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14 pages, 1714 KiB  
Article
Residual Adversarial Subdomain Adaptation Network Based on Wasserstein Metrics for Intelligent Fault Diagnosis of Bearings
by Haichao Cai, Bo Yang, Yujun Xue and Yanwei Xu
Appl. Sci. 2024, 14(19), 9057; https://doi.org/10.3390/app14199057 (registering DOI) - 7 Oct 2024
Abstract
Subdomain adaptation plays a significant role in the field of bearing fault diagnosis. It effectively aligns the pertinent distributions across subdomains and addresses the frequent issue of lacking local category information in domain adaptation. Nonetheless, this approach overlooks the quantitative discrepancies in distribution [...] Read more.
Subdomain adaptation plays a significant role in the field of bearing fault diagnosis. It effectively aligns the pertinent distributions across subdomains and addresses the frequent issue of lacking local category information in domain adaptation. Nonetheless, this approach overlooks the quantitative discrepancies in distribution between samples from the source and target domains, leading to the vanishing gradient issue during the training of models. To tackle this challenge, this paper proposes a bearing fault diagnosis method based on Wasserstein metric residual adversarial subdomain adaptation. The Wasserstein metric is introduced as the optimized objective function of the domain discriminator in RASAN-W. The distribution discrepancy between the source domain and target domain samples is quantitatively measured, achieving the alignment of the relevant subdomain distributions between the source domain and the target domain. Ultimately, extensive experiments conducted on two real-world datasets reveal that the diagnostic accuracy of this method is significantly enhanced when compared to various leading bearing fault diagnosis techniques. Full article
25 pages, 27763 KiB  
Article
Improved Multi-Size, Multi-Target and 3D Position Detection Network for Flowering Chinese Cabbage Based on YOLOv8
by Yuanqing Shui, Kai Yuan, Mengcheng Wu and Zuoxi Zhao
Plants 2024, 13(19), 2808; https://doi.org/10.3390/plants13192808 - 7 Oct 2024
Abstract
Accurately detecting the maturity and 3D position of flowering Chinese cabbage (Brassica rapa var. chinensis) in natural environments is vital for autonomous robot harvesting in unstructured farms. The challenge lies in dense planting, small flower buds, similar colors and occlusions. This study [...] Read more.
Accurately detecting the maturity and 3D position of flowering Chinese cabbage (Brassica rapa var. chinensis) in natural environments is vital for autonomous robot harvesting in unstructured farms. The challenge lies in dense planting, small flower buds, similar colors and occlusions. This study proposes a YOLOv8-Improved network integrated with the ByteTrack tracking algorithm to achieve multi-object detection and 3D positioning of flowering Chinese cabbage plants in fields. In this study, C2F-MLCA is created by adding a lightweight Mixed Local Channel Attention (MLCA) with spatial awareness capability to the C2F module of YOLOv8, which improves the extraction of spatial feature information in the backbone network. In addition, a P2 detection layer is added to the neck network, and BiFPN is used instead of PAN to enhance multi-scale feature fusion and small target detection. Wise-IoU in combination with Inner-IoU is adopted as a new loss function to optimize the network for different quality samples and different size bounding boxes. Lastly, ByteTrack is integrated for video tracking, and RGB-D camera depth data are used to estimate cabbage positions. The experimental results show that YOLOv8-Improve achieves a precision (P) of 86.5% and a recall (R) of 86.0% in detecting the maturity of flowering Chinese cabbage. Among them, mAP50 and mAP75 reach 91.8% and 61.6%, respectively, representing an improvement of 2.9% and 4.7% over the original network. Additionally, the number of parameters is reduced by 25.43%. In summary, the improved YOLOv8 algorithm demonstrates high robustness and real-time detection performance, thereby providing strong technical support for automated harvesting management. Full article
(This article belongs to the Section Plant Modeling)
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<p>Original test image of detection sample.</p>
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<p>Prediction results under sunlight of different models: (<b>a</b>) Faster R-CNN; (<b>b</b>) SSD; (<b>c</b>) RetinaNet; (<b>d</b>) YOLOv5; (<b>e</b>) YOLOv8; (<b>f</b>) YOLOv9; (<b>g</b>) RT-DETR; (<b>h</b>) YOLOv8-Improved (Ours).</p>
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<p>Prediction results under sunlight of different models: (<b>a</b>) Faster R-CNN; (<b>b</b>) SSD; (<b>c</b>) RetinaNet; (<b>d</b>) YOLOv5; (<b>e</b>) YOLOv8; (<b>f</b>) YOLOv9; (<b>g</b>) RT-DETR; (<b>h</b>) YOLOv8-Improved (Ours).</p>
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<p>Prediction outcomes under cloudy conditions of different models: (<b>a</b>) Faster R-CNN; (<b>b</b>) SSD; (<b>c</b>) RetinaNet; (<b>d</b>) YOLOv5; (<b>e</b>) YOLOv8; (<b>f</b>) YOLOv9; (<b>g</b>) RT-DETR; (<b>h</b>) YOLOv8-Improved (Ours).</p>
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<p>Prediction outcomes under cloudy conditions of different models: (<b>a</b>) Faster R-CNN; (<b>b</b>) SSD; (<b>c</b>) RetinaNet; (<b>d</b>) YOLOv5; (<b>e</b>) YOLOv8; (<b>f</b>) YOLOv9; (<b>g</b>) RT-DETR; (<b>h</b>) YOLOv8-Improved (Ours).</p>
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<p>Ablation experiments: (<b>a</b>) Loss curve; (<b>b</b>) Precision-recall curve.</p>
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<p>FPS for each model.</p>
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<p>Results of ByteTrack. (<b>a</b>) Tracking result frame 1, (<b>b</b>) Tracking result frame 2.</p>
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<p>Results of ByteTrack. (<b>a</b>) Tracking result frame 1, (<b>b</b>) Tracking result frame 2.</p>
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<p>Different growth states of sample: (<b>a</b>) Growing, (<b>b</b>) Ripe, (<b>c</b>) Over-Ripe, (<b>d</b>) Harvested.</p>
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<p>YOLOv8-Improved network architecture and modules: (<b>a</b>) YOLOv8-Improved; (<b>b</b>) Conv; (<b>c</b>) SPPF; (<b>d</b>) C2F-MLCA; (<b>e</b>) C2F.</p>
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<p>YOLOv8-Improved network architecture and modules: (<b>a</b>) YOLOv8-Improved; (<b>b</b>) Conv; (<b>c</b>) SPPF; (<b>d</b>) C2F-MLCA; (<b>e</b>) C2F.</p>
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<p>Neck network architecture: (<b>a</b>) PAN; (<b>b</b>) BiFPN.</p>
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<p>Mixed Local Channel Attention (MLCA): (<b>a</b>) Structural diagram; (<b>b</b>) Schematic diagram.</p>
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<p>Inner-IoU.</p>
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<p>The structure of object detection and tracking based on video.</p>
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<p>Heat map.</p>
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<p>Confusion matrices: (<b>a</b>) YOLOv8; (<b>b</b>) YOLOv8-W; (<b>c</b>) YOLOv8-WX; (<b>d</b>) YOLOv8-WY; (<b>e</b>) YOLOv8-WZ; (<b>f</b>) YOLOv8-Improved.</p>
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<p>Confusion matrices: (<b>a</b>) YOLOv8; (<b>b</b>) YOLOv8-W; (<b>c</b>) YOLOv8-WX; (<b>d</b>) YOLOv8-WY; (<b>e</b>) YOLOv8-WZ; (<b>f</b>) YOLOv8-Improved.</p>
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29 pages, 12444 KiB  
Article
Mapping Ecological Security Patterns Based on Ecosystem Service Valuation in the Qinling-Daba Mountain Area, China: A Multi-Scenario Study for Development and Conservation Tradeoffs
by Pingping Zhang, Mingjie Song and Qiaoqi Lu
Land 2024, 13(10), 1629; https://doi.org/10.3390/land13101629 - 7 Oct 2024
Abstract
When focusing on biodiversity maintenance, ecological security pattern (ESP) planning gradually becomes a multi-objective planning strategy for sustainable development; wildlife conservation and ecosystem health maintenance should be balanced with local economic development and people’s livelihood enhancement goals. This study focuses on ESP mapping [...] Read more.
