The follow-up application of underwater wireless sensor network is influenced by accuracy of self-localization of nodes. The self-localization of nodes is discussed in this paper. First of all, nodes of underwater wir...The follow-up application of underwater wireless sensor network is influenced by accuracy of self-localization of nodes. The self-localization of nodes is discussed in this paper. First of all, nodes of underwater wireless sensor network are classified into several levels according to the accuracy of position of nodes and the levels are from the first to the fifth in accordance with accuracy of nodes from high to low respectively. Secondly, the level of anchor nodes can be known by those unknown nodes from the information given by the anchor nodes themselves, At the same time the unknown nodes are able to be located in the area controlled by the first level of anchor nodes that are as the aggregation. Then the positioning algorithm is designed correspondingly in accordance with the accuracy level of nodes. Finally, the positioning algorithm is simulated and analyzed. The result shows that the unknown nodes can be located effectively by hierarchical control.展开更多
The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorect...The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.展开更多
Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reduci...Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes.展开更多
Lightweight nodes are crucial for blockchain scalability,but verifying the availability of complete block data puts significant strain on bandwidth and latency.Existing data availability sampling(DAS)schemes either re...Lightweight nodes are crucial for blockchain scalability,but verifying the availability of complete block data puts significant strain on bandwidth and latency.Existing data availability sampling(DAS)schemes either require trusted setups or suffer from high communication overhead and low verification efficiency.This paper presents ISTIRDA,a DAS scheme that lets light clients certify availability by sampling small random codeword symbols.Built on ISTIR,an improved Reed–Solomon interactive oracle proof of proximity,ISTIRDA combines adaptive folding with dynamic code rate adjustment to preserve soundness while lowering communication.This paper formalizes opening consistency and prove security with bounded error in the random oracle model,giving polylogarithmic verifier queries and no trusted setup.In a prototype compared with FRIDA under equal soundness,ISTIRDA reduces communication by 40.65%to 80%.For data larger than 16 MB,ISTIRDA verifies faster and the advantage widens;at 128 MB,proofs are about 60%smaller and verification time is roughly 25%shorter,while prover overhead remains modest.In peer-to-peer emulation under injected latency and loss,ISTIRDA reaches confidence more quickly and is less sensitive to packet loss and load.These results indicate that ISTIRDA is a scalable and provably secure DAS scheme suitable for high-throughput,large-block public blockchains,substantially easing bandwidth and latency pressure on lightweight nodes.展开更多
Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited ...Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited research directly comparing open and robotic RPLND.The objective of this systematic review is to identify all the literature with direct comparisons between the open and robotic techniques for RPLND and to compare the two techniques.The primary outcome was peri-operative outcomes,and the secondary outcomes included oncological outcomes and patient demographics.Methods:This systematic review was prospectively registered and was conducted in accordance with the PRISMA statement.The PubMed,Embase and MEDLINE databases were searched for relevant publication from January 2006 to August 2024.Results:Eight studies,totaling 3995 patients,are included in this systematic review,with 3521 patients who underwent open RPLND and 474 who underwent robotic RPLND.For open RPLND,the mean operative duration,blood loss and length of stay were 267.8 min,475 mL and 7.3 d,respectively.For robotic RPLND,the mean operative duration,blood loss and length of stay were 334.5 min,94.6 mL and 3.7 d,respectively.Teratoma was the most common RPLND specimen pathology from both open and robotic surgeries.For open RPLND,the specimens have 13–23 nodes(26–32 mm),whereas the robotic RPLND specimens have 13–28 nodes(18–20 mm).Conclusion:This systematic review suggests that the benefitsof robotic RPLND may be associated with reduced blood loss,shorter hospitalisation and an overall lower risk of minor and major complications while maintaining oncological safety.展开更多
BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning ofte...BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation.展开更多
Graph neural networks(GNN)have shown strong performance in node classification tasks,yet most existing models rely on uniform or shared weight aggregation,lacking flexibility in modeling the varying strength of relati...Graph neural networks(GNN)have shown strong performance in node classification tasks,yet most existing models rely on uniform or shared weight aggregation,lacking flexibility in modeling the varying strength of relationships among nodes.This paper proposes a novel graph coupling convolutional model that introduces an adaptive weighting mechanism to assign distinct importance to neighboring nodes based on their similarity to the central node.Unlike traditional methods,the proposed coupling strategy enhances the interpretability of node interactions while maintaining competitive classification performance.The model operates in the spatial domain,utilizing adjacency list structures for efficient convolution and addressing the limitations of weight sharing through a coupling-based similarity computation.Extensive experiments are conducted on five graph-structured datasets,including Cora,Citeseer,PubMed,Reddit,and BlogCatalog,as well as a custom topology dataset constructed from the Open University Learning Analytics Dataset(OULAD)educational platform.Results demonstrate that the proposed model achieves good classification accuracy,while significantly reducing training time through direct second-order neighbor fusion and data preprocessing.Moreover,analysis of neighborhood order reveals that considering third-order neighbors offers limited accuracy gains but introduces considerable computational overhead,confirming the efficiency of first-and second-order convolution in practical applications.Overall,the proposed graph coupling model offers a lightweight,interpretable,and effective framework for multi-label node classification in complex networks.展开更多
