The presence of a positive deep surgical margin in tongue squamous cell carcinoma(TSCC)significantly elevates the risk of local recurrence.Therefore,a prompt and precise intraoperative assessment of margin status is i...The presence of a positive deep surgical margin in tongue squamous cell carcinoma(TSCC)significantly elevates the risk of local recurrence.Therefore,a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection.In this study,we integrate Raman imaging technology with an artificial intelligence(AI)generative model,proposing an innovative approach for intraoperative margin status diagnosis.This method utilizes Raman imaging to swiftly and non-invasively capture tissue Raman images,which are then transformed into hematoxylin-eosin(H&E)-stained histopathological images using an AI generative model for histopathological diagnosis.The generated H&E-stained images clearly illustrate the tissue’s pathological conditions.Independently reviewed by three pathologists,the overall diagnostic accuracy for distinguishing between tumor tissue and normal muscle tissue reaches 86.7%.Notably,it outperforms current clinical practices,especially in TSCC with positive lymph node metastasis or moderately differentiated grades.This advancement highlights the potential of AI-enhanced Raman imaging to significantly improve intraoperative assessments and surgical margin evaluations,promising a versatile diagnostic tool beyond TSCC.展开更多
Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine...Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine’s Conservation Model as the theoretical framework,an item pool was formed through literature review,and the initial draft of the scale was refined through two rounds of Delphi expert consultation.A total of 200 postoperative patients were selected for item analysis,internal consistency testing,content validity,and structural validity analysis.Results:The final tool comprises four dimensions:energy conservation,structural integrity,personal integrity,and social integrity,with a total of 24 items.It demonstrates good content validity(I-CVI 0.82-1.00,S-CVI/Ave 0.95,S-CVI/UA 0.87)and excellent internal consistency(Cronbach’sαfor the overall scale was 0.934).Exploratory factor analysis revealed a KMO value of 0.931,Bartlett’s test of sphericityχ^(2)=4147.853(p<0.001),and four common factors were extracted,accounting for a cumulative variance contribution rate of 64.345%,indicating ideal structural validity.Conclusion:The results indicate that the assessment tool has good reliability and validity and can systematically evaluate postoperative wound healing,providing a scientific basis for clinical individualized nursing interventions.展开更多
BACKGROUND Scientifically sound and reasonable care strategies in surgical nursing play a crucial role in facilitating postoperative recovery and preventing complications.This study focused on the application of quant...BACKGROUND Scientifically sound and reasonable care strategies in surgical nursing play a crucial role in facilitating postoperative recovery and preventing complications.This study focused on the application of quantitative assessment strategies to postoperative care.By quantitatively analyzing the effects of nursing interventions,we explored their feasibility and effectiveness at improving postoperative recovery quality and reducing the incidence of complications.This study provides a scientific basis for nursing practice and offers new insights into nursing management with significant clinical value.AIM To analyze the efficacy of postoperative quantitative assessment strategy-based nursing care for patients with colorectal cancer(CRC).METHODS This randomized controlled trial evaluated the ability of nursing interventions using a quantitative assessment strategy to prevent postoperative complications and enhance patient recovery.Patients with CRC were randomly divided into routine nursing(RN)and quantitative assessment strategy nursing(QASN)groups.The RN group received standard care,while the QASN group also underwent screenings for visual analog scale for pain,Barthel Index for functional recovery,and self-rating anxiety scale and self-rating depression scale for psychological status.Follow-ups were conducted on postoperative days 1,7,14,28,and 56.RESULTS The participants’baseline characteristics did not significantly differ between study groups,thereby ensuring the reliability of the results.The QASN vs RN group showed significant improvements in pain management(visual analog scale scores)and psychological status(self-rating anxiety scale and self-rating depression scale scores)and a reduced incidence of postoperative complications(P<0.05).The follow-up evaluations at specified intervals confirmed these findings,indicating that quantitative assessment strategies significantly enhanced patients’postoperative pain management and psychological well-being.CONCLUSION Nursing interventions using structured quantitative assessments demonstrated significantly improved postoperative recovery and quality of life in patients with CRC,supporting their integration into standard postoperative care protocols.展开更多
BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomogra...BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomography imaging(GSI)to improve diagnostic accuracy in lymph node metastasis(LNM)assessment.AIM To extensively investigate the clinical utility of GSI in the preoperative assessment of CRC.METHODS The subject population included 200 patients with CRC who were admitted to Zibo Central Hospital from January 2022 to December 2023.All patients underwent dual-phase contrast-enhanced scans in the arterial and venous phases using GSI before surgical intervention.During the research,meticulous quantification was conducted regarding the number of patients with CRC with LNM as well as the exact count of metastatic lymph nodes.Moreover,for both metastatic and non-metastatic lymph nodes,the short diameter at the maximum crosssectional area(covering the axial,sagittal,and coronal planes),morphological features(including manifestations such as margin blurring,aggregation,and enhancement),and spectral parameters in the arterial and venous phases[specifically iodine concentration(IC),normalized IC(NIC),and the slope of the spectral curve(λHU)]were measured and recorded,and a comparative analysis was conducted.The diagnostic efficacy of each index with differences was systematically assessed using the receiver operating characteristic(ROC)curve.Concurrently,receiver operating characteristic curves were constructed for LNM screening based on the short diameter at the maximum cross-sectional area of lymph nodes and each spectral parameter in the arterial and venous phases.RESULTS The area under the curve of GSI for diagnosing LNM in patients with CRC can reach 0.897,with sensitivity,specificity,and accuracy of 92.59%,85.87%,and 89.50%,respectively.A total of 265 lymph nodes were analyzed from the 200 participants with CRC,with metastatic lymph nodes accounting for 56.60%.Compared with nonmetastatic lymph nodes,the short diameters of metastatic lymph nodes in the axial,sagittal,and coronal planes were significantly increased,whereas the IC values in the arterial and venous phases,the NIC value in the arterial phase,and theλHU values in the arterial and venous phases were significantly decreased.The short axial,sagittal,and coronal diameters,arterial-phase IC,venous-phase IC,arterial-phase NIC,arterial-phaseλHU,and venousphaseλHU for diagnosing metastatic lymph nodes demonstrated area under the curve values of 0.631,0.681,0.659,0.862,0.808,0.831,0.801,and 0.706,respectively.CONCLUSION GSI exhibits substantial clinical significance in the preoperative assessment of CRC.Among the parameters assessed,the arterial-phase IC demonstrates the most outstanding diagnostic performance,effectively improving the diagnostic efficacy for preoperative LNM in CRC.展开更多
AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was con...AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.RESULTS: For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P < 0.001), and the proportions of OLGIM stages III-IV cases were 42.3% and 19.9%, respectively (P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA (OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages III-IV (OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages III-IV (P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA (75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages III-IV (OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).CONCLUSION: OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.展开更多
