Search Results (2,914)

Scaling of artificial intelligence data centers is pushing the aggregate speed of photonic transceivers over 1.6 Tb/s and even 3.2 Tb/s, which in the multi-channel configuration accounts for a 200 Gb/s data transmission speed for each wavelength. Uni-traveling carrier photodetectors have proved high bandwidth performance utilizing ultra-fast carrier transit and ultra-small junction capacitance, while few reports discuss the effect of the coplanar lines on bandwidth. In this work, the parasitic effect of coplanar lines is studied, and a modified structure is designed for an InP-based waveguide uni-traveling carrier photodetector. Simulation results reveal a promotion rather than deterioration effect in PD frequency response from the coplanar lines after optimization, and the circuit analysis predicts a parasitic capacitance decrease over 40 fF, which is larger than the 23 fF junction capacitance itself. The fabricated photodetector verifies a 69% increase in bandwidth up to 120 GHz for the same active area at an external responsivity of 0.476 A/W. The eye-diagrams of 100 GBd and 140 GBd under PAM4 format also indicate huge potential for over 200 Gb/s/λ photodetection. Full article

Background/Objectives: Mechanical shocks generated by the recoil of hand-held power screwdrivers are a significant biomechanical stressor for the operator’s hand–arm complex. Currently, vibration exposure is measured at the tool-handle level, while operator-centered practical measures remain limited. This study proposes a computational methodology to quantify relative reductions in mechanical shock and biomechanical load across different workstations. Using wearable inertial measurement units, ratios of transmitted torque and worst-case wrist joint power were calculated directly at the operator’s upper limb, without direct force measurement. Methods: The methodology was tested with 30 participants performing standardized fastening tasks across five configurations: one unsupported and four with distinct support arms, paired with an electric and pneumatic in-line screwdriver. Results: Workstation configuration had a significant main effect on both the peak angular acceleration and the peak wrist angular velocity (p < 0.001 for both variables). Compared with the unsupported condition, all support-arm configurations substantially reduced the mechanical shock transmitted to the operator, decreasing the estimated transmitted torque by 71–81% and the worst-case wrist joint power by more than 95% (p < 0.001 for all pairwise comparisons). The articulated arm induced higher kinematic responses than telescopic and Cartesian designs. Age was the only significant covariate for hand peak angular acceleration (p = 0.039). Conclusions: The proposed methodology provides a simplified operator-centered approach for assessing mechanical shock transmission during screwdriving operations using wearable IMUs. This methodology may serve as a preliminary screening tool to support workstation design and ergonomic investigations. However, the present findings do not establish a direct relationship between the proposed indices and musculoskeletal disorder risk, and further validation against established ergonomic and clinical outcomes is required. Full article

Background: The optimal use of chemotherapy rechallenge in later-line metastatic colorectal cancer (mCRC) remains uncertain. We compared third-line FOLFOX plus bevacizumab rechallenge with regorafenib and examined whether the oxaliplatin-free interval was associated with treatment outcomes. Methods: This retrospective single-center study included 122 patients with metastatic left-sided, RAS (KRAS/NRAS) and BRAF wild-type, proficient mismatch repair (pMMR) colorectal adenocarcinoma treated between 2018 and 2025. All patients had received first-line FOLFOX plus cetuximab or panitumumab, followed by FOLFIRI plus bevacizumab after progression. In the third-line setting, 65 patients received FOLFOX plus bevacizumab as oxaliplatin rechallenge and 57 received regorafenib. The primary endpoint was progression-free survival (PFS). Cox regression, propensity score-based inverse probability of treatment weighting (IPTW), and treatment-by-oxaliplatin-free interval interaction analyses were performed. Results: Median third-line PFS was 7.33 months with FOLFOX plus bevacizumab rechallenge and 6.17 months with regorafenib (log-rank p < 0.001). FOLFOX plus bevacizumab rechallenge was associated with a lower hazard of progression in multivariable analysis (adjusted HR, 0.58; 95% CI, 0.39–0.88; p = 0.009), with consistent results in the propensity score-based IPTW sensitivity analysis (HR, 0.58; 95% CI, 0.40–0.86; p = 0.006). Restricted cubic spline analysis indicated a nonlinear association between OFI and PFS (p for nonlinearity = 0.005), while flexible modeling did not provide robust evidence of a treatment-by-OFI interaction (global p = 0.806). In exploratory subgroup analyses, FOLFOX plus bevacizumab rechallenge was associated with longer PFS than regorafenib among patients with an OFI of ≥6 months (adjusted HR, 0.39; 95% CI, 0.24–0.65; p < 0.001), whereas no significant difference was observed among those with an OFI of <6 months (adjusted HR, 0.66; 95% CI, 0.35–1.25; p = 0.199). Conclusions: FOLFOX plus bevacizumab rechallenge was associated with longer third-line PFS than regorafenib in this selected and uniformly treated mCRC cohort. OFI was associated with PFS in a nonlinear manner, but there was no robust evidence that it modified the relative treatment effect across its continuous range. Exploratory subgroup findings based on a 6-month cutoff require external validation. Full article

