Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the ...Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.展开更多
A Langevin delayed fractional system with multiple delays in control,is a delayed fractional system that includes delay parameters in both state and control,is first introduced.This paper is devoted to investigating t...A Langevin delayed fractional system with multiple delays in control,is a delayed fractional system that includes delay parameters in both state and control,is first introduced.This paper is devoted to investigating the relative controllability of the Langevin delayed fractional system with multiple delays in control.For linear systems to be relatively controllable,necessary and sufficient circumstances are identified by introducing and employing the Gramian matrix.The sufficient conditions for the relative controllability of semilinear systems are ofered based on Schauder's fixed point theorem.As an unusual approach,the controllability results of the delayed system are built for the first time on the exact solution produced by the MittagLeffler type function although controllability ones in the literature are built on the Volterra integral equations or the mild solutions produced by resolvent families.展开更多
Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid...Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid(RA)can suppress the neurotoxic effects of CO.This study further explores,in vivo and in vitro,the molecular mechanisms by which RA alleviates CO-induced central nervous system damage.Methods:A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO,and a DEACMP animal model was established in adult Kunming mice.Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay and Annexin V/propidium iodide(PI)double staining.The transcriptional and protein expression of each gene was detected using real time fluorescence quantitative PCR(RT-qPCR)and Western blotting.Long noncoding RNA(lncRNA)SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes.In DEACMP mice,SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression.Results:RA at 10 and 20μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes,downregulation of SNHG15 and LINGO-1,and upregulation of brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor B(TrkB)(all P<0.05).Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity(all P<0.05).Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels(all P<0.05).Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP(all P<0.05).Conclusion:RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes,thereby reducing central nervous system injury and exerting neuroprotective effects.LncRNA SNHG15 and LINGO-1 are key molecules mediating RA induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway.These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.展开更多
BACKGROUND Delayed post-pancreatectomy hemorrhage(PPH)is life-threatening,and endovascular interventions show promise.This retrospective study aimed to evaluate endovascular treatment outcomes for delayed PPH and iden...BACKGROUND Delayed post-pancreatectomy hemorrhage(PPH)is life-threatening,and endovascular interventions show promise.This retrospective study aimed to evaluate endovascular treatment outcomes for delayed PPH and identify mortality risk factors.AIM To conduct a single-center retrospective study of 88 patients with delayed PPH to systematically evaluate the clinical efficacy of endovascular treatment,identify independent risk factors for six-month mortality,and propose and validate a predictive model for individualized management of high-risk patients.METHODS This retrospective analysis included 88 patients with delayed PPH treated by endovascular intervention.Patients were stratified into survival(n=64)and mortality(n=24)groups.Clinical and procedural variables were assessed using univariate and multivariate logistic regression.Significant predictors were incorporated into a prognostic nomogram.Model performance was assessed through discrimination(area under the receiver operating characteristic curve),calibration,and decision curve analysis.RESULTS Technical and clinical success rates were 92.0%and 60.2%,respectively.The overall six-month mortality rate was 27.3%(24/88).Independent predictors of mortality included advanced age,prolonged operative time,shorter hospital stay,intra-abdominal infection,coagulation dysfunction,common hepatic artery bleeding,and failure to achieve clinical success.The nomogram demonstrated excellent discrimination(area under the receiver operating characteristic curve=0.943),with good calibration and favorable net benefit on decision curve analysis.CONCLUSION We proposed and validated a predictive nomogram for six-month mortality following endovascular treatment for delayed PPH.The model facilitates individualized risk stratification and may guide clinical decision-making.Early identification of high-risk patients-particularly older individuals or those with infection or coagulopathy-and prompt,personalized intervention may improve outcomes in this high-risk population.展开更多
The analysis of the ejaculate,better known as spermiogram,represents the first and main step to identify whether a series of sperm quality parameters are within the norm and therefore are consistent with normal sperm ...The analysis of the ejaculate,better known as spermiogram,represents the first and main step to identify whether a series of sperm quality parameters are within the norm and therefore are consistent with normal sperm fertilizing capacity.Among these,sperm concentration and motility are the first parameters to be evaluated through an estimation carried out by expert examiners.展开更多
BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a prom...BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.展开更多
