A gastric cancer (GC) diagnosis relies on histopathology. Endoscopy rates are increasing.
infection is a major GC risk factor. In an effort to elucidate abundant blood biomarkers, and potentially ...reduce the number of diagnostic surgical interventions, we investigated sera and biopsies from a cohort of 219
positive and negative patients diagnosed with GC, gastritis, and ulcers. This allowed the comparative investigation of the different gastroduodenal diseases, and the exclusion of protein changes resulting from bacterial infection or inflammation of the gastric mucosa when searching for GC-dependent proteins.
High-definition mass spectrometry-based expression analysis of tryptically digested proteins was performed, followed by multivariate statistical and network analyses for the different disease groups, with respect to
infection status. Significantly regulated proteins differing more than two-fold between groups were shortlisted, and their role in gastritis and GC discussed.
We present data of comparative protein analyses of biopsies and sera from patients suffering from mild to advanced gastritis, ulcers, and early to advanced GC, in conjunction with a wealth of metadata, clinical information, histopathological evaluation, and
infection status. We used samples from pre-malignant stages to extract prospective serum markers for early-stage GC, and present a 29-protein marker panel containing, amongst others, integrin β-6 and glutathione peroxidase. Furthermore, ten serum markers specific for advanced GC, independent of
infection, are provided. They include CRP, protein S100A9, and kallistatin. The majority of these proteins were previously discussed in the context of cancer or GC. In addition, we detected hypoalbuminemia and increased fibrinogen serum levels in gastritis.
Two protein panels were suggested for the development of multiplex tests for GC serum diagnostics. For most of the elements contained in these panels, individual commercial tests are available. Thus, we envision the design of multi-protein assays, incorporating several to all of the panel members, in order to gain a level of specificity that cannot be achieved by testing a single protein alone. As their development and validation will take time, gastritis diagnosis based on the fibrinogen to albumin serum ratio may be a quick way forward. Its determination at the primary/secondary care level for early diagnosis could significantly reduce the number of referrals to endoscopy. Preventive measures are in high demand. The protein marker panels presented in this work will contribute to improved GC diagnostics, once they have been transferred from a research result to a practical tool.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
For decades high voltage alternating current (HVAC) was considered as most economical solution to transmit and deliver electric power. With the recent developments in power electronic devices, high ...voltage direct current (HVDC) system becomes most prominent technology. Multi-terminal direct current (MTDC) based system as a promising technology for future power system is the major focus area for researchers and industries these days. A number of MTDC systems have been implemented physically. The major motivation to construct such MTDC systems is the integration of large-scale offshore power sources such as wind turbines and solar systems. This article discusses the most critical challenges and issues related to operation, control and protection schemes for integration of modular multi-level converter (MMC) based MTDC systems. At first detailed literature survey has been presented to show the challenges for MMC based MTDC systems, then an analysis related to those challenges for operation, control and protection schemes for existing MMC based MTDC systems has been provided. Finally, a road map to tackle such challenges has been suggested.
Historically, the power system has relied on synchronous generators (SGs) to provide inertia and maintain grid stability. However, because of the increased integration of power-electronics-interfaced ...renewable energy sources, the grid’s stability has been challenged in the last decade due to a lack of inertia. Currently, the system predominantly uses grid-following (GFL) converters, built on the assumption that inertial sources regulate the system stability. Such an assumption does not hold for the low-inertia grids of the future. Grid-forming (GFM) converters, which mimic the traditional synchronous machinery’s functionalities, have been identified as a potential solution to support the low-inertia grids. The performance analysis of GFM converters for small-signal instability can be found in the literature, but large-signal instability is still an open research question. Moreover, various topologies and configurations of GFM converters have been proposed. Still, no comparative study combining all GFC configurations from the perspective of large-signal stability issues can be found. This paper combines and compares all the existing GFM control schemes from the perspective of large-signal stability issues to pave the way for future research and development of GFM converters for large-signal stability analysis and stabilization of the future low-inertia grids.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Wearable sweat sensors offer the possibility of continuous real-time health monitoring of an individual at a low cost without invasion. A variety of sweat glucose sensors have been developed thus far ...to help diabetes patients frequently monitor blood glucose levels through sweat glucose as a surrogate marker. The present study demonstrates the development and characterization of a three-dimensional paper-based microfluidic electrochemical integrated device (3D PMED) for measuring glucose concentration in sweat in real-time via simple, non-invasive, capillary-action-based sample collection. The device was selective for glucose, and it detected glucose accurately in the clinically relevant range (0~2 mM) in an off-body setup. To the best of our knowledge, this is the first time NEXAR™ has been used for biosensing applications. Further, the developed glucose sensor has acceptable sensitivity of 16.8 µA/mM/cm
. Importantly, in an on-body setup, the device achieved a significant amperometric response to sweat glucose in a very short amount of time (a few seconds). With detailed investigations, this proof-of-concept study could help further the development of sensitive and selective sweat-based glucose sensing devices for real-time glucose monitoring in diabetes patients.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract In this paper, a novel negative refractive index metamaterial (NIM) is developed and characterized. The proposed metamaterial exhibits negative effective permittivity ( ε effe ) and negative ...effective permeability ( µ effe ) at millimeter wave frequency of 28 GHz. This attractive feature is utilized to enhance the gain of a microstrip patch antenna (MPA). Two thin layers of 5 × 5 subwavelength unit cell array of NIM are placed above a single MPA to enhance the gain of the antenna. Each unit cell has an area of 3.4 × 3.4 mm 2 . A gain increase of 7.9 dBi has been observed when using the proposed NIM as a superstrate. Furthermore, the NIM array is placed over a 2 × 2 array of MPAs with four ports to demonstrate versatility of the metamaterial. The total size of the 2 × 2 antenna array system with N-MTM is about 61.1 × 34 × 16mm 3 (5.71 λ × 3.18 λ × 1.5 λ , where λ is the free-space wavelength at 28 GHz). The measurement result indicate that the maximum gain of the antenna array is 13.5dBi. A gain enhancement of 7.55 dB in E-Plane and 7.25 dB in H-Plane at the resonant frequency of 28 GHz is obtained. The proposed antenna structure is suitable for 5G millimeter wave communications, in particular, for possible implementation in future millimeter wave access points and cellular base stations.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
This study sought to assess interest in global surgery rotations among current United States (US)‐based oral and maxillofacial surgery (OMS) residents.
