Minimal Risk Research Articles

Minimum Risk Quantification Method for Error Threshold of Wind Farm Equivalent Model Based on Bayes Discriminant Criterion

The error threshold is the cornerstone to balance the mathematical complexity and simulation speed of wind farm (WF) equivalent models, and can promote the standardization process of equivalent methodology. Due to differences in power system conditions and model evaluation standards in different countries, the form and indexes of error thresholds of WF equivalent models have not been unified yet. This paper proposes a theoretical method for quantifying the minimum risk of error threshold of WF equivalent models based on the Bayes discriminant criterion. Firstly, the Euclidean errors of WF equivalent models in different periods are quantified, and the probability density distributions of the errors are fitted by kernel density estimation. Secondly, the real-time weighted prior probability algorithm is used to obtain the prior probability of a valid WF equivalent model, and the different losses caused by the missed judgment and misjudgment of the model validity to power systems are taken into account. Thirdly, the minimum risk quantification model of error threshold is established based on the Bayes discriminant criterion, and the feasibility of the proposed method is verified by an actual WF with numerical examples. Compared with the existing error thresholds, the proposed error threshold can more quickly and accurately determine the validity of WF equivalent models.

Transforaminal Endoscopic Decompression Alone Versus Limited Decompression/Fusion in the Treatment of Adult Degenerative Scoliosis: A Retrospective Study.

A retrospective study. To investigate and compare the clinical and radiographical outcomes of endoscopic decompression alone and limited decompression/fusion surgery in the treatment of adult degenerative scoliosis (ADS). Follow-up data of 53 patients with lower limb radiculopathy associated with ADS who underwent focal surgical treatment were collected (endoscope group: 31 patients treated by transforaminal endoscopic decompression alone; fusion group: 22 patients who underwent limited decompression/fusion). The following data were retrospectively analyzed and compared between the two group: the demographics, Lenke-Silva level, radiographic parameters, surgical data, visual analogue scale (VAS) for back/leg pain, the Oswestry disability index (ODI), and the modified MacNab criteria. The mean follow-up period was 15.68 ± 3.26 months. The most frequent Lenke-Silva level was I in the endoscope group, and III in the fusion group. Preoperative Cobb angle in the endoscope group was significantly lower than that in the fusion group (23.92 ± 9.06 vs 39.58 ± 13.12, P < 0.05). All patients exhibited improved VAS and ODI scores postoperatively (P < 0.05). At the last follow-up, the Cobb angle had progressed by 1.51° in the endoscope group, whereas radiographic parameters were significantly improved in the fusion group. The reoperation and complication rate in the endoscope group were lower than those in the fusion group. The satisfaction rate post-surgery was comparable between the two groups. For patients with focal ADS, both limited decompression/fusion and transforaminal endoscopic decompression are viable treatment options. Advanced transforaminal endoscopic techniques enable effective decompression of the symptomatic foramen with minimal complication risk and negligible deformity progression, even in cases of significant scoliosis. While limited fusion surgery can achieve comparable clinical outcomes, it offers inferior deformity correction.

Electrolyzed water combined with ozone treatment for efficient removal of mancozeb residues from grapes.

Existing cleaning methods mainly focus on removing free-state pesticides. However, mancozeb can bind to the wax layer of grapes, forming bound-state residues that are difficult to remove. This study aims to develop an effective cleaning strategy to eliminate both free and bound mancozeb residues from grapes. Compared with the untreated mancozeb aqueous solution, the concentration of free mancozeb significantly decreased (p<0.05) after treatment with ozonated water (OW), electrolyzed water (EW), and their combination (OW+EW) for 60min. The combined treatment synergistically promoted mancozeb degradation, thus reducing its half-life to 38% and 75% of that observed when OW and EW were used alone, respectively. To investigate the effect of the waxy layer on mancozeb removal, oleanolic acid (OLA) was selected as a representative component. The binding effect of OLA limited the degradation of mancozeb in OW and EW, extending its half-life by 1.27 and 1.20 times, respectively. Density functional theory elucidated the mechanism by which the binding of OLA affects the degradation of mancozeb. Interestingly, the decomposition of mancozeb in OW + EW was almost unaffected by the introduction of OLA, indicating that the combined treatment could effectively remove bound-state mancozeb. The combined treatment was then successfully applied to remove mancozeb from grapes. After exposure to OW + EW for 10 min, the removal efficiency of mancozeb reached up to 80.61% with minimal risks of ethylene thiourea formation. There was no obvious change in the surface color of grapes after treatment. The findings provide valuable guidance for removing mancozeb from fresh fruits rich in waxy coatings.