When focusing on biodiversity maintenance, ecological security pattern (ESP) planning gradually becomes a multi-objective planning strategy for sustainable development; wildlife conservation and ecosystem health maintenance should be balanced with local economic development and people’s livelihood enhancement goals. This study focuses on ESP mapping in the Qinling-Daba Mountain area, which is an ecologically significant and socioeconomically underdeveloped area. The tradeoff between conservation and development is made by varying the area of ecological sources and incorporating ecosystem service tradeoffs into ecological source identification through multi-scenario designation. ESPs under six scenarios were generated based on the minimum resistance model, and the important ecological corridors and strategic points in each scenario were identified and compared. The results show the following: (1) The scenario that sets around 30 percent of the study area as ecological sources maintains the integrity of natural ecosystems and leaves space for food and material supply to residents. (2) In this scenario, the ecological sources are connected by 60 corridors that cross 137 townships with high population densities (>100 people/km2) and intersect with major traffic lines at 71 points. Engineering, management, or education strategies must be taken in these townships or intersections to avoid human–wildlife conflicts. (3) The study area needs to construct both short (north–south) corridors linking proximate ecological sources for species’ daily movement and long (west–east) corridors connecting large and distant sources for species’ seasonal migration and gene flow. (4) The multi-scenario approach turns out to be an effective strategy for ESP planning with considerations for development–conservation tradeoffs. Full article
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<p>Schematic diagrams of ecological security pattern (ESP).</p>
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<p>Location of the Qinling-Daba Mountain area, China.</p>
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<p>Research workflow.</p>
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<p>Spatial distribution of four ESVs in the Qinling-Daba Mountain area: (<b>a</b>) provisioning service, (<b>b</b>) supporting service, (<b>c</b>) regulating service, (<b>d</b>) cultural service.</p>
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<p>Spatial distribution of aggregated supporting, regulating, and cultural ecosystem service values in the Qinling-Daba Mountain area.</p>
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<p>Spatial distribution of ecological sources in different scenarios in the Qinling-Daba Mountain area: (<b>a</b>) Scenario A1, (<b>b</b>) Scenario A2, (<b>c</b>) Scenario B1, (<b>d</b>) Scenario B2, (<b>e</b>) Scenario C1, (<b>f</b>) Scenario C2. Change 1 indicates the change in ecological sources in the Min Mountain area, Change 2 indicates the change in ecological sources in the Qinling-Daba Mountain area, and Change 3 indicates the change in ecological sources in the Micang-Daba-Shennongjia Mountain area.</p>
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<p>The cumulative resistance surfaces for ecological corridor identification in the Qinling-Daba Mountain area.</p>
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<p>Ecological corridors in different scenarios in the Qinling-Daba Mountain area: (<b>a</b>) Scenario B1, (<b>b</b>) Scenario B2, (<b>c</b>) Scenario C1, (<b>d</b>) Scenario C2. Change 1 indicates the change in ecological corridors in the Min Mountain region, Change 2 indicates the change in ecological corridors in the Daba-Shennongjia Mountain area, Change 3 indicates the change in ecological corridors in the Qinling Mountain and Micang Mountain, and Change 4 indicates the change in ecological corridors in the Funiu Mountain.</p>
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<p>Distribution of important ecological corridors and strategic points in the Qinling-Daba Mountain area: (<b>a</b>) Scenario B1, (<b>b</b>) Scenario B2, (<b>c</b>) Scenario C1, (<b>d</b>) Scenario C2.</p>
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<p>Classification of ecosystem.</p>
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14 pages, 2089 KiB  
Article
Pest Detection Based on Lightweight Locality-Aware Faster R-CNN
by Kai-Run Li, Li-Jun Duan, Yang-Jun Deng, Jin-Ling Liu, Chen-Feng Long and Xin-Hui Zhu
Agronomy 2024, 14(10), 2303; https://doi.org/10.3390/agronomy14102303 - 7 Oct 2024
Abstract
Accurate and timely monitoring of pests is an effective way to minimize the negative effects of pests in agriculture. Since deep learning-based methods have achieved good performance in object detection, they have been successfully applied for pest detection and monitoring. However, the current [...] Read more.
