-dose letrozole groups than in the misoprostol group (p values = 0.0455 and 0.001, respectively). On the other hand, there was no significant difference in the complete abortion rate between the single-dose group and the multiple-dose letrozole group (p-value = 0.1713). The time to complete abortion was significantly shorter in the single-dose and multiple-dose letrozole groups than in the misoprostol group (p values = 0.0036 and 0.0049, respectively). On the other hand, there was no significant difference in the time to complete abortion between the single-dose letrozole group and the multiple-dose letrozole group (P = 0.532). Conclusion Single- and multiple-dose letrozole regimens followed by misoprostol had a higher rate and a shorter time to complete abortion than misoprostol alone. Trial registration The trial is registered at gov with the name “letrozole and abortion” and the identifier “NCT05198050”. The date of registration was April 1, 2022, registered prospectively. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=25&sid=S000BPDQ&cx=43mobl .