BACKGROUND As a minimally invasive technique,endoscopic submucosal dissection(ESD)is widely used in treating early colorectal cancer(ECRC)and precancerous lesions(PCLs).However,a common postoperative complication-dela...BACKGROUND As a minimally invasive technique,endoscopic submucosal dissection(ESD)is widely used in treating early colorectal cancer(ECRC)and precancerous lesions(PCLs).However,a common postoperative complication-delayed postoperative bleeding(DPOB)-can significantly hinder patient recovery.AIM To build and validate a predictive model for assessing post-ESD DPOB risk in ECRC and PCL patients,utilizing logistic regression methodology.METHODS A retrospective review was conducted on ECRC/PCL 302 patients who received ESD at our hospital between July 2021 and July 2024.The cohort was stratified based on the incidence of DPOB following ESD,forming DPOB and non-DPOB groups.Through allocation,they were further allocated into model and validation cohorts.Clinical variables from both cohorts were collated and subjected to univariate analysis to determine potential factors associated with post-ESD DPOB.Subsequently,we constructed a predictive model for DPOB risk employing logistic regression analysis.Model performance assessment used receiver operating characteristic curves in both the training and validation cohorts,with internal validation accomplished via 10-fold cross-validation.RESULTS The occurrence rate of DPOB was 9.93%.Univariate analysis revealed that the number of lesions,lesion size,lesion location,degree of submucosal fibrosis,and intraoperative bleeding were significantly associated with DPOB.Binary logistic regression analysis identified the number of lesions,lesion size,lesion location,and degree of submucosal fibrosis as independent DPOB determinants.A nomogram that was developed to quantify the DPOB risk exhibited that an increment in the total score corresponded to an increased risk.The model achieved area under the curve values of 0.831 and 0.821 in the model and validation groups,respectively,with P values of 0.853 and 0.203 in the Hosmer-Lemeshow test.The model demonstrated robust discriminative performance,with an average area under the curve of 0.795(95%confidence interval:0.702-0.887)in 10-fold cross-validation.CONCLUSION Collectively,the presence of multiple lesions,lesion size of≥3 cm,lesion localization in the rectum,and severe fibrosis are significant independent predictors of DPOB in patients undergoing surgery for ECRC or PCLs.The proposed risk prediction model,which integrates these factors,demonstrates excellent predictive accuracy and clinical utility,thereby providing a valuable tool for risk stratification and postoperative management in this patient population.展开更多
Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest...Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.展开更多
Through systematic analysis of risk factors associated with postoperative delayed discharge following retrograde intrarenal surgery(RIRS)with flexible ureteroscopic holmium laser lithotripsy under ambulatory surgery p...Through systematic analysis of risk factors associated with postoperative delayed discharge following retrograde intrarenal surgery(RIRS)with flexible ureteroscopic holmium laser lithotripsy under ambulatory surgery protocols,this study aims to develop and validate a risk prediction model for discharge delay.The ultimate objectives include establishing evidence-based clinical guidelines for urolithiasis management,enabling proactive intervention strategies,and optimizing physician-patient communication efficiency.METHODS:This retrospective cohort study analyzed clinical data from 253 patients undergoing ambulatory retrograde intrarenal surgery(RIRS)with flexible ureteroscopic holmium laser lithotripsy at the Day Surgery Unit and Urology Department of Hunan Provincial People's Hospital between January 2023 and December 2024.To identify predictors of discharge delay,Lasso-regularized logistic regression analysis was implemented for variable selection,followed by multivariable logistic regression modeling via R statistical software(version 4.3.1).A clinical prediction nomogram was developed to visualize risk stratification,with model performance evaluated through receiver operating characteristic(ROC)curve analysis,calibration plots,and decision curve analysis(DCA).Internal validation was conducted using 1,000-cycle bootstrap resampling to ensure model generalizability.展开更多
This paper is concerned with design-ing symbol labeling for a low-density parity-check(LDPC)-coded delayed bit-interleaved coded modu-lation(DBICM)scheme in a two-way relay channel(TWRC).We first present some properti...This paper is concerned with design-ing symbol labeling for a low-density parity-check(LDPC)-coded delayed bit-interleaved coded modu-lation(DBICM)scheme in a two-way relay channel(TWRC).We first present some properties of symbol labeling within a phase shift keying(PSK)modula-tion.These properties reduce the candidate labeling search space.Based on this search space,we take DBICM capacity as the cost function and propose a general method for optimizing symbol labeling by em-ploying the differential evolution algorithm.Numeri-cal results show that our labeling obtains a signal-to-noise ratio(SNR)gain up to 0.45 dB with respect to Gray labeling.展开更多
BACKGROUND Delayed umbilical cord separation(UCS)defined as failure of umbilical cord fall beyond 3 weeks is seen in up to 10%of newborns.Since delayed UCS can be associated with leukocyte adhesion deficiency(LAD)or c...BACKGROUND Delayed umbilical cord separation(UCS)defined as failure of umbilical cord fall beyond 3 weeks is seen in up to 10%of newborns.Since delayed UCS can be associated with leukocyte adhesion deficiency(LAD)or coagulation factorⅩⅢdeficiency,these children are commonly referred to hematology/oncology for further investigation.Although the incidence of urachal remnants(UR);also associated with delayed UCS,is more common(1.16%)than LAD(1:1000000 births),and coagulation factorⅩⅢdeficiency(1:5000000 births)it’s less commonly investigated.CASE SUMMARY Two otherwise healthy infants,a 6-week-old female and a 4-week-old male were seen at our hematology/oncology clinic for delayed UCS.In both cases the umbilical cords looked healthy,with no signs of infection or pus,but appeared to show small Umbilical Granulomas.They were both investigated for LAD type I and one was investigated forⅩⅢdeficiency,but both tests were negative.These infants however,were investigated via abdominal ultrasound which showed UR in both cases.These infants required no intervention.CONCLUSION This report demonstrates an often overlooked association between delayed UCS and UR and suggests abdominal ultrasound if necessary for diagnosis.展开更多
