Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration ...BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration can be delayed for several months,leading to concern for distant metastases.To counteract this,a novel treatment approach known as total neoadjuvant therapy(TNT)has gained popularity,in which patients receive both maChT and nCRT prior to resection.We utilized the National Cancer Database to examine temporal trends in TNT usage,and any potential effect on survival.AIM To study the temporal trends in the usage of TNT and evaluate its efficacy compared to neoadjuvant chemoradiation.METHODS We queried the National Cancer Database for patients with locally advanced rectal cancer,Stage II-III,from 2004-2015 treated with nCRT or TNT.TNT was defined as maChT initiated≥90 d prior to nCRT initiation.Overall survival was calculated from the date of diagnosis to the date of last contact or death using Kaplan-Meier curves to present the cumulative probability of survival,with logrank statistics to assess significance.Multivariable cox regression was used to identify predictors of survival and propensity score analysis accounted for bias.RESULTS We identified 9066 eligible patients,with 8812 and 254 patients receiving neoadjuvant chemoradiation followed by maChT and TNT,respectively.Nodal involvement,stage III disease,and treatment in recent years were predictive of TNT use.There was greater use of TNT with more advanced stage,specifically>1 node involved(odds ratio[OR]=2.88,95%confidence interval[CI]:2.11-3.93,P<0.01)and stage III disease(OR=2.88,95%CI:2.11-3.93,P<0.01).From 2010 to 2012 the use of TNT increased(OR=2.41,95%CI:1.27-4.56,P<0.01)with a greater increase from 2013 to 2015(OR=6.62,95%CI:3.57-12.25,P<0.01).Both the TNT and neoadjuvant chemoradiation arms had a similar 5-year survival at 76%and 78%respectively.Multivariable analysis with propensity score demonstrated that increased age,high comorbidity score,higher grade,African American race,and female gender had worse overall survival.CONCLUSION Our data demonstrates a rising trend in TNT use,particularly in patients with worse disease.Patients treated with TNT and nCRT had similar survival.Randomized trials evaluating TNT are underway.展开更多
Recent ionospheric observations report anomalous total electron content (TEC) deviations prior strong earthquakes. We discuss common fetures of the pre-earthquake TEC disturbances on the basis of statistics covering 5...Recent ionospheric observations report anomalous total electron content (TEC) deviations prior strong earthquakes. We discuss common fetures of the pre-earthquake TEC disturbances on the basis of statistics covering 50 strong seismic events during 2005-2006. The F2-layer ionospheric plasma drift under action of the electric fields of seismic origin is proposed as the main reason of producing TEC anomalies. The origin of such electric fields is discussed in terms of the lithosphere-atmosphere-ionosphere coupling system. This theory is supported by numerical simulations using global Upper Atmosphere Model (UAM). UAM calculations show that the vertical electric current with the density of about 20 - 40 nA/m2 flowing between the Earth and ionosphere over an area of about 200 by 2000 km is required to produce the TEC disturbances with the amplitude of about 30% - 50% relatively to the non-disturbed conditions. Ionosphere responses on the variations of the latitudinal position, direction and configuration of the vertical electric currents have been investigated. We show that not only the vertical component of the ionospheric plasma drift but also horizontal components play an important role in producing pre-earthquake TEC disturbances.展开更多
BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical perf...BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.展开更多
Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascul...Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated.展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted kidney.Historically,allograft nephrectomy has been considered the only reasonable option.More recently,nephron-sparing...BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted kidney.Historically,allograft nephrectomy has been considered the only reasonable option.More recently,nephron-sparing surgery (NSS) and ablative therapy (AT) have been proposed as alternative procedures in selected cases.AIM To review outcomes of AT for the treatment of renal allograft tumours.METHODS We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 Checklist.PubMed was searched in March 2019 without time restrictions for all papers reporting on radiofrequency ablation (RFA),cryoablation (CA),microwave ablation (MWA),high-intensity focused ultrasound (HIFU),and irreversible electroporation (IRE) of solid tumours of the kidney allograft.Only original manuscripts describing actual cases and edited in English were considered.All relevant articles were accessed in full text.Additional searches included all pertinent references.Selected studies were also assessed for methodological quality using a tool based on a modification of the Newcastle Ottawa scale.Data on recipient characteristics,transplant characteristics,disease characteristics,treatment protocols,and treatment outcomes were extracted and analysed.Given the nature and the quality of the studies available (mostly retrospective case reports and small retrospective uncontrolled case series),a descriptive summary was provided.RESULTS Twenty-eight relevant studies were selected describing a total of 100 AT procedures in 92 patients.Recipient age at diagnosis ranged from 21 to 71 years whereas time from transplant to diagnosis ranged from 0.1 to 312 mo.Most of the neoplasms were asymptomatic and diagnosed incidentally during imaging carried out for screening purposes or for other clinical reasons.Preferred diagnostic modality was Doppler-ultrasound scan followed by computed tomography scan,and magnetic resonance imaging.Main tumour types were: papillary renal cell carcinoma (RCC) and clear cell RCC.Maximal tumour diameter ranged from 5 to 55 mm.The vast majority of neoplasms were T1a N0 M0 with only 2 lesions staged T1b N0 M0.Neoplasms were managed by RFA (n = 78),CA (n = 15),MWA (n = 3),HIFU (n = 3),and IRE (n = 1).Overall,3 episodes of primary treatment failure were reported.A single case of recurrence was identified.Follow-up ranged from 1 to 81 mo.No cancer-related deaths were observed.Complication rate was extremely low (mostly < 10%).Graft function remained stable in the majority of recipients.Due to the limited sample size,no clear benefit of a single procedure over the other ones could be demonstrated.CONCLUSION AT for renal allograft neoplasms represents a promising alternative to radical nephrectomy and NSS in carefully selected patients.Properly designed clinical trials are needed to validate this therapeutic approach.展开更多
Food provides not only essential nutrients required for life, but also bioactive compounds usefull to maintan good health and disease prevention. Abundant epidemiological evidences suggest that consumption of food ric...Food provides not only essential nutrients required for life, but also bioactive compounds usefull to maintan good health and disease prevention. Abundant epidemiological evidences suggest that consumption of food rich in antioxi-dants (non-nutritional components) can prevent degenerative diseases. A total of 26 commonly consumed nuts, oil seeds, edible oils, milk and milk products were chosen for the study. Considering the fact that antioxidant content (AOC) and phenolic contents (PC) of these foods was not established systematically in Indian context. Therefore, we have assessed and correlated the AOC and PC, an important antioxidant constituents of plant foods. AOC was assessed by DPPH (2, 2-Diphenyl-1-picryl hydrazyl) scavenging activity and FRAP (Ferric reducing antioxidant power) methods and phenolic content (PC), using Folin-Ciocalteu reagent. Among the nuts and oil seeds arecanut had the highest phenolic and antioxidant content 10841, 4220341 mg/100g respectively. In milk, edible oils and sugars the values ranged from 336 -11674 mg/100g. Jaggery had the highest PC and AOC among the foods studied . Although AOC and PC showed wide variation among the foods, AOC was correlated significantly with PC. Indeed the ‘r’ value between PC and AOC (DPPH and FRAP) was 0.99 (p < 0.01) among the nuts and oil seeds, while in milk, milk products and sugars, the “r” values ranged from 0.93 and 0.99 (p < 0.01) respectively. The overall results indicate that the phenolic compounds may be significant contributors to the AOC of the foods studied.展开更多