Recycle of Fe/Ca-rich fly ash in preparation of modified porous ceramsite for selective and efficient phosphate recovery

Although wastewater management has systematically developed globally, the removal efficiency of phosphates still posed a serious challenge and attracted worldwide concerns. On the other side, the discharge of fly ash (FA) from sludge incineration also caused serious environmental problems. In this study, Fe/Ca-rich FA was recycled to synthesize a porous ceramsite (modified CFA) through a non-sintered method. It could be an efficient adsorbent for phosphate recovery in virtue of abundant adsorption sites, accompanied by its low-cost and environmental friendliness. The phosphate adsorption capacity was 26.31 mg-P·g-1 for modified CFA, and its average adsorption rate could reach 1.344 mg-P·(g·day)-1 in the first 2 days. While it could also efficiently immobilize phosphate for a quite long period in the dynamic system effluent. According to electron microscopic and spectroscopic characterizations, modified CFA was indicated to chemisorb and immobilize phosphates via multiple interface interactions. Phosphates were firstly H-bonded with the surface Fe/Ca-OH of modified CFA and then rapidly coordinate with active Fe sites through a ligand exchange mechanism. When the exposed Fe sites had been saturated-adsorbed, inner-sphere Ca-O-P coordination would be further formed. In summary, this study provides a promising FA-derived adsorbent and realizes the efficient P pollution management with low cost and minimal environmental risks, which would be a potential waste-to-wealth strategy for further applications.

Genome Instability Induced by Topoisomerase Misfunction.

Topoisomerases alter DNA topology by making transient DNA strand breaks (DSBs) in DNA. The DNA cleavage reaction mechanism includes the formation of a reversible protein/DNA complex that allows rapid resealing of the transient break. This mechanism allows changes in DNA topology with minimal risks of persistent DNA damage. Nonetheless, small molecules, alternate DNA structures, or mutations in topoisomerase proteins can impede the resealing of the transient breaks, leading to genome instability and potentially cell death. The consequences of high levels of enzyme/DNA adducts differ for type I and type II topoisomerases. Top1 action on DNA containing ribonucleotides leads to 2-5 nucleotide deletions in repeated sequences, while mutant Top1 enzymes can generate large deletions. By contrast, small molecules that target Top2, or mutant Top2 enzymes with elevated levels of cleavage lead to small de novo duplications. Both Top1 and Top2 have the potential to generate large rearrangements and translocations. Thus, genome instability due to topoisomerase mis-function is a potential pathogenic mechanism especially leading to oncogenic progression. Recent studies support the potential roles of topoisomerases in genetic changes in cancer cells, highlighting the need to understand how cells limit genome instability induced by topoisomerases. This review highlights recent studies that bear on these questions.