The delayed nitrogen application technology is a crucial method for achieving high yield and efficiency in wheat cultivation.Specifically,more nitrogen is supplied to the middle and late growth stages of wheat by adju...The delayed nitrogen application technology is a crucial method for achieving high yield and efficiency in wheat cultivation.Specifically,more nitrogen is supplied to the middle and late growth stages of wheat by adjusting the application time and proportion of nitrogen fertilizer.This approach helps improve the tiller-bearing percentage and increase the number of grains per ear and the thousand-grain weight,while also reducing nitrogen loss and enhancing fertilizer use efficiency.This paper systematically elaborated on the high-yield and high-efficiency cultivation technology system with delayed nitrogen application for wheat,covering variety selection,soil management,sowing technology,the principle and implementation methods of delayed nitrogen application,integrated water and fertilizer management,field management,and comprehensive pest and disease control.Considering the ecological characteristics of major wheat-growing regions in China,tailored technical solutions were proposed,and operational key points of critical technological steps were introduced in detail.Through scientific variety distribution,precise nitrogen management,and integrated pest control,wheat yield and quality can be enhanced while achieving cost saving,improved efficiency,and ecological environmental protection.This paper provides systematic theoretical guidance and practical references for promoting thedelayed nitrogen application technology in wheat,thereby supporting the sustainable development of China s wheat industry.展开更多
The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair....The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair.Despite substantial research,the cellular and molecular mechanisms underlying EMD’s effects,particularly at the single-cell resolution,remain incompletely understood.This study established a delayed tooth replantation model in rats to investigate these aspects.Tooth loss rate and degree of loosening were evaluated at 4 and 8 weeks.Micro-CT,HE staining,TRAP staining,and immunofluorescence staining were evaluated to assess EMD’s efficacy.Single-cell sequencing analyses generated single-cell maps that explored enrichment pathways,cell communication,and potential repair mechanisms.Findings indicated that EMD could reduce the rate of tooth loss,promote periodontal membrane repair,and reduce root and bone resorption.Single-cell analysis revealed that EMD promotes the importance of Vtn+fibroblasts,enhancing matrix and tissue regeneration functions.Additionally,EMD stimulated osteogenic pathways,reduced osteoclastic activity,and promoted angiogenesis-related pathways,particularly bone-related H-type vessel expression in endothelial cells.Gene modules associated with angiogenesis,osteogenesis,and odontoblast differentiation were identified,suggesting EMD might facilitate osteogenesis and odontoblast differentiation by upregulating endothelium-related genes.Immune cell analysis indicated that EMD did not elicit a significant immune response.Cell communication analysis suggested that EMD fostered pro-regenerative networks driven by interactions between mesenchymal stem cells,fibroblasts,and endothelial cells.In conclusion,EMD proves to be an effective root surface therapy agent that supports the restoration of delayed replantation teeth.展开更多
Multi-resonance thermally ac-tivated delayed fluorescence(MR-TADF)emitters are one of the most excellent materi-als for high performance or-ganic light-emitting diodes(OLEDs)with high color puri-ty benefiting from the...Multi-resonance thermally ac-tivated delayed fluorescence(MR-TADF)emitters are one of the most excellent materi-als for high performance or-ganic light-emitting diodes(OLEDs)with high color puri-ty benefiting from their nar-row full width at half maxi-mum(FWHM)and great de-vice performance.However,small spin-orbit coupling(SOC)is one of drawbacks for MR-TADF emitters and introduction of heavy atoms may be one effective solution.In this work,four MR-TADF molecules with different atoms(O,S,Se)are carried out based on the first-principles calculation,and excited state dynamics in both toluene and solid phase is investi-gated.Our calculation results indicate that heavy atoms could induce smaller adiabatic ener-gy gap and larger SOC between the first singlet excited state and the first triplet excited state,which is advantageous for the conversion of singlet and triplet excitons,and thus the generation of thermally activated delayed fluorescence(TADF).Though the reorganization energy and full width at half maximum(FWHM)of emission are increased,the influence is quite limited.Besides,the fluorescent rates are also little influenced.Our calculation results indicate that heavy atom introduction is an efficient strategy to enhance the SOC values of MR-TADF emitters without influencing other properties significantly.展开更多
Most of acridine based thermally activated delayed fluorescence(TADF)emitters are characterized by advantageous reverse intersystem crossing(RISC)rate(kRISCs)due to the perpendicular orientation of the acridine donor ...Most of acridine based thermally activated delayed fluorescence(TADF)emitters are characterized by advantageous reverse intersystem crossing(RISC)rate(kRISCs)due to the perpendicular orientation of the acridine donor to the acceptor moiety,but suffer from a poor radiation rate(kr)typically in the order of 10^(6) s^(−1).Herein,two sky blue TADF emitters 3,6-DMAC-AD-Py and 3,6-SFAC-AD-Py were developed by linking acridine(DMAC)and spiro-fluorene-acridine(SFAC)donors to 10-(pyridin-2-yl)acridin-9(10H)-one(AD-Py)acceptor.Larger SFAC and electron-deficient pyridyl groups are deliberately incorporated in 3,6-SFACAD-Py since the unique through-space interaction between them is designed to drive the rotation of inner acridine ring in SFAC for enhancing frontier molecular orbitals overlap while keeping a decent TADF behavior.Thus,the kr of 3,6-SFACAD-Py is increased to 1.5×10^(7) s^(−1).Simultaneously,SFAC donors improve spin orbital coupling strength and reduce the energy gaps,generating kRISC of 1.8×10^(6) s^(−1).This is the first acridine donor based TADF emitter realizing kr of 10^(7) s^(−1) and kRISC of 10^(6) s^(−1) by a through-space interaction strategy.3,6-SFACAD-Py enables a highly efficient sky-blue organic light-emitting diode with a maximum external quantum efficiency(EQE)of 34.7%and Commission International de I'Eclairage coordinates of(0.19,0.37).More importantly,the EQE still remained 27.6%and 16.9%at high brightness of 1000 and 10,000 cd m^(−2).展开更多
Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or ...Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.展开更多
BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characteriz...BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characterized by delayed onset of neurological and cognitive deficits,DPHLS presents substantial diagnostic and therapeutic challenges.AIM To consolidate current knowledge on pathophysiology,clinical features,diagnostic approaches,and management strategies for DPHLS,providing a comprehensive overview and highlighting gaps for future research.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines,we systematically searched PubMed,ScienceDirect and Hinari databases using terms related to delayed post-hypoxic leukoencephalopathy.Inclusion criteria were original research articles,case reports,and case series involving human subjects with detailed clinical,neuroimaging,or pathological data on DPHLS.Data were extracted on study characteristics,participant demographics,clinical features,neuroimaging findings,pathological findings,treatment,and outcomes.The quality assessment was performed using the Joanna Briggs Institute critical appraisal checklist.RESULTS A total of 73 cases were reviewed.Common comorbidities included schizoaffective disorder,bipolar disorder,hypertension,and substance use disorder.The primary causes of hypoxia were benzodiazepine overdose,opioid overdose,polysubstance overdose,and carbon monoxide(CO)poisoning.Symptoms frequently include decreased level of consciousness,psychomotor agitation,cognitive decline,parkinsonism,and encephalopathy.Neuroimaging commonly revealed diffuse T2 hyperintensities in cerebral white matter,sometimes involving the basal ganglia and the globus pallidus.Magnetic resonance spectroscopy often showed decreased N-acetylaspartate,elevated choline,choline-to-creatinine ratio,and normal or elevated lactate.Treatment is often supportive,including amantadine,an antioxidant cocktail,and steroids.Hyperbaric oxygen therapy may be beneficial in those with CO poisoning.Parkinsonism was often treated with levodopa.Most of the patients had substantial recovery over the course of months and many cases had some residual neurocognitive deficits.CONCLUSION DPHLS remains a complex and multifaceted condition with various etiologies and clinical manifestations.Early recognition and appropriate management are crucial to improving patient outcomes.Future research should focus on standardizing diagnostic criteria,using advanced imaging techniques,and exploring therapeutic interventions to improve understanding and treatment of DPHLS.Conducting prospective cohort studies and developing biomarkers for early diagnosis and monitoring will be essential to advance patient care.展开更多
The damped Helmholtz-Duffing oscillator is a topic of great interest in many different fields of study due to its complex dynamics.By transitioning from conventional continuous differential equations to their fractal ...The damped Helmholtz-Duffing oscillator is a topic of great interest in many different fields of study due to its complex dynamics.By transitioning from conventional continuous differential equations to their fractal counterparts,one gains insights into the system's response under new mathematical frameworks.This paper presents a novel method for converting standard continuous differential equations into their fractal equivalents.This conversion occurs after the nonlinear system is transformed into its linear equivalent.Numerical analyses show that there are several resonance sites in the fractal system,which differ from the one resonance point found in the continuous system.One important finding is that the fractal system loses some of its stabilizing power when decaying behavior is transformed into a diffuse pattern.Interestingly,a decrease in the fractal order in resonance settings shows a stabilizing impact,highlighting the dynamics'complexity inside fractal systems.This endeavor to convert to fractals is a revolutionary technique that is being employed for the first time.展开更多
[Objective] The research aimed to study the effects of magnetic stress on the delayed luminescence of mung bean leaves.[Method]With mung bean leaves as the experimental materials,the delayed luminescence curve of mung...[Objective] The research aimed to study the effects of magnetic stress on the delayed luminescence of mung bean leaves.[Method]With mung bean leaves as the experimental materials,the delayed luminescence curve of mung bean leaves under the same magnetic field intensity at different processing time was measured by using BPCL-type weak luminescence measuring instrument.[Result] The absorption of the magnetic field stimulation within the leaves had its own rules.A certain magnetic field intensity and a certain...展开更多
文摘Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.
文摘A Langevin delayed fractional system with multiple delays in control,is a delayed fractional system that includes delay parameters in both state and control,is first introduced.This paper is devoted to investigating the relative controllability of the Langevin delayed fractional system with multiple delays in control.For linear systems to be relatively controllable,necessary and sufficient circumstances are identified by introducing and employing the Gramian matrix.The sufficient conditions for the relative controllability of semilinear systems are ofered based on Schauder's fixed point theorem.As an unusual approach,the controllability results of the delayed system are built for the first time on the exact solution produced by the MittagLeffler type function although controllability ones in the literature are built on the Volterra integral equations or the mild solutions produced by resolvent families.