Augmented reality (AR) has been studied extensively as a means of supporting warehouse order picking, particularly through wearable displays, visual guidance, and pilot applications. Less attention has been given to how these elements are brought together when an AR solution is introduced into an operating warehouse. This study develops a six-phase Design Science framework for the systematic adoption and implementation of AR in warehouse logistics. The framework integrates strategic and organizational readiness, data preparation, business process redesign, multi-criteria hardware selection, three-tier system architecture, human-centric interface design, and phased implementation with continuous improvement. The framework was instantiated through an industrial Vision Picking pilot in the central distribution center of a telecommunications provider. The pilot included ARIS-based process redesign, AHP-supported selection of a head-mounted display, integration with the existing warehouse information systems, and development of a context-aware wearable interface for location and product-identifier verification. A comparative operational evaluation showed that productivity increased from 106.3 to 112.0 lines per hour per picker, corresponding to a 5.36% improvement, while the error rate decreased from 36.2 to 11.1 errors per 10,000 order lines, corresponding to a 69.34% reduction. Because the evaluation relies on aggregated operational indicators from a single industrial implementation, the findings serve as case-based evidence of the proposed framework’s practical applicability rather than as generalizable evidence of AR technology effectiveness. The study contributes an integrated decision-support artifact that connects organizational, process, technological, and human-centric implementation decisions within a coherent AR adoption pathway for warehouse logistics. Full article

Reliable discrimination between power swings and short-circuit faults is essential for secure transmission line protection, since misclassification may lead to unnecessary tripping or delayed fault clearing. Conventional power swing blocking techniques, particularly those based on impedance trajectory analysis, often require system-dependent settings and may exhibit reduced reliability under dynamic operating conditions with increasing renewable generation penetration. This paper proposes a setting-independent method for power swing and fault discrimination based on the Second Central Moment (SCM) of normalized instantaneous voltage and current signals. In this context, setting-independent means that the method does not require line-specific protection settings or case-by-case threshold tuning, although nominal voltage, nominal current, system frequency, and sampling frequency are required for signal normalization and sliding-window implementation. The SCM provides a statistical measure of signal dispersion that enables classification into three operating states: steady-state operation, power swing conditions, and fault events. Common SCM decision boundaries are applied without adjustment across the evaluated transmission lines, operating conditions, fault characteristics, power-swing frequencies, and levels of inverter-based resource penetration. The proposed method is validated through time-domain simulations using the Kundur two-area benchmark system and the IEEE 14-bus network under a wide range of disturbance scenarios, including oscillatory conditions, symmetrical and asymmetrical faults, renewable integration, and swing–fault sequences. For benchmarking purposes, the SCM-based algorithm is compared with a commercial Swing Center Voltage (SCV)-based blocking scheme widely implemented in digital relays. The results show that the proposed method achieves reliable swing–fault discrimination with low computational complexity while providing earlier blocking activation under slow oscillatory conditions and inherent fault discrimination capability. These characteristics support its practical application in real-time transmission line protection. Full article

