Search Results (17)

To address the high computational and communication overheads and the limited edge security found in many existing batch verification methods for Mobile Edge Computing (MEC), this paper presents a blockchain-based batch authentication and symmetric group key agreement protocol. A core feature of this protocol is the establishment of a shared symmetric key among all authenticated participants. This symmetry in key distribution is fundamental for enabling secure and efficient broadcast or multicast communication within the MEC group. The protocol introduces a chameleon hash function built on elliptic curves, allowing smart mobile devices (SMDs) to generate lightweight signatures. The edge server (ES) then performs efficient large-scale batch authentication using an aggregate signature technique. Considering the need for secure and independent communication between SMDs and ES, the protocol further establishes a one-to-one session key agreement mechanism and uses a Merkle tree to verify session key correctness. Formal verification with ProVerif2.05 tool confirms the protocol’s security and multiple protection properties. Experimental results show that, compared with the CPPBA, ECCAS, and LBVP schemes, the protocol improves computational efficiency of batch authentication by 0.94%, 67.20%, and 49.53%, respectively. For group key agreement, the protocol achieves a 35.26% improvement in computational efficiency over existing schemes. Full article

Background/Objectives: Biliary tract cancers (BTCs) are aggressive malignancies with a poor prognosis. Surgery remains the only curative option, yet recurrence rates are high, and the role of adjuvant chemotherapy remains debated. This study aims to evaluate the impact of adjuvant chemotherapy and prognostic factors on survival outcomes in resected BTCs. Methods: We conducted a retrospective multicenter study analyzing patients diagnosed with intrahepatic (iCCA) and extrahepatic cholangiocarcinoma (eCCA) or gallbladder cancer (GBC) who underwent curative-intent surgical resection between 1999 and 2023. Demographic, clinicopathological, and treatment data were collected from institutional databases. Survival outcomes were assessed using Kaplan–Meier analysis, and prognostic factors were identified through Cox proportional hazards regression. Results: A total of 155 patients were included, with a median follow-up of 84.6 months. The cohort comprised 38.7% iCCA, 31.6% eCCA, and 29.7% GBC. R0 resection was achieved in 77.4% of cases, while lymph node involvement was present in 39.4%. Median overall survival (OS) significantly varied by stage (p < 0.001), ranging from >60 months for stage I to ~12 months for stage IVA. Eastern Cooperative Oncology Group (ECOG) performance status (PS) emerged as the strongest independent prognostic factor for OS (p < 0.001). Adjuvant chemotherapy, administered to 49.0% of patients, did not significantly improve OS in the overall cohort (p = 0.899). However, subgroup analyses suggested potential benefits in iCCA and eCCA but not in GBC. High CA19-9 levels and vascular invasion were associated with poorer survival outcomes. Conclusions: This study highlights the prognostic significance of ECOG PS, resection margin status, lymph node involvement, and CA19-9 levels in resected BTCs. The lack of a clear survival benefit from adjuvant chemotherapy underscores the need for improved therapeutic strategies. Future research should focus on refining risk stratification models and identifying more effective adjuvant treatments to enhance long-term survival outcomes in patients with BTC. Full article

As acne scars remain challenging to treat, this study compared the safety and efficacy of two laser modalities for acne scar treatment. Between 2022 and 2024, 88 patients were treated for acne scars using either the Hybrid platform with the ProScan applicator, which delivers fractional ablative carbon dioxide (CO₂) 10,600 nm and non-ablative 1570 nm wavelengths in a dual mode, or the Pixel CO₂ laser with the LiteScan applicator, which delivers a fractional ablative CO₂ 10,600 nm wavelength alone. Clinical efficacy was assessed using the Echelle d’Evaluation Clinique des Cicatrices D’Acne (ECCA) scale. Both groups showed significant improvements in ECCA scores post-treatment (p < 0.001, Wilcoxon signed-rank test). However, the percentage change in scores from baseline to post-treatment did not differ significantly between the groups (p > 0.05, Wilcoxon rank-sum test). Adverse effects were mild and transient, resolving within a few days, with no significant differences between the groups (p > 0.05, chi-squared test). Both laser modalities demonstrated high efficacy and safety in treating acne scars, with significant post-treatment improvement in scar severity. Full article