基金supported by the Natural Science Foundation of Hunan Province(2021JJ31089)the Scientific Research Project of Health Commission of Hunan Province(202203104548),China。
文摘Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid(RA)can suppress the neurotoxic effects of CO.This study further explores,in vivo and in vitro,the molecular mechanisms by which RA alleviates CO-induced central nervous system damage.Methods:A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO,and a DEACMP animal model was established in adult Kunming mice.Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay and Annexin V/propidium iodide(PI)double staining.The transcriptional and protein expression of each gene was detected using real time fluorescence quantitative PCR(RT-qPCR)and Western blotting.Long noncoding RNA(lncRNA)SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes.In DEACMP mice,SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression.Results:RA at 10 and 20μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes,downregulation of SNHG15 and LINGO-1,and upregulation of brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor B(TrkB)(all P<0.05).Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity(all P<0.05).Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels(all P<0.05).Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP(all P<0.05).Conclusion:RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes,thereby reducing central nervous system injury and exerting neuroprotective effects.LncRNA SNHG15 and LINGO-1 are key molecules mediating RA induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway.These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.
文摘BACKGROUND Delayed post-pancreatectomy hemorrhage(PPH)is life-threatening,and endovascular interventions show promise.This retrospective study aimed to evaluate endovascular treatment outcomes for delayed PPH and identify mortality risk factors.AIM To conduct a single-center retrospective study of 88 patients with delayed PPH to systematically evaluate the clinical efficacy of endovascular treatment,identify independent risk factors for six-month mortality,and propose and validate a predictive model for individualized management of high-risk patients.METHODS This retrospective analysis included 88 patients with delayed PPH treated by endovascular intervention.Patients were stratified into survival(n=64)and mortality(n=24)groups.Clinical and procedural variables were assessed using univariate and multivariate logistic regression.Significant predictors were incorporated into a prognostic nomogram.Model performance was assessed through discrimination(area under the receiver operating characteristic curve),calibration,and decision curve analysis.RESULTS Technical and clinical success rates were 92.0%and 60.2%,respectively.The overall six-month mortality rate was 27.3%(24/88).Independent predictors of mortality included advanced age,prolonged operative time,shorter hospital stay,intra-abdominal infection,coagulation dysfunction,common hepatic artery bleeding,and failure to achieve clinical success.The nomogram demonstrated excellent discrimination(area under the receiver operating characteristic curve=0.943),with good calibration and favorable net benefit on decision curve analysis.CONCLUSION We proposed and validated a predictive nomogram for six-month mortality following endovascular treatment for delayed PPH.The model facilitates individualized risk stratification and may guide clinical decision-making.Early identification of high-risk patients-particularly older individuals or those with infection or coagulopathy-and prompt,personalized intervention may improve outcomes in this high-risk population.
文摘The analysis of the ejaculate,better known as spermiogram,represents the first and main step to identify whether a series of sperm quality parameters are within the norm and therefore are consistent with normal sperm fertilizing capacity.Among these,sperm concentration and motility are the first parameters to be evaluated through an estimation carried out by expert examiners.
基金Supported by the Shandong Province Traditional Chinese Medicine Technology Project,No.Q-2023147the Weifang Health Commission Research Project,No.WFWSJK-2023-033+3 种基金the Weifang City Science and Technology Development Plan(Medical Category),No.2023YX057the Weifang Medical University 2022 Campus Level Education and Teaching Reform and Research Project,No.2022YB051Norman Bethune Public Welfare Foundation,No.ezmr2023-037Special Research Project on Optimized Management of Acute Pain,Wu Jieping Medical Foundation.
文摘BACKGROUND Delayed wound healing is a common clinical complication following gastric cancer radical surgery,adversely affecting patient prognosis.With advances in artificial intelligence,machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention.AIM To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making.METHODS We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1,2014 to December 30,2023.Seventy percent of the dataset was selected as the training set and 30%as the validation set.Decision trees,support vector machines,and logistic regression were used to construct a risk prediction model.The performance of the model was evaluated using accuracy,recall,precision,F1 index,and area under the receiver operating characteristic curve and decision curve.RESULTS This study included five variables:Sex,elderly,duration of abdominal drainage,preoperative white blood cell(WBC)count,and absolute value of neutrophils.These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing.The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets.Specifically,the decision tree model achieved higher accuracy,F1 index,recall,and area under the curve(AUC)values.The support vector machine model also demonstrated better performance than logistic regression,with higher accuracy,recall,and F1 index,but a slightly lower AUC.The key variables of sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils were found to be strong predictors of delayed wound healing.Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing,with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage.Similarly,preoperative WBC count,sex,elderly,and absolute value of neutrophils were associated with a higher risk of delayed wound healing,highlighting the importance of these variables in the model.CONCLUSION The model is able to identify high-risk patients based on sex,elderly,duration of abdominal drainage,preoperative WBC count,and absolute value of neutrophils can provide valuable insights for clinical decision-making.
