AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(...AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.展开更多
This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 2...This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 280 Chinese parents(mothers=70.0%,fathers=30.0%)of children with ID through purposive sampling and analyzed using partial least squares structural equation modeling(PLS-SEM).The results indicated that parental involvement not only directly enhanced children’s social skills but also indirectly improved them by alleviating parenting stress,which acted as a partial mediator.Contrary to the stress-buffering hypothesis,social support did not moderate the negative impact of parenting stress on social skills.Theoretically,this study contributes by validating ecological systems theory through a shift in focus from individual deficits to family systems,while also challenging the conventional view of stress-buffering theory.Accordingly,parent-support programs should integrate practical involvement training with systematic stress reduction and provide tailored assistance such as behavior-management training and respite care.展开更多
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.展开更多
To address the problems of low accuracy by the CONWEP model and poor efficiency by the Coupled Eulerian-Lagrangian(CEL)method in predicting close-range air blast loads of cylindrical charges,a neural network-based sim...To address the problems of low accuracy by the CONWEP model and poor efficiency by the Coupled Eulerian-Lagrangian(CEL)method in predicting close-range air blast loads of cylindrical charges,a neural network-based simulation(NNS)method with higher accuracy and better efficiency was proposed.The NNS method consisted of three main steps.First,the parameters of blast loads,including the peak pressures and impulses of cylindrical charges with different aspect ratios(L/D)at different stand-off distances and incident angles were obtained by two-dimensional numerical simulations.Subsequently,incident shape factors of cylindrical charges with arbitrary aspect ratios were predicted by a neural network.Finally,reflected shape factors were derived and implemented into the subroutine of the ABAQUS code to modify the CONWEP model,including modifications of impulse and overpressure.The reliability of the proposed NNS method was verified by related experimental results.Remarkable accuracy improvement was acquired by the proposed NNS method compared with the unmodified CONWEP model.Moreover,huge efficiency superiority was obtained by the proposed NNS method compared with the CEL method.The proposed NNS method showed good accuracy when the scaled distance was greater than 0.2 m/kg^(1/3).It should be noted that there is no need to generate a new dataset again since the blast loads satisfy the similarity law,and the proposed NNS method can be directly used to simulate the blast loads generated by different cylindrical charges.The proposed NNS method with high efficiency and accuracy can be used as an effective method to analyze the dynamic response of structures under blast loads,and it has significant application prospects in designing protective structures.展开更多
Stem volume estimation is crucial in forest ecology and management,particularly for timber harvesting strategies and carbon stock assessments.This study aimed to develop a variable-exponent taper equation specifically...Stem volume estimation is crucial in forest ecology and management,particularly for timber harvesting strategies and carbon stock assessments.This study aimed to develop a variable-exponent taper equation specifically tailored to savanna tree species using close-range photogrammetry(CRP)data and to evaluate its performance against conventional volume equations for stem volume estimation.A dataset of 30 trees across five dominant savanna species was used to fit the taper model,which was validated using a separate dataset of 322 trees from 14 species.The results demonstrated significant improvements in volume estimation accuracy when using the taper equation.At the tree level,the root mean square error(RMSE)decreased by 47%,from 598 to 319 dm^(3),and the mean absolute bias(MAB)by 48%,from 328 to 172 dm3,compared to volume equations.Similarly,at the plot level,RMSE was reduced by 42% and MAB by 40%.The model performed well for species with regular forms.However,species with irregular tapers exhibited higher errors,reflecting the challenges of modeling stem forms of mixed species.The use of CRP proved valuable,providing high-resolution diameter measurements that improved model parameterization.This study underscores the importance of advanced data collection methods for enhancing taper model accuracy and suggests that further species-specific adjustments are needed to improve performance for species with irregular forms.The findings support the broader application of taper equations for improving stem volume estimates in savanna ecosystems,contributing to better forest management and resource monitoring practices.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for...BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.展开更多
BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esoph...BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.展开更多
Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 t...Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 thoracic wall and rib lesions from 66 patients,a total of 32 males and 34 females,aged(53.2±5.6)years old with pathologically confirmed lung adenocarcinoma who underwent both 99mTc-MDP SPECT/CT and MSCT examinations from March 2017 to September 2023.The diagnostic efficacy of the two imaging modalities was compared using pathological confirmation or clinical follow-up as the gold standard.Results:Pathological confirmation or clinical follow-up revealed 74 lesions with thoracic wall bone involvement in lung adenocarcinoma(20 lesions confirmed by surgical pathology and 54 lesions confirmed by clinical follow-up)and 4 lesions without thoracic wall or rib involvement(2 lesions confirmed by surgical pathology and 2 lesions confirmed by clinical follow-up).The diagnostic sensitivity,specificity,and accuracy of 99mTc-MDP SPECT/CT were 97.3%,50.0%,and 94.9%,respectively.Its diagnostic sensitivity and accuracy were higher than those of MSCT(72.3%and 74.4%,respectively),with statistically significant differences(P<0.05).The specificity of 99mTc-MDP SPECT/CT was lower than that of MSCT(100.0%),but the difference was not statistically significant(P<0.05).There were no statistically significant differences in the positive predictive value and negative predictive value between 99mTc-MDP SPECT/CT and MSCT(P>0.05).99mTc-MDP SPECT/CT examination revised the MSCT tumor staging in 14 patients[21.2%(14/66)]with lung adenocarcinoma.Conclusion:99mTc-MDP SPECT/CT imaging demonstrates superior diagnostic efficacy compared to MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.It offers more accurate tumor staging than MSCT,and an accurate diagnosis aids in clinical treatment decision-making.展开更多
