Magnesium(Mg)-based bioresorbable stents represent a potentially groundbreaking advancement in cardiovascular therapy;offering tem-porary vessel support and complete biodegradability—addressing limitations of traditi...Magnesium(Mg)-based bioresorbable stents represent a potentially groundbreaking advancement in cardiovascular therapy;offering tem-porary vessel support and complete biodegradability—addressing limitations of traditional stents like in-stent restenosis and long-term com-plications.However,challenges such as rapid corrosion and suboptimal endothelialisation have hindered their clinical adoption.This review highlights the latest breakthroughs in surface modification,alloying,and coating strategies to enhance the mechanical integrity,corrosion resistance,and biocompatibility of Mg-based stents.Key surface engineering techniques,including polymer and bioactive coatings,are ex-amined for their role in promoting endothelial healing and minimising inflammatory responses.Future directions are proposed,focusing on personalised stent designs to optimize efficacy and long-term outcomes,positioning Mg-based stents as a transformative solution in interventional cardiology.展开更多
Steatotic liver disease(SLD)encompasses a group of disorders characterized by the excessive accumulation of fat in the liver.It is classified into four categories based on clinical manifestations:Metabolic dysfunction...Steatotic liver disease(SLD)encompasses a group of disorders characterized by the excessive accumulation of fat in the liver.It is classified into four categories based on clinical manifestations:Metabolic dysfunction-associated SLD(MASLD),metabolic-alcohol-associated liver disease(ALD),ALD,and cryptogenic SLD.In the United States,its prevalence stands at 34.2%,making it the most common cause of cirrhosis and hepatocellular carcinoma(HCC).In addition to factors related to endocrine,nutrition,and medications,several genetic markers have been implicated in the disease's pathogenesis.Notable genes include PNPLA3,TM6SF2,GCKR,MBOAT7 and HSD17B13.These genetic polymorphisms can significantly impact prognosis and disease outcomes.For example,PNPLA3 is the most frequently associated gene with MASLD,increasing the risk of HCC by 12-fold and liver-related mortality by 18-fold.Furthermore,certain genetic markers are more prevalent in specific ethnic groups;for instance,PNPLA3 is common among Hispanics,while TM6SF2 is linked to higher fat content in African Americans.With a better understanding of the genetic factors involved in the pathogenesis of SLD,significant advancements have been made in diagnostics and therapeutics.This review explores the role of genetic factors in the disease's development,discusses current advancements in non-invasive diagnostic modalities,and examines therapeutic improvements based on these genetic insights to achieve better outcomes.展开更多
Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort.Propofol,benzodiazepines and opioids continue to be widely used.However,in recent years,Remim...Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort.Propofol,benzodiazepines and opioids continue to be widely used.However,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)endoscopy.It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation.Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug interactions.It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy.Furthermore,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the world.However,the use of Propofol is associated with hemodynamic instability and respiratory depression.In contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural sedation.In this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural sedation.We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.展开更多
Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstructio...Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstruction methods either compromise on accuracy with iterative algorithms or suffer from limited generalizability with task-specific deep learning approaches.Methods:We present LDM-PIR,a lightweight physics-conditioned diffusion multi-model for medical image reconstruction that addresses key challenges in magnetic resonance imaging(MRI),CT,and low-photon imaging.Unlike traditional iterative methods,which are computationally expensive,or task-specific deep learning approaches lacking generalizability,integrates three innovations.A physics-conditioned diffusion framework that embeds acquisition operators(Fourier/Radon transforms)and noise models directly into the reconstruction process.A multi-model architecture that unifies denoising,inpainting,and super-resolution via shared weight conditioning.A lightweight design(2.1M parameters)enabling rapid inference(0.8s/image on GPU).Through self-supervised fine-tuning with measurement consistency losses adapts to new imaging modalities using fewer annotated samples.Results:Achieves state-of-the-art performance on fastMRI(peak signal-to-noise ratio(PSNR):34.04 for single-coil/31.50 for multi-coil)and Lung Image Database Consortium and Image Database Resource Initiative(28.83 PSNR under Poisson noise).Clinical evaluations demonstrate superior preservation of anatomical structures,with SSIM improvements of 8.8%for single-coil and 4.36%for multi-coil MRI over uDPIR.Conclusion:It offers a flexible,efficient,and scalable solution for medical image reconstruction,addressing the challenges of noise,undersampling,and modality generalization.The model’s lightweight design allows for rapid inference,while its self-supervised fine-tuning capability minimizes reliance on large annotated datasets,making it suitable for real-world clinical applications.展开更多
文摘Magnesium(Mg)-based bioresorbable stents represent a potentially groundbreaking advancement in cardiovascular therapy;offering tem-porary vessel support and complete biodegradability—addressing limitations of traditional stents like in-stent restenosis and long-term com-plications.However,challenges such as rapid corrosion and suboptimal endothelialisation have hindered their clinical adoption.This review highlights the latest breakthroughs in surface modification,alloying,and coating strategies to enhance the mechanical integrity,corrosion resistance,and biocompatibility of Mg-based stents.Key surface engineering techniques,including polymer and bioactive coatings,are ex-amined for their role in promoting endothelial healing and minimising inflammatory responses.Future directions are proposed,focusing on personalised stent designs to optimize efficacy and long-term outcomes,positioning Mg-based stents as a transformative solution in interventional cardiology.
