Background: Limited data exists for the efficacy and outcomes of nivolumab as a second-line treatment for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the efficacy and safety of nivolumab in patients with uHCC who experienced disease progression during sorafenib treatment. Methods: In this retrospective, observational, multicenter study, adult Child-Turcotte-Pugh A/7B patients with uHCC who tolerated sorafenib therapy but showed disease progression switched to second-line intravenous nivolumab (n = 42). A similar number of consecutive, unselected patients who were maintained on sorafenib therapy, regardless of tumoral response or progression, served as historical controls (n = 38). The primary endpoint was overall survival (OS, defined as the time from starting sorafenib in either group up to death due to any cause) and analyzed by intention-to-treat. Results: The mean age of the overall cohort was 72.4 ± 10.1 years, of whom 87.5% were males and 58.8% had underlying viral etiology. Patients in the two cohorts were similar, except those who received nivolumab had more co-morbidities (70.0% vs. 15.4%), ECOG-2 status (21.4% vs. 15.8%), BCLC stage C (81.0% vs. 47.4%), and extravascular invasion (54.4% vs. 21.8%) (p < 0.05 for all). More patients in the nivolumab arm were Child-Turcotte-Pugh B (35.7% vs. 21.1%, p = 0.15). Median OS was 22.2 months (95% CI: 8.9–49.8) on second-line nivolumab and 11.0 months (95% CI: 3.6–18.4) on sorafenib alone (HR 1.93; 95% CI: 1.1–3.3, p = 0.014). Median OS after starting nivolumab was 10.2 months, and time-to-progression was 4.9 months (95% CI: 3.2–6.3). Conclusion: Nivolumab is an effective second-line treatment option in patients with uHCC who progress on sorafenib, with significantly improved OS. These early real-life data offer encouraging results, similar to those shown in Phase I/IIa clinical trials. Further investigations are warranted for the use of nivolumab as a monotherapy. Full article

With cyclohexane (CH), benzene (BE), and ethyl acetate (EA) as solvents, Naomaohu lignite (NL, a typical oil-rich, low-rank coal) from Hami, Xinjiang, was thermally dissolved (TD) to obtain three types of soluble organics (NL_CH, NL_BE, and NL_EA) and the corresponding insoluble portions (NL_CH-R, NL_BE-R, and NL_EA-R). Ultimate analysis, X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TG-DTG), and gas chromatography–mass spectrometry (GC/MS) were used to characterize NL and its soluble and insoluble portions. Results showed that, compared with NL, the C element in NL_CH-R, NL_BE-R, and NL_EA-R increased, while the O element decreased significantly, indicating that thermal dissolution is a carbon enrichment process and an effective deoxidation method. The GC/MS results showed that oxygen-containing organic compounds (OCOCs) are dominant in NL_CH, NL_BE, and NL_EA. NL_CH is mainly composed of ketones (11.90%) and esters (19.04%), while NL_BE and NL_EA are composed of alcohols (12.18% and 2.42%, respectively) and esters (66.09% and 84.08%, respectively), with alkyl and aromatic acid esters as the main components. Among them, EA exhibits significant selective destruction for oxygen-containing functional groups in NL. XPS, FTIR, and TG-DTG results showed that thermal dissolution can not only affect the macromolecular network structure of NL, but also improve its pyrolysis reactivity. In short, thermal dissolution can effectively obtain oxygen-containing organic compounds from NL. Full article

Cystic echinococcosis is a zoonotic parasitic disease that affects the liver in more than 70% of cases, and there is still an underestimated incidence in endemic areas. With a peculiar clinical presentation that ranges from paucisymptomatic illness to severe and possibly fatal complications, quality imaging and serological studies are required for diagnosis. The mainstay of treatment to date is surgery combined with antiparasitic agents. The surgical armamentarium consists of open and laparoscopic procedures for selected cases with growing confidence in parenchyma-sparing interventions. Endoscopic retrograde cholangiopancreatography (ERCP) is extremely useful for the diagnosis and treatment of biliary fistulas. Recent relevant studies in the literature are reviewed, and two complex cases are presented. The first patient underwent open surgery to treat 11 liver cysts, and during the follow-up, a right pulmonary cyst was diagnosed that was treated by minimally invasive surgery. The second case is represented by the peritoneal rupture of a giant liver cyst in a young woman who underwent laparoscopic surgery. Both patients developed biliary fistulas that were managed by ERCP. Both patients exhibited a non-specific clinical presentation and underwent several surgical procedures combined with antiparasitic agents, highlighting the necessity of customized treatment in order to decrease complications and successfully cure the disease. Full article