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu...BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.展开更多
Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a referen...Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.展开更多
Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurr...Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.展开更多
Self-localization is a fundamental requirement for the mobile robot. Robot usually contains a large number of dif- ferent sensors, which provide the information of robot localization, and all the sensor information sh...Self-localization is a fundamental requirement for the mobile robot. Robot usually contains a large number of dif- ferent sensors, which provide the information of robot localization, and all the sensor information should be considered for the optimal location. Kalman filter is efficient to realize the information fusion. Used as an efficient sensor fusion algorithm, Kalman filter is an advanced filtering technique which can reduce errors of the position and orientation of the sensors. Kalman filter has been paied much attention to robot automation and solutions to solve uncertainties such as robot localization, navigation, following, tracking, motion control, estimation and prediction. The paper briefly describes Kalman filter theory, and establishes a simple mathematical model based on muti-sensor mobile robot. Meanwhile, Kalman filter is used in robot self-localization by simulations, and it is demonstrated by simulations that Kalman filter is effective.展开更多
An on-the-fly,self-localization system is developed for mobile robot which is operative in a 3D environment with elaborative 3D landmarks.The robot estimates its pose recursively through a MAP estimator that incorpora...An on-the-fly,self-localization system is developed for mobile robot which is operative in a 3D environment with elaborative 3D landmarks.The robot estimates its pose recursively through a MAP estimator that incorporates the information collected from odometry and unidirectional camera.We build the nonlinear models for these two sensors and maintain that the uncertainty manipulation of robot motion and inaccurate sensor measurements should be embedded and tracked throughout our system.We describe the uncertainty framework in a probabilistic geometry viewpoint and use unscented transform to propagate the uncertainty,which undergoes the given nonlinear functions.Considering the processing power of our robot,image features are extracted in the vicinity of corresponding projected features.In addition,data associations are evaluated by statistical distance.Finally,a series of systematic experiments are conducted to prove the reliable and accurate performance of our system.展开更多
Many applications of wireless sensor networks can benefit from fine-grained localization. In this paper, we proposed an accurate, distributed localization method based on the time difference between radio signal and s...Many applications of wireless sensor networks can benefit from fine-grained localization. In this paper, we proposed an accurate, distributed localization method based on the time difference between radio signal and sound wave. In a trilateration, each node adaptively chooses a neighborhood of sensors and updates its position estimate with trilateration, and then passes this update to neighboring sensors. Application examples demonstrate that the proposed method is more robust and accurate in localizing node than the previous proposals and it can achieve comparable results using much fewer anchor nodes than the previous methods.展开更多
When a group of mobile agents track a target,they can locate themselves and the target in a cooperative manner.To maximize the group advantage,a parallel integration strategy of cooperative target-localization(CTL)and...When a group of mobile agents track a target,they can locate themselves and the target in a cooperative manner.To maximize the group advantage,a parallel integration strategy of cooperative target-localization(CTL)and cooperative self-localization(CSL)is designed.Firstly,a global cost function containing the agents’positions and the target’s position is established.Secondly,along with the agents’positions being re-estimated during CTL,the Utransform is employed to propagate the error covariance of the position estimations among the agents.The simulation results show that,the proposal exploits more information for locating the target and the agents than the cases where CTL and CSL run separately,and the global optimal position estimations of the agents and the target are obtained.展开更多
This paper develops a new algorithm for sensor network self-localization, which is an enhanced version of the existing Crocco’s method in [11]. The algorithm explores the noisy time of flight (TOF) measurements that ...This paper develops a new algorithm for sensor network self-localization, which is an enhanced version of the existing Crocco’s method in [11]. The algorithm explores the noisy time of flight (TOF) measurements that quantify the distances between sensor nodes to be localized and sources also at unknown positions. The newly proposed technique first obtains rough estimates of the sensor node and source positions, and then it refines the estimates via a least squares estimator (LSE). The LSE takes into account the geometrical constraints introduced by the desired global coordinate system to improve performance. Simulations show that the new technique offers superior localization accuracy over the original Crocco’s algorithm under small measurement noise condition.展开更多