Блокада нервов нижней конечности: показания и преимущества

An inadequate approach to the choice of anesthetic care during surgery and in the postoperative period leads to numerous complications, chronic pain, decreased quality of life, as well as to the formation of a negative patient attitude and dissatisfaction with anesthetic care. Currently, there is a constant search for optimal methods of anesthetic management, especially in high-risk patients. Objective. To summarize and present current information on lower limb nerve blockade. Materials and methods. During the research work, an analysis of dissertations on this topic for 2014–2023 was carried out, and Internet resources Elibrary, Cyberleninka, PubMed for the last 9 years were used, since there are not enough literary sources on this topic from 2018 to 2023. Results. An analysis of Russian and foreign literature for 2014–2023 was given, devoted to such a type of anesthetic management as lower limb nerve blockade. Indications, anatomical features, methods, complications in femoral, obturator and sciatic nerve blockades are described. Conclusion. Due to the use of ultrasound navigation, neuromuscular stimulation, catheter technologies, it has become possible to perform peripheral blockades with a minimal risk of complications, as well as to carry out extended peripheral blockades, which allows to speed up the postoperative recovery of patients. Due to the lack of influence of peripheral blockades on hemodynamics, a smaller number of severe complications inherent in central blockades, anesthesiologists increasingly prefer peripheral blockades when choosing a method of anesthetic support for operations on the lower extremities. This type of anesthesia is offered as an alternative to neuraxial blockades, especially in elderly patients with a high class of physical condition.

The pulmonary nodule: from incidental finding to pathological confirmation

As the number of CT examinations of the lungs increases, so does the prevalence of incidentally discovered pulmonary nodules. While most lung nodules are benign, the risk of malignancy significantly rises with the presence of risk factors and specific imaging features. Upon encountering an incidental nodule, efforts should focus on achieving an accurate pathological diagnosis, particularly to ascertain malignancy while minimizing the risks associated with unnecessary diagnostic procedures. A comprehensive understanding of the typical characteristics and behavior of malignant lung nodules, along with a detailed patient history and standardized clinical and imaging risk assessment, is crucial for determining the optimal diagnostic approach. Additionally, the decision regarding histologic confirmation should consider the patient's comorbidities, preferences, and the examiner's expertise. Emerging sampling technologies provide methods for addressing peripheral lung nodules with minimal risk of complications.

Interpretable Machine Learning-Based Influence Factor Identification for 3D Printing Process-Structure Linkages.

Three-dimensional printing technology is a rapid prototyping technology that has been widely used in manufacturing. However, the printing parameters in the 3D printing process have an important impact on the printing effect, so these parameters need to be optimized to obtain the best printing effect. In order to further understand the impact of 3D printing parameters on the printing effect, make theoretical explanations from the dimensions of mathematical models, and clarify the rationality of certain important parameters in previous experience, the purpose of this study is to predict the impact of 3D printing parameters on the printing effect by using machine learning methods. Specifically, we used four machine learning algorithms: SVR (support vector regression): A regression method that uses the principle of structural risk minimization to find a hyperplane in a high-dimensional space that best fits the data, with the goal of minimizing the generalization error bound. Random forest: An ensemble learning method that constructs a multitude of decision trees and outputs the class that is the mode of the classes (classification) or mean prediction (regression) of the individual trees. GBDT (gradient boosting decision tree): An iterative ensemble technique that combines multiple weak prediction models (decision trees) into a strong one by sequentially minimizing the loss function. Each subsequent tree is built to correct the errors of the previous tree. XGB (extreme gradient boosting): An optimized and efficient implementation of gradient boosting that incorporates various techniques to improve the performance of gradient boosting frameworks, such as regularization and sparsity-aware splitting algorithms. The influence of the print parameters on the results under the feature importance and SHAP (Shapley additive explanation) values is compared to determine which parameters have the greatest impact on the print effect. We also used feature importance and SHAP values to compare the importance impact of print parameters on results. In the experiment, we used a dataset with multiple parameters and divided it into a training set and a test set. Through Bayesian optimization and grid search, we determined the best hyperparameters for each algorithm and used the best model to make predictions for the test set. We compare the predictive performance of each model and confirm that the extrusion expansion ratio, elastic modulus, and elongation at break have the greatest influence on the printing effect, which is consistent with the experience. In future, we will continue to delve into methods for optimizing 3D printing parameters and explore how interpretive machine learning can be applied to the 3D printing process to achieve more efficient and reliable printing results.