Circular agriculture is of practical significance for Jiangsu agriculture. The research conducted quantitative analysis on circular agriculture in Jiangsu by estab- lishing assessment index system of circular agricult...Circular agriculture is of practical significance for Jiangsu agriculture. The research conducted quantitative analysis on circular agriculture in Jiangsu by estab- lishing assessment index system of circular agriculture development, In 2013, most indices of Jiangsu circular agriculture kept higher than national levels, but many problems exist such as excessive uses of chemical fertilizer, pesticide and mulch. Therefore, it is effective for advancing circular agriculture in Jiangsu to stabilize gov- emment fiscal support and broaden financing channels.展开更多
This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based...This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based on the internal model principle,a distributed dynamic output feedback control law is proposed to achieve both robust output regulation of the closed-loop system and plant input sharing among the actuators.A practical example of five motors cooperatively driving an uncertain shaft under an external load torque is presented to show the effectiveness of the proposed control law.展开更多
With the expanding applications of unmanned aerial vehicles(UAVs),precise flight evaluation has emerged as a critical enabler for efficient path planning,directly impacting operational performance and safety.Tradition...With the expanding applications of unmanned aerial vehicles(UAVs),precise flight evaluation has emerged as a critical enabler for efficient path planning,directly impacting operational performance and safety.Traditional path planning algorithms typically combine Dubins curves with local optimization to minimize trajectory length under 3D spatial constraints.However,these methods often overlook the correlation between pilot control quality and UAV flight dynamics,limiting their adaptability in complex scenarios.In this paper,we propose an intelligent flight evaluation model specifically designed to enhancemulti-waypoint trajectory optimization algorithms.Our model leverages a decision tree to integrate attitude parameters and trajectory matching metrics,establishing a quantitative link between pilot control quality and UAV flight states.Experimental results demonstrate that the proposed model not only accurately assesses pilot performance across diverse skill levels but also improves the optimality of generated trajectories.When integrated with our path planning algorithm,it efficiently produces optimal trajectories while strictly adhering to UAV flight constraints.This integrated framework highlights significant potential for real-time UAV training,performance assessment,and adaptive mission planning applications.展开更多
Modern battlefields exhibit high dynamism,where traditional static weighting methods in combat effectiveness assessment fail to capture real-time changes in indicator values,leading to limited assessment accuracy—esp...Modern battlefields exhibit high dynamism,where traditional static weighting methods in combat effectiveness assessment fail to capture real-time changes in indicator values,leading to limited assessment accuracy—especially critical in scenarios like sudden electronic warfare or degraded command,where static weights cannot reflect the operational value decay or surge of key indicators.To address this issue,this study proposes a dynamic adaptive weightingmethod for evaluation indicators based onG1-CRITIC-PIVW.First,theG1(Sequential Relationship Analysis Method)subjective weighting method—translates expert knowledge into indicator importance rankings—leverages expert knowledge to quantify the relative importance of indicators via sequential relationship ranking,while the CRITIC(Criteria Importance Through Intercriteria Correlation)objective weighting method—derives weights from data characteristics by integrating variability and inter-correlations—calculates weights by integrating indicator variability and inter-indicator correlations,ensuring data-driven objectivity.These two sets of weights are then fused using a deviation coefficient optimization model,minimizing the squared deviation from a reference weight and adjusting the fusion coefficient via Spearman’s rank correlation to resolve potential conflicts between subjective and objective judgments.Subsequently,the PIVW(Punishment-Incentive VariableWeight)theory—adapts weights to realtime indicator performance via penalty/incentive rules—is applied for dynamic adjustment.Scenario-specific penalty λ_(1) and incentive λ_(2) thresholds are set based on operational priorities and indicator volatility,penalizing indicators with values below λ_(1) and incentivizing those exceeding λ_(2) to reflect real-time indicator performance.Experimental validation was conducted using an Air Defense and Anti-Missile(ADAM)system effectiveness assessment framework,with data covering 7 indicators across 3 combat scenarios.Results show that compared to static weighting methods,the proposed method reduces MAE(Mean Absolute Error)by 15%-20% and weighted decision error rate by 84.2%,effectively reducing overestimation/underestimation of combat effectiveness in dynamic scenarios;compared to Entropy-TOPSIS,it lowers MAE by 12% while achieving a weighted Kendall’sτconsistency coefficient of 0.85,ensuring higher alignment with expert judgment.This method enhances the accuracy and scenario adaptability of effectiveness assessment,providing reliable decision support for dynamic battlefield environments.展开更多
Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai C...Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.展开更多
Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly deve...Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly develops and deployment increases,these impacts are becoming increasingly evident.A comprehensive understanding of these impacts is crucial for sustainable development.Based on the harmonization of previous detailed life cycle assessment(LCA)studies,this study develops a simplified LCA model that estimates the life cycle environmental impacts of wind turbines based on their nominal power.Using this simplified LCA model,we assess the global warming potential(GWP),acidification potential(AP),and cumulative energy demand(CED)of wind power at the regional scale for 2022 and under three future scenarios(high-power wind turbine promotion,reduced wind curtailment,and a comprehensive development scenario).The results indicate that in 2022,the life cycle GWP,AP,and CED of wind power in western China were 10.76 g CO_(2) eq/kWh,0.177 g SO_(2) eq/kWh,and 17.6 kJ/kWh,respectively.Scenario simulations suggest that reducing wind curtailment is the most effective approach for reducing emissions in Inner Mongolia,Gansu,Qinghai,Ningxia,and Xinjiang,producing average decreases of 8.64%in GWP,8.39%in AP,and 9.26%in CED.In contrast,for Guangxi,Chongqing,Sichuan,Guizhou,Yunnan,Xizang,and Shaanxi,the promotion of high-power wind turbines provides greater environmental benefits than reducing curtailment,producing average decreases of 3.45%,3.09%,and 4.29%in GWP,AP,and CED,respectively.These findings help clarify the environmental impact of wind power across its life cycle at the regional scale and provide theoretical references for the direction of future wind power development and the formulation of related policies.展开更多
Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for me...Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for medical students to address fragmented standards,rapid technological evolution,and insufficient localized ethical norms.Objective:To establish a Chinese expert consensus defining core AI competencies and a multi-modal assessment framework for medical students.Methods:A multidisciplinary(including medical education,clinical medicine,medical AI,public health,and medical ethics)expert group(n=32)developed an initial competency list based on the“Knowledge-Skills-Attitude”Medical Competency Model.Two Delphi rounds(100%response rate;consensus threshold:mean≥4.0,CV≤0.25)refined the framework.Core competencies were prioritized via Analytic Hierarchy Process(AHP).The final consensus document was established after multiple expert group meetings.Results:The consensus defines AI literacy for medical students as a comprehensive attribute for integrating AI into profes-sional knowledge,clinical practice,research,and health management.It comprises a 21-item Competencies of AI Proficiency(CAIP)list across knowledge(eight indicators),skills(seven indicators),and attitude(six indicators)dimensions.Key com-petencies prioritized include understanding AI's role in multidisciplinary knowledge integration(CAIP3),identifying AI output biases(CAIP4),understanding health data governance(CAIP2),maintaining physician-led AI-assisted diagnosis(CAIP16),and identifying AI diagnostic biases(CAIP12).A multi-modal assessment framework is recommended,including paper-based/computerized tests for knowledge,situational judgment tests(SJTs)for attitudes,and objective structured clinical examinations(OSCEs)with a specific“AI Clinical Decision Conflict Scoring Scale”for skills.A multi-stage dynamic assessment system(“Pre-enrollment-Pre-clinical-Post-clinical”)is proposed for longitudinal tracking.Educational integration pathways emphasize embedding AI literacy modularly from early undergraduate years,constructing an integrated curriculum covering fundamental principles,advanced large model applications(e.g.,prompt engineering,agent development),and ethical considerations,supported by a"digital twin hospital platform."Conclusion:This consensus provides authoritative,China-specific guidance for defining and assessing medical students'AI literacy,adhering to national policies and regulations.It offers a core action framework for optimizing AI integration into medical education,fostering future healthcare professionals proficient in both AI technology and medical humanism,with a commitment to dynamic updating to adapt to evolving AI advancements.展开更多
This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the L...This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the Life Cycle Assessment(LCA)methodology.The treatments are either in-situ or exsitu,the latter requiring an initial dredging to transport the contaminated sediments to the management site.More in detail,four ex-situ remediation technologies based on landfilling,bioremediation,electrokinetic technique and soil washing were identified.These technologies are compared to an in-situ strategy currently under validation for enhancing bioremediation of the polluted sediments of the Bagnoli-Coroglio site.Our results indicate that the disposal in landfilling site is the worst option in most categories(e.g.,650 kg CO_(2) eq./t of treated sediment,considering the nearest landfilling site),followed by the bioremediation,mainly due to the high energy demand.Electrokinetic remediation,soil washing,and innovative in-situ technology represent the most sustainable options.In particular,the new in-situ technology appears to be the least impacting in all categories(e.g.,54 kg CO_(2) eq./t of treated sediment),although it is expected to require longer treatment time(estimated up to 12 months based on its potential efficiency).It can reduce the impact on climate change more than 12 times compared to the disposal and 7 times compared to bioremediation in addition to the possibility to avoid/reduce the dredging operations and the consequent dispersion of pollutants.The results open relevant perspectives towards more eco-sustainable and costly effective actions for the reclamation of contaminated marine sediments.展开更多
Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure f...Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.展开更多
Sustainable forest management practices frequently confront the tension between economic viability and conservation objectives,particularly where forests occur in environmentally sensitive zones.The use of skidders in...Sustainable forest management practices frequently confront the tension between economic viability and conservation objectives,particularly where forests occur in environmentally sensitive zones.The use of skidders in protected areas is an essential solution for enabling timber harvesting in environments where the establishment of new skidding trails is either prohibited or highly restricted.These machines are the most used timber extraction machines in Central and Eastern Europe,and cable/adapted skidders are used to increase productivity and to reduce labor.This study compared the work cycles,productivity and costs of four types of skidders working in similar coniferous stands:a dedicated cable skidder,a dedicated cable-grapple skidder,a dedicated grapple skidder and an adapted skidder.The comparison of delay-free work cycles of the four skidders showed the largest share is occupied by travel loaded.The cable-grapple skidder had the highest average speed of 5.6 km h^(-1),followed by the grapple skidder at 3.97 km h^(-1),the cable skidder at 3.79 km h^(-1),and the adapted skidder with an average speed of 3.31 km h^(-1).The average delay-free productivity of the study skidders is highest for the adapted skidder,followed by the grapple skidder with a slightly lower rate,the cable-grapple skidder,and the cable skidder.In conclusion,the average payload of the grapple skidder and the cable grapple skidder is less than the maximum payload of the machine.This is due to the narrow skidding roads and because these skidders are not suitable for the specific site-selective felling with marked single and small groups of trees.The dedicated cable skidders and the adapted cable skidder are very close in productivity.The average productivity of dedicated cable skidders was 17.7 m^(3) h^(-1),while the productivity of the adapted skidder is 14.5 m^(3) h^(-1).Considering this,adapted skidders could be a good solution for improving economic productivity in sensitive forests.展开更多
Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general contr...Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.展开更多
Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although la...Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although land cover information has long been recognized as an essential component for monitoring SDGs,a standardized scientific framework for identifying and prioritizing land cover related essential variables does not exist.Therefore,we propose a novel expert-and data-driven framework for identifying,refining,and selecting a priority list of Essential Land cover-related Variables for SDGs(ELcV4SDGs).This framework integrates methods including expert knowledge-based analysis,clustering of variables with similar attributes,and quantified index calculation to establish the priority list.Applying the framework to 15 specific SDG indicators,we found that the ELcV4SDGs priority list comprises three main categories,type and structure,pattern and intensity,and process and evolution of land cover,which are further divided into 19 subcategories and ultimately encompass 50 general variables.The ELcV4SDGs will support detailed spatial monitoring and enhance their scientific applications for SDG monitoring and assessment,thereby guiding future SDG priority actions and informing decision-making to advance the 2030 SDGs agenda at local,national,and global levels.展开更多
Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogen...Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogeneity remains challenging.To address this,this study first captures the morphology of large-scale(1000 mm × 1000 mm) slate and granite joints via 3D laser scanning.Analysis of these surfaces and corresponding push/pull tests on carved specimens revealed a potential correlation between the heterogeneity of roughness and shear strength.A comparative evaluation of five statistical metrics identified information entropy(Hs) as the most robust indicator for quantifying rock joint heterogeneity.Further analysis using Hsreveals that the heterogeneity is anisotropic and,critically,that shear strength heterogeneity is governed not only by roughness heterogeneity but is also significantly influenced by the mean roughness value,normal stress,and intact rock tensile strength.Consequently,a simple comparison of roughness Hsvalues is insufficient for reliably comparing shear strength heterogeneity.To overcome this limitation,a theoretical framework is developed to explicitly map fundamental roughness statistics(mean and heterogeneity) to shear strength heterogeneity.This framework culminates in a practical workflow that allows for the rapid,field-based assessment of shear strength heterogeneity using readily obtainable rock joint roughness data.展开更多
