Weighing the impact of bariatric surgery: A meta-analysis of long-term outcomes of Roux-en-Y gastric bypass and sleeve gastrectomy.

This study presents an optimization framework for designing a 50-storey steel high-rise building subjected to dynamic wind and seismic loading. The goal is to minimize total structural weight while meeting code-based limits on drift, displacement, stress, panel-zone shear and strong column–weak beam behaviour. A discrete special relativity search (DSRS) algorithm is introduced by mapping continuous special relativity search update rules into a discrete selection scheme and adding adaptive coefficients to improve convergence. The algorithm is integrated with SAP2000 to perform nonlinear dynamic analyses, with constraint violations addressed through a penalty-based fitness function. The optimized design achieves a minimum weight of 2.93 × 106 kg, significantly lower than the initial configuration. Statistical evaluation over 3000 function calls yields mean, median and worst solutions of 6.42 × 106, 6.59 × 106 and 7.86 × 106 kg, demonstrating efficiency. Stress-ratio and drift checks confirm compliance with AISC 360-16 and Iranian Standard 2800, indicating that DSRS is effective for discrete structural optimization.

Abstract Background Robotic-assisted bariatric surgery has emerged as a precise tool in managing obesity, offering potential benefits in recovery and patient satisfaction. However, patient-reported outcomes (PROs) are crucial for evaluating its role in holistic care. This study assesses PROs in robotic sleeve gastrectomy and gastric bypass patients, exploring the clinical and operative advancements in obesity through robotic-assisted bariatric surgery. Methods A cross-sectional survey was conducted among 115 patients undergoing robotic bariatric procedures (78 sleeve gastrectomy, 34 gastric bypass, 3 other) at SRS Strasbourg from March 2024 to May 2025. A 17-item questionnaire evaluated satisfaction, recovery time, complications, trust in robotic technology, and qualitative perceptions. Descriptive statistics, chi-square tests, and multivariable ordinal logistic regression analyzed associations with demographics and procedure type. Results High satisfaction was reported by 87.8% (101/115) of patients, with 81.7% (94/115) noting clear preoperative explanations. Rapid recovery was evident, with 47.8% (55/115) resuming daily activities within one week. Complications (self-describing) occurred in 13.9% (16/115), mainly gastrointestinal (for example, vomiting), with no significant difference between procedures (χ2 = 0.68, P = 0.41). Trust in robotic technology was strong (83.5% strongly agreed), and 86.1% would recommend it. Ordinal logistic regression revealed younger age (<40 years) increased odds of higher satisfaction levels (OR = 2.5, 95% c.i.: 1.5–4.2, P < 0.001). Qualitative feedback emphasized minimal scarring, quick recovery, and weight loss benefits, supporting improved diabetes management through enhanced surgical precision. Conclusion Robotic bariatric surgery yields excellent PROs, facilitating faster recovery and high patient trust, which are vital for effective obesity and diabetes management. These findings advocate for integrating robotic technologies into multidisciplinary approaches, to optimize patient-centered outcomes.

The utility of combination treatment with gemcitabine and camonsertib, an ataxia telangiectasia and Rad3-related kinase inhibitor (ATRi), in mediating tumor cell death was assessed in preclinical models, prompting clinical investigation. The phase 1b TRESR study (NCT04497116) aimed to evaluate the safety, tolerability and preliminary efficacy of the combination in patients with advanced solid tumors harboring DNA damage repair (DDR) gene alterations. Cell lines and tumor xenografts were tested across a range of dose levels and schedules. Patients (N = 76) harboring tumors with DDR gene alterations received camonsertib (80-120 mg) and de-escalating gemcitabine (1000-100 mg/m²) in 21- or 28-day cycles on an intermittent dosing regimen. Safety, tolerability, and preliminary efficacy were assessed to identify an optimal dosing regimen. In pre-clinical models, low-dose camonsertib (1/3 maximum tolerated dose [MTD]) and gemcitabine led to tumor regression and was well tolerated with minimal body weight loss observed. In patients, synergistic toxicities were observed, primarily myelosuppression, resulting in gemcitabine de-escalation. The introduction of a one week on / one week off (1/1w) schedule in combination with low-dose gemcitabine allowed for spontaneous neutrophil recovery, fewer dose modifications, and improved tolerability. Tumor responses were primarily observed in patients with gynecological cancers, with tumor control maintained for greater than one year in some patients. Camonsertib and low-dose gemcitabine demonstrated preliminary clinical activity, but due to challenging tolerability further evaluation is warranted to identify the optimal dosing regimen and subset of patients who may benefit most from this combination.