A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally ...A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.展开更多
Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially av...Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.展开更多
Knowing about the far away past is something teenagers are not interested in.They prefer to deal with the present time,their present interactions,and their present life.When they study history of the past,they most of...Knowing about the far away past is something teenagers are not interested in.They prefer to deal with the present time,their present interactions,and their present life.When they study history of the past,they most often do it just to have good grades,not for a personal interest.But this condition can be changed,their interests can be enlarged,so as to include what happened centuries ago,and this can be done with educational proposals that appear to them fun,involving and different from the usual school routines.Over the years,the author has proposed several educational activities that captured the interest and motivated teenagers to put themselves in another time period and understand what happened.The following projects show not only how to make them curious about what happened in the far away past,but through that understanding,know more about themselves,to see themselves as individuals who are able to make a difference also in the present and future times.展开更多
The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, tes...The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, testing whether retention of vocabulary acquired incidentally is contingent on amount of task-induced involvement.Using short-and long term, namely immediate posttest and delayed posttest, retention of twelve unfamiliar words was investigated in three learning tasks (reading, reading plus fill-in and writing) with varying degrees of “involvement load”- various combinations of need, search and evaluation. The results of the experiment partially support the Involvement Load Hypothesis: retention in the writing group was higher than that in the reading plus fill-in group; retention in the reading plus fill-in group was higher than that in the reading group. The results are discussed in light of the construct of task-induced involvement.展开更多
[Objective] The aim was to explore the measurement of coordinate parameter by multi-baseline digital close-range photogrammetry system.[Method] The 3-dimensional coordinate of 8-year-old Jujube was measured by using L...[Objective] The aim was to explore the measurement of coordinate parameter by multi-baseline digital close-range photogrammetry system.[Method] The 3-dimensional coordinate of 8-year-old Jujube was measured by using Lensphoto multi-baseline digital close-range photogrammetry system,and through comparing with measured data of Total Station,the error and accuracy of photogrammetry data were analyzed.[Result] The absolute error of X,Y and Z coordinate was 0-0.014,0-0.018 and 0-0.004 m respectively,and the relative error of X,Y and Z coordinate was less than 0.145%.The significance test of pairs for the photogrammetry data and measured data of Total Station indicated that the space coordinate data of stumpage were accurately measured by using the multi-baseline digital close-range photogrammetry method,and the photogrammetry data meet the need of space coordinate measurement for virtual plant growth simulation.[Conclusion] This study had provided theoretical basis for the growth measurement of virtual plant growth simulation.展开更多
Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high...Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.展开更多
Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a mos...Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.展开更多
Multiple myeloma(MM)is a common malignant hematological tumor in adults,which is characterized by clonal malignant proliferation of plasma cells in the bone marrow and secretion of a large number of abnormal monoclona...Multiple myeloma(MM)is a common malignant hematological tumor in adults,which is characterized by clonal malignant proliferation of plasma cells in the bone marrow and secretion of a large number of abnormal monoclonal immunoglobulins(M protein),leading to bone destruction,hypercalcemia,anemia,and renal insufficiency(Alexandrakis et al.,2015;Yang et al.,2018).Since a large number of new drugs,represented by proteasome inhibitors and immunomodulators,have been successfullyused to treat MM.展开更多
Objective： Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma（DLBCL）. Previous studies have suggested that older patients are more prone to extranodal involvement. This study...Objective： Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma（DLBCL）. Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.Methods： A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender,extranodal involvement, age-adjusted international prognostic index（aa IPI）, rituximab infusion and radiotherapy on patient outcomes were evaluated.Results： Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aa IPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.Conclusions： Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution.The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.展开更多
文摘AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.