Methods
An anonymous 23‐question survey ...was distributed to 633 current OMS residents in the US to examine resident interest in global surgery rotations during residency. The primary outcome variable was resident interest in participating in global OMS rotations during residency training, whereas the primary predictor variable was the presence of residency faculty involved in global OMS work. Descriptive statistics were calculated for all study variables and univariate/multivariate logistic regression analyses were conducted to identify predictors of interest in global OMS rotations.
Results
A total of 120 residents with an average age of 30.4 ± 3.2 years responded to the survey. At present, 22 (18.5%) residents stated that their residency programs offer some sort of global OMS rotation and 21 (95.5%) of these claimed they were willing to participate in global OMS rotations at their residency program. Out of the residents who stated their program did not offer a global OMS rotation, 86 (87.8%) respondents stated they would be interested in adding a dedicated global OMS rotation to their residency curriculum. The presence of OMS residency faculty involved in global OMS work (p = 0.030) and a resident's willingness to dedicate vacation time to participate in a global surgery rotation (p = 0.005) were associated with increased interest in a global surgery rotation.
Conclusion
The majority of respondents would welcome a dedicated global OMS rotation during their residency training.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
International travel goes hand in hand with medical delivery to underserved communities. The global health care worker can be exposed to a wide range of infectious diseases during their global ...experiences. A pretravel risk assessment visit and all appropriate vaccinations and education must be performed. Universal practices of water safety, food safety, and insect avoidance will prevent most travel-related infections and complications. Region-specific vaccinations will further reduce illness risk. An understanding of common travel-related illness signs and symptoms is helpful. Emerging pathogens that can cause a pandemic should be understood to avoid health care worker infection and spread.
Telemedicine is the specialty of medicine that uses the evolving telecommunications industry combined with medical information technology to provide remote medical services. The use of smartphone ...telemedicine is an efficient and effective way for remote specialist consultation and should be considered by the oral and maxillofacial surgeon. Smartphones provide fast and clear access to electronically mailed digital images and allows the oral/maxillofacial surgeon free mobility, not restricted by the constraints of a desktop personal computer. This in turn allows for improved efficiency of the specialty consultation and improved triaging, ultimately providing improved care to the maxillofacial patient.
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GEOZS, NUK, OILJ, SBCE, UL
The shift towards electrified transportation has increased the importance of interleaved DC-DC converters with integrated magnetic components aiming for increased power density and system efficiency. ...A new structural inductor geometry, that retains the advantages of coupled inductors while ensuring high power density and tackling the problems of high airgap fringing flux losses, uneven flux distribution and three-phase current un-balancing associated with the conventional bulky inductors is proposed. Moreover, a new high-fidelity magnetic equivalent circuit (HFMEC) model was derived and applied for the design of this geometry which reduces the inaccuracies associated with the traditional magnetic equivalent circuit (MEC) modelling. The model proved to be capable of evaluating the flux and current characteristics much quicker and with less computational cost as compared to the finite element analysis approach especially when complex geometries are involved. The proposed inductor geometry is modelled based on HFMEC, designed in Solidworks, simulated in ANSYS and MAXWELL 3D, fabricated and then implemented with a three-phase interleaved converter to evaluate the performance.
To assess urologists' ability to predict the grade and stage of new bladder cancers from the cystoscopic features alone.
We conducted a prospective clinical study on consecutive patients who ...underwent transurethral resection of bladder tumor (TURBT) for new bladder cancers. Using only cystoscopic tumor morphology at the time of initial TURBT, 3 urology consultants predicted the grade and stage, recording these on a proforma along with tumor features. Predictions were compared with assessments by uropathologists, blinded to the clinical prediction. We analyzed the accuracy in (1) predicting the exact grade and stage of the cancer; (2) differentiating between low- and high-grade cancers; and (3) discerning between Ta, T1, and T2 cancers.
Of 248 patients, 224 were suitable for analysis. The positive predictive values for low- and high-grade cancers were 85.8% and 71.3%, respectively. The overall likelihood of a consultant predicting high-grade cancers as being low grade was 16/83 (19.3%). When tumors were large (>30 mm), this likelihood dropped significantly to 7.3% (4/55) (odds ratio = 3.1, 95% confidence interval = 1.0-9.7, P = .04). Non–muscle-invasive and muscle-invasive cancers were predicted accurately in 93.4% and 85.2% patients, respectively. Six of 161 (3.7%) tumors predicted to be non–muscle-invasive bladder cancer were actually muscle invasive on histology.
For clinical purposes, in newly presenting patients with bladder cancer, urologists appear to reliably predict lower grade and muscle-invasive disease, confirming widely held belief. This allows for appropriate and efficient use of surgical expertise, available technology, and selection of participants for clinical trials on the basis of prehistology risk categories.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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