文摘BACKGROUND As a minimally invasive technique,endoscopic submucosal dissection(ESD)is widely used in treating early colorectal cancer(ECRC)and precancerous lesions(PCLs).However,a common postoperative complication-delayed postoperative bleeding(DPOB)-can significantly hinder patient recovery.AIM To build and validate a predictive model for assessing post-ESD DPOB risk in ECRC and PCL patients,utilizing logistic regression methodology.METHODS A retrospective review was conducted on ECRC/PCL 302 patients who received ESD at our hospital between July 2021 and July 2024.The cohort was stratified based on the incidence of DPOB following ESD,forming DPOB and non-DPOB groups.Through allocation,they were further allocated into model and validation cohorts.Clinical variables from both cohorts were collated and subjected to univariate analysis to determine potential factors associated with post-ESD DPOB.Subsequently,we constructed a predictive model for DPOB risk employing logistic regression analysis.Model performance assessment used receiver operating characteristic curves in both the training and validation cohorts,with internal validation accomplished via 10-fold cross-validation.RESULTS The occurrence rate of DPOB was 9.93%.Univariate analysis revealed that the number of lesions,lesion size,lesion location,degree of submucosal fibrosis,and intraoperative bleeding were significantly associated with DPOB.Binary logistic regression analysis identified the number of lesions,lesion size,lesion location,and degree of submucosal fibrosis as independent DPOB determinants.A nomogram that was developed to quantify the DPOB risk exhibited that an increment in the total score corresponded to an increased risk.The model achieved area under the curve values of 0.831 and 0.821 in the model and validation groups,respectively,with P values of 0.853 and 0.203 in the Hosmer-Lemeshow test.The model demonstrated robust discriminative performance,with an average area under the curve of 0.795(95%confidence interval:0.702-0.887)in 10-fold cross-validation.CONCLUSION Collectively,the presence of multiple lesions,lesion size of≥3 cm,lesion localization in the rectum,and severe fibrosis are significant independent predictors of DPOB in patients undergoing surgery for ECRC or PCLs.The proposed risk prediction model,which integrates these factors,demonstrates excellent predictive accuracy and clinical utility,thereby providing a valuable tool for risk stratification and postoperative management in this patient population.
基金supported by the National Natural Science Foundation of China(Grant No.82302173).
文摘Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.
文摘Through systematic analysis of risk factors associated with postoperative delayed discharge following retrograde intrarenal surgery(RIRS)with flexible ureteroscopic holmium laser lithotripsy under ambulatory surgery protocols,this study aims to develop and validate a risk prediction model for discharge delay.The ultimate objectives include establishing evidence-based clinical guidelines for urolithiasis management,enabling proactive intervention strategies,and optimizing physician-patient communication efficiency.METHODS:This retrospective cohort study analyzed clinical data from 253 patients undergoing ambulatory retrograde intrarenal surgery(RIRS)with flexible ureteroscopic holmium laser lithotripsy at the Day Surgery Unit and Urology Department of Hunan Provincial People's Hospital between January 2023 and December 2024.To identify predictors of discharge delay,Lasso-regularized logistic regression analysis was implemented for variable selection,followed by multivariable logistic regression modeling via R statistical software(version 4.3.1).A clinical prediction nomogram was developed to visualize risk stratification,with model performance evaluated through receiver operating characteristic(ROC)curve analysis,calibration plots,and decision curve analysis(DCA).Internal validation was conducted using 1,000-cycle bootstrap resampling to ensure model generalizability.
文摘This paper is concerned with design-ing symbol labeling for a low-density parity-check(LDPC)-coded delayed bit-interleaved coded modu-lation(DBICM)scheme in a two-way relay channel(TWRC).We first present some properties of symbol labeling within a phase shift keying(PSK)modula-tion.These properties reduce the candidate labeling search space.Based on this search space,we take DBICM capacity as the cost function and propose a general method for optimizing symbol labeling by em-ploying the differential evolution algorithm.Numeri-cal results show that our labeling obtains a signal-to-noise ratio(SNR)gain up to 0.45 dB with respect to Gray labeling.
文摘BACKGROUND Delayed umbilical cord separation(UCS)defined as failure of umbilical cord fall beyond 3 weeks is seen in up to 10%of newborns.Since delayed UCS can be associated with leukocyte adhesion deficiency(LAD)or coagulation factorⅩⅢdeficiency,these children are commonly referred to hematology/oncology for further investigation.Although the incidence of urachal remnants(UR);also associated with delayed UCS,is more common(1.16%)than LAD(1:1000000 births),and coagulation factorⅩⅢdeficiency(1:5000000 births)it’s less commonly investigated.CASE SUMMARY Two otherwise healthy infants,a 6-week-old female and a 4-week-old male were seen at our hematology/oncology clinic for delayed UCS.In both cases the umbilical cords looked healthy,with no signs of infection or pus,but appeared to show small Umbilical Granulomas.They were both investigated for LAD type I and one was investigated forⅩⅢdeficiency,but both tests were negative.These infants however,were investigated via abdominal ultrasound which showed UR in both cases.These infants required no intervention.CONCLUSION This report demonstrates an often overlooked association between delayed UCS and UR and suggests abdominal ultrasound if necessary for diagnosis.