Self-localization is one of the most important aspects for using mobile robots in unstructured environments. In this paper, the authors introduce a new approach for a self-localization and navigation unit for mobile p...Self-localization is one of the most important aspects for using mobile robots in unstructured environments. In this paper, the authors introduce a new approach for a self-localization and navigation unit for mobile platforms in extraterrestrial environments, based on the authors＂ successful results in self-localization of forestry machines on earth. The presented approach is developed from a highly modular concept, which allows a simple but efficient adaption to specific applications by just substituting some scenario dependent components. In this paper, the authors will explain the general concept and the terrestrial implementation so far. On this basis, the authors will demonstrate and discuss the necessary adaptions to the general concept in order to handle the different conditions on extraterrestrial surfaces.展开更多
BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors...BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors is their penetration of neighboring tissues,such as lymphatic and blood arteries,due to the tumor cells'capacity to break down the extracellular matrix(ECM).Matrix metalloproteinases(MMPs)constitute a family of proteolytic enzymes that facilitate tissue remodeling and the degradation of the ECM.MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions.MMP-13,a collagenase family member,is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens,whereas MMP-9 is thought to accelerate the growth of tumors.Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.AIM To assess the immunohistochemical expression of MMP-9 and MMP-13 in OSCC.METHODS A total of 40 cases with histologically confirmed OSCC by incisional biopsy were included in this cross-sectional retrospective study.The protocols for both MMP-9 and MMP-13 immunohistochemical staining were performed according to the manufacturer’s recommendations along with the normal gingival epithelium as a positive control.All the observations were recorded and Pearson’sχ²test with Fisher exact test was used for statistical analysis.RESULTS Our study showed no significant correlation between MMP-9 and MMP-13 staining intensity and tumor size.The majority of the patients were in advanced TNM stages(III and IV),and showed intense expression of MMP-9 and MMP-13.CONCLUSION The present study suggests that both MMP-9 and MMP-13 play an important and independent role in OSCC progression and invasiveness.Intense expression of MMP-9 and MMP-13,irrespective of histological grade of OSCC,correlates well with TNM stage.Consequently,it is evident that MMP-9 and MMP-13 are important for the invasiveness and progression of tumors.The findings may facilitate the development of new approaches for evaluating lymph node metastases and interventional therapy techniques,hence enhancing the prognosis of patients diagnosed with OSCC.展开更多
The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagn...The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.展开更多
基金Funded by Department of Education of Zhejiang Province (No.Y201119307)
文摘The follow-up application of underwater wireless sensor network is influenced by accuracy of self-localization of nodes. The self-localization of nodes is discussed in this paper. First of all, nodes of underwater wireless sensor network are classified into several levels according to the accuracy of position of nodes and the levels are from the first to the fifth in accordance with accuracy of nodes from high to low respectively. Secondly, the level of anchor nodes can be known by those unknown nodes from the information given by the anchor nodes themselves, At the same time the unknown nodes are able to be located in the area controlled by the first level of anchor nodes that are as the aggregation. Then the positioning algorithm is designed correspondingly in accordance with the accuracy level of nodes. Finally, the positioning algorithm is simulated and analyzed. The result shows that the unknown nodes can be located effectively by hierarchical control.
文摘The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.
基金supported by a grant from Kom op tegen Kanker(Stand Up to Cancer,Belgium).
文摘Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes.
基金supported in part by the Research Fund of Key Lab of Education Blockchain and Intelligent Technology,Ministry of Education(EBME25-F-08).
文摘Lightweight nodes are crucial for blockchain scalability,but verifying the availability of complete block data puts significant strain on bandwidth and latency.Existing data availability sampling(DAS)schemes either require trusted setups or suffer from high communication overhead and low verification efficiency.This paper presents ISTIRDA,a DAS scheme that lets light clients certify availability by sampling small random codeword symbols.Built on ISTIR,an improved Reed–Solomon interactive oracle proof of proximity,ISTIRDA combines adaptive folding with dynamic code rate adjustment to preserve soundness while lowering communication.This paper formalizes opening consistency and prove security with bounded error in the random oracle model,giving polylogarithmic verifier queries and no trusted setup.In a prototype compared with FRIDA under equal soundness,ISTIRDA reduces communication by 40.65%to 80%.For data larger than 16 MB,ISTIRDA verifies faster and the advantage widens;at 128 MB,proofs are about 60%smaller and verification time is roughly 25%shorter,while prover overhead remains modest.In peer-to-peer emulation under injected latency and loss,ISTIRDA reaches confidence more quickly and is less sensitive to packet loss and load.These results indicate that ISTIRDA is a scalable and provably secure DAS scheme suitable for high-throughput,large-block public blockchains,substantially easing bandwidth and latency pressure on lightweight nodes.
