Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone...Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone regeneration promotion effect of allo-BMSCs in 3D-printed autologous bone particle(ABP)scaffolds.First,we concurrently printed scaffolds with polycaprolactone,ABPs,and allo-BMSCs for appropriate support,providing bioactive factors and seed cells to promote osteogenesis.In vitro studies showed that ABP scaffolds promoted allo-BMSC osteogenic differentiation.In vivo studies revealed that the implantation of scaffolds loaded with ABPs and allo-BMSCs into canine skull defects for nine months promoted osteogenesis.Further experiments suggested that only a small portion of implanted allo-BMSCs survived and differentiated into vascular endothelial cells,chondrocytes,and osteocytes.The implanted allo-BMSCs released stromal cell-derived factor 1 through paracrine signaling to recruit native BMSCs into the defect,promoting bone regeneration.This study contributes to our understanding of allo-BMSCs,providing information relevant to their future application.展开更多
Attempts have been made to modulate motor sequence learning(MSL)through repetitive transcranial magnetic stimulation,targeting different sites within the sensorimotor network.However,the target with the optimum modula...Attempts have been made to modulate motor sequence learning(MSL)through repetitive transcranial magnetic stimulation,targeting different sites within the sensorimotor network.However,the target with the optimum modulatory effect on neural plasticity associated with MSL remains unclarified.This study was therefore designed to compare the role of the left primary motor cortex and the left supplementary motor area proper(SMAp)in modulating MSL across different complexity levels and for both hands,as well as the associated neuroplasticity by applying intermittent theta burst stimulation together with the electroencephalogram and concurrent transcranial magnetic stimulation.Our data demonstrated the role of SMAp stimulation in modulating neural communication to support MSL,which is achieved by facilitating regional activation and orchestrating neural coupling across distributed brain regions,particularly in interhemispheric connections.These findings may have important clinical implications,particularly for motor rehabilitation in populations such as post-stroke patients.展开更多
BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a ...BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.展开更多
Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC ...Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC patients are diagnosed at the limited-stage.Histor-ically,the standard of care for these patients has been 4-6 cycles of concurrent chemoradiotherapy(cCRT),with the exception of a minor-ity of early-stage T1-2N0 patients who may undergo radical surgery.2 Despite an initial high sensitivity to treatment,over 50%of patients experience disease recurrence within two years,with a median overall survival(OS)ranging from 16 to 24 months.For the past three decades,while there have been novel explorations in radiotherapy dosing and fractionation,the treatment paradigm for limited-stage SCLC(LS-SCLC)has remained largely unchanged,with no significant improvement in patient survival outcomes.展开更多
Objective:Radiotherapy(RT)is the definitive treatment for stageⅡnasopharyngeal carcinoma(NPC),which is classified as stagesⅠA andⅠB in the latest ninth edition of American Joint Committee on Cancer(AJCC)/Union for ...Objective:Radiotherapy(RT)is the definitive treatment for stageⅡnasopharyngeal carcinoma(NPC),which is classified as stagesⅠA andⅠB in the latest ninth edition of American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC).A crucial question is whether concurrent chemo-radiotherapy(CCRT)could derive additional benefits to this recent“down-staging”subgroup of NPC patients.This study aimed to interrogate clinical and radiomic features for predicting 5-year progression-free survival(PFS)of stageⅡNPC treated with RT alone or CCRT.Methods:Imaging and clinical data of 166 stageⅡNPC(eighth edition AJCC/UICC)patients were collected.Data were allocated into training,internal testing,and external testing sets.For each case,851 radiomic features were extracted and 10 clinical features were collected.Radiomic and clinical features most associated with the 5-year PFS were selected separately.A combined model was developed using multivariate logistic regression by integrating selected features and treatment option to predict 5-year PFS.Model performances were evaluated by area under the receiver operating curve(AUC),prediction accuracy,and decision curve analysis.Survival analyses including Kaplan-Meier analysis and Cox regression model were performed for further analysis.Results:Thirteen radiomic features,three clinical features,and treatment option were considered for model development.The combined model showed higher prognostic performance than using either.For the merged testing set(internal and external testing sets),AUC is 0.76(combined)vs.0.56-0.80(clinical or radiomic alone)and accuracy is 0.75(combined)vs.0.62-0.73(clinical or radiomic alone).Kaplan-Meier analysis using the combined model showed significant discrimination in PFS of the predicted low-risk and high-risk groups in the training and internal testing cohorts(P<0.05).Conclusions:Integrating with clinical and radiomic features could provide prognostic information on 5-year PFS under either treatment regimen,guiding individualized decisions of chemotherapy based on the predicted treatment outcome.展开更多