Quasi total double Roman domination stability in graphs

Insufficient blood supply negatively affects transfusion-dependent patients. Sustaining adequate blood units relies on community education. As future healthcare professionals, medical science students may assist in increasing the number of blood donations. This study assessed blood donation knowledge among medical science students at Umm Al-Qura University in Makkah City, Saudi Arabia. Twenty-three questions were administered in an online survey to assess knowledge, attitudes, and practices (KAP) of medical science students regarding blood donation. A chi-squared test was used to examine associations with the status of the blood donation. A total of 286 students from four departments responded to the questionnaire. Remarkably, higher contributions regarding knowledge and attitude questions were observed in female participants, compared to male participants. Furthermore, students that donated blood demonstrated greater awareness of their blood group (p < 0.05), minimum weight legibility, and knowledge regarding the duration of the blood donation procedure (p < 0.01). This study assessed the KAP regarding blood donation among medical science students at Umm Al-Qura University, Saudi Arabia. Furthermore, the most commonly reported barrier was the belief that the individual was not sufficiently fit or healthy to donate. Consequently, targeted education is crucial to emphasize the importance of blood donation and mitigate hospital blood shortages, especially for patients who require blood transfusion units regularly.

ABSTRACT This study investigates the development of a biobased thermoplastic elastomeric biocomposite based on thermoplastic starch (TPS) dynamically vulcanized with natural rubber (NR), epoxidized natural rubber (ENR25 and ENR50), and reinforced with 20 phr rice husk ash (RHA). The effects of rubber polarity and filler incorporation on mechanical, thermal, and environmental performance were comprehensively examined. Among all formulations, ENR50/TPS/RHA20 exhibited the most balanced properties, achieving tensile strength of 5.3 MPa and elongation at break of 410%, compared to 1.0 MPa and 440% for NR/TPS. TSSR analysis revealed superior thermal elasticity with an initial stress of 0.18 MPa and high relaxation temperatures ( T 10 ≈ 80°C, T 50 ≈ 155°C, T 90 ≈ 190°C). Thermogravimetric results indicated a final degradation temperature of 421°C and 9.8% char residue, confirming improved thermal resistance. Additionally, ENR50/TPS/RHA20 showed reduced water absorption (∼22.5% at 72 h) and minimal weight loss (&lt;25%) after 60 days of soil burial. These findings demonstrate that the combination of polar ENR and silica‐rich RHA significantly enhances interfacial adhesion, mechanical reinforcement, and environmental stability, making ENR50/TPS/RHA20 a promising candidate for sustainable elastomer applications. The novelty lies in the synergistic reinforcement strategy: using different ENR polarities (ENR25, ENR50) with biobased RHA to simultaneously improve mechanical, thermal, and environmental properties of TPS‐based biocomposites.

