目的评估5.0 T MRI非增强3D-FLAIR序列在内耳内淋巴积水诊断中的价值。方法前瞻性纳入临床确诊梅尼埃病的25例患者[男12例,女13例,平均年龄(57.42±12.66)岁],均接受5.0 T内耳磁共振钆造影检查。扫描序列包括:常规内耳MRI平扫(T1WI...目的评估5.0 T MRI非增强3D-FLAIR序列在内耳内淋巴积水诊断中的价值。方法前瞻性纳入临床确诊梅尼埃病的25例患者[男12例,女13例,平均年龄(57.42±12.66)岁],均接受5.0 T内耳磁共振钆造影检查。扫描序列包括:常规内耳MRI平扫(T1WI轴位、T2WI抑脂轴位以及T2WI抑脂冠状位)、内耳水成像序列以及3D-FLAIR平扫检查;双倍剂量对比剂注射4 h后行增强3D-FLAIR和薄层T1WI脂肪抑制序列检查。由两名具有10年经验的头颈部放射科医师对非增强3D-FLAIR及增强3D-FLAIR序列进行独立阅片,对耳蜗、前庭有无内淋巴积水进行独立评判,如有分歧则通过协商达成一致。两种方法对内淋巴积水诊断的一致性检验采用McNemar精确检验。结果以增强3D-FLAIR序列的诊断结果为参考标准,25例患者均检出不同部位及程度的内淋巴积水,25例患者共50侧耳,其中19侧左耳存在耳蜗内淋巴积水,18侧右耳存在耳蜗内淋巴积水;9侧左前庭存在内淋巴积水,6侧右前庭存在内淋巴积水。15侧耳的前庭内淋巴积水均可在非增强3D-FLAIR观察到同样的影像表现,37侧耳蜗内淋巴积水,非增强序列可观察到34例。非增强3D-FLAIR对前庭积水的诊断一致性为100%,对耳蜗积水的诊断一致性为91.9%(34/37)。两种方法对内淋巴积水诊断的一致性检验差异无统计学意义。结论5.0 T非增强3D-FLAIR在内淋巴积水诊断中具有较高的准确性,可用于不能耐受增强检查的梅尼埃患者。展开更多
受全球变化影响,原本湿润的西南地区自21世纪以来干旱事件频发,已对区域内植被生长造成了不同程度的抑制,威胁西南生态屏障安全。本研究采用标准化降水蒸散指数分析了西南地区2001-2016年极端干旱事件的频率和特征,选择了持续时间最长...受全球变化影响,原本湿润的西南地区自21世纪以来干旱事件频发,已对区域内植被生长造成了不同程度的抑制,威胁西南生态屏障安全。本研究采用标准化降水蒸散指数分析了西南地区2001-2016年极端干旱事件的频率和特征,选择了持续时间最长、影响范围最广的2009-2010年极端干旱事件,利用CLM5.0陆面过程模式(Community Land Model version 5.0)对2009-2010年极端干旱事件下植被生长进行数值模拟,并将模拟结果与三套遥感数据[Global Inventory Modeling and Mapping Studies(GIMMS),Global Land Surface Satellite(GLASS),Global Mapping(GLOBMAP)]进行对比验证CLM5.0对西南地区植被对干旱响应的模拟适用性。结果表明,2001-2016年,中国西南地区发生3例持续时间超过6个月的极端干旱事件,其中持续时间最长、最严重的干旱发生在2009-2010年。模拟发现在2009-2010年极端干旱期间,CLM5.0对植被与干旱的相关性、滞后响应、累积效应以及抵抗力和恢复力的模拟效果较好,植被对干旱的响应强度呈从东南向西北递减的特征,68.66%的区域植被对干旱表现出滞后响应,且滞后响应(78.02%)、累积效应(89.17%)与干旱均呈现较大面积的正相关,与多源遥感的描述有较高的一致性。在对不同植被类型的干旱抵抗力和恢复力的模拟方面,CLM5.0的模拟表现也较为出色,森林比灌木和草甸有更强的干旱抵抗力,且森林的干旱抵抗力和恢复力呈现明显的相反趋势。本研究使用CLM5.0模型模拟与多源遥感验证的方法,为理解西南地区植被对干旱的多方面响应提供了一个补充视角,有助于较全面地评估和预测西南干旱对植被活动的影响。展开更多
OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early ide...OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early identification and management.METHODS:The study was conducted in three phases.First,a comprehensive review of Traditional Chinese Medicine(TCM)literature and diagnostic criteria was performed,generating initial KDS symptoms for pregnancy.Second,a two-round Delphi survey,involving 21 experts from TCM,obstetrics,and gynaecology,assessed importance,relevance,and appropriateness of the items.Third,a psychometric evaluation was conducted,including exploratory factor analysis and internal consistency assessment.RESULTS:In the first Delphi round,19 items were flagged for revision or removal due to expert variability,with 12 items deemed irrelevant.In the second round,consensus was reached,resulting in a 25-item scale.After psychometric evaluation,seven items were removed due to poor factor loadings,leaving an 18-item scale.Three factors—physiological discomfort,fatigue&weakness,and excretion abnormalities—accounted for 78.4%of the variance.The final scale demonstrated excellent internal consistency(Cronbach's alpha=0.959).CONCLUSION:The validated 18-item KDS-PRMsPregnancy Scale is a reliable tool for assessing KDS in pregnant women.Future research should focus on validation in diverse populations and exploring its predictive validity for pregnancy outcomes.展开更多
Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosupp...Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.展开更多
