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Immune Escape and Drug Resistance Mutations in Patients with Hepatitis B Virus Infection: Clinical and Epidemiological Implications
No full textManagement of All Patients with Multiple Actinic Keratoses Requires Lifelong Follow-Up and Repeated Treatment Cycles: A 12-Year Prospective Observational Study of a Cohort of 81 Patients
No full textBackground: Many treatments for multiple actinic keratoses (mAKs) have been proven efficient in clinical trials. However, there is a lack of evidence regarding the long-term impact of therapies on the disease progression in mAKs patients. Objectives: This study aims to investigate the long-term clinical trajectory of mAKs patients undergoing repeated topical interventions. It also assesses the clinical effectiveness of these treatments and patients' adherence to an extended follow-up protocol in a real-world context. Methods: We conducted a prospective follow-up of a cohort comprising 81 treatment-naïve mAKs patients from 2012 to 2023. Patients received examinations and, when necessary, interventions every six months. Instances of treatment cycle discontinuation and refusals to continue with specific therapies were systematically recorded. Descriptive statistics alongside the Student's t-test were employed to evaluate improvements in the Physician Global Assessment (PGA) scores following treatment with the same medication. Results: The average total number of medical examinations and treatments administered per patient was 23.0 ± 0.4 and 16.1 ± 2.4, respectively. Annually, the average number of examinations and treatments per patient was 1.9 ± 0.1 and 1.3 ± 0.2, respectively. We completed 539 (41.6%) treatment cycles using MAL-PDT, 182 (14.0%) with DHA, 97 (7.5%) with IMI, 101 (7.8%) with 5-FU, 25 (1.9%) with FU, and 353 (27.2%) with cryosurgery. PGA values indicated a statistically significant reduction following each treatment at the 30-day post-treatment mark; however, these values exhibited an increase by the six-month follow-up visit. The rates of treatment cycle discontinuation were as follows: 28.0% with MAL-PDT, 22.0% with DHA, 27.8% with IMI, 22.8% with 5-FU, and 24.0% with FU. Refusal rates for subsequent treatment cycles with the same drug were documented as 32.7% for MAL-PDT, 17.6% for DHA, 24.7% for IMI, 21.8% for 5-FU, 20.0% for FU, and 12.2% for cryotherapy. Throughout the study duration, 223 cases of squamous cell carcinoma (SCC), 46 cases of basal cell carcinoma (BCC), and 4 malignant melanomas (MMs) emerged on the face or scalp, along with 71 SCCs, 64 BCCs, and 8 MMs in other body regions. Conclusion: Immunocompetent patients with mAKs require lifelong follow-up accompanied by repeated treatment cycles, as the clearance rates, regardless of the degree achieved after a single treatment cycle, tend to be temporary. These patients are at a heightened risk of developing skin tumors
Disordered plasmonic system with dense copper nano-island morphology
No full textDry synthesis is a highly versatile method for the fabrication of nanoporous metal films, since it enables easy and reproducible deposition of single or multi-layers of nanostructured materials that can find intriguing applications in plasmonics, photochemistry and photocatalysis, to name a few. Here, we extend the use of this methodology to the preparation of copper nano-islands that represent an affordable and versatile example of disordered plasmonic substrates. Although the island morphology is disordered, the high density of these nanostructures with large surface area results in a good homogeneity on a macroscale, which is beneficial for plasmonic applications such as bio-sensing and photo-catalysis. With cathodoluminescence and electron-energy-loss spectroscopies we confirm the nano-islands as sources of the local field enhancement and identify the plasmonic resonance bands in the visible and near-infrared spectral range. The decay dynamics of the plasmonic signal are slower in the nano-island as compared to bulk copper films, which can be rationalized by a reduced energy dissipation in the nano-island films. Our study demonstrates a robust and lithography-free fabrication pathway to obtain nanostructured plasmonic copper substrates that represent a highly versatile low-cost alternative for future applications ranging from sensing to photochemistry and photocatalysis
Efficacy of Segmental Muscle Vibration on Pain Modulation in Patients with Primary Cervical Dystonia Treated with Botulinum Type-A Toxin: A Protocol for a Randomized Controlled Trial
No full textThe global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Cancer is a leading cause of death globally. Accurate cancer burden information is crucial for policy planning, but many countries do not have up-to-date cancer surveillance data. To inform global cancer-control efforts, we used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 framework to generate and analyse estimates of cancer burden for 47 cancer types or groupings by age, sex, and 204 countries and territories from 1990 to 2023, cancer burden attributable to selected risk factors from 1990 to 2023, and forecasted cancer burden up to 2050. Methods: Cancer estimation in GBD 2023 used data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Cancer mortality was estimated using ensemble models, with incidence informed by mortality estimates and mortality-to-incidence ratios (MIRs). Prevalence estimates were generated from modelled survival estimates, then multiplied by disability weights to estimate years lived with disability (YLDs). Years of life lost (YLLs) were estimated by multiplying age-specific cancer deaths by the GBD standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. We used the GBD 2023 comparative risk assessment framework to estimate cancer burden attributable to 44 behavioural, environmental and occupational, and metabolic risk factors. To forecast cancer burden from 2024 to 2050, we used the GBD 2023 forecasting framework, which included forecasts of relevant risk factor exposures and used