Isolated water and energy microgrids (IWEMGs) serve as vital solutions for enhancing the well-being of remote and rural communities, particularly in areas where water and energy resources are scarce. This has spurred research into the interdependence between the water and energy sectors (water–energy nexus), a field that has grown in response to technological advancements. Through a systematic optimization framework, this review critically evaluates the integration of various technologies within IWEMGs, encompassing infrastructure, management, and strategic planning, while considering economic and social impacts. IWEMGs incorporate diverse technologies for the infrastructure, management, and strategic planning of water and energy resources, integrating economic and social considerations to inform decisions that affect both immediate and long-term sustainability and reliability. This article presents an exhaustive review of the literature on IWEMG management, employing an approach that synthesizes existing studies to enhance the understanding of strategic IWEMG management and planning. It introduces a structured taxonomy for organizing research trends and tackling unresolved challenges within the field. Notably, the review identifies critical gaps, such as the lack of comprehensive data on water demand in isolated locations, and underscores the emerging role of game theory and machine learning in enriching IWEMG management frameworks. Ultimately, this review outlines essential indicators for forthcoming research, focusing on the optimization, management, and strategic planning of IWEMG resources and infrastructure, thereby setting a direction for future technological and methodological advancements in the field. Full article

The proliferation of wireless technologies, particularly the advent of 5G networks, has ushered in transformative possibilities for enhancing vehicular communication systems, particularly in the context of autonomous driving. Leveraging sensory data and mapping information downloaded from base stations using I2V links, autonomous vehicles in these networks present the promise of enabling distant perceptual abilities essential to completing various tasks in a dynamic environment. However, the efficient down-link transmission of vehicular network data via base stations, often relying on spectrum sharing, presents a multifaceted challenge. This paper addresses the intricacies of spectrum allocation in vehicular networks, aiming to resolve the thorny issues of cross-station interference and coupling while adapting to the dynamic and evolving characteristics of the vehicular environment. A novel approach is suggested involving the utilization of a multi-agent option-critic reinforcement learning algorithm. This algorithm serves a dual purpose: firstly, it learns the most efficient way to allocate spectrum resources optimally. Secondly, it adapts to the ever-changing dynamics of the environment by learning various policy options tailored to different situations. Moreover, it identifies the conditions under which a switch between these policy options is warranted as the situation evolves. The proposed algorithm is structured in two layers, with the upper layer consisting of policy options that are shared across all agents, and the lower layer comprising intra-option policies executed in a distributed manner. Through experimentation, we showcase the superior spectrum efficiency and communication quality achieved by our approach. Specifically, our approach outperforms the baseline methods in terms of training average reward convergence stability and the transmission success rate. Control-variable experiments also reflect the better adaptability of the proposed method as the environmental conditions change, underscoring the significant potential of the proposed method in aiding successful down-link transmissions in vehicular networks. Full article

This study explores the correlation between residents’ subjective assessments of urban neighbourhoods, obtained through virtual walkthroughs, and objective measures of deprivation. Our study was set within a specific city in the United Kingdom, with neighbourhoods selected based on Indices of Multiple Deprivation (IMD). We invited residents in the UK through Prolific, a crowdsourcing platform. Employing complete case analysis, TF-IDF keyword extraction, the Kruskal–Wallis test, and Spearman’s rank-order correlation, our study examines the alignment between subjective assessments and existing deprivation measures (IMD). The results reveal a nuanced relationship, suggesting potential subjective biases influencing residents’ perceptions. Despite these complexities, the study highlights the value of virtual walkthroughs in offering a holistic overview of neighbourhoods. While acknowledging the limitations posed by subjective biases, we argue that virtual walkthroughs provide insights into residents’ experiences that potentially complement traditional objective measures of deprivation. By capturing the intricacies of residents’ perceptions, virtual walkthroughs contribute to a more comprehensive understanding of neighbourhood deprivation. This research informs future endeavours to integrate subjective assessments with objective measures for robust neighbourhood evaluations. Full article