文摘Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited research directly comparing open and robotic RPLND.The objective of this systematic review is to identify all the literature with direct comparisons between the open and robotic techniques for RPLND and to compare the two techniques.The primary outcome was peri-operative outcomes,and the secondary outcomes included oncological outcomes and patient demographics.Methods:This systematic review was prospectively registered and was conducted in accordance with the PRISMA statement.The PubMed,Embase and MEDLINE databases were searched for relevant publication from January 2006 to August 2024.Results:Eight studies,totaling 3995 patients,are included in this systematic review,with 3521 patients who underwent open RPLND and 474 who underwent robotic RPLND.For open RPLND,the mean operative duration,blood loss and length of stay were 267.8 min,475 mL and 7.3 d,respectively.For robotic RPLND,the mean operative duration,blood loss and length of stay were 334.5 min,94.6 mL and 3.7 d,respectively.Teratoma was the most common RPLND specimen pathology from both open and robotic surgeries.For open RPLND,the specimens have 13–23 nodes(26–32 mm),whereas the robotic RPLND specimens have 13–28 nodes(18–20 mm).Conclusion:This systematic review suggests that the benefitsof robotic RPLND may be associated with reduced blood loss,shorter hospitalisation and an overall lower risk of minor and major complications while maintaining oncological safety.
基金Supported by Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2023MSXM060.
文摘BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation.
基金Support by Sichuan Science and Technology Program[2023YFSY0026,2023YFH0004]Guangzhou Huashang University[2024HSZD01,HS2023JYSZH01].
文摘Graph neural networks(GNN)have shown strong performance in node classification tasks,yet most existing models rely on uniform or shared weight aggregation,lacking flexibility in modeling the varying strength of relationships among nodes.This paper proposes a novel graph coupling convolutional model that introduces an adaptive weighting mechanism to assign distinct importance to neighboring nodes based on their similarity to the central node.Unlike traditional methods,the proposed coupling strategy enhances the interpretability of node interactions while maintaining competitive classification performance.The model operates in the spatial domain,utilizing adjacency list structures for efficient convolution and addressing the limitations of weight sharing through a coupling-based similarity computation.Extensive experiments are conducted on five graph-structured datasets,including Cora,Citeseer,PubMed,Reddit,and BlogCatalog,as well as a custom topology dataset constructed from the Open University Learning Analytics Dataset(OULAD)educational platform.Results demonstrate that the proposed model achieves good classification accuracy,while significantly reducing training time through direct second-order neighbor fusion and data preprocessing.Moreover,analysis of neighborhood order reveals that considering third-order neighbors offers limited accuracy gains but introduces considerable computational overhead,confirming the efficiency of first-and second-order convolution in practical applications.Overall,the proposed graph coupling model offers a lightweight,interpretable,and effective framework for multi-label node classification in complex networks.
文摘BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.
文摘Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund,“Research on the Role and Mechanism of PIGU in Regulating MUC-1 in Gastric Cancer Immune Escape”(Project No.:2023YJY-29)Shaanxi Provincial Natural Science Basic Research Program,“Research on the Mechanism and Clinical Significance of miR-140-5p Related to Gastric Cancer Recurrence and Metastasis”(Project No.:2023-JC-YB-639)。
文摘Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.
基金Research Fund for the Doctoral Program of Higher Education of China(No.20123718120007)
文摘Self-localization is a fundamental requirement for the mobile robot. Robot usually contains a large number of dif- ferent sensors, which provide the information of robot localization, and all the sensor information should be considered for the optimal location. Kalman filter is efficient to realize the information fusion. Used as an efficient sensor fusion algorithm, Kalman filter is an advanced filtering technique which can reduce errors of the position and orientation of the sensors. Kalman filter has been paied much attention to robot automation and solutions to solve uncertainties such as robot localization, navigation, following, tracking, motion control, estimation and prediction. The paper briefly describes Kalman filter theory, and establishes a simple mathematical model based on muti-sensor mobile robot. Meanwhile, Kalman filter is used in robot self-localization by simulations, and it is demonstrated by simulations that Kalman filter is effective.