Defective phononic crystals(PnCs)have enabled spatial localization and quantitative amplification of elastic wave energy.Most previous research has focused on applications such as narrow-bandpass filters,ultrasonic se...Defective phononic crystals(PnCs)have enabled spatial localization and quantitative amplification of elastic wave energy.Most previous research has focused on applications such as narrow-bandpass filters,ultrasonic sensors,and piezoelectric energy harvesters,typically operating under the assumption of an external elastic wave incidence.Recently,a novel approach that uses defective PnCs as ultrasonic actuators to generate amplified waves has emerged.However,the existing studies are limited to the generation of either longitudinal or bending waves,with no research addressing the concurrent generation of both.Hence,this paper proposes a straightforward methodology for the concurrent generation and amplification of both wave types utilizing defect modes at independent defect-band frequencies.Bimorph piezoelectric elements are attached to the defect,with each element connected to independent external voltage sources.By precisely adjusting the magnitude and temporal phase differences between the voltage sources,concurrently amplified wave generation is achieved.The paper highlights the advantages of the proposed analytical model.This model is both computationally time-efficient and accurate,in comparison with the COMSOL simulation results.For instance,in case studies,the analytical model reduces the computational time from one hour to mere seconds,while maintaining acceptable error rates of 1%in peak frequencies.This concurrent wave-generation methodology opens new avenues for applications in rotating machinery fault diagnosis,structural health monitoring,and medical imaging.展开更多
A novel Additive Manufacturing(AM)-driven concurrent design strategy based on the beam characterization model considering strength constraints is proposed.The lattice topology,radius size,Building Orientation(BO),and ...A novel Additive Manufacturing(AM)-driven concurrent design strategy based on the beam characterization model considering strength constraints is proposed.The lattice topology,radius size,Building Orientation(BO),and structural yield strength can be simultaneously adjusted by integrating the overall process-structure-performance relationship of the AM process into the optimization.Specifically,the transverse isotropic material model is adopted to describe the material properties induced by the layer-by-layer manner of additive manufacturing.To bolster lattice strength performance,the stress constraints and ratio constraints of lattice struts are employed.The Tsai-Wu yield criterion is implemented to characterize the lattice strut's strength,while the P-norm method streamlines the handling of multiple constraints,minimizing computational overhead.Moreover,the gradient-based optimization model is established,where both the individual struts diameters and BO can be designed,and the buckling-prone spatial struts are strategically eliminated to improve the lattice strength further.Furthermore,several typical structures are optimized to verify the effectiveness of the proposed method.The optimized results are quite encouraging since the heterogeneous lattice structures with optimized BO obtained by the strength-based concurrent method show a remarkably improved performance compared to traditional designs.展开更多
BACKGROUND Patients with concurrent acute biliary pancreatitis(ABP)and acute cholangitis(AC)may experience exacerbated clinical consequences due to bile duct stones.However,studies exploring this topic remain limited....BACKGROUND Patients with concurrent acute biliary pancreatitis(ABP)and acute cholangitis(AC)may experience exacerbated clinical consequences due to bile duct stones.However,studies exploring this topic remain limited.AIM To compare the clinical presentation and outcomes of patients experiencing AC with and without ABP.METHODS This single-center retrospective cohort study included 358 patients with AC who underwent endoscopic retrograde cholangiopancreatography(ERCP)between January 2016 and December 2017.Patients were divided into two groups:AC with ABP(n=90)and AC without ABP(n=268).Clinical characteristics,laboratory data,ERCP results,primary study outcome[intensive care unit(ICU)admission],and secondary outcomes including 30-day mortality,length of hospital stay,and 30-day readmission rate were analyzed and compared.RESULTS All patients in the AC with ABP group had interstitial pancreatitis.The AC with ABP group had significantly higher white cell count(WBC)counts(13.1×10^(3)/μL vs 10.4×10^(3)/μL,P=0.007)and more abnormal WBC results(61.1%vs 42.3%,P=0.015).Liver biochemical tests,AC severity,ERCP success,adverse events,ICU admissions,30-day mortality,hospital stay,and readmission rates did not differ significantly between the two groups.Univariate analysis showed no significant link between concurrent ABP and ICU admission,although significance was marginal in moderate/severe ABP cases(P=0.051).In the multivariate analysis,age(P=0.035)and cardiovascular dysfunction(P<0.001)were independently associated with length of ICU stay.CONCLUSION Concurrent interstitial ABP and AC did not significantly affect outcomes.Age and cardiovascular dysfunction were stronger predictors of ICU admission and should guide clinical monitoring and management.展开更多
