Hypertensive diseases of pregnancy (HDPs) represent a global clinical challenge, affecting 5–10% of women and leading to complications for both maternal well-being and fetal development. At the heart of these complications is endothelial dysfunction, with oxidative stress emerging as a pivotal causative factor. The reduction in nitric oxide (NO) bioavailability is a vital indicator of this dysfunction, culminating in blood pressure dysregulation. In the therapeutic context, although antihypertensive medications are commonly used, they come with inherent concerns related to maternal–fetal safety, and a percentage of women do not respond to these therapies. Therefore, alternative strategies that directly address the pathophysiology of HDPs are required. This article focuses on the potential of the nitrate-nitrite-NO pathway, abundantly present in dark leafy greens and beetroot, as an alternative approach to treating HDPs. The objective of this review is to discuss the prospective antioxidant role of nitrate. We hope our discussion paves the way for using nitrate to improve endothelial dysfunction and control oxidative stress, offering a potential therapy for managing HDPs. Full article

Background and Objectives: Chlamydia trachomatis (C. trachomatis) represents one of the most prevalent bacterial sexually transmitted diseases. This study aims to explore the relationship between HLA alleles/genotypes/haplotypes and C. trachomatis infection to better understand high-risk individuals and potential complications. Materials and Methods: This prospective study recruited participants from Transylvania, Romania. Patients with positive NAAT tests for C. trachomatis from cervical/urethral secretion or urine were compared with controls regarding HLA-DR and -DQ alleles. DNA extraction for HLA typing was performed using venous blood samples. Results: Our analysis revealed that the presence of the DRB1*13 allele significantly heightened the likelihood of C. trachomatis infection (p = 0.017). Additionally, we observed that individuals carrying the DRB1*01/DRB1*13 and DQB1*03/DQB1*06 genotype had increased odds of C. trachomatis infection. Upon adjustment, the association between the DRB1*01/DRB1*13 genotype and C. trachomatis remained statistically significant. Conclusions: Our findings underscore the importance of specific HLA alleles and genotypes in influencing susceptibility to C. trachomatis infection. These results highlight the intricate relationship between host genetics and disease susceptibility, offering valuable insights for targeted prevention efforts and personalized healthcare strategies. Full article

Group recommender systems aim to provide recommendations to a group of users as a whole rather than to individual users. Nonetheless, prevailing methodologies predominantly aggregate user preferences without adequately accounting for the unique individual intents influencing item selection. This oversight becomes particularly problematic in the context of ephemeral groups formed by users with limited shared historical interactions, which exacerbates the data sparsity challenge. In this paper, we introduce a novel Disentangled Self-Attention Group Recommendation framework with auto-regressive contrastive learning method, termed DAGA. This framework not only employs disentangled neural architectures to reconstruct the multi-head self-attention network but also incorporates modules for mutual information optimization via auto-regressive contrastive learning to better leverage the context information of user–item and group–item historical interactions, obtaining group representations and further executing recommendations. Specifically, we develop a disentangled model comprising multiple components to individually assess and interpret the diverse intents of users and their impacts on collective group preferences towards items. Building upon this model, we apply the principle of contrastive mutual information maximization to train our framework, aligning the group representations with the corresponding user representations derived from each factor of the disentangled model, thereby enriching the contextual understanding required to effectively address the challenges posed by ephemeral groups. Empirical evaluations conducted on three real-world benchmark datasets substantiate the superior performance of our proposed framework over existing state-of-the-art group recommendation approaches. Full article