The objective of this study was to conduct a detailed analysis of the available flow series in the Chiriquí Viejo River basin in Panama. This paper examines the patterns of variation within these series and calculates various hydrological indexes indicative of the region’s hydrology. Utilizing advanced hydrological indexes within the Chiriquí Viejo River basin in Panama, which spans an area of 1376 km² and supports an estimated population of 100,000 inhabitants, analytical methods were employed to compute indexes such as the Daily Flow Variation Index (QVAR), the Slope of the Flow Duration Curve (R2FDC), the Hydrological Regulation Index (IRH), and the average duration of low (DLQ75) and high (DHQ25) flow pulses. The results indicate moderate flow variability (QVAR of 0.72) and a Hydrological Regulation Index (IRH) of 2.32, signifying a moderate capacity for flow regulation. Notably, low flow events (DLQ75) lasted approximately 3.73 days, while high flow events (DHQ25) lasted around 4.08 days. The study highlights a significant capacity to respond to extreme events, with maximum annual flows reaching 80.25 m³/s and minimum flows dropping to 3.01 m³/s. Despite the significant contribution of the basin to hydroelectric power generation and other economic activities, there is an observed need for sustainable management that accommodates hydrological fluctuations and promotes resource conservation. The conclusions indicate that these findings are critical for future planning and conservation strategies in the region, emphasizing the importance of integrating multidisciplinary approaches for Hydro-Social Sustainability. This novel and holistic approach underscores the interdependence between hydrological dynamics, socio-economic activities, and environmental sustainability, aiming to ensure the long-term resilience of the Chiriquí Viejo basin and its communities. Full article

This study explores the current landscape of social value (SV) research in the construction industry, analyzing global trends and identifying future research directions. Using bibliometric analysis, research published in Elsevier Scopus database from 2013 to 2023 was extracted using the keywords “social value” AND “construction industry.” The results indicate fluctuating but growing interest in the subject area of social value in construction research over the past decade with 2020 recording the highest number of publications. Our findings show a focus on social value indicators, socioeconomic impacts, project management, innovative practices, and cross-sector collaborations. Additionally, there is a strong tendency in social value (SV) research in the construction sector to favor the social procurement and measurement of social value variables in construction projects. This study contributes to the academic literature by examining the research focuses and identifying the trends in social value research within the construction sector over the previous ten years, as well as by emphasizing new knowledge areas. It suggests the need for guidelines for the integration in construction processes in both developing and developed countries and advocates for further research on social value in the built environment. The study also reveals a lack of attention to social value (SV) in African countries’ construction sectors. Additionally, it calls for innovative strategies to be employed for the creation of social value in the sector globally. Full article

Efficient recovery of gallium (Ga) from vanadium slag processing residue (VSPR) solution is of great significance for environmental protection and resource utilization, but improving its selective adsorption against the coexisting Sc³⁺ and In³⁺ is still challenging. Herein, a novel adsorbent consisting of 4-amino-3-hydrazino-1,2,4-triazol-5-thiol (AHTZT)-modified graphene oxide (GO-AHTZT) was successfully synthesized that exhibits a higher adsorption selectivity for Ga³⁺ in VSPR solution with coexisting Sc³⁺ and In³⁺. Under optimal conditions, the adsorption capacity of GO-AHTZT for Ga³⁺ can reach 23.92 mg g⁻¹, which is 4.9 and 12.6 times higher than that for Sc³⁺ (4.87 mg g⁻¹) and In³⁺ (1.90 mg g⁻¹) adsorption, indicating the excellent anti-interference ability of GO-AHTZT against Sc³⁺ and In³⁺. The process and mechanism of Ga³⁺ adsorption onto GO-AHTZT was also studied and discussed in detail. By measuring the adsorption process and by characterizing the adsorbent before and after adsorption, we demonstrate that the selective interaction between the Ga³⁺- and N-containing groups in AHTZT is the main reason for the improved adsorption selectivity. This work opens up an avenue for the design and synthesis of highly selective adsorbents for Ga³⁺ in complex VSPR solutions. Full article