Abstract A039: Joint roles of proteomics and neighborhood-level social determinants of metastatic prostate cancer

Abstract Introduction: Striking racial disparities in prostate cancer (PCa) outcomes among American Black men warrant significant efforts to identify early predictors of lethal PCa, to avoid over- treatment of clinically favorable disease with minimal risk of progression. Building on prior work, this study examined independent and joint roles of proteomic markers and social determinants of health (SDOHs) in predicting prostate disease aggressiveness in a racially diverse cohort of men undergoing prostate biopsy. Methodology: A retrospective cohort of 300 men biopsied for prostate cancer was assembled at University Hospitals (UH) Seidman Cancer Center in Cleveland, Ohio between January 1, 2005-May 2022. An extensive medical chart review was performed to identify Black and White men undergoing transrectal ultrasound- guided biopsy that resulted in: (i) a negative biopsy in patients with a history of 1+ prior negative biopsy and no PCa history (“NEG”); (ii) a biopsy-detected PCa of Gleason sum 6 (“GL6”); and (iii) biopsy-detected PCa with nodal and/or distant metastases at initial cancer detection (“METS”). Prostate biopsy tissues were obtained on each patient, balancing 100 men per biopsy group, and balanced on race (1:1) within each biopsy group. Informed by findings from an untargeted analysis of the entire proteome of 60 patients (“Discovery cohort”), we conducted a targeted proteomics analysis of 16 protein markers generated from prostate biopsy tissue, using mass spectrometry, on n=240 patients (“Verification cohort”). Chi-square testing and Analysis of Variance (ANOVA) were used to assess associations between protein expression, neighborhood-level SDOHs, and biopsy group. Race-stratified analyses were performed to examine statistical interactions between study associations. Principal components (PC) analysis was used to identify protein markers that predicted the greatest variance in biopsy group. Multivariable logistic regression (MLR) was used to predict METS (vs. NEG and GL6, combined), as a function of PC-selected protein markers and census block-group level area deprivation index (ADI). Bonferroni correction was used to establish the threshold for the decision rule of statistical significance (alpha error 0.05/16 markers: p&amp;lt; 0.0031). Results: Median patient age was 68 years. Protein expression distributions were transformed into quintiles due to non-normality. Of 16 protein markers, 14 were significantly correlated with biopsy group, including PARP 1 and TGFB1, for which METS patients had the highest expression. ADI was strongly correlated with race but not protein expression. ADI was significantly higher in METS patients, followed by GL6 and lowest in NEG group; however no associations were seen for ADI with protein expression. Eight proteins were found to predict METS in PC and MLR analysis. Conclusions: These data support use of proteomics markers to predict a metastatic versus non-metastatic biopsy result. Next steps include deep exploration of proteome findings generated in the Discovery cohort, such as biological pathways. Citation Format: Jennifer Cullen, Tao Liu, Holly Hartman, Fangzhou Liu, Anood Alfahmy, Rini Ghosh, Ayesha Shafi, Julia Payne, Randy Vince, Lee Ponsky, Gregory MacLennan. Joint roles of proteomics and neighborhood-level social determinants of metastatic prostate cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A039.