Accurate and timely monitoring of pests is an effective way to minimize the negative effects of pests in agriculture. Since deep learning-based methods have achieved good performance in object detection, they have been successfully applied for pest detection and monitoring. However, the current pest detection methods fail to balance the relationship between computational cost and model accuracy. Therefore, this paper proposes a lightweight, locality-aware faster R-CNN (LLA-RCNN) method for effective pest detection and real-time monitoring. The proposed model uses MobileNetV3 to replace the original backbone, reduce the computational complexity, and compress the size of the model to speed up pest detection. The coordinate attention (CA) blocks are utilized to enhance the locality information for highlighting the objects under complex backgrounds. Furthermore, the generalized intersection over union (GIoU) loss function and region of interest align (RoI Align) technology are used to improve pest detection accuracy. The experimental results on different types of datasets validate that the proposed model not only significantly reduces the number of parameters and floating-point operations (FLOPs), but also achieves better performance than some popular pest detection methods. This demonstrates strong generalization capabilities and provides a feasible method for pest detection on resource-constrained devices. Full article
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<p>The structure of LLA-RCNN. RPN is the region proposal network. CA is the coordinate attention block.</p>
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<p>The spatial relationships of the boxes in GIoU.</p>
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<p>The two types of inverse residual block structure diagrams for MobileNetv3X.</p>
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<p>The Coordinate Attention (CA) Module.</p>
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<p>The sample images from the FP6 dataset for comparison with other typical models. (<b>a</b>) Ground-truth, (<b>b</b>) YOLOv5s, (<b>c</b>) CenterNet, (<b>d</b>) YOLOv8s, (<b>e</b>) faster R-CNN, and (<b>f</b>) LLA-RCNN.</p>
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<p>The sample images of the LLA-RCNN-predicted RP5 dataset.</p>
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20 pages, 6328 KiB  
Article
Kiln–House Isomorphism and Cultural Isomerism in the Pavilions of the Yuci Area: The Xiang-Ming Pavilion as an Example
by Zexi Zhang, Chongen Wang and Chuanjin Hu
Buildings 2024, 14(10), 3188; https://doi.org/10.3390/buildings14103188 - 7 Oct 2024
Abstract
The pavilion is a time-honored architectural form in the Chinese silhouette with strong regional characteristics. Its appearance and technical means are often adaptively combined according to the characteristics of local architecture. The “kiln–house isomorphism” is a unique construction technology of the Shanxi construction [...] Read more.
The pavilion is a time-honored architectural form in the Chinese silhouette with strong regional characteristics. Its appearance and technical means are often adaptively combined according to the characteristics of local architecture. The “kiln–house isomorphism” is a unique construction technology of the Shanxi construction type in China. Therefore, the “kiln–house isomorphism” is generally adopted for the construction of pavilions in Shanxi. This study focuses on Xiaonanzhuang Village, Yuci District, Jinzhong City, Shanxi Province. Taking the Xiang-ming Pavilion, the core building of the village, as an example, we analyze the architectural characteristics of the “kiln–house isomorphism” in the pavilion in this area, describe the general construction rules of the region, and conduct a deep investigation of the five “cultural isomerism” factors of the pavilions in the region, namely, geomancy, etiquette and music, beliefs, clans, and cultivation and study. The results of this research will enrich the regional knowledge of such pavilions and add new objects for the protection of local architectural heritage, providing a theoretical basis for the contemporary adaptive reuse of pavilions in the Yuci area from a cultural perspective. Full article
(This article belongs to the Section Architectural Design, Urban Science, and Real Estate)
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<p>Map of “kiln–house isomorphic” buildings. Note: This map is downloaded from the standard map service website of the Ministry of Natural Resources, PRC.</p>
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<p>(<b>a</b>) Xiang-ming Pavilion (shot in 2009). (<b>b</b>) Xiang-ming Pavilion (shot in 2024).</p>
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<p>(<b>a</b>) The Xiang-ming Pavilion’s surrounding environment (shot in 1985). (<b>b</b>) The Xiang-ming Pavilion’s surrounding environment (shot in 2024).</p>
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<p>Geographical location of the research object. Note: This map is downloaded from the standard map service website of the Ministry of Natural Resources, PRC.</p>
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<p>The general form of a “kiln–house Isomorphic” building (Purple Bamboo Forest Temple, Ancient Village of Dian Tou).</p>
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<p>Research steps.</p>
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<p>(<b>a</b>) South Facade of the Xiang-ming Pavilion (shot in 2024). (<b>b</b>) West-side elevation of the Xiang-ming Pavilion (shot in 2024).</p>
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<p>Plan of the Xiang-ming Pavilion.</p>
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<p>Elevation of the Xiang-Ming Pavilion.</p>
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<p>Schematic diagram of building structure.</p>
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<p>Xiang-ming Pavilion interior space (shot in 2024).</p>
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<p>Xiang-Ming Pavilion decorative components (shot in 2024).</p>
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<p>(<b>a</b>) The Romance of the Three Kingdoms. (<b>b</b>) plum blossom, Orchid, Bamboo and Chrysanthemum paintings. (<b>c</b>) Guan Yu sculpture. (<b>d</b>) Kui Xing sculpture (shot in 2024).</p>
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<p>(<b>a</b>) Xiang-Ming plaque. (<b>b</b>) Yu-lin plaque (shot in 2024).</p>
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21 pages, 10838 KiB  
Article
DLCH-YOLO: An Object Detection Algorithm for Monitoring the Operation Status of Circuit Breakers in Power Scenarios
by Riben Shu, Lihua Chen, Lumei Su, Tianyou Li and Fan Yin
Electronics 2024, 13(19), 3949; https://doi.org/10.3390/electronics13193949 - 7 Oct 2024
Abstract
In the scenario of power system monitoring, detecting the operating status of circuit breakers is often inaccurate due to variable object scales and background interference. This paper introduces DLCH-YOLO, an object detection algorithm aimed at identifying the operating status of circuit breakers. Firstly, [...] Read more.
In the scenario of power system monitoring, detecting the operating status of circuit breakers is often inaccurate due to variable object scales and background interference. This paper introduces DLCH-YOLO, an object detection algorithm aimed at identifying the operating status of circuit breakers. Firstly, we propose a novel C2f_DLKA module based on Deformable Large Kernel Attention. This module adapts to objects of varying scales within a large receptive field, thereby more effectively extracting multi-scale features. Secondly, we propose a Semantic Screening Feature Pyramid Network designed to fuse multi-scale features. By filtering low-level semantic information, it effectively suppresses background interference to enhance localization accuracy. Finally, the feature extraction network incorporates Generalized-Sparse Convolution, which combines depth-wise separable convolution and channel mixing operations, reducing computational load. The DLCH-YOLO algorithm achieved a 91.8% mAP on our self-built power equipment dataset, representing a 4.7% improvement over the baseline network Yolov8. With its superior detection accuracy and real-time performance, DLCH-YOLO outperforms mainstream detection algorithms. This algorithm provides an efficient and viable solution for circuit breaker status detection. Full article
14 pages, 1477 KiB  
Article
Mutations of the Cx43 Gene in Non-Small Cell Lung Cancer: Association with Aberrant Localization of Cx43 Protein Expression and Tumor Progression
by Jung-Chien Chen, Kun-Tu Yeh, Yueh-Min Lin and Ya-Wen Cheng
Medicina 2024, 60(10), 1641; https://doi.org/10.3390/medicina60101641 - 7 Oct 2024
Abstract
Background and Objectives: The Connexin43 (Cx43) gene is a suspected tumor suppressor gene, as re-expressed wild-type Cx43 genes reduce the malignancy potential of tumor cells. However, the role of Cx43 gene expression in human lung tumorigenesis remains unclear. Materials and [...] Read more.