Using solid waste as a substitute for conventional cement has become an important way to reduce carbon emissions.This paper attempted to utilize steel slag(SS)and fly ash(FA)as supplementary cementitious material by u...Using solid waste as a substitute for conventional cement has become an important way to reduce carbon emissions.This paper attempted to utilize steel slag(SS)and fly ash(FA)as supplementary cementitious material by utilizing CO_(2)mineralization curing technology.This study examined the dominant and interactive influences of the residual water/cement ratio,CO_(2)pressure,curing time,and SS content on the mechanical properties and CO_(2)uptake rate of CO_(2)mineralization curing SS-FA-Portland cement ternary paste specimens.Additionally,microstructural development was analyzed.The findings demonstrated that each factor significantly affected compressive strength and CO_(2)uptake rate,with factor interactions becoming more pronounced at higher SS dosages(>30%),lower residual water/cement ratios(0.1-0.15),and CO_(2)pressures of 0.1-0.3 MPa.Microscopic examinations revealed that mineralization primarily yielded CaCO_(3)and silica gel.The residual w/c ratio and SS content significantly influenced the CaCO_(3)content and crystallinity of the mineralization products.Post-mineralization curing,the percentage of pores larger than 50 nm significantly decreased,the proportion of harmless pores smaller than 20 nm increased,and pore structure improved.This study also found that using CO_(2)mineralization curing SS-FA-Portland cement solid waste concrete can significantly reduce the negative impact on the environment.展开更多
AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in whic...AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer(GC)most frequently develops.The operative link for gas-tritis assessment(OLGA)staging system ranks the GC risk according to both the topography and the severity of gastric atrophy(as assessed histologically on the ba-sis of the Sydney protocol for gastric mucosal biopsy).Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages Ⅲ-Ⅳ with a higher risk of GC.A recently-proposed modification of the OLGA staging system(OLGIM)basically incorporates the OLGA frame,but replaces the atrophy score with an assessment of intestinal metaplasia(IM)alone.A series of 4552 consecutive biopsy sets(2007-2009)was re-trieved and reassessed according to both the OLGA and the OLGIM staging systems.A set of at least 5 biopsy samples was available for all the cases considered.RESULTS:In 4460 of 4552 cases(98.0%),both the high-risk stages(Ⅲ + Ⅳ)and the low-risk stages(0 +Ⅰ + Ⅱ)were assessed applying the OLGA and OL-GIM criteria.Among the 243 OLGA high-risk stages,14(5.8%)were down-staged to a low risk using OLGIM.The 67(1.5%)incidentally-found neoplastic lesions(intraepithelial or invasive)were consistently associated with high-risk stages,as assessed by both OLGA and OLGIM(P < 0.001 for both).Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage(stage Ⅲ)were associated with a low-risk OLGIM stage(stage Ⅱ).CONCLUSION:Gastritis staging systems(both OLGA and OLGIM)convey prognostically important informa-tion on the gastritis-associated cancer risk.Because of its clinical impact,the stage of gastritis should be included as a conclusive message in the gastritis histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA staging in the identif ication of patients at high risk of gastric cancer.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.82272955 and 22203057)the Natural Science Foundation of Fujian Province(Grant No.2021J011361).
文摘The presence of a positive deep surgical margin in tongue squamous cell carcinoma(TSCC)significantly elevates the risk of local recurrence.Therefore,a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection.In this study,we integrate Raman imaging technology with an artificial intelligence(AI)generative model,proposing an innovative approach for intraoperative margin status diagnosis.This method utilizes Raman imaging to swiftly and non-invasively capture tissue Raman images,which are then transformed into hematoxylin-eosin(H&E)-stained histopathological images using an AI generative model for histopathological diagnosis.The generated H&E-stained images clearly illustrate the tissue’s pathological conditions.Independently reviewed by three pathologists,the overall diagnostic accuracy for distinguishing between tumor tissue and normal muscle tissue reaches 86.7%.Notably,it outperforms current clinical practices,especially in TSCC with positive lymph node metastasis or moderately differentiated grades.This advancement highlights the potential of AI-enhanced Raman imaging to significantly improve intraoperative assessments and surgical margin evaluations,promising a versatile diagnostic tool beyond TSCC.
基金Sichuan Provincial Nursing Research Project of the Sichuan Nursing Association in 2023(Project No.:H23028)。
文摘Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine’s Conservation Model as the theoretical framework,an item pool was formed through literature review,and the initial draft of the scale was refined through two rounds of Delphi expert consultation.A total of 200 postoperative patients were selected for item analysis,internal consistency testing,content validity,and structural validity analysis.Results:The final tool comprises four dimensions:energy conservation,structural integrity,personal integrity,and social integrity,with a total of 24 items.It demonstrates good content validity(I-CVI 0.82-1.00,S-CVI/Ave 0.95,S-CVI/UA 0.87)and excellent internal consistency(Cronbach’sαfor the overall scale was 0.934).Exploratory factor analysis revealed a KMO value of 0.931,Bartlett’s test of sphericityχ^(2)=4147.853(p<0.001),and four common factors were extracted,accounting for a cumulative variance contribution rate of 64.345%,indicating ideal structural validity.Conclusion:The results indicate that the assessment tool has good reliability and validity and can systematically evaluate postoperative wound healing,providing a scientific basis for clinical individualized nursing interventions.
文摘BACKGROUND Scientifically sound and reasonable care strategies in surgical nursing play a crucial role in facilitating postoperative recovery and preventing complications.This study focused on the application of quantitative assessment strategies to postoperative care.By quantitatively analyzing the effects of nursing interventions,we explored their feasibility and effectiveness at improving postoperative recovery quality and reducing the incidence of complications.This study provides a scientific basis for nursing practice and offers new insights into nursing management with significant clinical value.AIM To analyze the efficacy of postoperative quantitative assessment strategy-based nursing care for patients with colorectal cancer(CRC).METHODS This randomized controlled trial evaluated the ability of nursing interventions using a quantitative assessment strategy to prevent postoperative complications and enhance patient recovery.Patients with CRC were randomly divided into routine nursing(RN)and quantitative assessment strategy nursing(QASN)groups.The RN group received standard care,while the QASN group also underwent screenings for visual analog scale for pain,Barthel Index for functional recovery,and self-rating anxiety scale and self-rating depression scale for psychological status.Follow-ups were conducted on postoperative days 1,7,14,28,and 56.RESULTS The participants’baseline characteristics did not significantly differ between study groups,thereby ensuring the reliability of the results.The QASN vs RN group showed significant improvements in pain management(visual analog scale scores)and psychological status(self-rating anxiety scale and self-rating depression scale scores)and a reduced incidence of postoperative complications(P<0.05).The follow-up evaluations at specified intervals confirmed these findings,indicating that quantitative assessment strategies significantly enhanced patients’postoperative pain management and psychological well-being.CONCLUSION Nursing interventions using structured quantitative assessments demonstrated significantly improved postoperative recovery and quality of life in patients with CRC,supporting their integration into standard postoperative care protocols.