Socio-demographic Index as a covariate for forecasting the proportion of each cancer not affected by these risk factors. Progress towards the UN Sustainable Development Goal (SDG) target 3.4 aim to reduce non-communicable disease mortality by a third between 2015 and 2030 was estimated for cancer. Findings: In 2023, excluding non-melanoma skin cancers, there were 18·5 million (95% uncertainty interval 16·4 to 20·7) incident cases of cancer and 10·4 million (9·65 to 10·9) deaths, contributing to 271 million (255 to 285) DALYs globally. Of these, 57·9% (56·1 to 59·8) of incident cases and 65·8% (64·3 to 67·6) of cancer deaths occurred in low-income to upper-middle-income countries based on World Bank income group classifications. Cancer was the second leading cause of deaths globally in 2023 after cardiovascular diseases. There were 4·33 million (3·85 to 4·78) risk-attributable cancer deaths globally in 2023, comprising 41·7% (37·8 to 45·4) of all cancer deaths. Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by -5·6% (-12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3). Interpretation: Cancer is a major contributor to global disease burden, with increasing numbers of cases and deaths forecasted up to 2050 and a disproportionate growth in burden in countries with scarce resources. The decline in age-standardised mortality rates from cancer is encouraging but insufficient to meet the SDG target set for 2030. Effectively and sustainably addressing cancer burden globally will require comprehensive national and international efforts that consider health systems and context in the development and implementation of cancer-control strategies across the continuum of prevention, diagnosis, and treatment. Funding: Gates Foundation, St Jude Children's Research Hospital, and St Baldrick's Foundation
Enhancing Aluminum Alloy Properties Through Low Pressure Forging: A Comprehensive Study on Heat Treatments
No full textThe weight reduction is a key objective in modern engineering, particularly in the automotive industry, to enhance vehicle performance and reduce the carbon footprint. In this context aluminum alloys are widely used in structural automotive applications, often through forging processes that enhance mechanical properties compared to the results for casting. However, the high cost of forging can limit its economic feasibility. Low pressure forging (LPF) combines the benefits of casting and forging, employing controlled pressure to fill the mold cavity and improve metal purity. This study investigates the effectiveness of the LPF process in optimizing the mechanical properties of AlSi7Mg aluminum alloy by evaluating the influence of three different magnesium content levels. The specimens underwent T6 heat treatment (solubilization treatment followed by artificial aging), with varying aging times and temperatures. Microstructural analysis and tensile tests were conducted to determine the optimal conditions for achieving superior mechanical strength, contributing to the design of lightweight, high-performance components for advanced automotive applications. The most promising properties were achieved with a T6 treatment consisting of solubilization at 540 °C for 6 h followed by aging at 180 °C for 4 h, resulting in mechanical properties of σy 280 MPa, σm 317 MPa, and A% 3.5%
Recent Developments in Torsion Design of SFRC Elements
No full textThe limited availability of research studies related to the behavior of Steel Fiber Reinforced Concrete (SFRC) members subjected to torsion has hindered the development of clear and reliable design guidelines. Recent efforts by various researchers have been devoted to the development of analytical models for predicting the torsional response of SFRC members, supported by experimental results which have highlighted the efficiency of steel fibers in improving the torsional resistance and stiffness. For beams subjected to moderate or low levels of torsion, steel fibers, even at moderate dosages, have demonstrated the potential to replace minimum conventional torsion reinforcement, thus providing significant advantages for practical applications. This paper presents a discussion of the recent developments in research related to testing SFRC members under pure torsion. A comprehensive database of experimental test data is collated to provide a state-of-the-art in this respect. Additionally, the manuscript delves into analytical prediction models for the torsional capacity by some European code-oriented models, recently introduced by the Eurocode 2 as well as by the Authors of this paper. The results of model predictions are compared with available experimental data to assess the effectiveness and reliability of the models
Adaptive and Sustainable Manufacturing Processes for Profiles and Tubes: Challenges and Innovations
No full textMetal profiles and tubes serve diverse industrial needs, from structural support to fluid conveyance, in sectors like automotive, food, energy, furnishing, and appliances. Their production involves a complex supply chain of deformation, welding, and cutting processes, often handled by separate industrial entities, each with specialized skills in machinery, tooling, or manufacturing. It is a relatively traditional sector, where the innovations fostered by the digital and green transitions are crucial to maintain competitiveness and are beginning to sink in. Advanced control systems enhance economic, environmental, and energy efficiency, improve product quality, and reduce waste. Achieving these benefits requires integration across the supply chain and diverse competences. This paper aims at presenting the state of the art, the main innovations, and challenges represented by the use of advanced control systems along the reference supply chain. Particular attention will be paid to the impact of process and machine architecture and the effects on the in-line implementation of new frontier technologies applicable to industrial control such as AI, Digital Twins, sensors, and new concepts of flexible processing and sustainable manufacturing