In cervical biopsies, for diagnosis of Human Papilloma Virus (HPV) related conditions, the immunohistochemical staining for p16 has a diagnostic value only if diffusely and strongly positive, pattern named “block-like”. “Weak and/or focal (w/f) p16 expression” is commonly considered nonspecific. In our previous study, we demonstrated the presence of high-risk HPV (hrHPV) DNA by LiPa method in biopsies showing w/f p16 positivity. The aim of the present study was to investigate the presence of hrHPV-DNA by CISH in the areas showing w/f p16 expression. We assessed the presence of hrHPV16, 18, 31, 33, 51 by CISH in a group of 20 cervical biopsies showing w/f p16 expression, some with increased Ki67, and in 10 cases of block-like expression, employed as control. The immunohistochemical p16 expression was also assessed by digital pathology. hrHPV-CISH nuclear positivity was encountered in 12/20 cases of w/f p16 expression (60%). Different patterns of nuclear positivity were identified, classified as punctate, diffuse and mixed, with different epithelial distributions. Our results, albeit in a limited casuistry, show the presence of HPV in an integrated status highlighted by CISH in w/f p16 positive cases. This could suggest the necessity of a careful follow-up of the patients with “weak” and/or “focal” immunohistochemical patterns of p16, mainly in cases of increased Ki67 cell proliferation index, supplemented with molecular biology examinations. Full article

Dendrobium nobile is an important orchid plant that has been used as a traditional herb for many years. For the further pharmaceutical development of this resource, a combined transcriptome and metabolome analysis was performed in different parts of D. nobile. First, saccharides, organic acids, amino acids and their derivatives, and alkaloids were the main substances identified in D. nobile. Amino acids and their derivatives and flavonoids accumulated strongly in flowers; saccharides and phenols accumulated strongly in flowers and fruits; alkaloids accumulated strongly in leaves and flowers; and a nucleotide and its derivatives and organic acids accumulated strongly in leaves, flowers, and fruits. Simultaneously, genes for lipid metabolism, terpenoid biosynthesis, and alkaloid biosynthesis were highly expressed in the flowers; genes for phenylpropanoids biosynthesis and flavonoid biosynthesis were highly expressed in the roots; and genes for other metabolisms were highly expressed in the leaves. Furthermore, different members of metabolic enzyme families like cytochrome P450 and 4-coumarate-coA ligase showed differential effects on tissue-specific metabolic accumulation. Members of transcription factor families like AP2-EREBP, bHLH, NAC, MADS, and MYB participated widely in differential accumulation. ATP-binding cassette transporters and some other transporters also showed positive effects on tissue-specific metabolic accumulation. These results systematically elucidated the molecular mechanism of differential accumulation in different parts of D. nobile and enriched the library of specialized metabolic products and promising candidate genes. Full article

Recently, the role of trace elements in the pathophysiology of obesity, insulin resistance (IR), and metabolic diseases has been explored. In this cross-sectional study, we aimed to assess the association of overweight, obesity, and cardiometabolic traits with serum copper (Cu) levels in 346 Mexican adults. Serum Cu level was measured by inductively coupled plasma mass spectrometry (ICP-MS). Anthropometrical data were collected, and biochemical parameters were measured. The triglyceride-glucose (TyG) index was used as a surrogate marker to evaluate IR. Overweight and obesity status was positively associated with the serum Cu level (β = 19.434 ± 7.309, p = 0.008). Serum Cu level was observed to have a positive association with serum triglycerides level (β = 0.160 ± 0.045, p < 0.001) and TyG (β = 0.001 ± 0.001, p < 0.001). Additionally, high serum Cu level was positively associated with overweight and obesity status (odds ratio [OR] = 1.9, 95% confidence interval [95% CI] 1.1–3.4, p = 0.014), hypertriglyceridemia (OR = 3.0, 95% CI 1.7–5.3, p < 0.001), and IR (OR = 2.6, 95% CI 1.4–4.6, p = 0.001). In conclusion, our results suggest that overweight, obesity, hypertriglyceridemia, and IR are positively associated with serum Cu levels in Mexican adults. Full article

With the rapid development of China’s aviation industry, the accurate prediction of civil aviation passenger volume is crucial to the sustainable development of the industry. However, the current prediction of civil aviation passenger traffic has not yet reached the ideal accuracy, so it is particularly important to improve the accuracy of prediction. This paper explores and compares the effectiveness of the backpropagation (BP) neural network model and the SARIMA model in predicting civil aviation passenger traffic. Firstly, this study utilizes data from 2006 to 2019, applies these two models separately to forecast civil aviation passenger traffic in 2019, and combines the two models to forecast the same period. Through comparing the mean relative error (MRE), mean square error (MSE), and root mean square error (RMSE), the prediction accuracies of the two single models and the combined model are evaluated, and the best prediction method is determined. Subsequently, using the data from 2006 to 2019, the optimal method is applied to forecast the civil aviation passenger traffic from 2020 to 2023. Finally, this paper compares the epidemic’s impact on civil aviation passenger traffic with the actual data. This paper improves the prediction accuracy of civil aviation passenger volume, and the research results have practical significance for understanding and evaluating the impact of the epidemic on the aviation industry. Full article