文摘BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomography imaging(GSI)to improve diagnostic accuracy in lymph node metastasis(LNM)assessment.AIM To extensively investigate the clinical utility of GSI in the preoperative assessment of CRC.METHODS The subject population included 200 patients with CRC who were admitted to Zibo Central Hospital from January 2022 to December 2023.All patients underwent dual-phase contrast-enhanced scans in the arterial and venous phases using GSI before surgical intervention.During the research,meticulous quantification was conducted regarding the number of patients with CRC with LNM as well as the exact count of metastatic lymph nodes.Moreover,for both metastatic and non-metastatic lymph nodes,the short diameter at the maximum crosssectional area(covering the axial,sagittal,and coronal planes),morphological features(including manifestations such as margin blurring,aggregation,and enhancement),and spectral parameters in the arterial and venous phases[specifically iodine concentration(IC),normalized IC(NIC),and the slope of the spectral curve(λHU)]were measured and recorded,and a comparative analysis was conducted.The diagnostic efficacy of each index with differences was systematically assessed using the receiver operating characteristic(ROC)curve.Concurrently,receiver operating characteristic curves were constructed for LNM screening based on the short diameter at the maximum cross-sectional area of lymph nodes and each spectral parameter in the arterial and venous phases.RESULTS The area under the curve of GSI for diagnosing LNM in patients with CRC can reach 0.897,with sensitivity,specificity,and accuracy of 92.59%,85.87%,and 89.50%,respectively.A total of 265 lymph nodes were analyzed from the 200 participants with CRC,with metastatic lymph nodes accounting for 56.60%.Compared with nonmetastatic lymph nodes,the short diameters of metastatic lymph nodes in the axial,sagittal,and coronal planes were significantly increased,whereas the IC values in the arterial and venous phases,the NIC value in the arterial phase,and theλHU values in the arterial and venous phases were significantly decreased.The short axial,sagittal,and coronal diameters,arterial-phase IC,venous-phase IC,arterial-phase NIC,arterial-phaseλHU,and venousphaseλHU for diagnosing metastatic lymph nodes demonstrated area under the curve values of 0.631,0.681,0.659,0.862,0.808,0.831,0.801,and 0.706,respectively.CONCLUSION GSI exhibits substantial clinical significance in the preoperative assessment of CRC.Among the parameters assessed,the arterial-phase IC demonstrates the most outstanding diagnostic performance,effectively improving the diagnostic efficacy for preoperative LNM in CRC.
文摘AIM: To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.METHODS: A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.RESULTS: For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P < 0.001), and the proportions of OLGIM stages III-IV cases were 42.3% and 19.9%, respectively (P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA (OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages III-IV (OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages III-IV (P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA (75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages III-IV (OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).CONCLUSION: OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.
基金Supported by Jiangsu Agricultural S&T Self-innovation Project(CX(13)5068)~~
文摘Circular agriculture is of practical significance for Jiangsu agriculture. The research conducted quantitative analysis on circular agriculture in Jiangsu by estab- lishing assessment index system of circular agriculture development, In 2013, most indices of Jiangsu circular agriculture kept higher than national levels, but many problems exist such as excessive uses of chemical fertilizer, pesticide and mulch. Therefore, it is effective for advancing circular agriculture in Jiangsu to stabilize gov- emment fiscal support and broaden financing channels.
基金Supported by the Shenzhen Key Laboratory of Control Theory and Intelligent Systems (ZDSYS20220330161800001)the National Natural Science Foundation of China (62303207)the Guangdong Basic and Applied Basic Research Foundation (2024A1515010725)。
文摘This paper studies cooperative robust parallel operation of multiple actuators over an undirected communication graph.The plant is modeled as an uncertain linear system,and the actuators are linear and identical.Based on the internal model principle,a distributed dynamic output feedback control law is proposed to achieve both robust output regulation of the closed-loop system and plant input sharing among the actuators.A practical example of five motors cooperatively driving an uncertain shaft under an external load torque is presented to show the effectiveness of the proposed control law.
基金funded in part by the Fundamental Research Funds for the Central Universities under Grant NS2023052in part by the Natural Science Foundation of Jiangsu Province of China under Grants No.BK20231439 and No.BK20222012.
文摘With the expanding applications of unmanned aerial vehicles(UAVs),precise flight evaluation has emerged as a critical enabler for efficient path planning,directly impacting operational performance and safety.Traditional path planning algorithms typically combine Dubins curves with local optimization to minimize trajectory length under 3D spatial constraints.However,these methods often overlook the correlation between pilot control quality and UAV flight dynamics,limiting their adaptability in complex scenarios.In this paper,we propose an intelligent flight evaluation model specifically designed to enhancemulti-waypoint trajectory optimization algorithms.Our model leverages a decision tree to integrate attitude parameters and trajectory matching metrics,establishing a quantitative link between pilot control quality and UAV flight states.Experimental results demonstrate that the proposed model not only accurately assesses pilot performance across diverse skill levels but also improves the optimality of generated trajectories.When integrated with our path planning algorithm,it efficiently produces optimal trajectories while strictly adhering to UAV flight constraints.This integrated framework highlights significant potential for real-time UAV training,performance assessment,and adaptive mission planning applications.
基金funded by the National Natural Science Foundation of China(NSFC)under Grant Number 72071209.