Theshortest-pathproblem,afundamentalchallenge ingraphtheoryandcomputerscience,seekstofindapath of minimum cumulative weight between vertices in a weighted graph. Its solution is critical to a vast array of applications, includingnetworkrouting,logistics,robotics,andbioinformatics. This paper provides a comprehensive review and comparative analysis of four foundational algorithms that address this prob- lem: Dijkstra’s algorithm, the Bellman-Ford algorithm, the A* search algorithm, and the Floyd-Warshall algorithm. We delve into the historical context, theoretical underpinnings, and operational mechanics of each method. The analysis contrasts these algorithms across several key dimensions: algorithmic paradigm (greedy,dynamicprogramming,heuristicsearch),problemscope (single-source vs. all-pairs), handling of edge weights (including negative values), and computational complexity. By juxtaposing their respective strengths, weaknesses, and ideal use cases, this review illustrates that the selection of an optimal shortest-path algorithm is not a matter of absolute superiority but a nuanced decision contingent upon specific problem constraints such as graph structure, edge weight properties, and the required scope of the solution. The paper concludes by contextualizing these classic algorithms as essential building blocks for modern, more complex pathfinding solutions and highlights ongoing research that continues to refine our understanding of this classic compu- tational problem

We consider the following NP-hard generalization of the Minimum Spanning Tree problem. Given an undirected \(n\)-vertex edge-weighted complete graph and integers \(d\) and \(m\), find \(m\) edge-disjoint spanning trees of diameter at most \(d\) with minimum total weight. We propose a new polynomial-time approximation algorithm for the problem and study its performance guarantees on random inputs, that is, when the edge weights of the graph are i. i. d. random variables. We show that under mild conditions on the distribution parameters the proposed algorithm is asymptotically optimal for the case of continuous and discrete uniform distribution on \([a_n, b_n]\), \(a_n&gt;0\), the shifted exponential distribution with shift \(a_n&gt;0\), and distributions dominating the above. In contrast to a number of previous results for related problems, the new algorithm is asymptotically optimal not only if \(d\) tends to infinity with \(n\), but for constant \(d\) as well.

The recent trend in wind power generation has been moving toward larger wind turbines, with an emphasis on high blade aerodynamic efficiency and minimal weight. This leads to more flexible wind turbine blades that are more susceptible to blade failure arisen from induced vibrations; which makes vibration control critical. In this paper, application of two control strategies to reduce wind turbine blade vibrations is investigated, offering an insight into how they compare and advantages and disadvantages of each. First, the turbine blade is modelled as an Euler-Bernoulli cantilever beam with three degrees of freedom. Most often, only the first mode of vibration is modelled in previous researches, causing significant error in cases of excitation close to higher resonant frequency and inadequacy of proposed solutions that place tuned mass dampers (TMDs) or actuators close to nodes of neglected modes of vibration, limiting their applicability. To address that, the system is truncated at three modes of vibration. NREL 5 MW wind turbine was used as reference wind turbine design in this study. To moderate vibration with a passive solution, a tuned mass damper is implemented in the model and its design parameters are found using a simple optimization algorithm. The designed TMD with a mass ratio of 5% reduced the peak value of displacement amplitude of blade tip to less than 1.2 meters under the defined excitation load. For an active solution, a modal control system configuration involving three actuators is described and a multivariable proportional-derivative (PD) control logic is implemented, with optimum gain values resulting from a systematic trial and error approach. The designed controller reduced the peak value of displacement amplitude of blade tip to less than 0.15 meters under the defined excitation load. In either case, the interaction of TMD/actuator placement with mode shapes is discussed, and an adequate placement strategy is proposed. Presented results imply that, despite its many practical advantages, a passive vibration absorber may not be a viable solution in harsh conditions, whereas the designed active controller provides satisfactory performance with reasonable values of actuating force and displays extremely robust behaviour.

ABSTRACT This study explores the combined use of plasma-activated water (PAW) washing and clay nanocomposite polyethylene (NCPs-PE) films to enhance the postharvest preservation of sweet lemons over five months under ambient storage. Structural analyses (FTIR, XRD, SEM, AFM and, EDS) confirmed successful incorporation of clay nanoparticles into the PE matrix, resulting in intercalated nanocomposite structures, homogeneous surface morphology, and good filler-polymer compatibility. The NCPs-PE films exhibited higher moisture content (MC), water vapor permeability (WVP) than pure PE, while water vapor transmission rate (WVTR) remained unchanged at p < .05. The films demonstrated superior antifungal activity against Penicillium digitatum (inhibition zone = 30 mm) and reduced decay rates compared to neat PE. Fruits packed with NCPs-PE showed the lowest decay rate (33%), while PAW washing combined with PE packaging resulted in minimal weight loss (3.18 ± 0.26 g) and optimal firmness (1.92 ± 0.02 N). Overall, the synergistic effect of nanocomposite packaging and PAW treatment effectively limited microbial growth, maintained fruit quality, and extended shelf life, indicating the potential for sustainable citrus preservation, though further optimization is needed for commercial application.