Background: The Royal Marsden Hospital (RMH) score is a simple prognostic score based on serum albumin, lactate dehydrogenase, and the number of metastatic organ sites. Although its prognostic value has been demonstrated across several advanced cancer populations, evidence specifically in patients with de novo metastatic colorectal cancer (mCRC) initiating first-line treatment remains limited. Methods: This single-center retrospective cohort study included 189 patients with de novo mCRC who initiated first-line systemic treatment between January 2015 and January 2026. Patients were classified as low risk (RMH score 0–1) or high risk (RMH score 2–3). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, and factors independently associated with survival outcomes were evaluated using multivariable Cox regression. Results: Of the 189 patients, 142 (75.1%) were classified as low risk and 47 (24.9%) as high risk. Median PFS and OS for the entire cohort were 11.3 and 27.4 months, respectively. Median PFS was 11.8 months in the low-risk group and 7.6 months in the high-risk group (p < 0.001). Median OS was 33.8 and 13.7 months, respectively (p < 0.001). After adjustment for relevant clinicopathological factors, high-risk RMH status remained independently associated with shorter PFS (HR, 2.16; 95% CI, 1.51–3.09; p < 0.001) and OS (HR, 2.95; 95% CI, 2.03–4.29; p < 0.001). Conclusions: The RMH score was independently associated with both PFS and OS in patients with de novo mCRC initiating first-line systemic treatment. Based on simple and routinely available baseline parameters, the RMH score may serve as a complementary prognostic marker alongside established clinical and molecular factors. Full article

Objectives: This study aimed to compare the effectiveness of nivolumab and axitinib as second-line treatments in patients with metastatic renal cell carcinoma (mRCC) who had progressed after one prior tyrosine kinase inhibitor (TKI)-based therapy. Methods: We retrospectively evaluated 68 patients with mRCC who received nivolumab or axitinib as second-line treatment at two centers. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method and compared using the log-rank test. Multivariable Cox proportional hazards regression models were performed to evaluate the association of treatment with PFS and OS after adjustment for International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk group and year of second-line treatment initiation. Results: Nineteen patients received nivolumab, and 49 received axitinib. Median PFS was 9.27 months (95% confidence interval [CI], 5.75–12.79) with nivolumab and 5.87 months (95% CI, 4.73–7.01) with axitinib (log-rank p = 0.011). Median OS was 48.27 months (95% CI, 4.16–92.37) and 30.20 months (95% CI, 19.95–40.44), respectively (log-rank p = 0.027). In multivariable analysis, axitinib was associated with a significantly higher risk of progression or death compared with nivolumab (hazard ratio [HR], 3.494; 95% CI, 1.690–7.225; p = 0.001). IMDC risk group was also significantly associated with PFS (overall p = 0.003), whereas year of second-line treatment initiation was not (HR, 1.070; 95% CI, 0.883–1.296; p = 0.489). For OS, axitinib was associated with a significantly higher risk of death compared with nivolumab (HR, 2.410; 95% CI, 1.200–4.838; p = 0.013), while neither IMDC risk group (overall p = 0.477) nor treatment year (HR, 1.102; 95% CI, 0.922–1.317; p = 0.286) was significantly associated with OS. Conclusions: In this two-center retrospective cohort, nivolumab was associated with longer PFS and OS than axitinib in the second-line treatment of mRCC, and these associations remained significant after adjustment for IMDC risk group and year of treatment initiation. However, the retrospective design, small sample size, imbalance in treatment allocation and nephrectomy rates, and potential residual confounding limit causal interpretation. Prospective studies are warranted to confirm these findings. Full article