A new perspective on denoising based on optimal transport

Abstract In the standard formulation of the classical denoising problem, one is given a probabilistic model relating a latent variable $\varTheta \in \varOmega \subset{\mathbb{R}}^{m} \; (m\ge 1)$ and an observation $Z \in{\mathbb{R}}^{d}$ according to $Z \mid \varTheta \sim p(\cdot \mid \varTheta )$ and $\varTheta \sim G^{*}$, and the goal is to construct a map to recover the latent variable from the observation. The posterior mean, a natural candidate for estimating $\varTheta $ from $Z$, attains the minimum Bayes risk (under the squared error loss) but at the expense of over-shrinking the $Z$, and in general may fail to capture the geometric features of the prior distribution $G^{*}$ (e.g. low dimensionality, discreteness, sparsity). To rectify these drawbacks, in this paper we take a new perspective on this denoising problem that is inspired by optimal transport (OT) theory and use it to study a different, OT-based, denoiser at the population level setting. We rigorously prove that, under general assumptions on the model, this OT-based denoiser is mathematically well-defined and unique, and is closely connected to the solution to a Monge OT problem. We then prove that, under appropriate identifiability assumptions on the model, the OT-based denoiser can be recovered solely from information of the marginal distribution of $Z$ and the posterior mean of the model, after solving a linear relaxation problem over a suitable space of couplings that is reminiscent of standard multimarginal OT problems. In particular, due to Tweedie’s formula, when the likelihood model $\{ p(\cdot \mid \theta ) \}_{\theta \in \varOmega }$ is an exponential family of distributions, the OT-based denoiser can be recovered solely from the marginal distribution of $Z$. In general, our family of OT-like relaxations is of interest in its own right and for the denoising problem suggests alternative numerical methods inspired by the rich literature on computational OT.

Web system in the management of Preprofessional internship in students at the Private University of Trujillo [Sistema web en la gestión de Prácticas Pre Profesionales en los estudiantes de la Universidad Privada de Trujillo

The objective of this study is to improve the management of preprofessional internships for students at the Private University of Trujillo. The Directorate of Professional Development and Job Board, in charge of connecting students with companies for their pre-professional internships, carries out a series of manual processes for this purpose and disseminates them through printed publications in the university's wall newspapers, where on many occasions they go unnoticed. In addition to this, students do not necessarily have classes scheduled every day of the week, losing the opportunity to apply for a job offer that has been recently published and whose time for submitting the file is in a short period of time. As these are printed publications, there is minimal risk of them being lost, damaged or intentionally tampered with, without the management being aware of it. With the arrival of the COVID-19 pandemic and everything that this entailed, since the current government declared a state of national emergency, the Directorate saw a decrease in the population of students eligible for pre-professional internships. The study corresponds to the cross-sectional correlational type, with a variant population for each identified indicator. For statistical analysis, the SPSS Static 21 program was used and the Kolgomorov-Smirnov normality test, Student's t test and Wilcoxon for related samples were used to test the hypotheses. The results showed that the time spent searching for information before the implementation of the web system is greater than the time spent searching after the implementation of the web system (p=0.00). The Rational Unified Process software development methodology was used, supported by the unified modeling language (UML). On the other hand, the time to register pre-professional internship advertisements before the implementation of the web system is greater than the time to search after the implementation of the web system (p=0.00). Also the degree of user satisfaction before the implementation of the web system is lower than the degree of user satisfaction after the implementation of the web system (p=0.00). It concludes with a decrease of 83.02% in the time spent searching for ads; a 57.40% decrease in the time to publish ads, and a 45.51% increase in the level of user satisfaction. All this leads to the conclusion that the implementation of a web system improves the management of pre-professional internships of students at the Private University of Trujillo.

Safe Food Coloring Agent as an Alternative to Eosin Stain.