文摘Modern battlefields exhibit high dynamism,where traditional static weighting methods in combat effectiveness assessment fail to capture real-time changes in indicator values,leading to limited assessment accuracy—especially critical in scenarios like sudden electronic warfare or degraded command,where static weights cannot reflect the operational value decay or surge of key indicators.To address this issue,this study proposes a dynamic adaptive weightingmethod for evaluation indicators based onG1-CRITIC-PIVW.First,theG1(Sequential Relationship Analysis Method)subjective weighting method—translates expert knowledge into indicator importance rankings—leverages expert knowledge to quantify the relative importance of indicators via sequential relationship ranking,while the CRITIC(Criteria Importance Through Intercriteria Correlation)objective weighting method—derives weights from data characteristics by integrating variability and inter-correlations—calculates weights by integrating indicator variability and inter-indicator correlations,ensuring data-driven objectivity.These two sets of weights are then fused using a deviation coefficient optimization model,minimizing the squared deviation from a reference weight and adjusting the fusion coefficient via Spearman’s rank correlation to resolve potential conflicts between subjective and objective judgments.Subsequently,the PIVW(Punishment-Incentive VariableWeight)theory—adapts weights to realtime indicator performance via penalty/incentive rules—is applied for dynamic adjustment.Scenario-specific penalty λ_(1) and incentive λ_(2) thresholds are set based on operational priorities and indicator volatility,penalizing indicators with values below λ_(1) and incentivizing those exceeding λ_(2) to reflect real-time indicator performance.Experimental validation was conducted using an Air Defense and Anti-Missile(ADAM)system effectiveness assessment framework,with data covering 7 indicators across 3 combat scenarios.Results show that compared to static weighting methods,the proposed method reduces MAE(Mean Absolute Error)by 15%-20% and weighted decision error rate by 84.2%,effectively reducing overestimation/underestimation of combat effectiveness in dynamic scenarios;compared to Entropy-TOPSIS,it lowers MAE by 12% while achieving a weighted Kendall’sτconsistency coefficient of 0.85,ensuring higher alignment with expert judgment.This method enhances the accuracy and scenario adaptability of effectiveness assessment,providing reliable decision support for dynamic battlefield environments.
基金supported by the Northeast Geological Science and Technology Innovation Center of China Geological Survey(Grant NO.QCJJ2022-43)the Natural Resources Comprehensive Survey Project(Grant Nos.DD20230470,DD20230508)the National Groundwater Monitoring Network Operation and Maintenance Program(Grant No.DD20251300109).
文摘Excessive levels of Fluoride(F−)and Cadmium(Cd)in drinking groundwater may pose health risks.This study assessed the health risks associated with F−and Cd contamination in rural drinking groundwater sources in Wutai County,Shanxi Province,China,to support population health protection,water resource management,and environmental decision-making.Groundwater samples were collected and analyzed,and a Human Health Risk Model(HHRA)was applied to evaluate groundwater quality.The results showed that both contents of F−and Cd in groundwater exceeded the Class III limits of China's national groundwater quality standard(GB/T 14848—2024).Fluoride levels met the Class V threshold,with enrichment area mainly located in the east part of the study area.Cadmium levels reached Class IV,with elevated concentrations primarily observed in the western and northwestern regions.Correlation analysis revealed that F−showed weak or no correlation with other measured substances,indicating independent sources.Health risk assessment results indicated that F−poses potential health risks to rural residents,while cadmium,due to its relatively low concentrations,does not currently present a significant health risk.Among different demographic groups,the health risk levels of F−exposure followed the order:Infants>children>adult females>adult males.The findings highlight that fluoride is the primary contributor to health risks associated with groundwater consumption in the study area.Strengthened monitoring and prevention of F−contamination are urgently needed.This research provides a scientific basis for the prevention and control of fluoride pollution in groundwater and offers practical guidance for safeguarding drinking water safety in rural China.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF1303405).
文摘Compared with traditional energy sources,wind power has a lower environmental impact.However,emissions are still generated across the life cycle of wind turbines,from production to recycling.As wind power rapidly develops and deployment increases,these impacts are becoming increasingly evident.A comprehensive understanding of these impacts is crucial for sustainable development.Based on the harmonization of previous detailed life cycle assessment(LCA)studies,this study develops a simplified LCA model that estimates the life cycle environmental impacts of wind turbines based on their nominal power.Using this simplified LCA model,we assess the global warming potential(GWP),acidification potential(AP),and cumulative energy demand(CED)of wind power at the regional scale for 2022 and under three future scenarios(high-power wind turbine promotion,reduced wind curtailment,and a comprehensive development scenario).The results indicate that in 2022,the life cycle GWP,AP,and CED of wind power in western China were 10.76 g CO_(2) eq/kWh,0.177 g SO_(2) eq/kWh,and 17.6 kJ/kWh,respectively.Scenario simulations suggest that reducing wind curtailment is the most effective approach for reducing emissions in Inner Mongolia,Gansu,Qinghai,Ningxia,and Xinjiang,producing average decreases of 8.64%in GWP,8.39%in AP,and 9.26%in CED.In contrast,for Guangxi,Chongqing,Sichuan,Guizhou,Yunnan,Xizang,and Shaanxi,the promotion of high-power wind turbines provides greater environmental benefits than reducing curtailment,producing average decreases of 3.45%,3.09%,and 4.29%in GWP,AP,and CED,respectively.These findings help clarify the environmental impact of wind power across its life cycle at the regional scale and provide theoretical references for the direction of future wind power development and the formulation of related policies.
基金Science and Technology Innovation 2030 Major Project,Grant/Award Number:2023ZD0508506。
文摘Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for medical students to address fragmented standards,rapid technological evolution,and insufficient localized ethical norms.Objective:To establish a Chinese expert consensus defining core AI competencies and a multi-modal assessment framework for medical students.Methods:A multidisciplinary(including medical education,clinical medicine,medical AI,public health,and medical ethics)expert group(n=32)developed an initial competency list based on the“Knowledge-Skills-Attitude”Medical Competency Model.Two Delphi rounds(100%response rate;consensus threshold:mean≥4.0,CV≤0.25)refined the framework.Core competencies were prioritized via Analytic Hierarchy Process(AHP).The final consensus document was established after multiple expert group meetings.Results:The consensus defines AI literacy for medical students as a comprehensive attribute for integrating AI into profes-sional knowledge,clinical practice,research,and health management.It comprises a 21-item Competencies of AI Proficiency(CAIP)list across knowledge(eight indicators),skills(seven indicators),and attitude(six indicators)dimensions.Key com-petencies prioritized include understanding AI's role in multidisciplinary knowledge integration(CAIP3),identifying AI output biases(CAIP4),understanding health data governance(CAIP2),maintaining physician-led AI-assisted diagnosis(CAIP16),and identifying AI diagnostic biases(CAIP12).A multi-modal assessment framework is recommended,including paper-based/computerized tests for knowledge,situational judgment tests(SJTs)for attitudes,and objective structured clinical examinations(OSCEs)with a specific“AI Clinical Decision Conflict Scoring Scale”for skills.A multi-stage dynamic assessment system(“Pre-enrollment-Pre-clinical-Post-clinical”)is proposed for longitudinal tracking.Educational integration pathways emphasize embedding AI literacy modularly from early undergraduate years,constructing an integrated curriculum covering fundamental principles,advanced large model applications(e.g.,prompt engineering,agent development),and ethical considerations,supported by a"digital twin hospital platform."Conclusion:This consensus provides authoritative,China-specific guidance for defining and assessing medical students'AI literacy,adhering to national policies and regulations.It offers a core action framework for optimizing AI integration into medical education,fostering future healthcare professionals proficient in both AI technology and medical humanism,with a commitment to dynamic updating to adapt to evolving AI advancements.