文摘This study investigated the effects of parental involvement,parenting stress,and social support on the social skills of school-aged children(6-18 years old)with intellectual disabilities(ID).Data were collected from 280 Chinese parents(mothers=70.0%,fathers=30.0%)of children with ID through purposive sampling and analyzed using partial least squares structural equation modeling(PLS-SEM).The results indicated that parental involvement not only directly enhanced children’s social skills but also indirectly improved them by alleviating parenting stress,which acted as a partial mediator.Contrary to the stress-buffering hypothesis,social support did not moderate the negative impact of parenting stress on social skills.Theoretically,this study contributes by validating ecological systems theory through a shift in focus from individual deficits to family systems,while also challenging the conventional view of stress-buffering theory.Accordingly,parent-support programs should integrate practical involvement training with systematic stress reduction and provide tailored assistance such as behavior-management training and respite care.
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.52271317 and 52071149)the Fundamental Research Funds for the Central Universities(HUST:2019kfy XJJS007)。
文摘To address the problems of low accuracy by the CONWEP model and poor efficiency by the Coupled Eulerian-Lagrangian(CEL)method in predicting close-range air blast loads of cylindrical charges,a neural network-based simulation(NNS)method with higher accuracy and better efficiency was proposed.The NNS method consisted of three main steps.First,the parameters of blast loads,including the peak pressures and impulses of cylindrical charges with different aspect ratios(L/D)at different stand-off distances and incident angles were obtained by two-dimensional numerical simulations.Subsequently,incident shape factors of cylindrical charges with arbitrary aspect ratios were predicted by a neural network.Finally,reflected shape factors were derived and implemented into the subroutine of the ABAQUS code to modify the CONWEP model,including modifications of impulse and overpressure.The reliability of the proposed NNS method was verified by related experimental results.Remarkable accuracy improvement was acquired by the proposed NNS method compared with the unmodified CONWEP model.Moreover,huge efficiency superiority was obtained by the proposed NNS method compared with the CEL method.The proposed NNS method showed good accuracy when the scaled distance was greater than 0.2 m/kg^(1/3).It should be noted that there is no need to generate a new dataset again since the blast loads satisfy the similarity law,and the proposed NNS method can be directly used to simulate the blast loads generated by different cylindrical charges.The proposed NNS method with high efficiency and accuracy can be used as an effective method to analyze the dynamic response of structures under blast loads,and it has significant application prospects in designing protective structures.
基金partially funded by the International Foundation for Science(Grant No:I-1-D-6066-1).
文摘Stem volume estimation is crucial in forest ecology and management,particularly for timber harvesting strategies and carbon stock assessments.This study aimed to develop a variable-exponent taper equation specifically tailored to savanna tree species using close-range photogrammetry(CRP)data and to evaluate its performance against conventional volume equations for stem volume estimation.A dataset of 30 trees across five dominant savanna species was used to fit the taper model,which was validated using a separate dataset of 322 trees from 14 species.The results demonstrated significant improvements in volume estimation accuracy when using the taper equation.At the tree level,the root mean square error(RMSE)decreased by 47%,from 598 to 319 dm^(3),and the mean absolute bias(MAB)by 48%,from 328 to 172 dm3,compared to volume equations.Similarly,at the plot level,RMSE was reduced by 42% and MAB by 40%.The model performed well for species with regular forms.However,species with irregular tapers exhibited higher errors,reflecting the challenges of modeling stem forms of mixed species.The use of CRP proved valuable,providing high-resolution diameter measurements that improved model parameterization.This study underscores the importance of advanced data collection methods for enhancing taper model accuracy and suggests that further species-specific adjustments are needed to improve performance for species with irregular forms.The findings support the broader application of taper equations for improving stem volume estimates in savanna ecosystems,contributing to better forest management and resource monitoring practices.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
基金supported by the National High Level Hospital Clinical Research Funding(No.2024-GSP-TJ-15&No.2023-GSP-QN-17)the Chinese Society of Cardiology’s Foundation(CSCF2023B03).
文摘BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.
文摘BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.