The Editors of Asian Pacific Journal of Reproduction wish to thank all reviewers listed below,as well as any others whose names may have been inadvertently omitted,for contributing their time and expertise in reviewin...The Editors of Asian Pacific Journal of Reproduction wish to thank all reviewers listed below,as well as any others whose names may have been inadvertently omitted,for contributing their time and expertise in reviewing manuscripts submitted to the journal in 2025.Their efforts have greatly contributed to the continued growth and quality of the journal.Here we acknowledge,with special thanks,to those who reviewed one or more papers during the year.Every effort has been made to ensure the accuracy of the list;we apologize for any errors or omissions.展开更多
The editors of International Journal of Ophthalmology gratefully acknowledge the members of IJO Editorial Board and reviewers from 51 countries and regions who participated in the peer-reviews and provided their valua...The editors of International Journal of Ophthalmology gratefully acknowledge the members of IJO Editorial Board and reviewers from 51 countries and regions who participated in the peer-reviews and provided their valuable comments between Nov.1st,2024 and Oct.31st,2025.They volunteer their valuable time and expertise,and without them we would not maintain the necessary quality expected of the journal.We apologize if we have inadvertently missed a reviewer’s name off this list.展开更多
We conducted plant growth experiments in microbe-free vermiculite to study the effects of four types of fermented seaweed liquid fertilizer (SLF) made from nori (Pyropia yezoensis) seaweed on the germination, plant gr...We conducted plant growth experiments in microbe-free vermiculite to study the effects of four types of fermented seaweed liquid fertilizer (SLF) made from nori (Pyropia yezoensis) seaweed on the germination, plant growth characteristics, SPAD value, and nutrient content and uptake of komatsuna (Brassica rapa L. var. wakana komatsuna). The four types of fermented nori SLF used in this study were prepared by anaerobic fermentation of unwashed nori (SLF1), aerobic fermentation of unwashed nori (SLF2), anaerobic fermentation of washed nori (SLF3), and aerobic fermentation of washed nori (SLF4). Komatsuna seeds treated with 200-, 300-, and 400-fold dilutions of SLFs exhibited improved relative germination ratios (RGRs) at 3 and 4 days after sowing (DAS). At 4 DAS, the RGRs of seeds treated with 10-, 100-, 200-, 300-, and 400-fold SLF dilutions showed no differential effect. Seeds treated with undiluted SLFs did not germinate by 4 DAS. SLF1 may promote komatsuna seed germination. The nitrogen (N), calcium, magnesium, sodium (Na), and iodine (I) contents of plants treated with SLF1 were significantly increased relative to plants treated with the other SLFs. Moreover, the I and Na contents of plants were significantly increased by foliar spray application of different dilutions of SLF1. However, SLF treatment markedly reduced the shoot dry weight compared with 1/2-strength modified Hoagland nutrient (MHN) solution, although the same amounts of N and K were applied. SPAD values of the plants treated with SLFs were significantly higher than those of plants treated with MHN. Foliar treatment with SLFs had no significant effect on plant growth, SPAD value, or uptake of nutrients (except Na) relative to the control, but the I content was increased. Plants treated with SLF1 and SLF2 exhibited the highest Na uptake. Foliar spray treatments with SLF1 resulted in the highest I contents in plants. Based on our results, SLF1 is suitable for use as a liquid fertilizer to promote germination and increase nutrient content in komatsuna. These results need to be followed up in soil experiments in the presence of microbes in the rhizosphere.展开更多
Extreme climate events(e.g.,heatwaves and droughts)are becoming increasingly frequent due to global climate change,which inevitably affects tree growth and various other ecological processes.While the impacts of droug...Extreme climate events(e.g.,heatwaves and droughts)are becoming increasingly frequent due to global climate change,which inevitably affects tree growth and various other ecological processes.While the impacts of droughts on these processes have been widely evaluated,the effects of heatwaves on tree growth and soil water content(SWC)remain poorly understood,particularly those related to thinning treatment.In this study,we evaluated the impacts of the 2021 Pacific Northwest Heatwave and