With a burgeoning global population, meeting the demand for increased food production presents challenges, particularly concerning mineral deficiencies in diets. Micronutrient shortages like iron, iodine, zinc, selenium, and magnesium carry severe health implications, especially in developing nations. Biofortification of plants and plant products emerges as a promising remedy to enhance micronutrient levels in food. Utilizing agronomic biofortification, conventional plant breeding, and genetic engineering yields raw materials with heightened micronutrient contents and improved bioavailability. A similar strategy extends to animal-derived foods by fortifying eggs, meat, and dairy products with micronutrients. Employing “dual” biofortification, utilizing previously enriched plant materials as a micronutrient source for livestock, proves an innovative solution. Amid biofortification research, conducting in vitro and in vivo experiments is essential to assess the bioactivity of micronutrients from enriched materials, emphasizing digestibility, bioavailability, and safety. Mineral deficiencies in human diets present a significant health challenge. Biofortification of plants and animal products emerges as a promising approach to alleviate micronutrient deficiencies, necessitating further research into the utilization of biofortified raw materials in the human diet, with a focus on bioavailability, digestibility, and safety. Full article

Reusing reclaimed water is of paramount importance to achieve the 2030 Agenda for Sustainable Development Goals 6 and 13. In Europe, a recent Regulation set minimum requirements for water reuse in agriculture. However, some challenges remain considering microbial risks and their prevention. In this study, two urban wastewater treatment plants (WWTPs) were investigated from the perspective of reuse. A five-year investigation was performed on routine monitoring parameters collected under different weather conditions (wet/dry) and treatments (chlorination/non-chlorination) in inlet and outlet samples. Moreover, a three-month investigation focused on microbial parameters, including indicators, index pathogens (Human Adenovirus—HAdV, Salmonella spp.), and other viral pathogens (norovirus, enterovirus, and SARS-CoV-2). The long-term study revealed the compliance of both WWTPs for chemical parameters (organic substances and solids) in more than 90% of samples, whereas for Escherichia coli, the compliance ranged from 96.1% with chlorination under dry weather to 16.7% without chlorination in wet days. E. coli was positively associated with chemical oxygen demand (COD), which could be a promising and online measurable proxy of E. coli. The study on microbial performance demonstrated sound reliability in detecting E. coli as a suitable surrogate for Salmonella in chlorinated effluents, but neither bacterial nor viral indicators are able to represent HAdV. Although chlorination was able to remove most of the pathogens considered, the compliance with microbial indicators seems insufficient to represent viral water safety. Full article

Soil pollution caused by heavy metal(oid)s has generated great concern worldwide due to their toxicity, persistence, and bio-accumulation properties. To assess the baseline data, the heavy metal(oid)s, including manganese (Mn), iron (Fe), Cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), lead (Pb), mercury (Hg), chromium (Cr), and cadmium (Cd), were evaluated in surface soil samples collected from the farmlands of Grand Forks County, North Dakota. Samples were digested via acid mixture and analyzed via inductively coupled plasma mass spectrometry (ICP MS) analysis to assess the levels, ecological risks, and possible sources. The heavy metal(oid) median levels exhibited the following decreasing trend: Fe > Mn > Zn > Ni > Cr > Cu > Pb > Co > As > Cd > Hg. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) suggested the main lithogenic source for the studied metal(oid)s. Metal(oid) levels in the current investigation, except Mn, are lower than most of the guideline values set by international agencies. The contamination factor (C_f), geo accumulation index (I_geo) and enrichment factor (EF) showed considerable contamination, moderate contamination, and significant enrichment, respectively, for As and Cd on median value basis. Ecological risk factor (E_r) results exhibited low ecological risk for all studied metal(oid)s except Cd, which showed considerable ecological risk. The potential ecological risk index (PERI) levels indicated low ecological risk to considerable risk. Overall, the results indicate the accumulation of As and Cd in the study area. The high nutrients of the soils potentially affect their accumulation in crops and impact on consumers’ health. This drives the impetus for continued environmental monitoring programs. Full article