Introduction Eosin stain is a commonly used histological dye that selectively binds to acidic structures in cells, imparting a color between pink and red. Eosin stain can be harmful due to its chemical composition. Inhaling eosin stain in powder form or as aerosolized droplets can cause irritation in the respiratory tract. To overcome the toxic effects of eosin, many naturally available organic substitutes have been tested in histopathology laboratories, including rose extract, beetroot stain, and curcumin. These natural stain alternatives provide effective staining of tissue while ensuring minimal risk to laboratory personnel. Aim The study was conducted to evaluate the efficacy of food coloring agents over eosin stain in histopathological investigations. Materials and method The study was carried out in Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, India. The sample size comprised 30 oral mucosal lesion blocks. After the preparation of four micron thick sections from each block, one was stained with hematoxylin and eosin (H&E) stain and the other with a food coloring agent. Sections were kept in food color stain for three minutes. Next, the sections were dehydrated, cleared, and mounted in dibutylphthalate polystyrene xylene (DPX). To evaluate the staining with H&E and food color, each section was scored 0 for inadequate staining, one for adequate, and two for excellent staining. The tissue components stained for the study were red blood cells (RBCs), collagen fibers, muscle fibers, epithelium overall, basement membrane, cell membrane, desmosomes, keratin, cytoplasm, and nuclei. Kolmogorov-Smirnov tests were used to calculate the inferential statistics for the different variables between the groups. The distribution of the study sample was found to be not normal; therefore, a nonparametric test of significance was applied. Results All the tissue components showed excellent staining by H&E (score 2). Among the tissue components, in most of the samples, keratin, cytoplasm, and RBCs showed excellent staining (score 2) on par with the H&E stain. Other tissue components showed no staining (score 0) to adequate staining (score 1). The basement membrane and cell membrane staining were not adequate (score 0). The nuclear staining by hematoxylin was unaffected by food color and was on par with normal H&E staining. Conclusion We conclude that tomato red food color, which is non-toxic, safe for the health of laboratory personnel, easy to dispose of, and environmentally friendly, could be used as a replacement for eosin in the routine H&E techniques. Our observations could be strengthened by increasing the sample sizes and modifying the stain preparation to ensure positive staining of all tissue components, thereby enhancing the results.

Comparing regulatory guidance on risk minimization/mitigation and the Reporting recommendation Intended for pharmaceutical Risk Minimization Evaluation Studies checklist.

The latest country-specific regulatory guidance for assessing effectiveness of risk minimization measures (RMM) strategies was identified across five continents-Africa (Egypt, South Africa), Asia (Australia, China, Japan, South Korea, Singapore), Europe (EU-27, United Kingdom), North America (Unites States, Canada) and South America (Brazil)-and compared to the Reporting recommendation Intended for pharmaceutical Risk Minimization Evaluation Studies (RIMES) checklist, developed to assess the quality of effectiveness evaluations and endorsed by the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). RIMES checklist items address study hypothesis, participants, measures, statistical analysis and results. European Medical Agency (EMA) and Food and Drug Administration (FDA) guidance only partially aligned with RIMES, primarily for measures and results. In the absence of country-specific guidance, most countries recommended following EMA or FDA guidelines; Japan and South Africa mentioned the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH E2E) guideline; Brazil and China had no guidance/recommendations. Worldwide, there was a lack of RMM-specific guidance and, when guidance existed, they were not harmonized, and alignment with the RIMES checklist was limited.

Staged strategy of combined rotational atherectomy and intravascular lithotripsy for severely calcified lesions: an evaluation using multimodality intracoronary imaging—a case report

Abstract Background Severely calcified lesions are the most significant challenge for percutaneous coronary intervention, exhibiting poor clinical outcomes. Some severely calcified lesions remain untreatable with conventional balloons or even atherectomy devices. Intravascular lithotripsy is a new option for treating severe calcification. Case summary Herein, we describe a case of ischaemic cardiomyopathy with a thick, circumferential calcified lesion in the proximal and mid-segments of the left anterior descending coronary artery. In the first session, high-pressure balloons, cutting balloons, and rotational atherectomy failed to disrupt the calcification. In the staged additional treatment that was subsequently planned, eight cycles of intravascular lithotripsy created multiple fractures in the deep calcification, resulting in successful stent deployment. The effect of intravascular lithotripsy was observed mainly in calcified areas with lipid components detected using near-infrared spectroscopy-intravascular ultrasound. Discussion Our report suggests the efficacy of employing a combined strategy of rotational atherectomy with small burrs and intravascular lithotripsy in the treatment of severe calcification with a minimal risk of complications. Our study introduces a novel aspect by utilizing near-infrared spectroscopy-intravascular ultrasound to evaluate calcified lesions before performing intravascular lithotripsy. To our knowledge, there have been no similar reports to date. The effect of intravascular lithotripsy on calcified lesions may be related to the distribution of lipid components and/or heterogeneity within the calcification.