thinning on forest growth and SWC,as well as assessed how thinning might mitigate the heatwave's impacts in lodgepole pine forests in British Columbia,Canada.We measured meteorological data(air temperature,rainfall,solar radiation(SR),relative humidity(RH),and wind speed(W_(s)),sap flow,SWC,soil temperature(T_(s)),and tree diameters at the breast height(DBH)during the growing season(June–September)in the control(27,000 stems·ha^(-1)),lightly thinned(4,500 stems·ha^(-1)),and heavily thinned(1,100 stems·ha^(-1))experimental plots from 2018 to 2024.We found that thinning persistently and significantly(p<0.05)increased individual tree growth,with the most pronounced effects in the heavily thinned stands.The 2021 Pacific Northwest Heatwave led to an exceptionally hot growing season,significantly(p<0.05)reducing forest growth and SWC across all plots.Forest growth recovered in 2022 in the thinned plots but remained suppressed in the unthinned plots,suggesting that thinning effectively mitigated the impact of the heatwave on forest growth,while the heatwave's impacts were persistent in the unthinned plots.Our study highlights that thinning is a practical management strategy for improving tree growth and supporting climate change adaptation to extreme climate events.展开更多
Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an...Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.展开更多
Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
Comprehensive quantitative evaluation of shale gas content and the controlling factors in different occurrence states is of great significance for accurately assessing gas-bearing capacity and providing effective well...Comprehensive quantitative evaluation of shale gas content and the controlling factors in different occurrence states is of great significance for accurately assessing gas-bearing capacity and providing effective well-production strategies. A total of 122 core samples from well JY-A in the Fuling shale gas field were studied to reveal the characteristics of S_1 l shale,15 of which were selected to further predict the shale gas content in different occurrence states, which are dependent on geological factors in the thermal evolution process. Geological parameters were researched by a number of laboratory programs, and the factors influential in controlling shale gas content were extracted by both PCA and GRA methods and prediction models were confirmed by the BE method using SPSS software. Results reveal that the adsorbed gas content is mainly controlled by TOC, Ro, SSA, PD and pyrite content, and the free gas content is mainly controlled by S_2, quartz content, gas saturation and formation pressure for S_1 l in well JY-A. Three methods, including the on-site gas desorption method, the empirical formula method, and the multiple regression analysis method were used in combination to evaluate the shale gas capacity of well JY-A, all of which show that the overall shale gas content of well JY-A is in the range of 2.0–5.0 m^3/t and that the free gas ratio is about 50%, lower than that of well JY-1. Cause analysis further confirms the tectonics and preservation conditions of S_1 l in the geological processes, especially the influence of eastern boundary faults on well JY-A, as the fundamental reasons for the differences in shale gas enrichment in the Jiaoshiba area.展开更多
Objective:To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston,Jamaica.Methods:The quantitative study used a stratified random sampling techniq...Objective:To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston,Jamaica.Methods:The quantitative study used a stratified random sampling technique in the selection of the 20 representative milk samples from six(6) supermarkets.Microbiological tests such as methylene blue reduction,standard plate count(SPC),coliform plate count(CPC),purity plate culture,gram staining and biochemical tests were performed to examine the microbes in purchased unexpired pasteurized milk.Results:One sample(BCr016) had a pH of 4.0.a rancid odour and curdled appearance.It decolourized within one hour during the methylene blue reduction test and was classified as class 4 milk.Seven of the samples were sterile with no microbe growth on the plate count agar and violet red bile salt agar(VRBA).The milk samples that appeared to be safe for consumption were all 10,11,12 and 13 days before expiration.The VRBA sample BCr016,had a colony count of 13 400 CFU/ mL.There was the presence of Escherichia coli in sample LCr021 which had a standard plate count of 1 580 SPC/mL and a coliform count of 500 CFU/mL.Enterobacter sp.was present in colonies from BCr016 and all the other milk samples.Conclusions:Unacceptable levels of Entembacter spp.and Escherichia coli were found in most of the samples.Effective measures to ensure safe milk for human consumption such as the phosphatase test and methylene blue reduction test should be routinely performed on each batch of milk processed by dairy plants.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