The development of a Mass Rapid Transit (MRT) system that interconnects multiple shopping centers has substantial potential to enhance the economic and social infrastructure of metropolitan areas. Improved connectivity not only reduces travel time and transportation costs for consumers but also increases foot traffic, alleviates urban traffic congestion, and contributes to reduced environmental pollution. This study presents a comparative performance analysis of two widely implemented Minimum Spanning Tree (MST) algorithms—Kruskal’s and Prim’s—to determine their suitability for designing optimal underground MRT routes connecting major malls in Jakarta. MST algorithms serve a critical role in graph theory by connecting all vertices with the minimum cumulative weight, while maintaining both acyclicity and full connectivity. Their application in transportation network design is essential for minimizing construction and operational expenses while simultaneously maximizing time efficiency and network reliability. The experimental results indicate that although both algorithms yield identical minimum spanning costs, Kruskal’s algorithm runs faster than Prim’s, particularly on sparse graphs that typify urban transportation systems. Despite this performance gap, both algorithms are categorized as polynomial-time algorithms, not in the nondeterministic polynomial (NP) class, as their computational processes do not exhibit exponential growth (i.e., not of the form 2ⁿ). Based on these findings, Kruskal’s algorithm is recommended for scenarios requiring faster computation in MRT network development. Nevertheless, both algorithms remain effective and applicable depending on specific graph characteristics and computational constraints.

We analyze the performance of quantum stabilizer codes, one of the most important classes for practical implementations, on both symmetric and asymmetric quantum channels. To this aim, we first derive the weight enumerator (WE) for the undetectable errors based on the quantum MacWilliams identities. The WE is then used to evaluate tight upper bounds on the error rate of CSS quantum codes with minimum weight decoding. For surface codes we also derive a simple closed form expression of the bounds over the depolarizing channel. We introduce a novel approach that combines the knowledge of WE with a logical operator analysis, allowing the derivation of the exact asymptotic error rate for short codes. For example, on a depolarizing channel with physical error rate &amp;#x03C1; &amp;#x2192; 0 , the logical error rate &amp;#x03C1; L is asymptotically &amp;#x03C1; L &amp;#x2248; 16 &amp;#x03C1; 2 for the [ [ 9 , 1 , 3 ] ] Shor code, &amp;#x03C1; L &amp;#x2248; 16.3 &amp;#x03C1; 2 for the [ [ 7 , 1 , 3 ] ] Steane code, &amp;#x03C1; L &amp;#x2248; 18.7 &amp;#x03C1; 2 for the [ [ 13 , 1 , 3 ] ] surface code, and &amp;#x03C1; L &amp;#x2248; 149.3 &amp;#x03C1; 3 for the [ [ 41 , 1 , 5 ] ] surface code. For larger codes our bound provides &amp;#x03C1; L &amp;#x2248; 1215 &amp;#x03C1; 4 and &amp;#x03C1; L &amp;#x2248; 663 &amp;#x03C1; 5 for the [ [ 85 , 1 , 7 ] ] and the [ [ 181 , 1 , 10 ] ] surface codes, respectively. Finally, we extend our analysis to include realistic, noisy syndrome extraction circuits by modeling error propagation throughout gadgets. This enables estimation of logical error rates under faulty measurements. The performance analysis serves as a design tool for developing fault-tolerant quantum systems by guiding the selection of quantum codes based on their error correction capability. Additionally, it offers a novel perspective on quantum degeneracy, showing it represents the fraction of non-correctable error patterns shared by multiple logical operators.