Breast cancer, a multifaceted and heterogeneous disease, poses significant challenges in terms of understanding its intricate resistance mechanisms and devising effective therapeutic strategies. This review provides a comprehensive overview of the intricate landscape of extracellular vesicles (EVs) in the context of breast cancer, highlighting their diverse subtypes, biogenesis, and roles in intercellular communication within the tumour microenvironment (TME). The discussion spans various aspects, from EVs and stromal cells in breast cancer to their influence on angiogenesis, immune response, and chemoresistance. The impact of EV production in different culture systems, including two dimensional (2D), three dimensional (3D), and organoid models, is explored. Furthermore, this review delves into the therapeutic potential of EVs in breast cancer, presenting emerging strategies such as engineered EVs for gene delivery, nanoplatforms for targeted chemotherapy, and disrupting tumour derived EVs as a treatment approach. Understanding these complex interactions of EV within the breast cancer milieu is crucial for identifying resistance mechanisms and developing new therapeutic targets. Full article

This study examines stock market response (SMR) to the Japanese tourism industry (TI) after the government’s announcement of travel subsidies (TRSs) during the COVID-19 pandemic in 2020, using a sample comprising 80 listed Japanese firms in the TI and an event study method (ESM) to determine the impact of government policy responses (GPRs) to the pandemic. This study found that investors in the TI reacted positively to the announcement of subsidies; this positive effect persisted for 50 trading days after the announcement but was weaker for transportation firms. The results suggest that TRSs are important for the TI, with a stronger link to travel-related firms, such as airlines and travel agencies, hotels, and amusement services. However, investors in the TI reacted negatively to policies that directly addressed the pandemic, such as social distance policies (SDPs). These results are robustly confirmed when we measure abnormal returns by using a three-factor model. The results offer useful insights for policymakers and practitioners aiming to mitigate economic loss from disasters such as the COVID-19 pandemic. Full article

Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) presents unique challenges and opportunities for treatment, particularly regarding de-escalation strategies to reduce treatment morbidity without compromising oncological outcomes. This paper examines the role of Transoral Robotic Surgery (TORS) as a de-escalation strategy in managing HPV-related OPSCC. We conducted a comprehensive literature review from January 2010 to June 2023, focusing on studies exploring TORS outcomes in patients with HPV-positive OPSCC. These findings highlight TORS’s potential to reduce the need for adjuvant therapy, thereby minimizing treatment-related side effects while maintaining high rates of oncological control. TORS offers advantages such as precise tumor resection and the ability to obtain accurate pathological staging, which can guide the tailoring of adjuvant treatments. Some clinical trials provide evidence supporting the use of TORS in specific patient populations. The MC1273 trial demonstrated promising outcomes with lower doses of adjuvant radiotherapy (RT) following TORS, showing high locoregional tumor control rates and favorable survival outcomes with minimal side effects. ECOG 3311 evaluated upfront TORS followed by histopathologically directed adjuvant therapy, revealing good oncological and functional outcomes, particularly in intermediate-risk patients. The SIRS trial emphasized the benefits of upfront surgery with neck dissection followed by de-escalated RT in patients with favorable survival and excellent functional outcomes. At the same time, the PATHOS trial examined the impact of risk-adapted adjuvant treatment on functional outcomes and survival. The ongoing ADEPT trial investigates reduced-dose adjuvant RT, and the DART-HPV study aims to compare standard adjuvant chemoradiotherapy (CRT) with a reduced dose of adjuvant RT in HPV-positive OPSCC patients. These trials collectively underscore the potential of TORS in facilitating treatment de-escalation while maintaining favorable oncological and functional outcomes in selected patients with HPV-related OPSCC. The aim of this scoping review is to discuss the challenges of risk stratification, the importance of HPV status determination, and the implications of smoking on treatment outcomes. It also explores the evolving criteria for adjuvant therapy following TORS, focusing on reducing radiation dosage and volume without compromising treatment efficacy. In conclusion, TORS emerges as a viable upfront treatment option for carefully selected patients with HPV-positive OPSCC, offering a pathway toward treatment de-escalation. However, selecting the optimal candidate for TORS-based de-escalation strategies is crucial to fully leverage the benefits of treatment de-intensification. Full article