Visual place recognition (VPR) is one of the important enabling technologies in localization and mapping for intelligent transportation systems (ITSs). Long-term VPR is challenging even with descriptors extracted exclusively for the discrimination of position, especially when there is a significant change in illumination conditions, seasons, viewpoints, occlusions, traffic, and/or changes in structures. Additionally, temporal adaptation is typically done after the learning of the descriptors, and adaptation goals do not directly impact the descriptor space, which can act as a conflict with existing place representations. In order to overcome this limitation, the MT-FusionNet descriptor backbone is jointly optimized with the Cross-Temporal Meta-Reweighting Recurrent Encoder (CT-MRRE) and a representation-preserving process with replay. The two steps of CT-MRRE are: residual cross-temporal alignment to correct the descriptors dislocated by the condition and suppressing unreliable descriptors in the context of the current environmental condition through recurrent reliability reweighting. Therefore, place discrimination, temporal adaptation, reliability estimation, and representation retention are all optimized in a single descriptor space. The average Recall@1 is 97.2% across the four sites, being 96.4%, 96.2%, 99.1%, and 97.0% for Oxford RobotCar, Nordland, City Center, and St Lucia, respectively. This is in line with the common four-dataset evaluation protocol, where it represents an average absolute gain of 2.8 percentage points over MT-FusionNet and of 3.7 percentage points over CerfeVPR. The complementary effect of the cross-temporal alignment, context-aware reliability reweighting and replay-supported joint optimization is revealed by the component analysis. These results show the usefulness of the combination of discriminative descriptor learning, cross-time adaptation, reliability weighting, and representation preservation in the evaluated environmental variations for long-term VPR. Full article

Parotid sialocele is a challenging complication following major salivary gland surgery. Traditional conservative management often fails, while revision surgery carries a high risk of iatrogenic facial nerve injury. This retrospective, single-center case series evaluated the clinical efficacy and safety of ultrasound-guided Botulinum Toxin Type A (BoNT-A) infiltration in eight consecutive patients presenting with post-surgical parotid sialoceles. The protocol comprised complete ultrasound-guided evacuative aspiration followed by intraglandular injections of OnabotulinumtoxinA into functional parenchyma using a standardized grid mapping technique. Dosage was individualized based on the sonographic estimation of the residual volume of glandular tissue. Post-procedure care included a soft diet, temporary avoidance of sialagogues, and strict avoidance of local massage for 24 h. Complete clinical and sonographic resolution was achieved in all 8 treated cases within a mean interval of 10 days post-injection. Follow-up at 3 months confirmed no recurrences or late-onset complications. No local or systemic adverse events were recorded. In this preliminary case series, ultrasound-guided intraglandular BoNT-A injection represented a safe and encouraging minimally invasive second-line option for post-surgical parotid sialoceles. Full article

Background: Total knee arthroplasty (TKA) is an established treatment for end-stage rheumatoid arthritis (RA). Although cemented fixation has traditionally been preferred because of concerns regarding poor bone quality, advances in implant design and osseointegration have renewed interest in cementless fixation. This study evaluated the long-term clinical and radiological outcomes of cementless TKA in patients with RA. Methods: A retrospective single-center study included adult patients with RA who underwent primary cementless TKA between 2004 and 2021 using the same cruciate retaining implant. Clinical outcomes were assessed using range of motion (ROM), Visual Analog Scale (VAS), Oxford Knee Score (OKS), and patient satisfaction. Radiographic evaluation assessed implant fixation, while implant survivorship was analyzed using bilateral clustering via a Marginal Cox model analysis. Results: Seventy-five cementless TKAs performed in 52 patients were analyzed after a mean clinical follow-up of 10.8 ± 3.8 years. Mean ROM was 101° ± 26.5°, mean VAS score was 0.88 ± 1.84, and mean OKS was 40.3 ± 7.1. Overall, patients were satisfied or very satisfied in 89.6% of implants. Radiographic assessment showed no evidence of progressive radiolucent lines, osteolysis, implant subsidence, aseptic loosening, or malalignment. Only one revision was required because of periprosthetic joint infection, resulting in an implant survivorship of 98.3% at long-term follow-up. Conclusions: Cementless TKA demonstrated excellent long-term implant survival, durable radiographic fixation, and favorable clinical and functional outcomes in patients with rheumatoid arthritis. These findings support modern cementless fixation as a reliable and effective alternative to cemented TKA in carefully selected RA patients. Full article