Better diagnostic tools are needed to improve the diagnosis of Clostridioides difficile infections (CDI) and reduce the overtreatment of colonized children. In this study, we evaluated two polymerase chain reaction (PCR) assays (Cepheid GeneXpert C. difficile and the Gastroenteritis PCR Panel by QIAstat-Dx) as a standalone method in combination with the PCR cycle threshold (Ct) value in positive samples to predict the presence of free toxins. We also evaluated the clinical impact of reporting toxin production results and provided comments alongside the PCR results in our pediatric population. PCR-positive stool samples from pediatric patients (aged 2 to 18 years old) were included in our study and tested for the presence of toxins A and B using the C. difficile Quik Chek Complete kit. For the clinical intervention, the CDI treatment rates 6 months pre- and post-intervention were compared. The use of PCR Ct value showed excellent sensitivity (100%) at a Ct value cutoff of 26.1 and 27.2 using the Cepheid GeneXpert C. difficile and the Gastroenteritis PCR Panel by QIAstat-Dx, respectively, while the toxin test showed inferior sensitivity of 64% in the PCR-positive samples. In addition, CDI treatment rates were decreased by 23% post-intervention. The results of our study suggest that nucleic acid amplification test (NAAT) assays supplemented by the use of PCR Ct value for positive samples can be used as standalone tests to differentiate CDI from colonization. Furthermore, the reporting of toxin production along with the PCR results can help reduce the unnecessary treatment of colonized children. Full article

Edwardsiella ictaluri is responsible for causing bacillary necrosis (BNP) in striped catfish (Pangasianodon hypophthalmus) in Vietnam. This study offers a comprehensive genomic characterization of E. ictaluri to enhance understanding of the molecular epidemiology, virulence, and antimicrobial resistance. E. ictaluri isolates were collected from diseased striped catfish in the Mekong Delta. The species was confirmed through PCR. Antimicrobial susceptibility testing was conducted using minimum inhibitory concentrations for commonly used antimicrobials. Thirty representative isolates were selected for whole genome sequencing to delineate their genomic profiles and phylogeny. All strains belonged to ST-26 and exhibited genetic relatedness, differing by a maximum of 90 single nucleotide polymorphisms. Most isolates carried multiple antimicrobial resistance genes, with the tet(A) gene present in 63% and floR in 77% of the genomes. The ESBL gene, bla_CTX-M-15, was identified in 30% of the genomes. Three plasmid replicon types were identified: IncA, p0111, and IncQ1. The genomes clustered into two clades based on their virulence gene profile, one group with the T3SS genes and one without. The genetic similarity among Vietnamese isolates suggests that disease spread occurs within the Mekong region, underscoring the importance of source tracking, reservoir identification, and implementation of necessary biosecurity measures to mitigate spread of BNP. Full article

Background: Micronutrient (MN) supplementation has a positive impact on clinical outcomes. However, the evidence for the impact of MN supplementation remains controversial. Therefore, our study aims to assess the impact on nutritional outcomes according to exploring the implementation of MN support with multidisciplinary collaboration. Methods: This retrospective cohort study was conducted at a university hospital in Incheon, Korea. All patients referred to a nutrition support team (NST) between July and November 2022 were included. The NST reviews the MN protocol, which includes multivitamins and trace elements, based on international nutrient guidelines. All patients who were on nothing per oral and did not meet ≥70% of their nutritional requirements within 1 week were recommended MN supplements. Compliance with the MN protocol was evaluated, alterations in nutritional status based on the Nutrition Risk Screening 2002 (NRS 2002) scoring system and clinical outcomes were assessed after 7 day and at discharge. Multiple logistic regression analysis was used to identify factors associated with high nutritional risk in discharged patients. In addition, a sub-analysis was performed on changes in the nutritional of patients on the ward and in the ICU. Results: A total of 255 patients were eligible for analysis, with many patients requiring an MN supply of nothing per oral. The rate of implementation of MN supplementation was 50.2%. The findings indicate a significant decrease in the NRS 2002 score in the good compliance group with MN supplementation. No significant differences in protocol compliance were observed in terms of mortality, hospital stay, or length of stay in the intensive care unit. However, bad compliance with MN supplementation was correlated with risk factors for malnutrition at discharge. In subgroup analysis, nutritional status in the ICU and wards improved, with a significant difference between the two groups. Conclusions: The implementation of a MN supplementation protocol by a multidisciplinary NST is a feasible approach for improving the nutritional status of inpatients. Ensuring high compliance with this protocol is crucial, as poor compliance has been identified as a risk factor for malnutrition at discharge. Active intervention by the NST is essential to achieve optimal nutritional outcomes. Full article