文摘BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by resection and postoperative multi-agent chemotherapy(maChT)is the standard of care for locally advanced rectal cancer.Using this approach,maChT administration can be delayed for several months,leading to concern for distant metastases.To counteract this,a novel treatment approach known as total neoadjuvant therapy(TNT)has gained popularity,in which patients receive both maChT and nCRT prior to resection.We utilized the National Cancer Database to examine temporal trends in TNT usage,and any potential effect on survival.AIM To study the temporal trends in the usage of TNT and evaluate its efficacy compared to neoadjuvant chemoradiation.METHODS We queried the National Cancer Database for patients with locally advanced rectal cancer,Stage II-III,from 2004-2015 treated with nCRT or TNT.TNT was defined as maChT initiated≥90 d prior to nCRT initiation.Overall survival was calculated from the date of diagnosis to the date of last contact or death using Kaplan-Meier curves to present the cumulative probability of survival,with logrank statistics to assess significance.Multivariable cox regression was used to identify predictors of survival and propensity score analysis accounted for bias.RESULTS We identified 9066 eligible patients,with 8812 and 254 patients receiving neoadjuvant chemoradiation followed by maChT and TNT,respectively.Nodal involvement,stage III disease,and treatment in recent years were predictive of TNT use.There was greater use of TNT with more advanced stage,specifically>1 node involved(odds ratio[OR]=2.88,95%confidence interval[CI]:2.11-3.93,P<0.01)and stage III disease(OR=2.88,95%CI:2.11-3.93,P<0.01).From 2010 to 2012 the use of TNT increased(OR=2.41,95%CI:1.27-4.56,P<0.01)with a greater increase from 2013 to 2015(OR=6.62,95%CI:3.57-12.25,P<0.01).Both the TNT and neoadjuvant chemoradiation arms had a similar 5-year survival at 76%and 78%respectively.Multivariable analysis with propensity score demonstrated that increased age,high comorbidity score,higher grade,African American race,and female gender had worse overall survival.CONCLUSION Our data demonstrates a rising trend in TNT use,particularly in patients with worse disease.Patients treated with TNT and nCRT had similar survival.Randomized trials evaluating TNT are underway.
文摘Recent ionospheric observations report anomalous total electron content (TEC) deviations prior strong earthquakes. We discuss common fetures of the pre-earthquake TEC disturbances on the basis of statistics covering 50 strong seismic events during 2005-2006. The F2-layer ionospheric plasma drift under action of the electric fields of seismic origin is proposed as the main reason of producing TEC anomalies. The origin of such electric fields is discussed in terms of the lithosphere-atmosphere-ionosphere coupling system. This theory is supported by numerical simulations using global Upper Atmosphere Model (UAM). UAM calculations show that the vertical electric current with the density of about 20 - 40 nA/m2 flowing between the Earth and ionosphere over an area of about 200 by 2000 km is required to produce the TEC disturbances with the amplitude of about 30% - 50% relatively to the non-disturbed conditions. Ionosphere responses on the variations of the latitudinal position, direction and configuration of the vertical electric currents have been investigated. We show that not only the vertical component of the ionospheric plasma drift but also horizontal components play an important role in producing pre-earthquake TEC disturbances.
文摘BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.
基金supported by the Natural Science Foundation of Liaoning Province of China,No.20170541036(to HYL)
文摘Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated.