基金Supported by The Key Science and Technology Project of Shangqiu City(2024056).
文摘The delayed nitrogen application technology is a crucial method for achieving high yield and efficiency in wheat cultivation.Specifically,more nitrogen is supplied to the middle and late growth stages of wheat by adjusting the application time and proportion of nitrogen fertilizer.This approach helps improve the tiller-bearing percentage and increase the number of grains per ear and the thousand-grain weight,while also reducing nitrogen loss and enhancing fertilizer use efficiency.This paper systematically elaborated on the high-yield and high-efficiency cultivation technology system with delayed nitrogen application for wheat,covering variety selection,soil management,sowing technology,the principle and implementation methods of delayed nitrogen application,integrated water and fertilizer management,field management,and comprehensive pest and disease control.Considering the ecological characteristics of major wheat-growing regions in China,tailored technical solutions were proposed,and operational key points of critical technological steps were introduced in detail.Through scientific variety distribution,precise nitrogen management,and integrated pest control,wheat yield and quality can be enhanced while achieving cost saving,improved efficiency,and ecological environmental protection.This paper provides systematic theoretical guidance and practical references for promoting thedelayed nitrogen application technology in wheat,thereby supporting the sustainable development of China s wheat industry.
基金the National Natural Science Foundation of China(U22A20314,82470988,32070826)National Key R&D of Program of China(2022YFC2504201)+2 种基金Outstanding Youth Fund of Chongqing Natural Science Foundation(CSTB2023NSCQJQX0006)Science and Technology Research Project of Chongqing Education Commission(KJQN202200471)CQMU Program for Youth Innovation in Future Medicine(W0075).
文摘The repair of the periodontal membrane is essential for the successful management of periodontal disease and dental trauma.Emdogain®(EMD)is widely used in periodontal therapy due to its ability to promote repair.Despite substantial research,the cellular and molecular mechanisms underlying EMD’s effects,particularly at the single-cell resolution,remain incompletely understood.This study established a delayed tooth replantation model in rats to investigate these aspects.Tooth loss rate and degree of loosening were evaluated at 4 and 8 weeks.Micro-CT,HE staining,TRAP staining,and immunofluorescence staining were evaluated to assess EMD’s efficacy.Single-cell sequencing analyses generated single-cell maps that explored enrichment pathways,cell communication,and potential repair mechanisms.Findings indicated that EMD could reduce the rate of tooth loss,promote periodontal membrane repair,and reduce root and bone resorption.Single-cell analysis revealed that EMD promotes the importance of Vtn+fibroblasts,enhancing matrix and tissue regeneration functions.Additionally,EMD stimulated osteogenic pathways,reduced osteoclastic activity,and promoted angiogenesis-related pathways,particularly bone-related H-type vessel expression in endothelial cells.Gene modules associated with angiogenesis,osteogenesis,and odontoblast differentiation were identified,suggesting EMD might facilitate osteogenesis and odontoblast differentiation by upregulating endothelium-related genes.Immune cell analysis indicated that EMD did not elicit a significant immune response.Cell communication analysis suggested that EMD fostered pro-regenerative networks driven by interactions between mesenchymal stem cells,fibroblasts,and endothelial cells.In conclusion,EMD proves to be an effective root surface therapy agent that supports the restoration of delayed replantation teeth.
基金supported by the National Natural Science Foundation of China(No.11974216,No.12374269)the support of the Taishan Scholar Project of Shandong Province。
文摘Multi-resonance thermally ac-tivated delayed fluorescence(MR-TADF)emitters are one of the most excellent materi-als for high performance or-ganic light-emitting diodes(OLEDs)with high color puri-ty benefiting from their nar-row full width at half maxi-mum(FWHM)and great de-vice performance.However,small spin-orbit coupling(SOC)is one of drawbacks for MR-TADF emitters and introduction of heavy atoms may be one effective solution.In this work,four MR-TADF molecules with different atoms(O,S,Se)are carried out based on the first-principles calculation,and excited state dynamics in both toluene and solid phase is investi-gated.Our calculation results indicate that heavy atoms could induce smaller adiabatic ener-gy gap and larger SOC between the first singlet excited state and the first triplet excited state,which is advantageous for the conversion of singlet and triplet excitons,and thus the generation of thermally activated delayed fluorescence(TADF).Though the reorganization energy and full width at half maximum(FWHM)of emission are increased,the influence is quite limited.Besides,the fluorescent rates are also little influenced.Our calculation results indicate that heavy atom introduction is an efficient strategy to enhance the SOC values of MR-TADF emitters without influencing other properties significantly.
基金the National Natural Science Foundation of China(22078051,22478063,22408035)the Fundamental Research Funds for the Central Universities(DUT22-LAB610)the Open Fund of the Key Laboratory of Advanced Display and System Applications,Ministry of Education,Shanghai University(OF202401)for financial support of this work.