This study aims to investigate the levels of pedagogical competencies and ESD competencies in a group of future primary school teachers when integrating teaching practices and the Sustainable Development Goals (SDGs) into a science education course. Both quantitative and qualitative research approaches were used. Eighty-eight of the student teachers demonstrated pedagogical and ESD competencies, as evidenced by the self-rated scores and course instructor-rated scores of their teaching practices which were collected and analyzed. In addition, the lesson plans designed by the student teachers were coded and scrutinized to identify their ESD-specific competencies related to designing primary science instruction. Furthermore, the student teachers responded to the questionnaires about their views and attitudes towards the integration of the SDGs and teaching practices. The findings reveal a difference between the participants’ self-rated scores and the instructor-rated scores for pedagogical competencies during the teaching practices, whereas the scores for general ESD competencies were closely aligned. Content knowledge, pedagogical content knowledge, and motivation and value related to sustainable development and science education were well represented in the lesson plans, and the student teachers generally held a positive attitude towards the integration of the SDGs and teaching practices. This study offers practical insights into the effective integration of pertinent topics and knowledge regarding sustainable development into teacher education and science education curricula. Full article

Background and Objectives: The aim of our single-center cohort study was the determination of the influence of the intrauterine lavage of granulocyte colony-stimulating growth factor (G-CSF) on clinical pregnancy rate in patients with a history of implantation failure older than 40 years. Materials and Methods: The study was conducted in Ferticare Prague SE between May 2018 and June 2020. Overall, 115 patients were distributed into two arms, with 48 subjects in the experimental and 67 in the control arm. All women have had a previous history of unsuccessful history of infertility treatment with their own genetic material and at least one ineffective cycle with the donated oocytes. The experimental arm underwent the intrauterine lavage of 0.5 mL of pure G-CSF from 120 to 48 h prior to embryo transfer. Results: The clinical pregnancy rate was 63.3% in the experimental arm and 47.8% in the control arm (p = 0.097 for Pearson's χ2, and p = 0.133 for Fisher’s exact test). However, the mean endometrial thickness on the day of embryo transfer did not appear to be statistically different (p = 0.139). Only the difference in endometrium thickness growth was statistically significant (p = 0.023). The increase in pregnancy rate is still encouraging for the future, even if it is not significant. Conclusion: Our study suggests the trend of increased pregnancy rate after the intrauterine G-CSF lavage in the interval of 120–48 h prior to embryo transfer. Full article

Background: Instability is a common cause of (total knee arthroplasty) TKA failure, which can be prevented by achieving proper gap balance during surgery. There is no consensus on the ideal gap balance in TKA, and different alignment philosophies result in varying soft-tissue tightness. Traditional TKA aims for symmetric compartment balance, while kinematic alignment (KA) restores anatomy and accepts asymmetric flexion gaps. This study evaluated the impact of these philosophies on the flexion gap balance and clinical outcomes. Methods: A retrospective review of 167 patients who received true or restricted KA robotic-assisted TKA with at least one year of follow-up was conducted. The groups were based on intraoperative flexion gap differences: symmetric (0–1 mm) (n = 94) and asymmetric (2–5 mm) (n = 73). Results: Preoperative demographics and postoperative clinical and functional scores were compared. Both groups were similar in demographics and preoperative scores. True KA alignment was more likely to result in an asymmetric flexion gap, while restricted KA produced symmetric gaps. Conclusions: The study found no adverse effects from the physiological asymmetric flexion gap, with clinical and functional outcomes comparable to symmetric gaps. A 5 mm difference between the medial and lateral gap width did not negatively impact the outcomes. True KA more frequently results in a physiological asymmetric flexion gap. Full article