Background:Individuals with unresectable stageⅢnon-small cell lung cancer(NSCLC)who receive complete concurrent chemoradiotherapy(cCRT)can benefit from long-term survival.Although neoadjuvant chemoim-munotherapy(NACI...Background:Individuals with unresectable stageⅢnon-small cell lung cancer(NSCLC)who receive complete concurrent chemoradiotherapy(cCRT)can benefit from long-term survival.Although neoadjuvant chemoim-munotherapy(NACIT)have achieved breakthroughs in treating unresectable stageⅢNSCLC,patients who have received induction chemoimmunotherapy are considered poor candidates for cCRT due to concerns about tolerability.Oral vinorelbine chemotherapy is widely used in clinical settings because of its safety,even for frail patients.The objective of this trial was to assess the efficacy and safety of oral vinorelbine plus concurrent radiotherapy(RT)for individuals with unresectable stageⅢNSCLC following NACIT who were not candidates for concurrent intravenous chemotherapy.Methods:This was a single-arm,phase 2 trial.The primary endpoint was the objective response rate(ORR),while the secondary endpoints consisted of the disease control rate(DCR),safety,overall survival(OS),as well as progression-free survival(PFS).Results:Between March 10,2023 and April 24,2025,46 individuals with unresectable stageⅢNSCLC were administered oral vinorelbine plus thoracic RT.Patients were treated with oral vinorelbine(60 mg/m^(2)once a week for 2 weeks as induction therapy before thoracic RT)and 30 mg/m^(2)per week with concurrent RT(59.4-60.2 Gy)over 5.5 weeks.The median age of the patients was 62.5 years,with 42 being male(91.3%).The ORR was 52.1%(95%confidence interval[CI],35.1%-65.9%),with 24 partial responders.A 95.7%DCR(85.5%-98.8%)was observed,and 20 patients had stable disease.The median follow-up was 22.5 months;the median PFS was 18.0 months and the median OS was not reached.The most commonly observed adverse events(AEs)included leukopenia(grade 1,26.1%),anemia(grade 1,17.4%),neutropenia(grade 1,10.9%),acute esophagitis(grade 2,17.4%),and treatment-related pneumonitis(grade 1-2,60.9%).No grade 3 or 4 treatment-related AEs were recorded.Conclusion:In individuals with unresectable stageⅢNSCLC who had received NACIT and were not candidates for concurrent intravenous chemotherapy with RT,the oral vinorelbine plus concurrent RT demonstrated promising antitumor efficacy with acceptable toxicity profiles.展开更多
Metadata prefetching and data placement play a critical role in enhancing access performance for file systems operating over wide-area networks.However,developing effective strategies for metadata prefetching in envir...Metadata prefetching and data placement play a critical role in enhancing access performance for file systems operating over wide-area networks.However,developing effective strategies for metadata prefetching in environments with concurrent workloads and for data placement across distributed networks remains a significant challenge.This study introduces novel and efficient methodologies for metadata prefetching and data placement,leveraging fine-grained control of prefetching strategies and variable-sized data fragment writing to optimize the I/O bandwidth of distributed file systems.The proposed metadata prefetching technique employs dynamic workload analysis to identify dominant workload patterns and adaptively refines prefetching policies,thereby boosting metadata access efficiency under concurrent scenarios.Meanwhile,the data placement strategy improves write performance by storing data fragments locally within the nearest data center and transmitting only the fragment location metadata to the remote data center hosting the original file.Experimental evaluations using real-world system traces demonstrate that the proposed approaches reduce metadata access times by up to 33.5%and application data access times by 17.19%compared to state-of-the-art techniques.展开更多
Objectives:The optimal treatment strategy for early-stage natural killer/T-cell lymphoma(NKTCL)remains unclear.This study aimed to evaluate and compare the clinical outcomes and adverse events(AEs)associated with two ...Objectives:The optimal treatment strategy for early-stage natural killer/T-cell lymphoma(NKTCL)remains unclear.This study aimed to evaluate and compare the clinical outcomes and adverse events(AEs)associated with two treatment regimens for early-stage NKTCL:pegaspargase with concurrent radiation therapy(P+CCRT)and pegaspargase,gemcitabine,and oxaliplatin(P-GEMOX)with sequential radiation therapy(SERT).Propensity score matching(PSM)was employed to ensure balanced comparison between these regimens.Methods:We assessed the efficacy of P+CCRT from a phase II trial and P-GEMOX combined with SERT using real-world data.PSM was conducted at a 1:1 ratio with a caliper of 0.18 to align baseline characteristics between the treatment groups.Key outcomes analyzed included overall response rate(ORR),complete response rate(CR),progression-free survival(PFS),overall survival(OS),and AEs.Results:Following PSM,the study included 52 patients,with 26 in each treatment group.Baseline characteristics were balanced between the cohorts.The ORR for P+CCRT group was 100.0%compared to 88.5%for P-GEMOX+SERT group,and the CR rates was 100.0%vs.76.9%,respectively.The 3-year OS and PFS rates were both 92.3%for P+CCRT,while P-GEMOX showed 92.3%OS and 80.8%PFS.Adverse events,including hematological toxicity,hepatotoxicity,and coagulation dysfunction,were comparable between the two regimens.Conclusion:P+CCRT is associated with comparable clinical outcomes compared to P-GEMOX+SERT in early-stage NKTCL,with comparable adverse events.Additionally,P+CCRT offers the benefit of a more streamlined treatment regimen with a shorter cycle.Given these encouraging results,further cohort studies are needed to validate these results.展开更多