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
文摘BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted kidney.Historically,allograft nephrectomy has been considered the only reasonable option.More recently,nephron-sparing surgery (NSS) and ablative therapy (AT) have been proposed as alternative procedures in selected cases.AIM To review outcomes of AT for the treatment of renal allograft tumours.METHODS We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 Checklist.PubMed was searched in March 2019 without time restrictions for all papers reporting on radiofrequency ablation (RFA),cryoablation (CA),microwave ablation (MWA),high-intensity focused ultrasound (HIFU),and irreversible electroporation (IRE) of solid tumours of the kidney allograft.Only original manuscripts describing actual cases and edited in English were considered.All relevant articles were accessed in full text.Additional searches included all pertinent references.Selected studies were also assessed for methodological quality using a tool based on a modification of the Newcastle Ottawa scale.Data on recipient characteristics,transplant characteristics,disease characteristics,treatment protocols,and treatment outcomes were extracted and analysed.Given the nature and the quality of the studies available (mostly retrospective case reports and small retrospective uncontrolled case series),a descriptive summary was provided.RESULTS Twenty-eight relevant studies were selected describing a total of 100 AT procedures in 92 patients.Recipient age at diagnosis ranged from 21 to 71 years whereas time from transplant to diagnosis ranged from 0.1 to 312 mo.Most of the neoplasms were asymptomatic and diagnosed incidentally during imaging carried out for screening purposes or for other clinical reasons.Preferred diagnostic modality was Doppler-ultrasound scan followed by computed tomography scan,and magnetic resonance imaging.Main tumour types were: papillary renal cell carcinoma (RCC) and clear cell RCC.Maximal tumour diameter ranged from 5 to 55 mm.The vast majority of neoplasms were T1a N0 M0 with only 2 lesions staged T1b N0 M0.Neoplasms were managed by RFA (n = 78),CA (n = 15),MWA (n = 3),HIFU (n = 3),and IRE (n = 1).Overall,3 episodes of primary treatment failure were reported.A single case of recurrence was identified.Follow-up ranged from 1 to 81 mo.No cancer-related deaths were observed.Complication rate was extremely low (mostly < 10%).Graft function remained stable in the majority of recipients.Due to the limited sample size,no clear benefit of a single procedure over the other ones could be demonstrated.CONCLUSION AT for renal allograft neoplasms represents a promising alternative to radical nephrectomy and NSS in carefully selected patients.Properly designed clinical trials are needed to validate this therapeutic approach.
文摘Food provides not only essential nutrients required for life, but also bioactive compounds usefull to maintan good health and disease prevention. Abundant epidemiological evidences suggest that consumption of food rich in antioxi-dants (non-nutritional components) can prevent degenerative diseases. A total of 26 commonly consumed nuts, oil seeds, edible oils, milk and milk products were chosen for the study. Considering the fact that antioxidant content (AOC) and phenolic contents (PC) of these foods was not established systematically in Indian context. Therefore, we have assessed and correlated the AOC and PC, an important antioxidant constituents of plant foods. AOC was assessed by DPPH (2, 2-Diphenyl-1-picryl hydrazyl) scavenging activity and FRAP (Ferric reducing antioxidant power) methods and phenolic content (PC), using Folin-Ciocalteu reagent. Among the nuts and oil seeds arecanut had the highest phenolic and antioxidant content 10841, 4220341 mg/100g respectively. In milk, edible oils and sugars the values ranged from 336 -11674 mg/100g. Jaggery had the highest PC and AOC among the foods studied . Although AOC and PC showed wide variation among the foods, AOC was correlated significantly with PC. Indeed the ‘r’ value between PC and AOC (DPPH and FRAP) was 0.99 (p < 0.01) among the nuts and oil seeds, while in milk, milk products and sugars, the “r” values ranged from 0.93 and 0.99 (p < 0.01) respectively. The overall results indicate that the phenolic compounds may be significant contributors to the AOC of the foods studied.