This study investigates the role of body composition parameters in patients with pancreatic cancer undergoing surgical treatment. The research involved 88 patients diagnosed with pancreatic cancer who underwent surgery at the Modena Cancer Center between June 2015 and October 2023. Body composition parameters were obtained from CT scans performed before and after surgery. The percentage of sarcopenic patients at the time of diagnosis of pancreatic cancer is 56.82%. Of the patients who died between the first and second CT evaluated, 58% were sarcopenic, thus confirming the role of sarcopenia on outcome. The study found that all body composition parameters (TAMA, SMI, VFI, and SFI) demonstrated a trend towards reduction between two examinations, indicating an overall depletion in muscle and adipose tissue. We then evaluated the relationships between fat-related parameters (VFI, SFI and VSR) and survival outcomes: overall survival and progression-free survival. Cox univariate regression model show significant parameter related to outcomes was adipose tissue, specifically VFI. The study found that higher VFI levels were associated with greater survival rates. This research holds promise for advancing our understanding of the link between body composition and the prognosis of pancreatic cancer patients. Full article

A competing-rates model is presented to account for operational changes in the metastable β-Zr phase of the Zr-2.5Nb alloy used to make CANDU reactor pressure tubes and is used to predict temperature gradients at the outlet rolled joints using the decomposition of the β-Zr phase as a proxy for temperature. High temperatures decompose the β phase by enhancing the formation of small particles of ω and α phases. Fast neutron flux causes the ω and α phases to shrink. This process is assumed to depend on the total volume of the particles, because they are comparable to, or smaller than, the size of the neutron displacement cascades. The barrier energy for thermal growth was determined to be 2.43 eV, when an Arrhenius A factor of 10¹³/s was assumed. The cross section for (ω+α)-phase shrinkage is 24.5 barns for Zr-2.5Nb irradiated in CANDU reactors. Assuming that the shrinkage is dominated by the migration of self-interstitial point defects, a defect production efficiency of 1.4% was found. Full article

This research focuses on the drying kinetics of industrial pineapple processing waste on a flat plate, revealing a two-phase drying process: an initial phase with a constant drying rate followed by a phase with a decreasing drying rate. During the constant rate phase, the convective mass transfer coefficient, influenced by temperature variations from 40 to 70 °C, ranged from 5.69 × 10⁻⁷ to 2.79 × 10⁻⁷ m s⁻¹. The study introduced a novel approach to modeling the decreasing drying rate phase, applying equations derived from the Fick equation. This process involved determining the activation energy and thermodynamic properties of drying using an experimental forced convection dryer at temperatures of 40, 50, 60, and 70 °C, and an air velocity of 1.5 m/s. Data were fitted to several mathematical models, including Fick’s with four series terms, and versions of the Henderson–Pabis and Page models modified by Cavalcanti-Mata, among others. The Cavalcanti-Mata and modified Page models provided the most accurate fit to the experimental data. Results showed that diffusion coefficients vary per model yet align with literature values. Additionally, enthalpy (ΔH) and entropy (ΔS) values decreased with temperature, while Gibbs free energy (ΔG) increased, indicating that drying is an energy-dependent, non-spontaneous process. Full article

Intelligent truck platoons can benefit road transportation due to the short gap and better fuel economy, but they are also subject to dynamic uncertainties and external disturbances. Therefore, this paper develops a novel robust control algorithm for connected truck platoons. By introducing a linearized expression method of platoon error dynamics based on state measurement, the state feedback mechanism combined with a nonsmooth controller for a truck platoon is proposed in the development of the distributed control method. The state-feedback controller can drive the nominal platoon system to the state of second-order consensus, and the nonsmooth controller counterparts the uncertainties and disturbances. The convergence and string stability of the proposed control algorithm are demonstrated both theoretically and experimentally, and the effectiveness and robustness are also verified by simulation tests. Full article