Exploring the Role of Buccal Film in Drug Delivery

A buccal film is a thin film of medication placed between the gum and cheek and left to dissolve. It is commonly used as a method of drug delivery, particularly for medications that need to be administered in small doses over a long period of time. The film typically contains active pharmaceutical ingredients in a variety of forms, including powders, granules, or gels. It is typically placed with a device, such as a spatula, and it dissolves rapidly and completely after being placed in the mouth. The benefits of buccal films include convenience, compliance, improved patient outcomes, and better patient satisfaction. The main disadvantage is that the dosage may not be as accurate as with other drug delivery methods. Buccal films is that they are an effective and safe method of administering medication to patients. Buccal films offer a fast and easy method of delivering drugs, with minimal risk of side effects, making them a preferred method of drug delivery for many patients and healthcare professionals.

Determining the oxidation stability of SnSe under atmospheric exposure

AbstractUnderstanding surface stability becomes critical as 2D materials like SnSe are developed for piezoelectric and optical applications. SnSe thin films deposited by molecular beam epitaxy showed no structural changes after a two-year exposure to atmosphere, as confirmed by X-ray diffraction and Raman spectroscopy. X-ray photoelectron spectroscopy and reflectivity show a stable 3.5 nm surface oxide layer, indicating a self-arresting oxidative process. Resistivity measurements show an electrical response dominated by SnSe post-exposure. This work shows that SnSe films can be used in ambient conditions with minimal risk of long-term degradation, which is critical for the development of piezoelectric or photovoltaic devices. Graphical Abstract

Prevalence and Association Between Sedentary Behavior and Suicidality Among College Students of Pre-Medical and Pre-Engineering Disciplines

Background: The mental health of college students, especially those in pre-medical and pre-engineering disciplines, is increasingly concerning due to academic pressures and sedentary behavior, which can lead to suicidal ideation (SI).Objective: This study aimed to examine the prevalence and association between sedentary behavior and SI among pre-medical and pre-engineering college students.Methods: A cross-sectional study was conducted with 200 students (100 pre-medical, 100 pre-engineering) from Government Degree College, Booni, Gilgit-Baltistan, using self-reported measures. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), and SI was evaluated with the Adult Suicide Ideation Questionnaire (ASIQ). Data analysis included descriptive statistics and independent t-tests using IBM SPSS Statistics version 25.Results: Pre-medical students showed higher sedentary behavior (59% high activity) and SI rates (52% minimal risk, 34% low risk, 12% moderate risk, 2% high risk) compared to pre-engineering students, who had 74% high physical activity and 91% minimal risk SI. Significant differences were found in physical activity (t(200) = -3.45, p &lt; .05) and SI (t(200) = 5.83, p &lt; .05) between groups.Conclusion: Promoting physical activity may protect against SI among college students, particularly those in high-pressure academic disciplines.

Cryoablation Without Excision for Early-Stage Breast Cancer: ICE3 Trial 5-Year Follow-Up on Ipsilateral Breast Tumor Recurrence