Background and Objectives: The Connexin43 (Cx43) gene is a suspected tumor suppressor gene, as re-expressed wild-type Cx43 genes reduce the malignancy potential of tumor cells. However, the role of Cx43 gene expression in human lung tumorigenesis remains unclear. Materials and Methods: Tumor tissues from 165 primary lung cancer patients were collected to study Cx43 protein expression and gene mutations using immunohistochemistry and direct DNA sequencing. In addition, Cx43 genes with or without mutations were transfected to CL-3 human lung cancer cells to confirm the function of these mutant forms of the Cx43 gene. Results: Aberrant localization of Cx43 protein in the nucleus and cytoplasm of tumor cells was detected in 14 out of 165 non-small cell lung cancer (NSCLC) patients. Mutations in the Cx43 gene were also found in patients with aberrant Cx43 localization, and transfection of these mutant genes into lung cancer cells enhanced their proliferation. Conclusions: To our knowledge, this is the first study to demonstrate Cx43 gene mutations in human lung neoplasm, supporting the hypothesis that Cx43 may function as a tumor suppressor in some lung cancer patients. Additionally, the findings suggest an association between aberrant localization of Cx43 protein expression and tumor progression. Full article
(This article belongs to the Section Oncology)
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<p>Immunohistochemical analysis of Cx43 protein expression using a monoclonal Cx43 anti-human antibody on paraffin sections of lung tumor specimens. (<b>A</b>) Negative control showing no Cx43 immunostaining (×200). (<b>B</b>) Positive control showing Cx43 protein expressed in the membrane of non-tumor lung tissue (arrow) (×400). (<b>C</b>) Nuclear localization of Cx43 in tumor cells (arrow) (patient 888C) (×400). (<b>D</b>) Cx43 expression in the cytoplasm of tumor cells (arrow) (patient 245D) (×400).</p>
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<p>Growth curves of CL-3 lung cancer cells expressing wild-type or mutant Cx43. Cells were transfected with wild-type <span class="html-italic">Cx43</span>, vector control, or mutant <span class="html-italic">Cx43</span> constructs (Cx43-18,19 and Cx43-57). Cell numbers were counted daily for 7 days. Data points represent the mean of three independent experiments + standard error of the mean.</p>
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<p>Kaplan–Meier survival curves for NSCLC patients stratified by Cx43 protein localization. Three groups are represented: patients with Cx43 membrane expression and negative immunostaining (black line), patients with Cx43 positive staining in the cytoplasm (dotted line), and patients with Cx43 positive staining in the nucleus (grey line). The <span class="html-italic">x</span>-axis represents days after surgery, while the <span class="html-italic">y</span>-axis shows the survival percentage.</p>
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13 pages, 3096 KiB  
Article
Prognostic Role of Specific KRAS Mutations Detected in Aspiration and Liquid Biopsies from Patients with Pancreatic Cancer
by Tereza Hálková, Bohuš Bunganič, Eva Traboulsi, Marek Minárik, Miroslav Zavoral and Lucie Benešová
Genes 2024, 15(10), 1302; https://doi.org/10.3390/genes15101302 - 7 Oct 2024
Abstract
Background/Objectives: Although the overall survival prognosis of patients in advanced stages of pancreatic ductal adenocarcinoma (PDAC) is poor, typically ranging from days to months from diagnosis, there are rare cases of patients remaining in therapy for longer periods of time. Early estimations of [...] Read more.
Background/Objectives: Although the overall survival prognosis of patients in advanced stages of pancreatic ductal adenocarcinoma (PDAC) is poor, typically ranging from days to months from diagnosis, there are rare cases of patients remaining in therapy for longer periods of time. Early estimations of survival prognosis would allow rational decisions on complex therapy interventions, including radical surgery and robust systemic therapy regimens. Understandably, there is great interest in finding prognostic markers that can be used for patient stratification. We determined the role of various KRAS mutations in the prognosis of PDAC patients using biopsy samples and circulating tumor DNA. Methods: A total of 118 patients with PDAC, clinically confirmed by endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNB), were included in the study. DNA was extracted from cytological slides following a standard cytology evaluation to ensure adequacy (viability and quantity) and to mark the tumor cell fraction. Circulating tumor DNA (ctDNA) was extracted from plasma samples of 45 patients in stage IV of the disease. KRAS mutations in exons 12 and 13 were detected by denaturing capillary electrophoresis (DCE), revealing a minute presence of mutation-specific heteroduplexes. Kaplan–Meier survival curves were calculated for individual KRAS mutation types. Results:KRAS mutations were detected in 90% of tissue (106/118) and 44% of plasma (20/45) samples. All mutations were localized at exon 2, codon 12, with G12D (GGT > GAT) being the most frequent at 44% (47/106) and 65% (13/20), followed by other types including G12V (GGT > GTT) at 31% (33/106) and 10% (2/20), G12R (GGT > CGT) at 17% (18/106) and 10% (2/20), G12C (GGT/TGT) at 5% (5/106) and 0% (0/20) and G12S (GGT/AGT) at 1% (1/106) and 5% (1/20) in tissue and plasma samples, respectively. Two patients had two mutations simultaneously (G12V + G12S and G12D + G12S) in both types of samples (2%, 2/106 and 10%, 2/20 in tissue and plasma samples, respectively). The median survival of patients with the G12D mutation in tissues was less than half that of other patients (median survival 101 days, 95% CI: 80–600 vs. 228 days, 95% CI: 184–602), with a statistically significant overall difference in survival (p = 0.0080, log-rank test), and furthermore it was less than that of all combined patients with other mutation types (101 days, 95% CI: 80–600 vs. 210 days, 95% CI: 161–602, p = 0.0166). For plasma samples, the survival of patients with this mutation was six times shorter than that of patients without the G12D mutation (27 days, 95% CI: 8–334 vs. 161 days, 95% CI: 107–536, p = 0.0200). In contrast, patients with detected KRAS G12R in the tissue survived nearly twice as long as other patients in the aggregate (286 days, 95% CI: 70–602 vs. 162 days, 95% CI: 122–600, p = 0.0374) or patients with other KRAS mutations (286 days, 95% CI: 70–602 vs. 137 days, 95% CI: 107–600, p = 0.0257). Conclusions: Differentiation of specific KRAS mutations in EUS-FNB and ctDNA (above all, the crucial G12D and G12R) is feasible in routine management of PDAC patients and imperative for assessment of prognosis. Full article