In the context of rapidly advancing agricultural technology, precise and efficient methods for crop detection and counting play a crucial role in enhancing productivity and efficiency in crop management. Monitoring corn tassels is key to assessing plant characteristics, tracking plant health, predicting yield, and addressing issues such as pests, diseases, and nutrient deficiencies promptly. This ultimately ensures robust and high-yielding corn growth. This study introduces a method for the recognition and counting of corn tassels, using RGB imagery captured by unmanned aerial vehicles (UAVs) and the YOLOv8 model. The model incorporates the Pconv local convolution module, enabling a lightweight design and rapid detection speed. The ACmix module is added to the backbone section to improve feature extraction capabilities for corn tassels. Moreover, the CTAM module is integrated into the neck section to enhance semantic information exchange between channels, allowing for precise and efficient positioning of corn tassels. To optimize the learning rate strategy, the sparrow search algorithm (SSA) is utilized. Significant improvements in recognition accuracy, detection efficiency, and robustness are observed across various UAV flight altitudes. Experimental results show that, compared to the original YOLOv8 model, the proposed model exhibits an increase in accuracy of 3.27 percentage points to 97.59% and an increase in recall of 2.85 percentage points to 94.40% at a height of 5 m. Furthermore, the model optimizes frames per second (FPS), parameters (params), and GFLOPs (giga floating point operations per second) by 7.12%, 11.5%, and 8.94%, respectively, achieving values of 40.62 FPS, 14.62 MB, and 11.21 GFLOPs. At heights of 10, 15, and 20 m, the model maintains stable accuracies of 90.36%, 88.34%, and 84.32%, respectively. This study offers technical support for the automated detection of corn tassels, advancing the intelligence and precision of agricultural production and significantly contributing to the development of modern agricultural technology. Full article

Urbanisation is a significant driver of global climate change. It increases global temperatures, impacting the health of residents. To date, research on urban heat environments has focused on society or ecology, overlooking the value of integrating the two factors. The research objective is to integrate socio-ecological benefits, explore the construction methods of ecological-cooling networks, and provide reasonable guidance for urban climate planning, thus contributing to the alleviation of urban heat risks and improving thermal comfort. Using Fuzhou as an example, an environmental risk framework was used to construct an urban heat environment risk assessment strategy based on hazards (thermal comfort), exposure (human-development footprint), and vulnerability (natural geographic conditions). The source area was identified based on evaluation results, an ecological network was constructed using circuit theory, and key nodes were identified. Results showed that in 2005 and 2020, 3% and 12% of areas in Fuzhou had higher thermal environmental risks, the proportion of low-risk areas was 43% and 28%, respectively. In sum, 54 ecological source locations, 124 ecological corridors, 76 ecological pinch points, 110 obstacle points, and 12 stepping stones were identified during the construction of corridors in 2020. Compared with 2005, the source area has decreased by 1622.46 km² and the average length of the corridor has also decreased by 4.69 km. Full article

We evaluated the relationship between decreased pregnancy-associated glycoprotein (PAG) levels, inflammatory parameters (serum amyloid A [SAA] and milk amyloid A [MAA]), postpartum inflammatory conditions (mastitis, ketosis, and follicular cysts), and the FOXP3 gene. Nineteen Holstein-Friesian cows were included in this study. Up to approximately eight weeks after delivery, weekly health examinations were performed for mastitis and ketosis, and reproductive organ ultrasonography was performed. The decreasing PAG rate was negatively correlated with SAA concentration (r = −0.493, p = 0.032). Cows with mastitis exhibited a slower trend of PAG decrease (p = 0.095), and a greater percentage of these cows had MAA concentrations above 12 µg/mL (p = 0.074) compared with those without mastitis. A negative correlation, although nonsignificant (r = −0.263, p = 0.385), was observed between the day-open period and decreased PAG rate. The day-open period was correlated with the presence or absence of follicular cysts (p = 0.046). Four cows that developed follicular cysts were homozygous for the G allele of the FOXP3 gene related to repeat breeders. These results indicate a relationship between a decreased PAG rate and inflammatory status during the postpartum period. Thus, suppressing inflammation during the perinatal period may improve reproductive efficiency in the dairy industry. Full article