Post-harvest quality maintenance of bell peppers (Capsicum annuum L.) presents significant challenges in commercial agriculture due to their high perishability and sensitivity to cold storage conditions. While ethylene regulators show promise in extending storage life, the optimal timing and method of application remain unclear. To evaluate the effectiveness of two ethylene regulators (1-methylcyclopropene (1-MCP) and sodium nitroprusside (SNP) as a nitric oxide donor) applied at different developmental stages on quality retention and antioxidant preservation in bell peppers during cold storage. Green Bianca and Red California Wonder bell pepper cultivars were treated with either 1 µmol L-1 1-MCP or 5 µmol L-1 SNP at three timing intervals: pre-harvest, post-harvest, or both. Following a factorial design with three replications, fruits were stored at 7 ± 0.5 °C with 80–85% relative humidity for 28 days. Comprehensive analysis included physical attributes (firmness, weight loss, shape index), chemical properties (pH, titratable acidity, soluble solids), bioactive compounds (vitamin C, phenolics, flavonoids), pigments (chlorophylls, carotenoids, lycopene), and physiological responses (chilling injury, ion leakage, antioxidant capacity). Pre-harvest application of SNP proved most effective for both cultivars, with Green Bianca showing superior retention of vitamin C (73.19 mg100g-1), antioxidant capacity (61.06%), and minimal weight loss (0.19%). Red California Wonder demonstrated optimal response to pre-harvest NO treatment, maintaining high antioxidant activity (45.16%) and vitamin C content (99.92 mg100g-1). Treatment timing significantly influenced effectiveness, with pre-harvest applications showing particular efficacy in maintaining membrane integrity and reducing chilling injury while preserving bioactive compounds. This study establishes the timing-dependent efficacy of ethylene regulators in bell pepper preservation and provides valuable insights for developing cultivar-specific post-harvest protocols. The findings offer practical solutions for extending market life and maintaining nutritional quality of bell peppers during cold storage, with potential applications in commercial post-harvest management systems.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-27407-w.

The construction sector is a significant contributor to resource consumption and environmental degradation due to energy-intensive processes. To reduce consumption, reuse-based design strategies could lead to structurally efficient and environmentally friendly solutions. However, effectively incorporating reused elements requires advanced design methods that allow for their rational disposition. This paper presents an innovative design approach based on a metaheuristic strategy developed through genetic algorithms for the design of minimum-weight gridshells using reusable components. The methodology is applied to a dome gridshell, tested under different stock and boundary conditions. An expedited greenhouse gas assessment is then carried out to evaluate the environmental benefits of the reuse-based solutions compared to solutions composed entirely of new elements. The results are presented in terms of geometry, disposition of reused and new members, weight, structural performance (buckling factor, demand to capacity ratio, displacements), and greenhouse gas emissions. The algorithm is able to find the minimum weight solution for all the considered stocks, and to account for the different governing design criteria characterizing fully and partially constrained gridshells. Furthermore, it can also be used to determine the characteristics that the stock of reused elements should possess in order to achieve more sustainable design solutions.

Abstract As electric vertical takeoff and landing (eVTOL) aircraft technology advances, the focus has shifted towards hybrid electric power systems to overcome battery-specific energy limitations. This study introduces a deterministic hybrid power ratio to develop a series gas turbine hybrid electric propulsion system for a generic quad tiltrotor aircraft. First, the failure modes were categorised into two groups based on the primary power component arrangement, and the risks associated with each other were assessed. Three failure modes were identified in typical eVTOL layouts, i.e. one engine inoperative (OEI), one battery pack inoperative (OBI) and one proprotor inoperative (OPI). In addition, for configurations where a single nacelle contained both the battery and motor, a combined OPI+OBI case was considered, thereby acknowledging interconnected risks and extending the scope to four potential failure modes. The study determined the minimum weight of hybrid power systems using tailored deterministic hybrid power ratios based on five proposed sizing rules. In conclusion, the paper proposes an efficient battery layout for lightweight hybrid power systems and an optimal hybrid power system for the eVTOL aircraft, aligned with current battery technology levels.