(This article belongs to the Section Human Genomics and Genetic Diseases)
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<p>If a mutation is present in the sample (in this case <span class="html-italic">KRAS</span> mutation), four peaks are visible in the electropherogram: wildtype homoduplex, mutant homoduplex and two heteroduplexes (from left to right). The figure illustrates electropherograms of standard samples with the most commonly detected <span class="html-italic">KRAS</span> mutations in PDAC tissues. Note that different <span class="html-italic">KRAS</span> mutations have different positions of peaks in the electroferogram. If no mutation is present in the sample, only one peak corresponding to the wildtype homoduplex is visible in the electropherogram.</p>
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<p>Overall survival curves (<b>a</b>) according to the presence of <span class="html-italic">KRAS</span> mutations in tumor tissue and (<b>b</b>) according to the presence of the three most common <span class="html-italic">KRAS</span> mutation subtypes in tumor tissue.</p>
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<p>Differences in OS of (<b>a</b>) patients with and without <span class="html-italic">KRAS</span> G12D in tumor tissue and (<b>b</b>) patients with <span class="html-italic">KRAS</span> G12D and patients with other <span class="html-italic">KRAS</span> mutations in tumor tissue.</p>
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<p>Differences in OS of (<b>a</b>) patients with and without <span class="html-italic">KRAS</span> G12V in tumor tissue and (<b>b</b>) patients with <span class="html-italic">KRAS</span> G12V and patients with other <span class="html-italic">KRAS</span> mutations in tumor tissue.</p>
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<p>Differences in OS of (<b>a</b>) patients with and without <span class="html-italic">KRAS</span> G12R in tumor tissue and (<b>b</b>) patients with <span class="html-italic">KRAS</span> G12R and patients with other <span class="html-italic">KRAS</span> mutations in tumor tissue.</p>
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<p>Overall survival curves according to the presence of <span class="html-italic">KRAS</span> mutations in ctDNA.</p>
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<p>Differences in OS of (<b>a</b>) patients with and without <span class="html-italic">KRAS</span> G12D in ctDNA and (<b>b</b>) patients with <span class="html-italic">KRAS</span> G12D and patients with other <span class="html-italic">KRAS</span> mutations in ctDNA.</p>
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17 pages, 1160 KiB  
Article
Well-Being and Healthcare Inequality on Bulon-Don Island in Southern Thailand—Results of a Pre-Intervention Field Survey
by Chutarat Sathirapanya, Suweena Khwanmad and Pornchai Sathirapanya
Children 2024, 11(10), 1217; https://doi.org/10.3390/children11101217 - 6 Oct 2024
Viewed by 257
Abstract
Background and objectives: Children living in an area distant from or associated with barriers to travelling to health service centres usually experience health and well-being disparities. This is a survey of child health and well-being on Bulon-Don Island, located 22 kms. from the [...] Read more.
Background and objectives: Children living in an area distant from or associated with barriers to travelling to health service centres usually experience health and well-being disparities. This is a survey of child health and well-being on Bulon-Don Island, located 22 kms. from the southern mainland of Thailand, to gather essential background data before activating responses from local service provider agencies. Methods: Demographic data, physical and crude psychological health, harm to health, and living conditions of Bulon-Don children aged 1–14 years were studied and compared with the results of the corresponding national child health survey. Descriptive statistics were used for the statistical analysis of significance (p < 0.05). Results: A total of 21 male and 41 female children (N = 62) participated in the survey after obtaining consents from parents or care providers. The islanders are Indigenous people who use their own languages and have traditional beliefs. Comparing with the children of the national survey, most children aged <5 years were found to have significantly lower height and weight according to their age (p = 0.044 and p = 0.043, respectively), whereas those aged >5 years had a similar nutritional status. In addition, there is a lack of facilities for healthy living. However, the mean total psychological and ethical standards scores were significantly higher in the 1–5 and 6–9-year-old children. Conclusions: Disparity of socio-political status, cultural beliefs and practices, socioeconomic basis, and geographic distance from the mainland were the social determinants and barriers of low health service accessibility for the islander children. Comprehensive child health and well-being evaluation in an enclave of isolation like this is mandatory before an integrated intervention carried out by the local healthcare and living facilities providers is implemented. Full article
17 pages, 2928 KiB  
Article
A Novel Chimeric Oncolytic Virus Mediates a Multifaceted Cellular Immune Response in a Syngeneic B16 Melanoma Model
by Sonja Glauß, Victoria Neumeyer, Lorenz Hanesch, Janina Marek, Nina Hartmann, Gabriela M. Wiedemann and Jennifer Altomonte
Cancers 2024, 16(19), 3405; https://doi.org/10.3390/cancers16193405 - 6 Oct 2024
Viewed by 302
Abstract
Background/Objectives: Oncolytic virotherapy is a promising approach in cancer immunotherapy. We have previously described a recombinant hybrid oncolytic virus (OV), VSV-NDV, which has a favorable safety profile and therapeutic immunogenicity, leading to direct oncolysis, abscopal effects, and prolonged survival in syngeneic in vivo [...] Read more.