文摘The Editors of Asian Pacific Journal of Reproduction wish to thank all reviewers listed below,as well as any others whose names may have been inadvertently omitted,for contributing their time and expertise in reviewing manuscripts submitted to the journal in 2025.Their efforts have greatly contributed to the continued growth and quality of the journal.Here we acknowledge,with special thanks,to those who reviewed one or more papers during the year.Every effort has been made to ensure the accuracy of the list;we apologize for any errors or omissions.
文摘The editors of International Journal of Ophthalmology gratefully acknowledge the members of IJO Editorial Board and reviewers from 51 countries and regions who participated in the peer-reviews and provided their valuable comments between Nov.1st,2024 and Oct.31st,2025.They volunteer their valuable time and expertise,and without them we would not maintain the necessary quality expected of the journal.We apologize if we have inadvertently missed a reviewer’s name off this list.
文摘We conducted plant growth experiments in microbe-free vermiculite to study the effects of four types of fermented seaweed liquid fertilizer (SLF) made from nori (Pyropia yezoensis) seaweed on the germination, plant growth characteristics, SPAD value, and nutrient content and uptake of komatsuna (Brassica rapa L. var. wakana komatsuna). The four types of fermented nori SLF used in this study were prepared by anaerobic fermentation of unwashed nori (SLF1), aerobic fermentation of unwashed nori (SLF2), anaerobic fermentation of washed nori (SLF3), and aerobic fermentation of washed nori (SLF4). Komatsuna seeds treated with 200-, 300-, and 400-fold dilutions of SLFs exhibited improved relative germination ratios (RGRs) at 3 and 4 days after sowing (DAS). At 4 DAS, the RGRs of seeds treated with 10-, 100-, 200-, 300-, and 400-fold SLF dilutions showed no differential effect. Seeds treated with undiluted SLFs did not germinate by 4 DAS. SLF1 may promote komatsuna seed germination. The nitrogen (N), calcium, magnesium, sodium (Na), and iodine (I) contents of plants treated with SLF1 were significantly increased relative to plants treated with the other SLFs. Moreover, the I and Na contents of plants were significantly increased by foliar spray application of different dilutions of SLF1. However, SLF treatment markedly reduced the shoot dry weight compared with 1/2-strength modified Hoagland nutrient (MHN) solution, although the same amounts of N and K were applied. SPAD values of the plants treated with SLFs were significantly higher than those of plants treated with MHN. Foliar treatment with SLFs had no significant effect on plant growth, SPAD value, or uptake of nutrients (except Na) relative to the control, but the I content was increased. Plants treated with SLF1 and SLF2 exhibited the highest Na uptake. Foliar spray treatments with SLF1 resulted in the highest I contents in plants. Based on our results, SLF1 is suitable for use as a liquid fertilizer to promote germination and increase nutrient content in komatsuna. These results need to be followed up in soil experiments in the presence of microbes in the rhizosphere.
基金supported by the British Columbia Ministry of Forces through long-term annual contracts with University of British Columbia(Okanagan)(No.RE25SIR242)the Natural Sciences and Engineering Research Council of Canada(NSERC),Discovery Grants Program(No.RGPIN-2021-02628)+1 种基金supported by the China Postdoctoral Science Foundation(No.2024M760387)Heilongjiang Postdoctoral Financial Assistance(No.LBH-Z24062)。
文摘Extreme climate events(e.g.,heatwaves and droughts)are becoming increasingly frequent due to global climate change,which inevitably affects tree growth and various other ecological processes.While the impacts of droughts on these processes have been widely evaluated,the effects of heatwaves on tree growth and soil water content(SWC)remain poorly understood,particularly those related to thinning treatment.In this study,we evaluated the impacts of the 2021 Pacific Northwest Heatwave and thinning on forest growth and SWC,as well as assessed how thinning might mitigate the heatwave's impacts in lodgepole pine forests in British Columbia,Canada.We measured meteorological data(air temperature,rainfall,solar radiation(SR),relative humidity(RH),and wind speed(W_(s)),sap flow,SWC,soil temperature(T_(s)),and tree diameters at the breast height(DBH)during the growing season(June–September)in the control(27,000 stems·ha^(-1)),lightly thinned(4,500 stems·ha^(-1)),and heavily thinned(1,100 stems·ha^(-1))experimental plots from 2018 to 2024.We found that thinning persistently and significantly(p<0.05)increased individual tree growth,with the most pronounced effects in the heavily thinned stands.The 2021 Pacific Northwest Heatwave led to an exceptionally hot growing season,significantly(p<0.05)reducing forest growth and SWC across all plots.Forest growth recovered in 2022 in the thinned plots but remained suppressed in the unthinned plots,suggesting that thinning effectively mitigated the impact of the heatwave on forest growth,while the heatwave's impacts were persistent in the unthinned plots.Our study highlights that thinning is a practical management strategy for improving tree growth and supporting climate change adaptation to extreme climate events.