Endoluminal biliary radiofrequency ablation (RFA) has been proposed as a palliative treatment for patients with malignant biliary obstruction (MBO) in order to improve stent patency and survival. However, the existing data on patients with inoperable extrahepatic cholangiocarcinoma (eCCA) are conflicting. We performed a meta-analysis of randomized trials comparing RFA plus stenting versus stenting alone in patients with inoperable eCCA. We searched for trials published in the PubMed/MEDLINE, Scopus, and Cochrane databases up to November 2023. Data extraction was conducted from published studies, and a quality assessment was carried out in accordance with the guidelines recommended by the Cochrane Collaboration. Hazard ratios (HRs) with 95% CI were estimated from the trials. The primary endpoints of interest were overall survival and stent patency. Out of 275 results, 5 randomized trials and 370 patients were included. While overall survival was not different between the groups (HR 0.62; 95% CI 0.36–1.07; p = 0.09; I² = 80%;), the subgroup analysis of studies employing plastic stents showed a trend toward better survival in the RFA-treated group (HR 0.42; 95% CI 0.22–0.80; p = 0.009; I² = 72%). Stent patency was improved in patients receiving RFA (HR 0.64; 95% CI 0.45–0.90; p = 0.01; I² = 23%). Adverse events were not different between the groups (OR 1.21; 95% CI 0.69–2.12; p = 0.50; I² = 0%). Despite the promising results, high heterogeneity and potential biases in the included studies suggest the need for further high-quality randomized trials to explore the potential cumulative effects of RFA on CCA treatment outcomes. Full article

Background: Identifying the projected incidence of hepatobiliary cancers and recognizing patient cohorts at increased risk can help develop targeted interventions and resource allocation. The expected incidence of subtypes of hepatobiliary cancers in different age groups, races, and genders remains unknown. Methods: Historical epidemiological data from the Surveillance, Epidemiology, and End Results (SEER) database was used to project future incidence of hepatobiliary malignancies in the United States and identify trends by age, race, and gender. Patients ≥18 years of age diagnosed with a hepatobiliary malignancy between 2001 and 2017 were included. US Census Bureau 2017 National Population projects provided the projected population from 2017 to 2029. Age–Period–Cohort forecasting model was used to estimate future births cohort-specific incidence. All analyses were completed using R Statistical Software. Results: We included 110381 historical patients diagnosed with a hepatobiliary malignancy between 2001 and 2017 with the following subtypes: hepatocellular cancer (HCC) (68%), intrahepatic cholangiocarcinoma (iCCA) (11.5%), gallbladder cancer (GC) (8%), extrahepatic cholangiocarcinoma (eCCA) (7.6%), and ampullary cancer (AC) (4%). Our models predict the incidence of HCC to double (2001 to 2029) from 4.5 to 9.03 per 100,000, with the most significant increase anticipated in patients 70–79 years of age. In contrast, incidence is expected to continue to decline among the Asian population. Incidence of iCCA is projected to increase, especially in the white population, with rates in 2029 double those in 2001 (2.13 vs. 0.88 per 100,000, respectively; p < 0.001). The incidence of GC among the black population is expected to increase. The incidence of eCCA is expected to significantly increase, especially among the Hispanic population, while that of AC will remain stable. Discussion: The overall incidence of hepatobiliary malignancies is expected to increase in the coming years, with certain groups at increased risk. These findings may help with resource allocation when considering screening, treatment, and research in the coming years. Full article

Research on engineered cementitious composites was carried out using recycled micronized powder from waste construction waste as a substitute for cement. Consequently, this paper focuses on the investigation of recycled micronized powder (RMP) as the subject of study. Using RMP-PP-ECCA0 as the control group, we explored the impact of polypropylene fiber content (0.5%, 1%, 1.5%, 2%) and the substitution rate of RMP (10%, 20%, 30%, 40%) on the mechanical properties, resistance to chloride ion penetration, and freeze–thaw durability of recycled micronized powder polypropylene-fiber-engineered cementitious composites (RMP-PP-ECCs). It was found that, with the increase in RMP substitution rate and fiber content, the mechanical, chloride ion permeation, and freeze–thaw resistance of recycled micronized powder polypropylene-fiber-engineered cementitious composites showed a trend of increasing and then decreasing when the RMP substitution rate was 10%, and the fiber content was 1.5%; the compressive, tensile, chloride ion permeation, and freeze–thaw resistance of recycled micronized powder polypropylene-fiber-engineered cementitious composites were most obviously improved. Compressive strength performance increased by 18.8%, tensile strength performance increased by 80.8%, maximum tensile strain increased by 314%, and electrical flux decreased by 56.3%. Meanwhile, when the recycled micronized powder substitution rate was 10%, the fiber content was 1%, with the most obvious improvement in flexural and freeze–thaw cycle resistance, compared with the control group 28 d flexural strength increased by 22%, after 150 freeze–thaw cycles, the mass-loss rate was reduced by 26%, and the relative dynamic elastic modulus was improved by 4%. In addition, the chemical composition of the regenerated microfractions and the defects in the matrix of the fracture surface of the tensile specimens, the distribution of polypropylene fibers, the surface morphology, and the failure mode were analyzed by X-ray diffraction and scanning electron microscopy. Full article