Aurora kinase A inhibition as a synthetic lethality strategy in ARID1A-mutated gastroenteropancreatic neuroendocrine carcinoma.

Abstract This study explores the potential of mango peel extract as an environmental friendly corrosion inhibitor for solder alloy in a saline environment, specifically a 1-liter solution containing 35.06 g of NaCl. The research employs the weight loss method to quantify corrosion inhibition, providing a quantitative assessment of the protective properties of the mango peel extract. Various concentrations of the purified inhibitor (200, 400, 600, and 800 ppm) were tested by immersing solder alloy samples for 24 hours. Results indicate a significant correlation between the concentration of mango peel extract and the extent of corrosion protection. As the concentration increased, weight loss of the solder alloy decreased, showcasing the extract’s effectiveness. Since at 800ppm the solution exhibited 0.001 weight loss, reflecting minimal weight loss, compared to the blank solution’s weight loss of 0.003, which indicated a higher rate of corrosion. These findings not only highlight the corrosion-inhibiting properties of mango peel extract but also emphasize its potential as a sustainable alternative to traditional chemical inhibitors. This work contributes valued insights into the development of eco-friendly corrosion prevention strategies in various industrial applications, paving the way for further studies on natural products in materials protection.

ABSTRACT Determining the minimum (Min MW) and maximum (Max MW) mud weights is essential for mitigating shear and tensile rock failures, and defining a safe operating window, which requires precise calculations of the stresses around the wellbore. However, it is frequently difficult to construct geomechanical models because of the lack and uncertain data, including direct stress measurements, core samples, and image logs. To overcome these limitations, this study used field data from southern Iraq to create artificial neural network (ANN) models that predict limits of Min MW and Max MW. Model training was conducted using datasets from one well, and validation against the Mogi–Coulomb failure criterion was conducted using datasets from another well. Strong predictive ability was shown by the ANN models, which obtained R2 values of 0.87 and 0.98 and RMSE values of 0.95 and 0.49 for Min MW and Max MW, respectively. The ANN models reduced the RMSE by 30–40% and increased prediction accuracy by roughly 15–25% in terms of R2 when compared to the conventional Mogi–Coulomb failure criterion. According to validation using caliper log data, both ANN and Mogi–Coulomb techniques successfully detected wellbore instabilities; however, the ANN models exhibit better generalization to new wells. These findings demonstrate that the ANN approach is a useful and effective method for mud weight design optimization and wellbore stability prediction in situations with limited data.

Background: Stunting is one of the problems in the context of the triple burden of disease. Growth conditions below standard indicate growth obstacles in the child. This research aims to analyse the factors that influence EWS and to evaluate the application of the EWS model in improving nutritional status in toddlers. The purpose of the study is to develop an EWS for nutritional status in children. Methods: This research used an explanatory design to determine EWS; quasi-experimental sampling was randomised (multistage random design) with 180 respondents in stage 1 and 38 respondents in stage 2—inclusion criteria: mothers who have children and are raising their own child. The research was conducted in the public health sector of Malang Regency. Data collection will be done using a questionnaire for each variable. Data analyzed with Partial Least Square, Wilcoxon Signed Rank Test, and Mann Whitney The results of this study showed that determining factors of EWS were body weight (X1.3), height (X1.4), birth length (X1.6), history of infection (X1.7), minimal weight gain (X1. 11), participation in integrated health service (X2.2), history of maternal infection (X3.2), birth interval (X3.3), land use (X4.2), food hygiene (X5.2), complementary feeding (X6. 1), responsive feeding (X6.2).. Results: The EWS model's effectiveness is associated with minimal weight gain in children (ρ&lt;0.001), but not with nutritional status (ρ=1.000) or upper arm circumference (ρ=0.207). Conclusion: It is hoped that the development of this model can be an intervention with an integrated approach to improve the minimal weight gain which in the long term may enhance nutritional status.of children under five.