近似串匹配技术在网络信息搜索、数字图书馆、模式识别、文本挖掘、IP路由查找、网络入侵检测、生物信息学、音乐研究计算等领域具有广泛的应用.基于CREW-PRAM(parallel random access machine with concurrent read and exclusive wri...近似串匹配技术在网络信息搜索、数字图书馆、模式识别、文本挖掘、IP路由查找、网络入侵检测、生物信息学、音乐研究计算等领域具有广泛的应用.基于CREW-PRAM(parallel random access machine with concurrent read and exclusive write)模型,采用波前式并行推进的方法直接计算编辑距离矩阵D,设计了一个允许k-差别的近似串匹配动态规划并行算法,该算法使用(m+1)个处理器,时间复杂度为O(n),算法理论上达到线性加速;采取水平和斜向双并行计算编辑距离矩阵D的方法,设计了一个使用a(m+1)个处理器和O(n/a+m)时间的、可伸缩的、允许k-差别的近似串匹配动态规划并行算法,+<11mna.基于分治策略,通过灵活拆分总线和合并子总线动态重构光总线系统,并充分利用光总线的消息播送技术和并行计算前缀和的方法,实现了汉明距离的并行计算,设计了两个基于LARPBS(linear arrays with reconfigurable pipelined bus system)模型的通信高效、可扩放的允许k-误配的近似串匹配并行算法,其中一个算法使用n个处理器,时间为O(m);另一个为常数时间算法,使用mn个处理器.展开更多
Maintainability influencing attributes are analyzed, their weight and value calculating methods are given, and the maintainability fuzzy evaluation method is proposed based on the relative closeness. According to the ...Maintainability influencing attributes are analyzed, their weight and value calculating methods are given, and the maintainability fuzzy evaluation method is proposed based on the relative closeness. According to the maintenance task simulation operated in virtual environment, the maintainability virtual evaluation model is built by analyzing the maintenance task for each replaceable unit of product. At last, a case study is given based upon the main landing gear system of a certain type civil aircraft, and the result indicates that the model is suitable for maintainability qualitative evaluation and can support maintainability concurrent design.展开更多
Design for modem engineering system is becoming multidisciplinary and incorporates practical uncertainties; therefore, it is necessary to synthesize reliability analysis and the multidisciplinary design optimization ...Design for modem engineering system is becoming multidisciplinary and incorporates practical uncertainties; therefore, it is necessary to synthesize reliability analysis and the multidisciplinary design optimization （MDO） techniques for the design of complex engineering system. An advanced first order second moment method-based concurrent subspace optimization approach is proposed based on the comparison and analysis of the existing multidisciplinary optimization techniques and the reliability analysis methods. It is seen through a canard configuration optimization for a three-surface transport that the proposed method is computationally efficient and practical with the least modification to the current deterministic optimization process.展开更多
This paper outlines a concurrent engineering environment that supports interaction between members of a geographically dispersed multidisciplinary team who is engaged in engineering design activities. Some ideas of en...This paper outlines a concurrent engineering environment that supports interaction between members of a geographically dispersed multidisciplinary team who is engaged in engineering design activities. Some ideas of engineering design, especially conceptual design are reviewed. A deeper scientific analysis of intelligent design is discussed. A new problem solving strategy and methodologies to implement cooperative design are proposed. Finally, a conceptual model of a blackboard system for accomplishing conceptual design automation is presented. Its fundamental principles, system organization and key implementation techniques are investigated in detail.展开更多
Taking a microwave product as an example, a system of integrated assembly structure design is presented. Getting design constraints from the upstream design section through product data management(PDM), the system gen...Taking a microwave product as an example, a system of integrated assembly structure design is presented. Getting design constraints from the upstream design section through product data management(PDM), the system generates the assembly scheme using the case? based method, then assigns the design requirements into each component of the assembly. The detail design for each component can be performed under these design constraints. In order to practise concurrent design, the system sends the final design result to the upstream section and downstream section through PDM to achieve information sharing and integration.展开更多
基金supported by the Science and Technology Development Fund of the Fourth Military Medical University(No.2016XB051)the Military Medical Promotion Plan of the Fourth Military Medical University(No.2016TSA-005)+2 种基金the Science and Technology Program of Guangzhou(No.201604040002)the Youth Development Project of Air Force Medical University(No.21QNPY072)the Xijing Hospital Booster Program(No.XJZT24CZ10).