In this paper, a sharp band-pass filter (BPF) with enhanced pass-band and stop-band specifications is presented. The filter can be utilized for 5G mid-band applications along with LTE42 (3.4–3.6 GHz) and LTE43 (3.6–3.8 GHz) to comply with the standards of different countries. The initial design of the filter consists of a high impedance transmission line connecting the filter’s two ports, which are terminated by 50 Ω resistors. Although this design results in reasonable pass-band characteristics, its stop-band and transition-band characteristics are relatively weak. Due to this shortcoming, the stop-band and transition-band characteristics of the filter are improved by locating sharp transmission zeros within the stop-band to determine the filter bandwidth and to significantly increase the stop-band attenuation. These modifications are achieved by inserting a pair of shunt short- and open-circuit stubs, a pair of short-circuited U-shaped parasitic elements, and a central short-circuited U-shaped element. The filter is mathematically analyzed and modeled, and the design steps are also demonstrated. The simulation and measured results are compatible, and the measurements show an insertion loss of 0.35 dB, stop-band attenuation larger than 20 dB, sharp transmission zeros, and a transition-band value within 10% of the center frequency. Full article

Background/Objectives: ATAC-seq footprinting can infer transcription-factor (TF) occupancy across the genome at near-base-pair resolution. However, its broad adoption is limited by high computational demands, complex command-line workflows, and fragmented support for bulk data with biological replicates and single-cell data. We developed fp-tools, a Python package that extends the TOBIAS framework into an integrated and reproducible platform for TF footprinting and motif discovery. Methods: fp-tools provides command-line and graphical workflows for Tn5 bias correction, footprint scoring, motif scanning, de novo motif discovery, replicate-aware differential analysis, scaled motif aggregation, and pseudobulk processing of single-cell ATAC-seq data. It compares TF occupancy across conditions using corrected cut-site profiles and motif-centered footprint scores. The package also produces interactive HTML reports, editable figures, and reusable YAML configurations. Results: In analyses of ENCODE ATAC-seq replicates from seven cancer cell lines, fp-tools recovered expected cell-type-associated TF programs, including erythroid and hepatocyte-lineage regulators. Validation against matched ChIP-seq data from four lines yielded a median area under the receiver operating characteristic curve (AUROC) of 0.765. In a public single-cell peripheral blood mononuclear cell (PBMC) ATAC-seq dataset, the pseudobulk workflow identified cell-type-specific footprint signatures across immune cell populations. fp-tools also discovered de novo motifs from candidate footprints that did not match known motif databases. In runtime benchmarking, fp-tools completed analyses faster and used less peak memory than the matched TOBIAS workflow tested in this study. Conclusions: fp-tools makes TOBIAS-style ATAC-seq footprinting more accessible and computationally efficient for bulk and single-cell studies. Its command-line tools, graphical interface, and interactive reports support reproducible analysis of TF occupancy in public and user-generated ATAC-seq datasets. Source code, examples, and documentation are available through the project’s GitHub repository and documentation website. Full article