文摘Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 thoracic wall and rib lesions from 66 patients,a total of 32 males and 34 females,aged(53.2±5.6)years old with pathologically confirmed lung adenocarcinoma who underwent both 99mTc-MDP SPECT/CT and MSCT examinations from March 2017 to September 2023.The diagnostic efficacy of the two imaging modalities was compared using pathological confirmation or clinical follow-up as the gold standard.Results:Pathological confirmation or clinical follow-up revealed 74 lesions with thoracic wall bone involvement in lung adenocarcinoma(20 lesions confirmed by surgical pathology and 54 lesions confirmed by clinical follow-up)and 4 lesions without thoracic wall or rib involvement(2 lesions confirmed by surgical pathology and 2 lesions confirmed by clinical follow-up).The diagnostic sensitivity,specificity,and accuracy of 99mTc-MDP SPECT/CT were 97.3%,50.0%,and 94.9%,respectively.Its diagnostic sensitivity and accuracy were higher than those of MSCT(72.3%and 74.4%,respectively),with statistically significant differences(P<0.05).The specificity of 99mTc-MDP SPECT/CT was lower than that of MSCT(100.0%),but the difference was not statistically significant(P<0.05).There were no statistically significant differences in the positive predictive value and negative predictive value between 99mTc-MDP SPECT/CT and MSCT(P>0.05).99mTc-MDP SPECT/CT examination revised the MSCT tumor staging in 14 patients[21.2%(14/66)]with lung adenocarcinoma.Conclusion:99mTc-MDP SPECT/CT imaging demonstrates superior diagnostic efficacy compared to MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.It offers more accurate tumor staging than MSCT,and an accurate diagnosis aids in clinical treatment decision-making.
文摘A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.
基金supported by the Sponsored by Tianjin Health Research Project(Grant No.TJWJ2023ZD003)the Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation(Grant Nos.Y-NCJH202201-0027 and Y-2022YMJN/MS-0001).
文摘Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.
文摘Knowing about the far away past is something teenagers are not interested in.They prefer to deal with the present time,their present interactions,and their present life.When they study history of the past,they most often do it just to have good grades,not for a personal interest.But this condition can be changed,their interests can be enlarged,so as to include what happened centuries ago,and this can be done with educational proposals that appear to them fun,involving and different from the usual school routines.Over the years,the author has proposed several educational activities that captured the interest and motivated teenagers to put themselves in another time period and understand what happened.The following projects show not only how to make them curious about what happened in the far away past,but through that understanding,know more about themselves,to see themselves as individuals who are able to make a difference also in the present and future times.
文摘The purpose of the paper is to study retention of vocabulary acquired incidentally on task-induced involvement by senior middle school students. Grade two of senior middle students participated in the experiments, testing whether retention of vocabulary acquired incidentally is contingent on amount of task-induced involvement.Using short-and long term, namely immediate posttest and delayed posttest, retention of twelve unfamiliar words was investigated in three learning tasks (reading, reading plus fill-in and writing) with varying degrees of “involvement load”- various combinations of need, search and evaluation. The results of the experiment partially support the Involvement Load Hypothesis: retention in the writing group was higher than that in the reading plus fill-in group; retention in the reading plus fill-in group was higher than that in the reading group. The results are discussed in light of the construct of task-induced involvement.
基金Supported by National Natural Science Foundation of China(30770401)National Eleventh Five-Year Plan for Forestry Scienceand Technology Support Topics(2006BADO3A0505)~~
文摘[Objective] The aim was to explore the measurement of coordinate parameter by multi-baseline digital close-range photogrammetry system.[Method] The 3-dimensional coordinate of 8-year-old Jujube was measured by using Lensphoto multi-baseline digital close-range photogrammetry system,and through comparing with measured data of Total Station,the error and accuracy of photogrammetry data were analyzed.[Result] The absolute error of X,Y and Z coordinate was 0-0.014,0-0.018 and 0-0.004 m respectively,and the relative error of X,Y and Z coordinate was less than 0.145%.The significance test of pairs for the photogrammetry data and measured data of Total Station indicated that the space coordinate data of stumpage were accurately measured by using the multi-baseline digital close-range photogrammetry method,and the photogrammetry data meet the need of space coordinate measurement for virtual plant growth simulation.[Conclusion] This study had provided theoretical basis for the growth measurement of virtual plant growth simulation.
文摘Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.
文摘Crohn's disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.
基金the National Natural Science Foundation of China(Nos.81800201 and 81872322)the Zhejiang Key Research and Development Project(No.2020C03014)the Key Project of Zhejiang Provincial Natural Science Foundation of China(No.LZ22H160009)。
文摘Multiple myeloma(MM)is a common malignant hematological tumor in adults,which is characterized by clonal malignant proliferation of plasma cells in the bone marrow and secretion of a large number of abnormal monoclonal immunoglobulins(M protein),leading to bone destruction,hypercalcemia,anemia,and renal insufficiency(Alexandrakis et al.,2015;Yang et al.,2018).Since a large number of new drugs,represented by proteasome inhibitors and immunomodulators,have been successfullyused to treat MM.
基金supported by the National Nature Science Foundation of China (No. 81071938, 81470365)
文摘Objective： Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma（DLBCL）. Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.Methods： A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender,extranodal involvement, age-adjusted international prognostic index（aa IPI）, rituximab infusion and radiotherapy on patient outcomes were evaluated.Results： Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aa IPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.Conclusions： Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution.The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.