文摘Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone regeneration promotion effect of allo-BMSCs in 3D-printed autologous bone particle(ABP)scaffolds.First,we concurrently printed scaffolds with polycaprolactone,ABPs,and allo-BMSCs for appropriate support,providing bioactive factors and seed cells to promote osteogenesis.In vitro studies showed that ABP scaffolds promoted allo-BMSC osteogenic differentiation.In vivo studies revealed that the implantation of scaffolds loaded with ABPs and allo-BMSCs into canine skull defects for nine months promoted osteogenesis.Further experiments suggested that only a small portion of implanted allo-BMSCs survived and differentiated into vascular endothelial cells,chondrocytes,and osteocytes.The implanted allo-BMSCs released stromal cell-derived factor 1 through paracrine signaling to recruit native BMSCs into the defect,promoting bone regeneration.This study contributes to our understanding of allo-BMSCs,providing information relevant to their future application.
基金supported by grants from the Zhejiang Provincial Natural Science Foundation(LGJ22H180001)Zhejiang Medical and Health Science and Technology Project(2021KY249)the National Key R&D Program of China(2017YFC1310000).
文摘Attempts have been made to modulate motor sequence learning(MSL)through repetitive transcranial magnetic stimulation,targeting different sites within the sensorimotor network.However,the target with the optimum modulatory effect on neural plasticity associated with MSL remains unclarified.This study was therefore designed to compare the role of the left primary motor cortex and the left supplementary motor area proper(SMAp)in modulating MSL across different complexity levels and for both hands,as well as the associated neuroplasticity by applying intermittent theta burst stimulation together with the electroencephalogram and concurrent transcranial magnetic stimulation.Our data demonstrated the role of SMAp stimulation in modulating neural communication to support MSL,which is achieved by facilitating regional activation and orchestrating neural coupling across distributed brain regions,particularly in interhemispheric connections.These findings may have important clinical implications,particularly for motor rehabilitation in populations such as post-stroke patients.
文摘BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced cases.Concurrent chemoradiotherapy(CCRT)has an inhibitory effect on MT.CASE SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our hospital.Computed tomography revealed right hydronephrosis and a 6-cm pelvic mass.Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell carci-noma.The patient was diagnosed with MT of MCT.Due to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse effects.After CCRT,her performance status improved,and the tumor size was reduced;surgery was performed.Five months postoperatively,the patient developed dis-semination and lymph node metastases.Palliative chemotherapy was ineffective.She died 18 months after treatment initiation.CONCLUSION EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.
基金supported by the Young Talents Program of Jiangsu Cancer Hospital(grant number:QL201813).
文摘Small cell lung cancer(SCLC)constitutes approximately 15%of all lung cancer cases,characterized by rapid tumor growth,a high pro-liferation rate,and a propensity for early metastasis.1 Approximately one-third of SCLC patients are diagnosed at the limited-stage.Histor-ically,the standard of care for these patients has been 4-6 cycles of concurrent chemoradiotherapy(cCRT),with the exception of a minor-ity of early-stage T1-2N0 patients who may undergo radical surgery.2 Despite an initial high sensitivity to treatment,over 50%of patients experience disease recurrence within two years,with a median overall survival(OS)ranging from 16 to 24 months.For the past three decades,while there have been novel explorations in radiotherapy dosing and fractionation,the treatment paradigm for limited-stage SCLC(LS-SCLC)has remained largely unchanged,with no significant improvement in patient survival outcomes.