文摘Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金financially supported by the Natural Science Foundation of China (NSFC Grant 41572106)+1 种基金the National Science and Technology Major Project "The enrichment conditions, evaluation technology and application of shale gas in the Sichuan Basin and its periphery" (Item No. 2017ZX05035002-006)State Key Laboratory of oil and gas resources and exploration, Chinese University of Petroleum-Beijing
文摘Comprehensive quantitative evaluation of shale gas content and the controlling factors in different occurrence states is of great significance for accurately assessing gas-bearing capacity and providing effective well-production strategies. A total of 122 core samples from well JY-A in the Fuling shale gas field were studied to reveal the characteristics of S_1 l shale,15 of which were selected to further predict the shale gas content in different occurrence states, which are dependent on geological factors in the thermal evolution process. Geological parameters were researched by a number of laboratory programs, and the factors influential in controlling shale gas content were extracted by both PCA and GRA methods and prediction models were confirmed by the BE method using SPSS software. Results reveal that the adsorbed gas content is mainly controlled by TOC, Ro, SSA, PD and pyrite content, and the free gas content is mainly controlled by S_2, quartz content, gas saturation and formation pressure for S_1 l in well JY-A. Three methods, including the on-site gas desorption method, the empirical formula method, and the multiple regression analysis method were used in combination to evaluate the shale gas capacity of well JY-A, all of which show that the overall shale gas content of well JY-A is in the range of 2.0–5.0 m^3/t and that the free gas ratio is about 50%, lower than that of well JY-1. Cause analysis further confirms the tectonics and preservation conditions of S_1 l in the geological processes, especially the influence of eastern boundary faults on well JY-A, as the fundamental reasons for the differences in shale gas enrichment in the Jiaoshiba area.
文摘Objective:To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston,Jamaica.Methods:The quantitative study used a stratified random sampling technique in the selection of the 20 representative milk samples from six(6) supermarkets.Microbiological tests such as methylene blue reduction,standard plate count(SPC),coliform plate count(CPC),purity plate culture,gram staining and biochemical tests were performed to examine the microbes in purchased unexpired pasteurized milk.Results:One sample(BCr016) had a pH of 4.0.a rancid odour and curdled appearance.It decolourized within one hour during the methylene blue reduction test and was classified as class 4 milk.Seven of the samples were sterile with no microbe growth on the plate count agar and violet red bile salt agar(VRBA).The milk samples that appeared to be safe for consumption were all 10,11,12 and 13 days before expiration.The VRBA sample BCr016,had a colony count of 13 400 CFU/ mL.There was the presence of Escherichia coli in sample LCr021 which had a standard plate count of 1 580 SPC/mL and a coliform count of 500 CFU/mL.Enterobacter sp.was present in colonies from BCr016 and all the other milk samples.Conclusions:Unacceptable levels of Entembacter spp.and Escherichia coli were found in most of the samples.Effective measures to ensure safe milk for human consumption such as the phosphatase test and methylene blue reduction test should be routinely performed on each batch of milk processed by dairy plants.