基金support in the literature analysis.This study has been carried out in the framework of the project funded by EU entitled“Bioremediation of contaminated sediments in coastal areas of exindustrial sites-LIFE SEDREMED”(No.LIFE20 ENV/IT/000572).
文摘This study compares the environmental sustainability of five alternatives for the remediation of marine sediments of one of the most polluted coastal sites in Europe(Bagnoli-Coroglio bay,Mediterranean Sea),using the Life Cycle Assessment(LCA)methodology.The treatments are either in-situ or exsitu,the latter requiring an initial dredging to transport the contaminated sediments to the management site.More in detail,four ex-situ remediation technologies based on landfilling,bioremediation,electrokinetic technique and soil washing were identified.These technologies are compared to an in-situ strategy currently under validation for enhancing bioremediation of the polluted sediments of the Bagnoli-Coroglio site.Our results indicate that the disposal in landfilling site is the worst option in most categories(e.g.,650 kg CO_(2) eq./t of treated sediment,considering the nearest landfilling site),followed by the bioremediation,mainly due to the high energy demand.Electrokinetic remediation,soil washing,and innovative in-situ technology represent the most sustainable options.In particular,the new in-situ technology appears to be the least impacting in all categories(e.g.,54 kg CO_(2) eq./t of treated sediment),although it is expected to require longer treatment time(estimated up to 12 months based on its potential efficiency).It can reduce the impact on climate change more than 12 times compared to the disposal and 7 times compared to bioremediation in addition to the possibility to avoid/reduce the dredging operations and the consequent dispersion of pollutants.The results open relevant perspectives towards more eco-sustainable and costly effective actions for the reclamation of contaminated marine sediments.
基金supported by the National Key R&D Program of China(Nos.2018YFC1004300 and 2018YFC1004302)the Science&Technology Program of Guizhou Province(Nos.QKHHBZ[2020]3002,QKHPTRC-GCC[2022]039-1 and QKHPTRCCXTD[2022]014)the Scientific Research Program of Guizhou Provincial Department of Education(No.QJJ[2023]019).
文摘Despite the widespread presence and frequent detection of polycyclic aromatic hydrocarbons(PAHs)in various aspects of life,there is limited research on their exposure levels in pregnant women and cumulative exposure from the living environment.This study included 1311 women in late pregnancy from the Zunyi birth cohort and measured the urinary concentrations of 10 hydroxylated PAH metabolites(OH-PAHs).Risk assessment was conducted based on the estimated daily intake to calculate the hazard quotient and hazard index(HI).A linear regression model was used to analyze the relationship between creatinine-adjusted OH-PAHs concentrations and living environment and lifestyle factors,while principal component analysis was applied to trace the sources of PAHs exposure.1-OHPYR was detected in all participants’urine,with naphthalene metabolites having the highest concentrations among creatinine-adjusted PAHs.OH-PAHs concentrations were associated with housing type,room number,cooking frequency,household size,exercise frequency,fuel type,distance from main road,and drinking water source.Pregnant women using traditional fuels and living in bungalows had higher health risks than those using clean energy and living in buildings.Those living within 100 m of a main road had higher HI than those farther away.Coal combustion was identified as the primary source of PAHs exposure.The study emphasizes the importance of reducing PAHs exposure,especially for pregnant women living in polluted environments.It recommends public health interventions such as improving indoor ventilation and providing clean energy to reduce related health risks.
基金supported by the inter-institutional agreement between the University of Forestry (Bulgaria)the Mediterranean University of Reggio Calabria (Italy)by the Ph.D. course “Agricultural, Food and Forestry Science” of the Mediterranean University of Reggio Calabria (Italy)—XXXIX cycle。
文摘Sustainable forest management practices frequently confront the tension between economic viability and conservation objectives,particularly where forests occur in environmentally sensitive zones.The use of skidders in protected areas is an essential solution for enabling timber harvesting in environments where the establishment of new skidding trails is either prohibited or highly restricted.These machines are the most used timber extraction machines in Central and Eastern Europe,and cable/adapted skidders are used to increase productivity and to reduce labor.This study compared the work cycles,productivity and costs of four types of skidders working in similar coniferous stands:a dedicated cable skidder,a dedicated cable-grapple skidder,a dedicated grapple skidder and an adapted skidder.The comparison of delay-free work cycles of the four skidders showed the largest share is occupied by travel loaded.The cable-grapple skidder had the highest average speed of 5.6 km h^(-1),followed by the grapple skidder at 3.97 km h^(-1),the cable skidder at 3.79 km h^(-1),and the adapted skidder with an average speed of 3.31 km h^(-1).The average delay-free productivity of the study skidders is highest for the adapted skidder,followed by the grapple skidder with a slightly lower rate,the cable-grapple skidder,and the cable skidder.In conclusion,the average payload of the grapple skidder and the cable grapple skidder is less than the maximum payload of the machine.This is due to the narrow skidding roads and because these skidders are not suitable for the specific site-selective felling with marked single and small groups of trees.The dedicated cable skidders and the adapted cable skidder are very close in productivity.The average productivity of dedicated cable skidders was 17.7 m^(3) h^(-1),while the productivity of the adapted skidder is 14.5 m^(3) h^(-1).Considering this,adapted skidders could be a good solution for improving economic productivity in sensitive forests.
基金supported by the National Natural Science Foundation of China(grant numbers 42171085)and the National Key R&D Program of China(Grant No.2024YFF1307801,2024YFF1307804).
文摘Integrated environmental management is important for sustainable development.Under China’s“Three Lines One Permit”(TLOP)policy,three types of management zones—priority protection,critical control,and general control zones—are established based on the ecological red line,the lower-limit line for environmental quality,and the resource use line.Human activities are regulated through a permit system.Integrated and multifactorial protection of soil,plant,hydrological,and atmospheric elements is promoted at the regional level.A follow-up assessment contributes to the improvement of policy implementation and effectiveness.This study demonstrates the achievements of the TLOP policy in Sichuan Province.Results show that(1)276 protection zones have been established under the ecological red line,covering key ecosystems and protected areas to ensure environmental security.Under the lower-limit line,1,626 functional(priority,key,and general control)zones have been designated to regulate air,water,and soil quality,enhancing environmental capacity and pollution control.(2)Through the integration and merging of the three lines,1,128 integrated management zones have been established,including 375,625,and 128 priority protection,critical control,and general control zones,respectively.Each zone has its own list of environmental permits to regulate human activities according to different environmental protection and natural resource development regimes.(3)The design of the follow-up assessment index system was informed by regional primary functions and industrial structure.The index system for provinces and cities is structured around three primary indicators—implementation updating,application,and guarantees—and 15 secondary indicators.The system for critical control zones is structured around environmental access,management,and effectiveness and 14 secondary indicators.A stringent environmental zoning system has been established through the TLOP policy,thereby safeguarding environmental security,promoting harmonious existence between humans and nature,and supporting the vision of Beautiful China.