文摘Objective:Radiotherapy(RT)is the definitive treatment for stageⅡnasopharyngeal carcinoma(NPC),which is classified as stagesⅠA andⅠB in the latest ninth edition of American Joint Committee on Cancer(AJCC)/Union for International Cancer Control(UICC).A crucial question is whether concurrent chemo-radiotherapy(CCRT)could derive additional benefits to this recent“down-staging”subgroup of NPC patients.This study aimed to interrogate clinical and radiomic features for predicting 5-year progression-free survival(PFS)of stageⅡNPC treated with RT alone or CCRT.Methods:Imaging and clinical data of 166 stageⅡNPC(eighth edition AJCC/UICC)patients were collected.Data were allocated into training,internal testing,and external testing sets.For each case,851 radiomic features were extracted and 10 clinical features were collected.Radiomic and clinical features most associated with the 5-year PFS were selected separately.A combined model was developed using multivariate logistic regression by integrating selected features and treatment option to predict 5-year PFS.Model performances were evaluated by area under the receiver operating curve(AUC),prediction accuracy,and decision curve analysis.Survival analyses including Kaplan-Meier analysis and Cox regression model were performed for further analysis.Results:Thirteen radiomic features,three clinical features,and treatment option were considered for model development.The combined model showed higher prognostic performance than using either.For the merged testing set(internal and external testing sets),AUC is 0.76(combined)vs.0.56-0.80(clinical or radiomic alone)and accuracy is 0.75(combined)vs.0.62-0.73(clinical or radiomic alone).Kaplan-Meier analysis using the combined model showed significant discrimination in PFS of the predicted low-risk and high-risk groups in the training and internal testing cohorts(P<0.05).Conclusions:Integrating with clinical and radiomic features could provide prognostic information on 5-year PFS under either treatment regimen,guiding individualized decisions of chemotherapy based on the predicted treatment outcome.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea,funded by the Ministry of Education(No.2022R1I1A1A01056406)。
文摘Defective phononic crystals(PnCs)have enabled spatial localization and quantitative amplification of elastic wave energy.Most previous research has focused on applications such as narrow-bandpass filters,ultrasonic sensors,and piezoelectric energy harvesters,typically operating under the assumption of an external elastic wave incidence.Recently,a novel approach that uses defective PnCs as ultrasonic actuators to generate amplified waves has emerged.However,the existing studies are limited to the generation of either longitudinal or bending waves,with no research addressing the concurrent generation of both.Hence,this paper proposes a straightforward methodology for the concurrent generation and amplification of both wave types utilizing defect modes at independent defect-band frequencies.Bimorph piezoelectric elements are attached to the defect,with each element connected to independent external voltage sources.By precisely adjusting the magnitude and temporal phase differences between the voltage sources,concurrently amplified wave generation is achieved.The paper highlights the advantages of the proposed analytical model.This model is both computationally time-efficient and accurate,in comparison with the COMSOL simulation results.For instance,in case studies,the analytical model reduces the computational time from one hour to mere seconds,while maintaining acceptable error rates of 1%in peak frequencies.This concurrent wave-generation methodology opens new avenues for applications in rotating machinery fault diagnosis,structural health monitoring,and medical imaging.
基金co-supported by National Key R&D Program of China(No.2022YFB4602003)Key Project of National Natural Science Foundation of China(No.12032018)+2 种基金Guangdong Basic and Applied Basic Research Foundation(No.2022A1515110489)National Natural Science Foundation of China-China Academy of General Technology Joint Fund for Basic Research(No.52375380)National Key Research and Development Program of China(No.2022YFB3402200)。
文摘A novel Additive Manufacturing(AM)-driven concurrent design strategy based on the beam characterization model considering strength constraints is proposed.The lattice topology,radius size,Building Orientation(BO),and structural yield strength can be simultaneously adjusted by integrating the overall process-structure-performance relationship of the AM process into the optimization.Specifically,the transverse isotropic material model is adopted to describe the material properties induced by the layer-by-layer manner of additive manufacturing.To bolster lattice strength performance,the stress constraints and ratio constraints of lattice struts are employed.The Tsai-Wu yield criterion is implemented to characterize the lattice strut's strength,while the P-norm method streamlines the handling of multiple constraints,minimizing computational overhead.Moreover,the gradient-based optimization model is established,where both the individual struts diameters and BO can be designed,and the buckling-prone spatial struts are strategically eliminated to improve the lattice strength further.Furthermore,several typical structures are optimized to verify the effectiveness of the proposed method.The optimized results are quite encouraging since the heterogeneous lattice structures with optimized BO obtained by the strength-based concurrent method show a remarkably improved performance compared to traditional designs.
文摘BACKGROUND Patients with concurrent acute biliary pancreatitis(ABP)and acute cholangitis(AC)may experience exacerbated clinical consequences due to bile duct stones.However,studies exploring this topic remain limited.AIM To compare the clinical presentation and outcomes of patients experiencing AC with and without ABP.METHODS This single-center retrospective cohort study included 358 patients with AC who underwent endoscopic retrograde cholangiopancreatography(ERCP)between January 2016 and December 2017.Patients were divided into two groups:AC with ABP(n=90)and AC without ABP(n=268).Clinical characteristics,laboratory data,ERCP results,primary study outcome[intensive care unit(ICU)admission],and secondary outcomes including 30-day mortality,length of hospital stay,and 30-day readmission rate were analyzed and compared.RESULTS All patients in the AC with ABP group had interstitial pancreatitis.The AC with ABP group had significantly higher white cell count(WBC)counts(13.1×10^(3)/μL vs 10.4×10^(3)/μL,P=0.007)and more abnormal WBC results(61.1%vs 42.3%,P=0.015).Liver biochemical tests,AC severity,ERCP success,adverse events,ICU admissions,30-day mortality,hospital stay,and readmission rates did not differ significantly between the two groups.Univariate analysis showed no significant link between concurrent ABP and ICU admission,although significance was marginal in moderate/severe ABP cases(P=0.051).In the multivariate analysis,age(P=0.035)and cardiovascular dysfunction(P<0.001)were independently associated with length of ICU stay.CONCLUSION Concurrent interstitial ABP and AC did not significantly affect outcomes.Age and cardiovascular dysfunction were stronger predictors of ICU admission and should guide clinical monitoring and management.