BackgroundThe ICE3 trial evaluated the safety and efficacy of cryoablation in women aged ≥60 years with low-risk, early-stage breast cancers, aiming to provide a non-operative treatment option and avoid potential surgical risks. This study presents 5-year follow-up trial results.MethodsThe ICE3 trial is an Institutional Review Board-approved, prospective, multicentered, non-randomized trial including women ≥ 60 years of age with unifocal, ultrasound visible, invasive ductal carcinoma ≤ 1.5 cm in size, histologic grade 1–2, hormone receptor (HR)-positive, and human epidermal growth factor receptor 2 (HER2)-negative. The primary study endpoint of 5-year ipsilateral breast tumor recurrence (IBTR) was evaluated based on Kaplan–Meier estimates.ResultsOverall, 194 patients meeting eligibility received successful cryoablation treatment per protocol and were included for analysis. The mean age was 74.9 years (55–94) with a mean tumor size of 7.4 mm transverse (2.8–14.0 mm) and 8.1 mm sagittal (2.5–14.9 mm). With a mean follow-up period of 54.16 months, the IBTR rate at 5 years was 4.3% and breast cancer survival was 96.7%. Of the 124 patients who received endocrine therapy only, the IBTR was 3.7%. No serious device-related adverse events were reported. Minor (88.2%) and moderate (9.6%) adverse events were mild in severity and resolved without residual effects. Quality-of-life score demonstrated statistically significant improvement (p < 0.001) in distress at 6 months as compared with baseline.ConclusionsBreast cryoablation presents a promising alternative to surgery in selected patients, offering the benefits of a minimally invasive procedure with minimal risks. Further studies are encouraged to confirm cryoablation as a viable alternative to surgical excision low-risk patients.

Luteal Phase Defects and Progesterone Supplementation

Importance: Luteal phase defects (LPDs), or an insufficiency of progesterone production during the luteal phase of the menstrual cycle, have been identified as a potential cause of recurrent pregnancy loss (RPL), but its exact contribution to RPL is not well-defined. In addition, the role of exogenous progesterone supplementation during pregnancy remains controversial. Objective: The goal of this review is to provide an updated, evidence-based summary of LPD, including prevalence and potential pathophysiologic mechanisms, and to explore the current controversies regarding progesterone supplementation for management and treatment of RPL. Evidence Acquisition: A literature review identified relevant research using a PubMed search, Cochrane summaries, review articles, textbook chapters, databases, and society guidelines. Results: Endogenous progesterone plays a crucial role in the first trimester of pregnancy, and therefore, insufficiency may contribute to RPL. However, the precise relationship between LPD and RPL remains unclear. LPD is primarily a clinical diagnosis based on a luteal phase less than 10 days. Although there may be a possibility of incorporating a combined clinical and biochemical approach in defining LPD, the current lack of validated diagnostic criteria creates a challenge for its routine incorporation in the workup of infertility. Moreover, no treatment modality has demonstrated efficacy in improving fertility outcomes for LPD patients, including progesterone supplementation, whose inconsistent data do not sufficiently support its routine use, despite its minimal risk. It is imperative that women diagnosed with LPD should be worked up for other potential conditions that may contribute to a shortened luteal phase. Future work needs to focus on identifying a reproducible diagnostic test for LPD to guide treatment. Conclusions and Relevance: Currently, the perceived relationship between LPD and RPL is challenged by conflicting data. Therefore, patients with an abnormal luteal phase should undergo a thorough workup to address any other potential etiologies. Although supplemental progesterone is commonly used for treatment of LPD and RPL, inconsistent supporting data call for exogenous hormone therapy to be only used in a research setting or after a thorough discussion of its shortcomings.

The benefits of implementing Robotic Process Automation in Accounting

Purpose: The purpose of the paper is to identify and evaluate the main benefits associated with implementing process automation in accountingMethodology/approach: The empirical part of the article includes the results of quantitative research, which was conducted using the survey method, employing purposive sampling of respondents. The study was conducted in the first quarter of 2024 on a sample of 109 enterprises based on a research questionnaire. Descriptive statistics measures were utilized in data analysis, taking into account the nature of the questions and scales included in the research tool.Findings: The research demonstrates the following key benefits of implementing ac-counting process automation in the surveyed enterprises: process transparency, risk minimization, increased enterprise productivity, and improved employee satisfaction.Research limitations/implications: The empirical research was exploratory and referred to a limited group of enterprises. However, they can constitute the basis for further research in assessing the use of process automation in accounting.Originality/value: The paper discusses the relatively unexplored area of modern accounting and presents empirical research findings on the benefits of implementing process automation in accounting. This study partially fills the research gap and contributes to the discussion on the use of modern technologies in accounting. The paper is one of the first studies to present the results of research conducted among business entities operating in Poland.