文摘Steatotic liver disease(SLD)encompasses a group of disorders characterized by the excessive accumulation of fat in the liver.It is classified into four categories based on clinical manifestations:Metabolic dysfunction-associated SLD(MASLD),metabolic-alcohol-associated liver disease(ALD),ALD,and cryptogenic SLD.In the United States,its prevalence stands at 34.2%,making it the most common cause of cirrhosis and hepatocellular carcinoma(HCC).In addition to factors related to endocrine,nutrition,and medications,several genetic markers have been implicated in the disease's pathogenesis.Notable genes include PNPLA3,TM6SF2,GCKR,MBOAT7 and HSD17B13.These genetic polymorphisms can significantly impact prognosis and disease outcomes.For example,PNPLA3 is the most frequently associated gene with MASLD,increasing the risk of HCC by 12-fold and liver-related mortality by 18-fold.Furthermore,certain genetic markers are more prevalent in specific ethnic groups;for instance,PNPLA3 is common among Hispanics,while TM6SF2 is linked to higher fat content in African Americans.With a better understanding of the genetic factors involved in the pathogenesis of SLD,significant advancements have been made in diagnostics and therapeutics.This review explores the role of genetic factors in the disease's development,discusses current advancements in non-invasive diagnostic modalities,and examines therapeutic improvements based on these genetic insights to achieve better outcomes.
文摘Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort.Propofol,benzodiazepines and opioids continue to be widely used.However,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)endoscopy.It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation.Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug interactions.It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy.Furthermore,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the world.However,the use of Propofol is associated with hemodynamic instability and respiratory depression.In contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural sedation.In this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural sedation.We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.
文摘Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstruction methods either compromise on accuracy with iterative algorithms or suffer from limited generalizability with task-specific deep learning approaches.Methods:We present LDM-PIR,a lightweight physics-conditioned diffusion multi-model for medical image reconstruction that addresses key challenges in magnetic resonance imaging(MRI),CT,and low-photon imaging.Unlike traditional iterative methods,which are computationally expensive,or task-specific deep learning approaches lacking generalizability,integrates three innovations.A physics-conditioned diffusion framework that embeds acquisition operators(Fourier/Radon transforms)and noise models directly into the reconstruction process.A multi-model architecture that unifies denoising,inpainting,and super-resolution via shared weight conditioning.A lightweight design(2.1M parameters)enabling rapid inference(0.8s/image on GPU).Through self-supervised fine-tuning with measurement consistency losses adapts to new imaging modalities using fewer annotated samples.Results:Achieves state-of-the-art performance on fastMRI(peak signal-to-noise ratio(PSNR):34.04 for single-coil/31.50 for multi-coil)and Lung Image Database Consortium and Image Database Resource Initiative(28.83 PSNR under Poisson noise).Clinical evaluations demonstrate superior preservation of anatomical structures,with SSIM improvements of 8.8%for single-coil and 4.36%for multi-coil MRI over uDPIR.Conclusion:It offers a flexible,efficient,and scalable solution for medical image reconstruction,addressing the challenges of noise,undersampling,and modality generalization.The model’s lightweight design allows for rapid inference,while its self-supervised fine-tuning capability minimizes reliance on large annotated datasets,making it suitable for real-world clinical applications.