基金supported by the Beijing Xisike Clinical Oncology Research Foundation(grant number:Y-pierrefabre202101-0119)the National High Level Hospital Clinical Research Funding and the Cooperation Fund of CHCAMS Beijing&Langfang&SZCH(grant number:CFA202502021).
文摘Background:Individuals with unresectable stageⅢnon-small cell lung cancer(NSCLC)who receive complete concurrent chemoradiotherapy(cCRT)can benefit from long-term survival.Although neoadjuvant chemoim-munotherapy(NACIT)have achieved breakthroughs in treating unresectable stageⅢNSCLC,patients who have received induction chemoimmunotherapy are considered poor candidates for cCRT due to concerns about tolerability.Oral vinorelbine chemotherapy is widely used in clinical settings because of its safety,even for frail patients.The objective of this trial was to assess the efficacy and safety of oral vinorelbine plus concurrent radiotherapy(RT)for individuals with unresectable stageⅢNSCLC following NACIT who were not candidates for concurrent intravenous chemotherapy.Methods:This was a single-arm,phase 2 trial.The primary endpoint was the objective response rate(ORR),while the secondary endpoints consisted of the disease control rate(DCR),safety,overall survival(OS),as well as progression-free survival(PFS).Results:Between March 10,2023 and April 24,2025,46 individuals with unresectable stageⅢNSCLC were administered oral vinorelbine plus thoracic RT.Patients were treated with oral vinorelbine(60 mg/m^(2)once a week for 2 weeks as induction therapy before thoracic RT)and 30 mg/m^(2)per week with concurrent RT(59.4-60.2 Gy)over 5.5 weeks.The median age of the patients was 62.5 years,with 42 being male(91.3%).The ORR was 52.1%(95%confidence interval[CI],35.1%-65.9%),with 24 partial responders.A 95.7%DCR(85.5%-98.8%)was observed,and 20 patients had stable disease.The median follow-up was 22.5 months;the median PFS was 18.0 months and the median OS was not reached.The most commonly observed adverse events(AEs)included leukopenia(grade 1,26.1%),anemia(grade 1,17.4%),neutropenia(grade 1,10.9%),acute esophagitis(grade 2,17.4%),and treatment-related pneumonitis(grade 1-2,60.9%).No grade 3 or 4 treatment-related AEs were recorded.Conclusion:In individuals with unresectable stageⅢNSCLC who had received NACIT and were not candidates for concurrent intravenous chemotherapy with RT,the oral vinorelbine plus concurrent RT demonstrated promising antitumor efficacy with acceptable toxicity profiles.
基金funded by the National Natural Science Foundation of China under Grant No.62362019the Hainan Provincial Natural Science Foundation of China under Grant No.624RC482.
文摘Metadata prefetching and data placement play a critical role in enhancing access performance for file systems operating over wide-area networks.However,developing effective strategies for metadata prefetching in environments with concurrent workloads and for data placement across distributed networks remains a significant challenge.This study introduces novel and efficient methodologies for metadata prefetching and data placement,leveraging fine-grained control of prefetching strategies and variable-sized data fragment writing to optimize the I/O bandwidth of distributed file systems.The proposed metadata prefetching technique employs dynamic workload analysis to identify dominant workload patterns and adaptively refines prefetching policies,thereby boosting metadata access efficiency under concurrent scenarios.Meanwhile,the data placement strategy improves write performance by storing data fragments locally within the nearest data center and transmitting only the fragment location metadata to the remote data center hosting the original file.Experimental evaluations using real-world system traces demonstrate that the proposed approaches reduce metadata access times by up to 33.5%and application data access times by 17.19%compared to state-of-the-art techniques.
基金funded by the National Natural Science Foundation of China grant 81700148 and Natural Science Foundation of Guangdong Province grant 2021A1515010093 and 2023A1515011862funded by the National Natural Science Foundation of China grant 82170181funded by the Basic and Applied Basic Research Foundation of Guangdong Province grant 2022B1515120087.