This paper aims to discuss the microvascular reconstruction of the orbit and adjacent regions and to propose a checklist to aid the reconstructive surgeon in this challenging undertaking. The discussion is based on a literature review that includes 32 retrospective case series, 5 case reports published in the last 34 years in PubMed, and 3 textbook chapters. Additionally, it relies on the senior author’s expertise, described in a case series, and two case reports published elsewhere. Classifications and treatment algorithms on microvascular orbit reconstruction generally disregard patient-related factors. A more holistic approach can be advantageous: patient-related factors, such as age, comorbidities, prognosis, previous interventions, radiotherapy, and the wish for maximal dental rehabilitation and a prosthetic eye, have the same importance as defect-related considerations and can inform the choice of a reconstructive option. In this manuscript, we examine defect- and patient-related factors and new technologies, provide a checklist, and examine future directions. The checklist is intended as a tool to aid in the decision-making process when reconstructing the orbital region with microvascular flaps. Full article

This paper introduces an efficient computational procedure for analyzing the propagation of harmonic waves in layered elastic media. This offers several advantages, including the ability to handle arbitrary frequencies, depths, and the number of layers above an elastic half-space, and efforts to follow dispersion curves and flag up possible singularities are investigated. While there are inherent limitations in terms of computational accuracy and capacity, this methodology is straightforward to implement for studying free or forced vibrations and obtaining relevant response data. We present computations of wavenumber dispersion diagrams, phase velocity plots, and response data in both the frequency and time domains. These computational results are provided for two example cases: plane strain and axisymmetry. Our methodology is grounded in a well-conditioned dynamic stiffness approach specifically tailored for deep-layered strata analysis. We introduce an innovative method for efficiently computing wavenumber dispersion curves. By tracking the slope of these curves, users can effectively manage continuation parameters. We illustrate this technique through numerical evidence of a layer resonance in a real-life case study characterized by a fold in the dispersion curves. Furthermore, this framework is particularly advantageous for engineers addressing problems related to ground-borne vibrations. It enables the analysis of phenomena such as zero group velocity (ZGV), where a singularity occurs, both in the frequency and time domains, shedding light on the unique characteristics of such cases. Given the reduced dimension of the problem, this formulation can considerably aid geophysicists and engineers in areas such as MASW or SASW techniques. Full article

This study examines the direct and interaction relationships between personality traits, psychosocial risk factors, and burnout among male and female workers in the retail sector in Spain. Through a cross sectional design involving 667 participants (241 men, 426 women), it employs self report questionnaires to measure these variables. In addition to a sociodemographic questionnaire, the MBI (burnout), NEO-FFI (personality), CarMen-Q (cognitive, temporal, emotional, and performance demands), and DECORE (support, control, and rewards) were administered. Results indicate that women exhibit higher emotional exhaustion and depersonalization. Results from stepwise multiple regression confirmed that personality traits directly impact burnout dimensions and psychosocial risk factors. Specifically, neuroticism and emotional job demands significantly influence emotional exhaustion, while depersonalization correlates with neuroticism, agreeableness, temporal demands, and organizational support. Personal accomplishment links with extraversion, interacting with temporal demands in men and cognitive demands in women. Individuals high in neuroticism and low in extraversion tend to perceive elevated emotional job demands, leading to intensified emotional exhaustion and depersonalization. The study confirms that personality traits and working conditions affect burnout differently for men and women. Full article