Background: Genetic eye diseases (GEDs) comprise a heterogeneous group of hereditary and de novo disorders that involve all ocular structures, including the retina, optic nerve, vitreous, anterior segment, and ocular development. Their marked clinical and genetic heterogeneity frequently delays diagnosis and access to genetic counseling, multidisciplinary management, and emerging gene-based therapies. Although ophthalmic deep phenotyping remains essential, we propose an approach that prioritizes genetic analysis, particularly in under-resourced healthcare settings with limited access to advanced imaging and electrophysiological tests. Methods: We conducted a retrospective observational study of 101 consecutive patients with suspected genetic eye diseases. All were evaluated at a tertiary referral center in northeastern Mexico between January 2020 and August 2023 through comprehensive ophthalmologic examination supplemented by optical coherence tomography, visual-field testing, and fundus photography when clinically indicated. All patients were offered early molecular testing while awaiting future tests, such as electrophysiological testing or further referral visits. Molecular testing consisted of an ophthalmology-focused next-generation sequencing multigene panel. Results: The primary outcome was molecular diagnostic yield. A clinically actionable molecular diagnosis was established in 45 patients, corresponding to an overall molecular diagnostic yield of 44.6%. A total of 165 variants were identified, including 70 pathogenic, 16 likely pathogenic, 43 variants of uncertain significance, and 36 likely benign variants. Usher syndrome was the most frequent molecular diagnosis (10/45, 22.2%), comprising nine patients with USH2A-associated Usher syndrome type 2 and one patient with MYO7A-associated Usher syndrome type 1B, followed by Stickler syndrome (8/45, 17.8%), oculocutaneous albinism (3/45, 6.7%), and Alström syndrome (2/45, 4.4%). Autosomal recessive disorders represented the predominant inheritance pattern (68.9%). Conclusions: Our findings support ophthalmology-focused multigene panels as an effective first-line diagnostic strategy for patients with suspected genetic eye diseases. Early molecular testing may shorten the diagnostic odyssey, optimize resource utilization, facilitate precision diagnosis and genetic counseling, and guide future targeted deep phenotypic evaluation, prognosis, and eligibility for emerging gene-specific therapies. Full article

Nickel(II) offers an appealing base for metallodrug design as it is abundant, inexpensive and forms well-defined complexes with N,O-donor ligands. Therefore, five Ni(II) complexes containing two tridentate 2-imine-8-hydroxyquinoline Schiff base ligands, derived from morpholine, piperidine, imidazole or 2-methyl-1H-limidazole, were synthesized and characterized in solution and solid state via analytical and spectroscopic techniques. Single crystals were solved using X-ray diffraction for the complex derived from 4-(2-aminopropyl)morpholine (1). This Ni(II) complex exhibits a distorted octahedrally coordinated Ni(II) center bound to two monodeprotonated NNO-tridentate ligands, adopting a meridional coordination mode, with the two oxygen atoms arranged cis to each other. The stability of the complexes in aqueous media buffered at pH 7.4 was evaluated with UV–Vis spectroscopy and their binding to bovine serum albumin (BSA) was assessed with fluorescence titrations. All complexes show strong reversible binding to BSA (K_SV ~10⁵), which stabilizes the lipophilic complexes in aqueous media. The antiproliferative activity of the complexes was screened against colon cancer cell lines (Colo205 and Colo320). They exhibit moderate anticancer activity (IC₅₀ = 15.1–92.5 μM), with structure–activity relationships favoring imidazole derivatives and maintaining activity against the doxorubicin-resistant cell line (Colo320) with resistance indices (1.3–3.1) comparable to or lower than doxorubicin. Overall, the complexes represent a platform to develop new anticancer Ni-based drugs. Full article

Cavitation erosion severely limits the service life of marine hydraulic components. Magnetron sputtering was utilized to fabricate TiSiN/AlCrTiVNbN high-entropy nitride nanomultilayer films, whose modulation periods ranged from 4 nm to 23 nm. The effects of modulation period on the microstructure, mechanical properties, and cavitation erosion resistance were systematically investigated. All films exhibited a single-phase face-centered cubic structure with a preferred orientation (200) plane. The film with a 6 nm layer period reached the highest hardness (38.9 GPa) and elastic modulus (214.1 GPa), which is due to the many closely fitting interfaces that effectively stopped line defect movement; in cavitation erosion tests in 3.5% salt water, this film had the lowest mass loss (0.8 mg) and its surface stayed in the best condition. Its superior cavitation erosion resistance originates from the synergistic effects of high-density coherent interfaces that obstructed crack propagation, enhanced mechanical properties that provided excellent resistance to plastic deformation, and the formation of a protective oxide layer during cavitation. As this work shows, optimizing the layer period is an effective strategy; it allows the design of strong protective films for ocean use. Full article