Background/Objectives: Oncolytic virotherapy is a promising approach in cancer immunotherapy. We have previously described a recombinant hybrid oncolytic virus (OV), VSV-NDV, which has a favorable safety profile and therapeutic immunogenicity, leading to direct oncolysis, abscopal effects, and prolonged survival in syngeneic in vivo tumor models. While OVs are known to mediate systemic anti-tumor immune responses, the detailed characterization of local and systemic immune responses to fusogenic oncolytic virotherapy remains unexplored. Methods and Results: We analyzed immune cell compartments in the spleen, blood, tumor-draining lymph nodes (TDLNs), and tumors over the course of VSV-NDV therapy in a bilateral syngeneic melanoma mouse model. Our results revealed significant local infiltration and activation of T lymphocytes in tumors and globally in the blood and spleen. Notably, in vivo CD8+ T cell depletion led to complete abrogation of the tumor response, highlighting the crucial role of T cells in promoting the therapeutic effects of oncolytic VSV-NDV. In vitro co-culture experiments enabled the interrogation of human immune cell responses to VSV-NDV-mediated oncolysis. Human peripheral blood mononuclear cells (PBMCs) were efficiently stimulated by exposure to VSV-NDV-infected cancer cells, which recapitulates the in vivo murine findings. Conclusions: Taken together, these data characterize a broad anti-tumor immune cell response to oncolytic VSV-NDV therapy and suggest that CD8+ T cells play a decisive role in therapeutic outcome, which supports the further development of this chimeric vector as a multimechanistic immunotherapy for solid cancers. Full article
(This article belongs to the Special Issue Oncolytic Viruses as an Emerging Aspect of Immune Oncology)
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<p>VSV-NDV reduces the tumor mass and mediates the expression of cytokines in murine melanoma. (<b>A</b>) The experimental set-up of the mechanistic endpoint experiment. C57BL6/J mice were implanted with B16OVA cells subcutaneously on contralateral flanks. Seven days later, the mice were randomly distributed into treatment groups (N = 6–8) and injected intratumorally with VSV-NDV (VN) at a dose of 1 × 10<sup>7</sup> TCID50 or PBS in an equal volume of 50 µL on day 0, 3, 6. Tumors were collected on days 2 and 10 post-treatment start. Created in BioRender. Altomonte, J. (2024) <a href="https://BioRender.com/p46u790" target="_blank">https://BioRender.com/p46u790</a>. (<b>B</b>) Tumor weight was measured on day 10. (<b>C</b>) Quantitative real-time RT-PCR was performed to measure intratumoral mRNA expression on day 2 (IL-15, IFN-<math display="inline"><semantics> <mrow> <mi>γ</mi> </mrow> </semantics></math>, IFN-α, IFN-β, and CXCL10) or day 10 (T-bet). Relative gene expression was quantified by normalization to GAPDH using the 2<sup>−ΔΔCt</sup> method. Data points indicate values of individual replicates (and group means are presented as bars); * indicates <span class="html-italic">p</span> ˂ 0.05, and ** indicates <span class="html-italic">p</span> ˂ 0.01).</p>
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<p>VSV-NDV treatment leads to T cell activation in tumors and lymph nodes. Bilateral B16OVA-bearing mice were treated intratumorally with VSV-NDV or PBS and analyzed by flow cytometry. (<b>A</b>) CD8<sup>+</sup>, CD4<sup>+</sup>, and OVA-TCR<sup>+</sup>CD8<sup>+</sup> T cells in the tumor on day 10. (<b>B</b>) VSV-TCR<sup>+</sup>CD8<sup>+</sup> T cells and the correlation of VSV<sup>+</sup>TCR and OVA<sup>+</sup>TCR in the tumor on day 10. (<b>C</b>) CD69 expression on CD8<sup>+</sup> T cells on day 10 in the tumor and PD-1 expression on CD4<sup>+</sup> and CD8<sup>+</sup> T cells on day 10 in the tumor. (<b>D</b>) OVA-TCR<sup>+</sup>CD8<sup>+</sup> or OVA-TCR<sup>+</sup>CD4<sup>+</sup> T cells on day 2 and day 10. (<b>E</b>) CD69 expression on day 2 and PD-1 expression on day 10 of OVA-TCR<sup>+</sup>CD8<sup>+</sup> T cells. N = 5–15 mice; data points indicate values of individual replicates (and group means + SD are presented as bars); * indicates <span class="html-italic">p</span> ˂ 0.05, ** <span class="html-italic">p</span> ˂ 0.01, *** <span class="html-italic">p</span> ˂ 0.001, **** <span class="html-italic">p</span> ˂ 0.0001.</p>
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<p>Intratumoral VSV-NDV treatment modulates CD44/CD62L expression patterns on T cells in B16 melanoma lesions and tumor-draining lymph nodes (TDLN). Bilateral B16OVA lesions and TDLNs were isolated from female C57Bl/6 mice treated with rVSV-NDV or PBS on day 10 post-treatment and analyzed by flow cytometry. (<b>A</b>) CD44/CD62L expression on CD8<sup>+</sup> T cells and CD122<sup>+</sup>CD44<sup>+</sup>CD62L<sup>+</sup>CD8<sup>+</sup> T cells on day 10 in the tumor. (<b>B</b>) CD44<sup>+</sup>CD62L<sup>−</sup>CD4<sup>+</sup>, CD44<sup>+</sup>CD62L<sup>−</sup>CD8<sup>+</sup>, and OVA-specific CD44<sup>+</sup>CD62L<sup>+</sup>CD8<sup>+</sup> T cells on day 10 in the TDLNs. N = 5–15; data points indicate values of individual replicates (and group means + SD are presented as bars); * indicates <span class="html-italic">p</span> ˂ 0.05, ** indicates <span class="html-italic">p</span> ˂ 0.01.</p>
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<p>Local VSV-NDV treatment mediates systemic immune-stimulatory effects. C57BL6/J mice were implanted with B16OVA cells subcutaneously on contralateral flanks and, 7 days later, injected intratumorally with VSV-NDV (VN) at a dose of 1 × 10<sup>7</sup> TCID50 or PBS and analyzed by flow cytometry for (<b>A</b>) OVA-TCR<sup>+</sup>CD8<sup>+</sup> and VSV-TCR<sup>+</sup>CD8<sup>+</sup> T cells on day 10, (<b>B</b>) CD69 expression on OVA-TCR<sup>+</sup>CD8<sup>+</sup> T cells in the spleen on day 2 and PD-1<sup>+</sup>OVA<sup>+</sup>CD8<sup>+</sup> T cells in the blood and spleen on day 10, (<b>C</b>) CD44<sup>+</sup>CD62L<sup>−</sup> expression on CD4<sup>+</sup>, CD8<sup>+</sup>, and OVA-TCR<sup>+</sup>CD8<sup>+</sup> T cells on day 10 in blood, or (<b>D</b>) in the spleen. Data points indicate values of individual replicates (and group means ± SD are presented as bars); * indicates <span class="html-italic">p</span> ˂ 0.05, ** <span class="html-italic">p</span> ˂ 0.01, *** <span class="html-italic">p</span> ˂ 0.001, **** <span class="html-italic">p</span> ˂ 0.0001.</p>
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<p>The intratumoral VSV-NDV treatment of B16 melanoma induces the enrichment and activation of innate immune cells. C57BL6/J mice were implanted with B16OVA cells subcutaneously on contralateral flanks. After seven days, the mice (N = 6–8) were injected intratumorally with VSV-NDV (VN) at a dose of 1 × 10<sup>7</sup> TCID50 or PBS in 50 µL on day 0, 3, 6. TDLNs or tumors were analyzed by flow cytometry for (<b>A</b>) for iNKT cell number and CD69 expression, (<b>B</b>) NK cell number, CD69 expression, IFN-γ expression, and NKG2D expression in the TDLNs and mature NK cells, NKG2D<sup>+</sup> NK cells, and IFN-γ in the spleen, or (<b>C</b>) for DC number, CD86 expression, and MHC-I expression in TDLNs. Data points indicate values of individual replicates (and group means ± SD are presented as bars); * indicates <span class="html-italic">p</span> ˂ 0.05, ** <span class="html-italic">p</span> ˂ 0.01, *** <span class="html-italic">p</span> ˂ 0.001, **** <span class="html-italic">p</span> ˂ 0.0001.</p>