Taking advantage of the growing production of organic waste for its conversion to waste-to-energy (WtE) also contributes to mitigating the problems associated with its final disposal, which is a global trend of increasing application. This work presents an innovative approach for the identification and prioritization of WtE alternatives available from the use of food waste (FW) present in the municipal solid waste (MSW) of a Colombian municipality with source separation and selective collection: (i) a systematic literature review, which allows one to identify WtE alternatives; (ii) the prospective MIC-MAC method (Matrice d’Impacts Croisés Multiplication Appliqués à un Classement) allowed the selection of criteria and sub criteria; (iii) the analytical hierarchical process (AHP) and the technique of order of preference by similarity to the ideal solution (TOPSIS), allowed a ranking of selected alternatives considering the technical, environmental, and social aspects. The WtE technologies identified were anaerobic digestion, gasification, incineration, biogas recovery from landfills, and pyrolysis; this last was excluded due to its greater application potential with substrates such as plastic waste. The six sub-criteria identified and prioritized were social acceptability (36%), greenhouse gas emissions mitigated (16.17%), MSW reduction (15.83%), energy production (13.80%), technological maturity (12.95%), and electrical energy conversion efficiency (5.25%), with the decreasing order of preferences of anaerobic digestion (78.2%), gasification (47.5%), incineration (27.4%), and biogas recovery from landfills (6.6%); the latter was the least desirable alternative (lower social acceptance and CO₂ tons mitigated in relation to the other options). The innovative nature of this study is the identification and consideration of the comprehensive management of this type of waste of a large number of criteria (120 environmental, 52 social, and 59 technical) and the validation of the results through a sensitivity analysis, which allowed us to confirm for this study, that anaerobic digestion is the most favorable technology for the treatment and energy use of FW. Full article

This study evaluated leachate recirculation (LR) as a stabilisation strategy for landfills using bioreactor experiments with excavated waste from a tropical landfill in Colombia. The experimental evaluation was performed in two 115 L bioreactors, one simulating the operation of a landfill with LR, Br2, where the leachate produced was recirculated at a rate of 0.8 L d⁻¹, and a control system without LR, Br1. Both systems reached stabilisation indicator values on a dry matter (DM) basis for volatile solids VS (<25% DM) and a biochemical methane potential BMP (≤10 mL CH₄ g⁻¹ DM). Likewise, towards the end of the experiment, the leachate generated in Br2 reached stabilisation indicator values for BOD₅ (<100 mg L⁻¹) and the BOD (biological oxygen demand)/COD (chemical oxygen demand) ratio (<0.1). Although the stabilisation criterion for COD was not met in any bioreactor (<200 mg L⁻¹), LR helped to release 19% more oxidisable organic matter in Br2 than in Br1, indicating a reduction in the contaminating potential of the waste in the case of uncontrolled discharges of leachate to the environment. Regarding biogas production, the generation of CH₄ in Br2 was more intense and its cumulative production was 34.5% higher than Br1; thus, Br2 achieved CH₄ emission rates, indicating waste stabilisation (<1.0 L CH₄ m⁻² h⁻¹) sooner than Br1, showing an accelerating effect of LR on waste degradation. A carbon mass balance indicated that waste degradation, in terms of the initial total organic carbon mineralisation and the C gas discharge via CH₄, was greater in Br2. These results demonstrate the LR potential to accelerate the stabilisation of a landfill but also to reduce greenhouse gas emissions in final disposal sites where biogas is also captured and utilised for energy production; a key aspect when improving the sustainability of landfill operations in developing countries. Full article

Background: Endobiliary radiofrequency ablation (RFA) is a promising treatment modality for patients with extrahepatic cholangiocarcinoma (eCCA). However, no study has investigated the combined use of endobiliary RFA and gemcitabine plus cisplatin (GC) chemotherapy. This study aimed to examine the feasibility and efficacy of endobiliary RFA with GC therapy for patients with unresectable eCCA. Methods: The study outcomes included overall survival (OS), progression-free survival (PFS), time to recurrent biliary obstruction (RBO), and adverse events associated with the treatment. These parameters were retrospectively compared between 25 patients who underwent RFA with self-expandable metal stent (SEMS) placement followed by GC therapy (with-RFA group) and a control cohort of 25 patients who underwent SEMS placement alone and GC therapy (without-RFA group). Results: The median time to RBO was significantly longer in the with-RFA group (10.7 versus 5.2 months, p = 0.048). The median OS was significantly higher in patients with locally advanced tumors in the with-RFA group (23.1 versus 16.6 months, p = 0.032), but did not differ significantly in patients with metastasis (11.4 versus 8.5 months, p = 0.180). Similarly, the median PFS was significantly higher in the with-RFA group in patients with locally advanced disease (10.1 versus 7.3 months, p = 0.015), while there was no significant difference in patients with metastasis (5.4 versus 4.4 months, p = 0.529). The rates of various toxicities did not differ significantly between the groups. Conclusions: Endobiliary RFA prolonged the patency period of uncovered SEMS combined with GC therapy in patients with eCCA. Although RFA also yielded survival benefits, its effect was restricted to locally advanced tumors. Full article