Sustainability targets set by the United Nations, such as Zero Hunger by 2030, encourage the search for innovative solutions to enhance food production while preserving the environment. Alternative protein sources for feed, while conventional resources like soymeal and fishmeal become more expensive and scarcer, is one of the possibilities. Studies on substituting fishmeal with insect meal show promising results in terms of animal growth and feed efficiency. This paper aims to assess the socio-economic benefits and costs of insect meal substituting fishmeal in feed and to highlight the factors influencing performance most. The study evaluates the economic value of insect-based products, waste reduction, and reduced greenhouse gas emissions as socio-economic benefits. It combines empirical data derived from laboratory trials and two case studies covering black soldier fly (Hermetia illucens) and yellow mealworm (Tenebrio molitor). Current analyses reveal negative socio-economic balances, emphasizing that reduction of operating and investment costs through upscaling and technological advancements can give a positive move, as well as factors such as current market valuations for nutrients can change significantly. Thus, a negative balance at the moment does not mean that insect rearing, and larva processing are not desirable from a long-term socio-economic perspective. Full article

Background: Intramedullary melanocytomas are exceedingly rare, with only twenty-four cases reported up to now. They present as local invasive tumors despite their benign biological behavior. Attempting a complete safe resection often results in severe post-operative neurological deficits, as in our case presented here. Methods: A systematic review was conducted across the PubMed and Scopus databases including studies published till February 2024. Results: A total of 19 studies were included, encompassing 24 cases. A similar distribution between sexes was noted (M:F 13:11), with ages ranging from 19 to 79 years. The thoracic segment was most affected, and intermediate-grade melanocytoma (19 cases) was the most common histotype. Radiographically, intramedullary melanocytomas usually appear as hyperintense hemorrhagic lesions peripheral to the central canal with focal nodular enhancement. Intraoperatively, they are black–reddish to tan and are tenaciously adherent lesions. In the sampled studies, IONM employment was uncommon, and post-operative new-onset neurological deficits were described in 16 cases. Adjuvant RT was used in four cases and its value is debatable. Recurrence is common (10 cases), and adjuvant therapies (RT or repeated surgery) seem to play a palliative role. Case presentation: A 68-year-old woman presented with a three-year history of worsening spastic paraparesis and loss of independence in daily activities (McCormick grade 4). An MRI revealed an intramedullary tumor from Th5 to Th7, characterized by T1-weighted hyperintensity and signs of recent intralesional hemorrhage. Multimodal neuromonitoring, comprising the D-Wave, guided the resection of a black–tan-colored tumor with hyper-vascularization and strong adherence to the white matter. During final dissection of the lesion to obtain gross total resection (GTR), a steep decline in MEPs and D-Wave signals was recorded. Post-operatively, the patient had severe hypoesthesia with Th9 level and segmental motor deficits, with some improvement during neurorehabilitation. Histopathology revealed an intermediate-grade melanocytoma (CNS WHO 2021 classification). A four-month follow-up documented the absence of relapse. Conclusions: This literature review highlights that intramedullary T1 hyperintense hemorrhagic thoracic lesions in an adult patient should raise the suspicion of intramedullary melanocytoma. They present as locally aggressive tumors, due to local invasiveness, which often lead to post-operative neurological deficits, and frequent relapses, which overwhelm therapeutic strategies leading to palliative care after several years. Full article

Service-oriented architectures have become increasingly prevalent in internet application design, leading to a proliferation of services. Managing and composing these web services pose a classic non-deterministic polynomial-time hard problem. The web service composition problem (WSCP) based on the input–output model (IOM) involves the automatic composition of services without relying on a pre-defined workflow. Multi-objective evolutionary algorithms offer a solution that goes beyond simple weighted average calculations for quality of service, catering to diverse user needs in service composition. This paper introduces a multi-objective heuristic algorithm based on the SPEA2 called MSPEA2+. Specific modifications are incorporated in MSPEA2+ to support the breeding, crossover, and mutation processes, tailored for IOM-based WSCP. Validating the algorithm performance through finding suitable combination results for each task in the WSC-08 dataset, our experiments showed that MSPEA2+ has better iterative efficiency than existing multi-objective methods and outperforms them in terms of quality of service. MSPEA2+ achieved the lowest IGD value across all seven tasks, an improvement of 81.7% IGD value compared with the SPEA2 algorithm in WSC-0804. Full article