文摘Most of acridine based thermally activated delayed fluorescence(TADF)emitters are characterized by advantageous reverse intersystem crossing(RISC)rate(kRISCs)due to the perpendicular orientation of the acridine donor to the acceptor moiety,but suffer from a poor radiation rate(kr)typically in the order of 10^(6) s^(−1).Herein,two sky blue TADF emitters 3,6-DMAC-AD-Py and 3,6-SFAC-AD-Py were developed by linking acridine(DMAC)and spiro-fluorene-acridine(SFAC)donors to 10-(pyridin-2-yl)acridin-9(10H)-one(AD-Py)acceptor.Larger SFAC and electron-deficient pyridyl groups are deliberately incorporated in 3,6-SFACAD-Py since the unique through-space interaction between them is designed to drive the rotation of inner acridine ring in SFAC for enhancing frontier molecular orbitals overlap while keeping a decent TADF behavior.Thus,the kr of 3,6-SFACAD-Py is increased to 1.5×10^(7) s^(−1).Simultaneously,SFAC donors improve spin orbital coupling strength and reduce the energy gaps,generating kRISC of 1.8×10^(6) s^(−1).This is the first acridine donor based TADF emitter realizing kr of 10^(7) s^(−1) and kRISC of 10^(6) s^(−1) by a through-space interaction strategy.3,6-SFACAD-Py enables a highly efficient sky-blue organic light-emitting diode with a maximum external quantum efficiency(EQE)of 34.7%and Commission International de I'Eclairage coordinates of(0.19,0.37).More importantly,the EQE still remained 27.6%and 16.9%at high brightness of 1000 and 10,000 cd m^(−2).
基金supported by the National Key Research and Development Program of China(No.2022YFB380-7300)the National Natural Science Foundation of China(No.12471455)+2 种基金the Clinical Cohort Construction Program of Peking University Third Hospital(BYSYDL2022005)the Key Clinical Projects of Peking University Third Hospital(BYSYZD2023006)the Innovation&Transfer Fund of Peking University Third Hospital(BYSYZHKC2023-109).
文摘Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.
文摘BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characterized by delayed onset of neurological and cognitive deficits,DPHLS presents substantial diagnostic and therapeutic challenges.AIM To consolidate current knowledge on pathophysiology,clinical features,diagnostic approaches,and management strategies for DPHLS,providing a comprehensive overview and highlighting gaps for future research.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines,we systematically searched PubMed,ScienceDirect and Hinari databases using terms related to delayed post-hypoxic leukoencephalopathy.Inclusion criteria were original research articles,case reports,and case series involving human subjects with detailed clinical,neuroimaging,or pathological data on DPHLS.Data were extracted on study characteristics,participant demographics,clinical features,neuroimaging findings,pathological findings,treatment,and outcomes.The quality assessment was performed using the Joanna Briggs Institute critical appraisal checklist.RESULTS A total of 73 cases were reviewed.Common comorbidities included schizoaffective disorder,bipolar disorder,hypertension,and substance use disorder.The primary causes of hypoxia were benzodiazepine overdose,opioid overdose,polysubstance overdose,and carbon monoxide(CO)poisoning.Symptoms frequently include decreased level of consciousness,psychomotor agitation,cognitive decline,parkinsonism,and encephalopathy.Neuroimaging commonly revealed diffuse T2 hyperintensities in cerebral white matter,sometimes involving the basal ganglia and the globus pallidus.Magnetic resonance spectroscopy often showed decreased N-acetylaspartate,elevated choline,choline-to-creatinine ratio,and normal or elevated lactate.Treatment is often supportive,including amantadine,an antioxidant cocktail,and steroids.Hyperbaric oxygen therapy may be beneficial in those with CO poisoning.Parkinsonism was often treated with levodopa.Most of the patients had substantial recovery over the course of months and many cases had some residual neurocognitive deficits.CONCLUSION DPHLS remains a complex and multifaceted condition with various etiologies and clinical manifestations.Early recognition and appropriate management are crucial to improving patient outcomes.Future research should focus on standardizing diagnostic criteria,using advanced imaging techniques,and exploring therapeutic interventions to improve understanding and treatment of DPHLS.Conducting prospective cohort studies and developing biomarkers for early diagnosis and monitoring will be essential to advance patient care.
文摘The damped Helmholtz-Duffing oscillator is a topic of great interest in many different fields of study due to its complex dynamics.By transitioning from conventional continuous differential equations to their fractal counterparts,one gains insights into the system's response under new mathematical frameworks.This paper presents a novel method for converting standard continuous differential equations into their fractal equivalents.This conversion occurs after the nonlinear system is transformed into its linear equivalent.Numerical analyses show that there are several resonance sites in the fractal system,which differ from the one resonance point found in the continuous system.One important finding is that the fractal system loses some of its stabilizing power when decaying behavior is transformed into a diffuse pattern.Interestingly,a decrease in the fractal order in resonance settings shows a stabilizing impact,highlighting the dynamics'complexity inside fractal systems.This endeavor to convert to fractals is a revolutionary technique that is being employed for the first time.
文摘[Objective] The research aimed to study the effects of magnetic stress on the delayed luminescence of mung bean leaves.[Method]With mung bean leaves as the experimental materials,the delayed luminescence curve of mung bean leaves under the same magnetic field intensity at different processing time was measured by using BPCL-type weak luminescence measuring instrument.[Result] The absorption of the magnetic field stimulation within the leaves had its own rules.A certain magnetic field intensity and a certain...