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients. Full article

In the rural zones of Latin American and Caribbean developing countries, the poorest households rely on traditional fuels such as firewood to meet their daily cooking needs. Many of those countries are located near the equator, where they have a tropical climate and grass is one of the most common biomass crops. The aim of this study was to evaluate the effect of harvesting age (30, 44, and 57 days) in the performance of anaerobic digestion of King Grass (Pennisetum purpureum cv. King Grass) grown under tropical climate conditions. Three reduction methods of crop size were also compared. Results showed that 44-day harvesting age presented the greater specific methane yield (347.8 mLCH₄ g⁻¹VS) and area-specific methane yield (9773 m³CH₄ ha⁻¹ y⁻¹). The machine chopped method (1–3 cm for stems and 1–10 cm for leaves) was the reduction method that maximized the methane production. From those results, the calculated area required for grass cultivation to provide the cooking energy to a typical family in the Colombian rural zones is 154 m². Full article

Biliary tract cancers (BTCs) include a heterogenous group of aggressive malignancies with limited therapeutic options. According to their anatomical location, these hepatobiliary tumors are usually classified into intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), and gallbladder cancer (GBC). Unfortunately, BTCs are often diagnosed when already metastatic, and although the advent of genomic sequencing has led to a deeper understanding of iCCA pathogenesis, very little data are currently available about the molecular landscape of eCCA. Moreover, despite novel systemic treatments emerging in BTC, the grim prognosis of eCCA patients has not changed in the past decade, and no targeted therapies have been approved so far. The aim of the current review is to provide an overview regarding molecular features and potential targeted therapies in eCCA, together with novel therapeutic approaches and future directions of translational and clinical research on this highly aggressive disease that poses many unanswered questions. Full article

Cholangiocarcinomas (CCAs) comprise of a heterogeneous group of cancers arising in the biliary tract (intrahepatic or iCCA, perihilar or pCCA and distal or dCCA; the latter are known under the collective term of eCCA), each subtype having its own particularities in carcinogenesis, management and prognosis. The increasing incidence in recent decades, limited treatment options and high mortality rates, even in the early stages, have led to an imperious need for more in-depth understanding and development of tailored treatments for this type of aggressive tumour. The wide use of molecular profiling has increased the understanding of biology and identified key molecular drivers, for example, IDH1 mutations or FGFR2 fusions for iCCA, or BRAF mutations in eCCA. Most recently, the FDA approved pemigatinib, an FGFR inhibitor and ivosidenib, an IDH1 inhibitor, but even though progress has been made to better understand the mechanisms of tumorigenesis, genetic make-up, and tumour resistance to standard chemotherapy and targeted therapies, cholangiocarcinomas still represent an important challenge in the daily clinical practice of oncology. The purpose of this review is to highlight the recent progress in the systemic treatment of advanced/metastatic CCAs with a focus on targeted drugs and their biomarkers currently evaluated in early-phase clinical trials. Full article

Evaluation of food intake quality using validated tools makes it possible to give individuals or populations recommendations for improving their diet. This study’s objective was to evaluate the reproducibility and ability to identify dietary patterns of the second version of the Mini Food Intake Quality Survey (Mini-ECCA v.2). The survey was administered using a remote voting system on two occasions with four-week intervals between administrations to 276 health science students (average age = 20.1 ± 3.1 years; 68% women). We then performed a per-question weighted kappa calculation, a cluster analysis, an ANOVA test by questionnaire item and between identified clusters, and a discriminant analysis. Moderate to excellent agreement was observed (weighted κ = 0.422–0.662). The cluster analysis identified three groups, and the discriminant analysis obtained three classification functions (85.9% of cases were correctly classified): group 1 (19.9%) was characterized by higher intake of water, vegetables, fruit, fats, oilseeds/avocado, meat and legumes (healthy food intake); group 2 (47.1%) frequently consumed both fish and unhealthy fats (habits in need of improvement); group 3 (33%) frequently consumed sweetened beverages, foods not prepared at home, processed foods, refined cereals and alcohol (unhealthy food intake). In conclusion, the Mini-ECCA v.2 has moderate to excellent agreement, and it is able to identify dietary patterns in university students. Full article