文摘受全球变化影响,原本湿润的西南地区自21世纪以来干旱事件频发,已对区域内植被生长造成了不同程度的抑制,威胁西南生态屏障安全。本研究采用标准化降水蒸散指数分析了西南地区2001-2016年极端干旱事件的频率和特征,选择了持续时间最长、影响范围最广的2009-2010年极端干旱事件,利用CLM5.0陆面过程模式(Community Land Model version 5.0)对2009-2010年极端干旱事件下植被生长进行数值模拟,并将模拟结果与三套遥感数据[Global Inventory Modeling and Mapping Studies(GIMMS),Global Land Surface Satellite(GLASS),Global Mapping(GLOBMAP)]进行对比验证CLM5.0对西南地区植被对干旱响应的模拟适用性。结果表明,2001-2016年,中国西南地区发生3例持续时间超过6个月的极端干旱事件,其中持续时间最长、最严重的干旱发生在2009-2010年。模拟发现在2009-2010年极端干旱期间,CLM5.0对植被与干旱的相关性、滞后响应、累积效应以及抵抗力和恢复力的模拟效果较好,植被对干旱的响应强度呈从东南向西北递减的特征,68.66%的区域植被对干旱表现出滞后响应,且滞后响应(78.02%)、累积效应(89.17%)与干旱均呈现较大面积的正相关,与多源遥感的描述有较高的一致性。在对不同植被类型的干旱抵抗力和恢复力的模拟方面,CLM5.0的模拟表现也较为出色,森林比灌木和草甸有更强的干旱抵抗力,且森林的干旱抵抗力和恢复力呈现明显的相反趋势。本研究使用CLM5.0模型模拟与多源遥感验证的方法,为理解西南地区植被对干旱的多方面响应提供了一个补充视角,有助于较全面地评估和预测西南干旱对植被活动的影响。
基金Supported by the National Natural Science Foundation of China:to Explore the Intergenerational Effects of Bu-Shen-Tian-Jing Therapeutic Principle on the Offspring of Hyper-Androgenic Polycystic Ovary Syndrome Based on Regulating Rhythmic Iron Death in the Ovarian Granulosa Cells Mediated by Fos Proto-OncogeneRetinoic Acid Receptor-Related Orphan Receptor A-Solute Carrier Family 7 Member 11(No.82274564)the National Natural Science Foundation of China:the Underlying Mechanism of Bu-Shen-Jian-Pi Therapeutic Principle in Regulating Ovarian Granulosa Cells Autophagy Mediated by Short-chain Fatty Acids-forkhead Box O1 Pathway and its Effects on the Development of Offspring of Polycystic Ovary Syndrome(No.82074476)the Open Fund Project of Zhejiang Key Laboratory of Maternal and Infant Health,Women’s Hospital,School of Medicine,Zhejiang University:Mediating Role of Kidney Deficiency in the Relationship between Fear of Childbirth and Delivery Modes:an Exploratory Investigation Grounded in the Classic Traditional Chinese Medicine Theories of“Fear Injuring Kidney”and“Kidney Storing Essence”(No.ZDFY2024-MI-2)。
文摘OBJECTIVE:To develop an expert consensus on kidney deficiency syndrome(KDS)in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale(KDS-PRMs-Pregnancy Scale)for early identification and management.METHODS:The study was conducted in three phases.First,a comprehensive review of Traditional Chinese Medicine(TCM)literature and diagnostic criteria was performed,generating initial KDS symptoms for pregnancy.Second,a two-round Delphi survey,involving 21 experts from TCM,obstetrics,and gynaecology,assessed importance,relevance,and appropriateness of the items.Third,a psychometric evaluation was conducted,including exploratory factor analysis and internal consistency assessment.RESULTS:In the first Delphi round,19 items were flagged for revision or removal due to expert variability,with 12 items deemed irrelevant.In the second round,consensus was reached,resulting in a 25-item scale.After psychometric evaluation,seven items were removed due to poor factor loadings,leaving an 18-item scale.Three factors—physiological discomfort,fatigue&weakness,and excretion abnormalities—accounted for 78.4%of the variance.The final scale demonstrated excellent internal consistency(Cronbach's alpha=0.959).CONCLUSION:The validated 18-item KDS-PRMsPregnancy Scale is a reliable tool for assessing KDS in pregnant women.Future research should focus on validation in diverse populations and exploring its predictive validity for pregnancy outcomes.
文摘Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.