基金supported by the Key Program of National Natural Science Foundation of China(Grant No.41930650)Young Scientists Fund of the National Natural Science Foundation of China(Grant No.42301310).
文摘Sustained and spatially explicit monitoring of the United Nations 2030 Agenda for Sustainable Development is critical for effectively tracking progress toward the global Sustainable Development Goals(SDGs).Although land cover information has long been recognized as an essential component for monitoring SDGs,a standardized scientific framework for identifying and prioritizing land cover related essential variables does not exist.Therefore,we propose a novel expert-and data-driven framework for identifying,refining,and selecting a priority list of Essential Land cover-related Variables for SDGs(ELcV4SDGs).This framework integrates methods including expert knowledge-based analysis,clustering of variables with similar attributes,and quantified index calculation to establish the priority list.Applying the framework to 15 specific SDG indicators,we found that the ELcV4SDGs priority list comprises three main categories,type and structure,pattern and intensity,and process and evolution of land cover,which are further divided into 19 subcategories and ultimately encompass 50 general variables.The ELcV4SDGs will support detailed spatial monitoring and enhance their scientific applications for SDG monitoring and assessment,thereby guiding future SDG priority actions and informing decision-making to advance the 2030 SDGs agenda at local,national,and global levels.
基金supported by the National Natural Science Foundation of China (Nos.42422705,42207175,42177117 and 42577170)the Ningbo Youth Leading Talent Project (No.2024QL051)+1 种基金the Chinese Academy of Engineering Science and Technology Strategy Consulting Project (No.2025-XZ-57)the Central Government Funding Program for Guiding Local Science and Technology Development (No.2025ZY01028)。
文摘Rock mass stability is significantly influenced by the heterogeneity of rock joint roughness and shear strength.While modern technology facilitates assessing roughness heterogeneity,evaluating shear strength heterogeneity remains challenging.To address this,this study first captures the morphology of large-scale(1000 mm × 1000 mm) slate and granite joints via 3D laser scanning.Analysis of these surfaces and corresponding push/pull tests on carved specimens revealed a potential correlation between the heterogeneity of roughness and shear strength.A comparative evaluation of five statistical metrics identified information entropy(Hs) as the most robust indicator for quantifying rock joint heterogeneity.Further analysis using Hsreveals that the heterogeneity is anisotropic and,critically,that shear strength heterogeneity is governed not only by roughness heterogeneity but is also significantly influenced by the mean roughness value,normal stress,and intact rock tensile strength.Consequently,a simple comparison of roughness Hsvalues is insufficient for reliably comparing shear strength heterogeneity.To overcome this limitation,a theoretical framework is developed to explicitly map fundamental roughness statistics(mean and heterogeneity) to shear strength heterogeneity.This framework culminates in a practical workflow that allows for the rapid,field-based assessment of shear strength heterogeneity using readily obtainable rock joint roughness data.
基金Project(52479115)supported by the National Natural Science Foundation of ChinaProject(2024SF-YBXM-615)supported by the Key Research and Development Program of Shaanxi Province,China+1 种基金Project(2022943)supported by the Youth Innovation Team of Shaanxi Universities,ChinaProject(300102283721)supported by the Fundamental Research Funds for the Central Universities,China。
文摘Using solid waste as a substitute for conventional cement has become an important way to reduce carbon emissions.This paper attempted to utilize steel slag(SS)and fly ash(FA)as supplementary cementitious material by utilizing CO_(2)mineralization curing technology.This study examined the dominant and interactive influences of the residual water/cement ratio,CO_(2)pressure,curing time,and SS content on the mechanical properties and CO_(2)uptake rate of CO_(2)mineralization curing SS-FA-Portland cement ternary paste specimens.Additionally,microstructural development was analyzed.The findings demonstrated that each factor significantly affected compressive strength and CO_(2)uptake rate,with factor interactions becoming more pronounced at higher SS dosages(>30%),lower residual water/cement ratios(0.1-0.15),and CO_(2)pressures of 0.1-0.3 MPa.Microscopic examinations revealed that mineralization primarily yielded CaCO_(3)and silica gel.The residual w/c ratio and SS content significantly influenced the CaCO_(3)content and crystallinity of the mineralization products.Post-mineralization curing,the percentage of pores larger than 50 nm significantly decreased,the proportion of harmless pores smaller than 20 nm increased,and pore structure improved.This study also found that using CO_(2)mineralization curing SS-FA-Portland cement solid waste concrete can significantly reduce the negative impact on the environment.
基金Supported by An AIRC grant from the Veneto Regional Authorities,2009the"Guido Berlucchi"Foundation+1 种基金the"Morgagni"Association for Oncological Research (PadovaPD)
文摘AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer(GC)most frequently develops.The operative link for gas-tritis assessment(OLGA)staging system ranks the GC risk according to both the topography and the severity of gastric atrophy(as assessed histologically on the ba-sis of the Sydney protocol for gastric mucosal biopsy).Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages Ⅲ-Ⅳ with a higher risk of GC.A recently-proposed modification of the OLGA staging system(OLGIM)basically incorporates the OLGA frame,but replaces the atrophy score with an assessment of intestinal metaplasia(IM)alone.A series of 4552 consecutive biopsy sets(2007-2009)was re-trieved and reassessed according to both the OLGA and the OLGIM staging systems.A set of at least 5 biopsy samples was available for all the cases considered.RESULTS:In 4460 of 4552 cases(98.0%),both the high-risk stages(Ⅲ + Ⅳ)and the low-risk stages(0 +Ⅰ + Ⅱ)were assessed applying the OLGA and OL-GIM criteria.Among the 243 OLGA high-risk stages,14(5.8%)were down-staged to a low risk using OLGIM.The 67(1.5%)incidentally-found neoplastic lesions(intraepithelial or invasive)were consistently associated with high-risk stages,as assessed by both OLGA and OLGIM(P < 0.001 for both).Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage(stage Ⅲ)were associated with a low-risk OLGIM stage(stage Ⅱ).CONCLUSION:Gastritis staging systems(both OLGA and OLGIM)convey prognostically important informa-tion on the gastritis-associated cancer risk.Because of its clinical impact,the stage of gastritis should be included as a conclusive message in the gastritis histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA staging in the identif ication of patients at high risk of gastric cancer.