Polyurethane (PU) is a promising material for addressing challenges in bone grafting. This study was designed to enhance the bone grafting capabilities of PU by integrating hydroxyapatite (HAp), which is known for its osteoconductive and osteoinductive potential. Moreover, a uniform distribution of HAp in the porous structure of PU increased the effectiveness of bone grafts. PEG/APTES-modified scaffolds were prepared through self-foaming reactions. A uniform pore structure was generated during the spontaneous foaming reaction, and HAp was uniformly distributed in the PU structure (PU15HAp and PU30HAp) during foaming. Compared with the PU scaffolds, the HAp-modified PU scaffolds exhibited significantly greater protein absorption. Importantly, the effect of the HAp-modified PU scaffold on bone repair was tested in a rat calvarial defect model. The microstructure of the newly formed bone was analyzed with microcomputed tomography (μ-CT). Bone regeneration at the defect site was significantly greater in the HAp-modified PU scaffold group than in the PU group. This innovative HAp-modified PU scaffold improves current bone graft materials, providing a promising avenue for improved bone regeneration. Full article

In advanced manufacturing, optimizing mixed-model synchronous assembly lines (MMALs) is crucial for enhancing productivity and adhering to sustainability principles, particularly in terms of energy consumption and energy-efficient sequencing. This paper introduces a novel approach by categorizing sequence-dependent setup times into bipartite categories: workpiece-independent and workpiece-dependent. This strategic division streamlines assembly processes, reduces idle times, and decreases energy consumption through more efficient machine usage. A new mathematical model is proposed to minimize the intervals at which workpieces are launched on an MMAL, aiming to reduce operational downtime that typically leads to excessive energy use. Given the Non-deterministic Polynomial-time hard (NP-hard) nature of this problem, a genetic algorithm (GA) is developed to efficiently find solutions, with performance compared against the traditional branch and bound technique (B&B). This method enhances the responsiveness of MMALs to variable production demands and contributes to energy conservation by optimizing the sequence of operations to align with energy-saving objectives. Computational experiments conducted on small and large-sized problems demonstrate that the proposed GA outperforms the conventional B&B method regarding solution quality, diversity level, and computational time, leading to energy reductions and enhanced cost-effectiveness in manufacturing settings. Full article

Objectives: This real-life study aimed to evaluate the safety of acetazolamide (ACZ), a carbonic anhydrase inhibitor with diuretic effects. ACZ has recently been proven to improve decongestion in the context of patients hospitalized for acute heart failure (HF). However, data in terms of safety are lacking. Methods: We conducted a monocentric observational prospective study from November 2023 to February 2024 in a 12-bed cardiology department, recording adverse events (hypotension, severe metabolic acidosis, severe hypokalemia and renal events) during in-hospital HF treatment. All patients hospitalized for acute HF during the study period treated with ACZ (500 mg IV daily for 3 days) on top of IV furosemide (n = 28, 48.3%) were compared with patients who have been treated with IV furosemide alone (n = 30, 51.7%). Results: The patients treated with ACZ were younger than those without (median age 78 (range 67–86) vs. 85 (79–90) years, respectively, p = 0.01) and had less frequent chronic kidney disease (median estimated glomerular fraction rate (60 (35–65) vs. 38 (26–63) mL/min, p = 0.02). As concerned adverse events during HF treatment, there were no differences in the occurrences of hypotension (three patients [10.7%] in the ACZ group vs. four [13.3%], p = 0.8), renal events (four patients [14.3%] in the ACZ group vs. five [16.7%], p = 1) and severe hypokalemia (two [7.1%] in the ACZ group vs. three [10%], p = 1). No severe metabolic acidosis occurred in either group. Conclusions: Although the clinical characteristics differed at baseline, with younger age and better renal function in patients receiving ACZ, the tolerance profile did not significantly differ from patients receiving furosemide alone. Additional observational data are needed to further assess the safety of ACZ–furosemide combination in the in-hospital management of HF, especially in older, frail populations. Full article