基金Supported by National Natural Science Foundation of China(60605023,60775048)Specialized Research Fund for the Doctoral Program of Higher Education(20060141006)
文摘An on-the-fly,self-localization system is developed for mobile robot which is operative in a 3D environment with elaborative 3D landmarks.The robot estimates its pose recursively through a MAP estimator that incorporates the information collected from odometry and unidirectional camera.We build the nonlinear models for these two sensors and maintain that the uncertainty manipulation of robot motion and inaccurate sensor measurements should be embedded and tracked throughout our system.We describe the uncertainty framework in a probabilistic geometry viewpoint and use unscented transform to propagate the uncertainty,which undergoes the given nonlinear functions.Considering the processing power of our robot,image features are extracted in the vicinity of corresponding projected features.In addition,data associations are evaluated by statistical distance.Finally,a series of systematic experiments are conducted to prove the reliable and accurate performance of our system.
文摘Many applications of wireless sensor networks can benefit from fine-grained localization. In this paper, we proposed an accurate, distributed localization method based on the time difference between radio signal and sound wave. In a trilateration, each node adaptively chooses a neighborhood of sensors and updates its position estimate with trilateration, and then passes this update to neighboring sensors. Application examples demonstrate that the proposed method is more robust and accurate in localizing node than the previous proposals and it can achieve comparable results using much fewer anchor nodes than the previous methods.
文摘When a group of mobile agents track a target,they can locate themselves and the target in a cooperative manner.To maximize the group advantage,a parallel integration strategy of cooperative target-localization(CTL)and cooperative self-localization(CSL)is designed.Firstly,a global cost function containing the agents’positions and the target’s position is established.Secondly,along with the agents’positions being re-estimated during CTL,the Utransform is employed to propagate the error covariance of the position estimations among the agents.The simulation results show that,the proposal exploits more information for locating the target and the agents than the cases where CTL and CSL run separately,and the global optimal position estimations of the agents and the target are obtained.
文摘This paper develops a new algorithm for sensor network self-localization, which is an enhanced version of the existing Crocco’s method in [11]. The algorithm explores the noisy time of flight (TOF) measurements that quantify the distances between sensor nodes to be localized and sources also at unknown positions. The newly proposed technique first obtains rough estimates of the sensor node and source positions, and then it refines the estimates via a least squares estimator (LSE). The LSE takes into account the geometrical constraints introduced by the desired global coordinate system to improve performance. Simulations show that the new technique offers superior localization accuracy over the original Crocco’s algorithm under small measurement noise condition.
文摘Self-localization is one of the most important aspects for using mobile robots in unstructured environments. In this paper, the authors introduce a new approach for a self-localization and navigation unit for mobile platforms in extraterrestrial environments, based on the authors＂ successful results in self-localization of forestry machines on earth. The presented approach is developed from a highly modular concept, which allows a simple but efficient adaption to specific applications by just substituting some scenario dependent components. In this paper, the authors will explain the general concept and the terrestrial implementation so far. On this basis, the authors will demonstrate and discuss the necessary adaptions to the general concept in order to handle the different conditions on extraterrestrial surfaces.
文摘BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors is their penetration of neighboring tissues,such as lymphatic and blood arteries,due to the tumor cells'capacity to break down the extracellular matrix(ECM).Matrix metalloproteinases(MMPs)constitute a family of proteolytic enzymes that facilitate tissue remodeling and the degradation of the ECM.MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions.MMP-13,a collagenase family member,is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens,whereas MMP-9 is thought to accelerate the growth of tumors.Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.AIM To assess the immunohistochemical expression of MMP-9 and MMP-13 in OSCC.METHODS A total of 40 cases with histologically confirmed OSCC by incisional biopsy were included in this cross-sectional retrospective study.The protocols for both MMP-9 and MMP-13 immunohistochemical staining were performed according to the manufacturer’s recommendations along with the normal gingival epithelium as a positive control.All the observations were recorded and Pearson’sχ²test with Fisher exact test was used for statistical analysis.RESULTS Our study showed no significant correlation between MMP-9 and MMP-13 staining intensity and tumor size.The majority of the patients were in advanced TNM stages(III and IV),and showed intense expression of MMP-9 and MMP-13.CONCLUSION The present study suggests that both MMP-9 and MMP-13 play an important and independent role in OSCC progression and invasiveness.Intense expression of MMP-9 and MMP-13,irrespective of histological grade of OSCC,correlates well with TNM stage.Consequently,it is evident that MMP-9 and MMP-13 are important for the invasiveness and progression of tumors.The findings may facilitate the development of new approaches for evaluating lymph node metastases and interventional therapy techniques,hence enhancing the prognosis of patients diagnosed with OSCC.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81672638 and W2421095)National Natural Science Foundation of Shandong Province(Grant No.ZR2024LMB011)Collaborative Academic Innovation Project of Shandong Cancer Hospital(Grant No.GF003)。
文摘The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.