文摘Objectives:The optimal treatment strategy for early-stage natural killer/T-cell lymphoma(NKTCL)remains unclear.This study aimed to evaluate and compare the clinical outcomes and adverse events(AEs)associated with two treatment regimens for early-stage NKTCL:pegaspargase with concurrent radiation therapy(P+CCRT)and pegaspargase,gemcitabine,and oxaliplatin(P-GEMOX)with sequential radiation therapy(SERT).Propensity score matching(PSM)was employed to ensure balanced comparison between these regimens.Methods:We assessed the efficacy of P+CCRT from a phase II trial and P-GEMOX combined with SERT using real-world data.PSM was conducted at a 1:1 ratio with a caliper of 0.18 to align baseline characteristics between the treatment groups.Key outcomes analyzed included overall response rate(ORR),complete response rate(CR),progression-free survival(PFS),overall survival(OS),and AEs.Results:Following PSM,the study included 52 patients,with 26 in each treatment group.Baseline characteristics were balanced between the cohorts.The ORR for P+CCRT group was 100.0%compared to 88.5%for P-GEMOX+SERT group,and the CR rates was 100.0%vs.76.9%,respectively.The 3-year OS and PFS rates were both 92.3%for P+CCRT,while P-GEMOX showed 92.3%OS and 80.8%PFS.Adverse events,including hematological toxicity,hepatotoxicity,and coagulation dysfunction,were comparable between the two regimens.Conclusion:P+CCRT is associated with comparable clinical outcomes compared to P-GEMOX+SERT in early-stage NKTCL,with comparable adverse events.Additionally,P+CCRT offers the benefit of a more streamlined treatment regimen with a shorter cycle.Given these encouraging results,further cohort studies are needed to validate these results.
文摘近似串匹配技术在网络信息搜索、数字图书馆、模式识别、文本挖掘、IP路由查找、网络入侵检测、生物信息学、音乐研究计算等领域具有广泛的应用.基于CREW-PRAM(parallel random access machine with concurrent read and exclusive write)模型,采用波前式并行推进的方法直接计算编辑距离矩阵D,设计了一个允许k-差别的近似串匹配动态规划并行算法,该算法使用(m+1)个处理器,时间复杂度为O(n),算法理论上达到线性加速;采取水平和斜向双并行计算编辑距离矩阵D的方法,设计了一个使用a(m+1)个处理器和O(n/a+m)时间的、可伸缩的、允许k-差别的近似串匹配动态规划并行算法,+<11mna.基于分治策略,通过灵活拆分总线和合并子总线动态重构光总线系统,并充分利用光总线的消息播送技术和并行计算前缀和的方法,实现了汉明距离的并行计算,设计了两个基于LARPBS(linear arrays with reconfigurable pipelined bus system)模型的通信高效、可扩放的允许k-误配的近似串匹配并行算法,其中一个算法使用n个处理器,时间为O(m);另一个为常数时间算法,使用mn个处理器.
基金National Natural Science Foundation of China-Joint Found of Civil Aviation Research (60572171)
文摘Maintainability influencing attributes are analyzed, their weight and value calculating methods are given, and the maintainability fuzzy evaluation method is proposed based on the relative closeness. According to the maintenance task simulation operated in virtual environment, the maintainability virtual evaluation model is built by analyzing the maintenance task for each replaceable unit of product. At last, a case study is given based upon the main landing gear system of a certain type civil aircraft, and the result indicates that the model is suitable for maintainability qualitative evaluation and can support maintainability concurrent design.
基金National Natural Science Foundation of China (10377015)
文摘Design for modem engineering system is becoming multidisciplinary and incorporates practical uncertainties; therefore, it is necessary to synthesize reliability analysis and the multidisciplinary design optimization （MDO） techniques for the design of complex engineering system. An advanced first order second moment method-based concurrent subspace optimization approach is proposed based on the comparison and analysis of the existing multidisciplinary optimization techniques and the reliability analysis methods. It is seen through a canard configuration optimization for a three-surface transport that the proposed method is computationally efficient and practical with the least modification to the current deterministic optimization process.
文摘This paper outlines a concurrent engineering environment that supports interaction between members of a geographically dispersed multidisciplinary team who is engaged in engineering design activities. Some ideas of engineering design, especially conceptual design are reviewed. A deeper scientific analysis of intelligent design is discussed. A new problem solving strategy and methodologies to implement cooperative design are proposed. Finally, a conceptual model of a blackboard system for accomplishing conceptual design automation is presented. Its fundamental principles, system organization and key implementation techniques are investigated in detail.
文摘Taking a microwave product as an example, a system of integrated assembly structure design is presented. Getting design constraints from the upstream design section through product data management(PDM), the system generates the assembly scheme using the case? based method, then assigns the design requirements into each component of the assembly. The detail design for each component can be performed under these design constraints. In order to practise concurrent design, the system sends the final design result to the upstream section and downstream section through PDM to achieve information sharing and integration.