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<p>In vivo CD8<sup>+</sup> T cell depletion abrogates the therapeutic effects of rVSV-NDV treatment. (<b>A</b>) The experimental set-up of CD8<sup>+</sup> T cell depletion in B16OVA tumor-bearing mice treated with oncolytic rVSV-NDV vectors in vivo. Mice (N = 5–6) received either CD8 depletion antibody or IgG isotype control in 100 µL PBS by intraperitoneal injection 6 days after tumor implantation. One day later, complete depletion was confirmed by flow cytometry, and mice received VSV-NDV (1 × 10<sup>7</sup> TCID50) or PBS in a 50 µL volume by intratumoral injection on day 0, 3, 6, and 14. (<b>B</b>) Tumor growth was monitored daily. (<b>C</b>) Tumor weights on day 7 post-treatment start. Data points indicate values of individual replicates (and group means ± SD are presented as bars); * indicates <span class="html-italic">p</span> &lt; 0.05 and ** indicates <span class="html-italic">p</span> &lt; 0.01.</p>
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<p>Human T cells and NK cells are activated by VSV-NDV-infected cancer cells in vitro. HepG2 cells pre-infected with VSV-NDV were co-cultured with human PBMCs in a 1:1 ratio for 24 h before analysis by flow cytometry. PBMCs that were not co-cultured served as controls. Activation was measured by (<b>A</b>) expression of CD69 on CD4<sup>+</sup> and CD8<sup>+</sup> T cells and CD25 expression on CD8<sup>+</sup> T cells or (<b>B</b>) expression of CD69 and IFN-γ on NK cells (N = 4–5 individual experiments); ** indicates <span class="html-italic">p</span> &lt; 0.01 and **** indicates <span class="html-italic">p</span> &lt; 0.0001.</p>
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11 pages, 1799 KiB  
Article
Process Mapping to Support the Implementation of a Regional Strategy to Address the Opioid Epidemic
by Yifei Liu, Stacy L. Farr, John A. Spertus, Danielle M. Olds, Tracey A. LaPierre and Holly N. Renwick Hagle
Healthcare 2024, 12(19), 1995; https://doi.org/10.3390/healthcare12191995 - 6 Oct 2024
Viewed by 229
Abstract
Background/Objective: To address the opioid epidemic in Kansas City, Missouri, local health systems sought to implement a referral to peer recovery coaches (PRCs) for clients presenting with opioid use disorder. Client referrals were made primarily through health system emergency departments, where PRCs met [...] Read more.
Background/Objective: To address the opioid epidemic in Kansas City, Missouri, local health systems sought to implement a referral to peer recovery coaches (PRCs) for clients presenting with opioid use disorder. Client referrals were made primarily through health system emergency departments, where PRCs met clients to facilitate linkages to recovery support for up to twelve months. This study aimed to evaluate and improve program implementation with process mapping at three local health systems. Methods: Using a five-phase conceptual framework and three development and implementation domains, providers, administrators, and PRCs were interviewed to identify the process for recognizing clients with opioid use disorders and referring them to PRCs. Serial meetings were held to validate the process maps at three health systems and a distillation of key processes was created to guide future analyses and implementation efforts. Results: A detailed process map for each health system was developed, from which a high-level process map was created to support future implementation efforts. Health system-specific process maps varied, although conceptually coherent elements were identified across each system to diagram a recovery ecosystem to support client referrals to PRCs. Conclusions: By systematically assessing the implementation of the same program across different health systems, critical steps, along with their barriers and facilitators, were identified that can be used to understand the processes of care associated with outcomes and to guide future implementation efforts. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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<p>High-level process map of the WR EPICC program.</p>
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<p>Health System A-specific process map.</p>
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<p>Health System B-specific process map.</p>
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<p>Health System C-specific process map.</p>
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12 pages, 1708 KiB  
Article
INEAS’s Cost-Effectiveness Analysis of Vemurafenib: Paving the Way for Value-Based Pricing in Tunisia
by Mouna Jameleddine, Nabil Harzallah, Hela Grati, Marie Christine Odabachian Jebali, Jaafar Chemli, Sebastián García Martí, Natalie Soto, Andrés Pichon-Riviere and Chokri Hamouda
J. Mark. Access Health Policy 2024, 12(4), 294-305; https://doi.org/10.3390/jmahp12040023 - 6 Oct 2024
Viewed by 119
Abstract
The Tunisian Health Technology Assessment (HTA) body, INEAS, conducted a cost-effectiveness analysis (CEA) of vemurafenib in the treatment of locally advanced or metastatic BRAF V600-mutated melanoma. The objective of this analysis was to enable the use of value-based pricing as a new approach [...] Read more.
The Tunisian Health Technology Assessment (HTA) body, INEAS, conducted a cost-effectiveness analysis (CEA) of vemurafenib in the treatment of locally advanced or metastatic BRAF V600-mutated melanoma. The objective of this analysis was to enable the use of value-based pricing as a new approach to price negotiation. This study was part of a broader HTA report that was prepared in response to a joint request from the regulatory authorities and the CNAM, Tunisia’s compulsory insurance scheme. Our analysis was based on a probabilistic Markov cohort model that calculated the costs and quality-adjusted life years (QALY) associated with vemurafenib compared to the standard of care from a public payer perspective. The CEA indicated that vemurafenib provides a gain of 0.38 life years (1.78 vs. 1.4) for an incremental cost of USD 101,106.62 from the perspective of the main public payer (CNAM). This study revealed an incremental cost-effectiveness ratio (ICER) of 163,311.40 USD/QALY and 163,911.46 USD/QALY, respectively, from the CNAM and public health facilities’ perspectives. Vemurafenib cannot be considered cost-effective in terms of what has normally been considered a reasonable willingness to pay (WTP) in Tunisia. A significant price reduction would be necessary to bring the incremental cost-effectiveness ratio to an acceptable level. Full article
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<p>Markov model with three health states.</p>
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<p>Tornado diagram illustrating the impact on the results of uncertainty in each parameter (CNAM perspective).</p>
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<p>Probabilistic sensitivity analysis (PHFs perspective).</p>
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<p>Acceptability curves.</p>
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27 pages, 60940 KiB  
Article
Cold Coastal City Neighborhood Morphology Design Method Based on Multi-Objective Optimization Simulation Analysis
by Sheng Xu, Peisheng Zhu, Fei Guo, Duoduo Yan, Shiyu Miao, Hongchi Zhang, Jing Dong and Xianchao Fan
Buildings 2024, 14(10), 3176; https://doi.org/10.3390/buildings14103176 - 5 Oct 2024
Viewed by 574
Abstract
In the context of global warming and the frequent occurrence of extreme weather, coastal cities are more susceptible to the heat island effect and localized microclimate problems due to the significant influence of the oceanic climate. This study proposes a computer-driven simulation optimization [...] Read more.
In the context of global warming and the frequent occurrence of extreme weather, coastal cities are more susceptible to the heat island effect and localized microclimate problems due to the significant influence of the oceanic climate. This study proposes a computer-driven simulation optimization method based on a multi-objective optimization algorithm, combined with tools such as Grasshopper, Ladybug, Honeybee and Wallacei, to provide scientific optimization decision intervals for morphology control and evaluation factors at the initial stage of coastal city block design. The effectiveness of this optimization strategy is verified through empirical research on typical coastal neighborhoods in Dalian. The results show that the strategy derived from the multi-objective optimization-based evaluation significantly improves the wind environment and thermal comfort of Dalian neighborhoods in winter and summer: the optimization reduced the average wind speed inside the block by 0.47 m/s and increased the UTCI by 0.48 °C in winter, and it increased the wind speed to 1.5 m/s and decreased the UTCI by 0.59 °C in summer. This study shows that the use of simulation assessment and multi-objective optimization technology to adjust the block form of coastal cities can effectively improve the seasonal wind and heat environment and provide a scientific basis for the design and renewal of coastal cities. Full article
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<p>Research flowchart.</p>
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<p>Three-dimensional schematic of the boundary condition setting and variable control for the ideal model.</p>
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<p>Top view of a typical neighborhood building plan layout.</p>
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<p>Ideal model for the experimental control group.</p>
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<p>Data logging and export module for multi-objective optimization processes.</p>
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<p>Map of Dalian City location and study area LCZ, and aerial photographs of the area.</p>
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<p>On-site measured points and instrument models.</p>
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<p>Parametric modeling and building numbering.</p>
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<p>Results of the UTCI vs. the average wind speed simulations for different neighborhood types.</p>
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<p>Boxplots of the distribution of the mean site wind speed and UTCI for each neighborhood type.</p>
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<p>Calculated wind speed and UTCI in the control group with different building orientations.</p>
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<p>Calculation of the wind speed and UTCI in the control group of different building floors.</p>
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<p>Mean trendline for 50 iterations of 4 optimization objectives.</p>
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<p>Multi-objective optimization solution set distribution and average optimal solution shape.</p>
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<p>Multi-objective optimization solution set distribution and cluster analysis.</p>
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<p>Neighborhood morphology of the non-dominated solution sets for the 5 clusters.</p>
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<p>Calculated results of the wind–heat environmental assessment for the winter and summer seasons (before optimization).</p>
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<p>Schematic diagram of the optimized design measures and local thermal comfort after the retrofit.</p>
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<p>Schematic diagram of the optimized design measures and local thermal comfort after the retrofit.</p>
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12 pages, 3569 KiB  
Article
Improved Small Object Detection Algorithm CRL-YOLOv5
by Zhiyuan Wang, Shujun Men, Yuntian Bai, Yutong Yuan, Jiamin Wang, Kanglei Wang and Lei Zhang
Sensors 2024, 24(19), 6437; https://doi.org/10.3390/s24196437 - 4 Oct 2024
Viewed by 247
Abstract
Detecting small objects in images poses significant challenges due to their limited pixel representation and the difficulty in extracting sufficient features, often leading to missed or false detections. To address these challenges and enhance detection accuracy, this paper presents an improved small object [...] Read more.
Detecting small objects in images poses significant challenges due to their limited pixel representation and the difficulty in extracting sufficient features, often leading to missed or false detections. To address these challenges and enhance detection accuracy, this paper presents an improved small object detection algorithm, CRL-YOLOv5. The proposed approach integrates the Convolutional Block Attention Module (CBAM) attention mechanism into the C3 module of the backbone network, which enhances the localization accuracy of small objects. Additionally, the Receptive Field Block (RFB) module is introduced to expand the model’s receptive field, thereby fully leveraging contextual information. Furthermore, the network architecture is restructured to include an additional detection layer specifically for small objects, allowing for deeper feature extraction from shallow layers. When tested on the VisDrone2019 small object dataset, CRL-YOLOv5 achieved an mAP50 of 39.2%, representing a 5.4% improvement over the original YOLOv5, effectively boosting the detection precision for small objects in images. Full article
12 pages, 1726 KiB  
Article
Adapting and Validating a Patient Prompt List to Assist Localized Prostate Cancer Patients with Treatment Decision Making
by Levi Ross, Linda Collins, Florida Uzoaru and Michael A. Preston
Healthcare 2024, 12(19), 1981; https://doi.org/10.3390/healthcare12191981 - 4 Oct 2024
Viewed by 252
Abstract
Background/Objectives: Effective communication between patients and healthcare providers is essential for informed decision making in cancer care. Communication aids that can help prostate cancer patients optimize their involvement in treatment care planning are not widely used in the U.S. This research details the [...] Read more.
Background/Objectives: Effective communication between patients and healthcare providers is essential for informed decision making in cancer care. Communication aids that can help prostate cancer patients optimize their involvement in treatment care planning are not widely used in the U.S. This research details the adaptation and validation process of a patient prompt list for localized prostate cancer patients undergoing treatment decisions. Methods: This process occurred in three steps: Step 1 involved gathering usable questions from the literature; in Step 2, we evaluated the tool’s content via expert (N = 6) feedback; and in Step 3, we assessed the usefulness of the prompt list with patients (N = 30). Results: Sixty percent of candidate questions (20/33) were retained for inclusion after achieving acceptable item-level content validity index (range: 0.83–1.00) and scale-level content validity index (S-CVI = 0.96) scores. The final 20 questions were classified into 5 domains (1: Treatment Options and Information, 2: Side Effects, Risks, and Recovery, 3: Emotional and Social Support, 4: Logistical and Practical Concerns, and 5: Future Health Considerations) through a card sorting exercise with a subset of patients (N = 3) and providers (N = 2). Most patients rated the prompt list as “useful or very useful” both to themselves (80%, N = 24) and to other men presenting with prostate cancer (83%, N = 25). Conclusions: The participatory process used to develop and validate the prompt list offers insights for the development of similar tools. Full article
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<p>Patients’ evaluations of the importance of prompt list questions.</p>
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<p>Patients’ judgments of the helpfulness of the prompt list by demographic characteristics.</p>
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<p>Prompt list questions grouped by thematic domains.</p>
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