An efficient TfOH-catalyzed O—H insertion reaction of α-aryl diazoesters with carboxylic acids is reported.This metal-free protocol provides an operationally simple method for a one-pot assembly of diverse α-acylox...An efficient TfOH-catalyzed O—H insertion reaction of α-aryl diazoesters with carboxylic acids is reported.This metal-free protocol provides an operationally simple method for a one-pot assembly of diverse α-acyloxy esters in moderate to high yields with a broad substrate scope.All starting materials are readily available,and the reactions can be conducted in the open air at room temperature.展开更多
A blue light-induced formal insertion reaction ofα-siloxy carbene into the C—H bond of 1,3-diketones has been reported.Under the irradiation of blue light,acylsilane converts toα-siloxy carbene,which then undergoes...A blue light-induced formal insertion reaction ofα-siloxy carbene into the C—H bond of 1,3-diketones has been reported.Under the irradiation of blue light,acylsilane converts toα-siloxy carbene,which then undergoes formal C—H bond insertion reaction with the enol form of 1,3-diketone.This method uses readily available and relative stable acylsilane as car-bene precursor,which features a simple and metal-free approach under mild conditions.Moreover,the synthetic potential of this protocol has been demonstrated by performing the reaction on a gram scale with comparable high yield.展开更多
The switchable cross-coupling of indoles and pyridotriazoles through carbene insertion at C_(2)-or C_(3)-positon has been developed in this paper.This highly site-selective C-H carbenoid functionalization is determine...The switchable cross-coupling of indoles and pyridotriazoles through carbene insertion at C_(2)-or C_(3)-positon has been developed in this paper.This highly site-selective C-H carbenoid functionalization is determined by both the Rh-catalyst species and auxiliary groups.[Cp∗RhCl_(2)]_(2) and coordinating pyrimidyl group direct the C-H carbenoid functionalization to occur at the C_(2)-position,while Rh2OAc4 and noncoordinating benzyl group lead the reaction to occur at the C_(3)-position of the indoles.This regioselective C−H functionalization strategy is of significant importance for the discovery of indole drugs.展开更多
BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdr...BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.展开更多
BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intr...BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intraoperative strategies.AIM To evaluate the predictive performance of machine learning(ML)algorithms for DCI by comparing three modeling approaches,identify factors influencing DCI,and develop a preoperative prediction model using ML algorithms to enhance colonoscopy quality and efficiency.METHODS This cross-sectional study enrolled 712 patients who underwent colonoscopy at a tertiary hospital between June 2020 and May 2021.Demographic data,past medical history,medication use,and psychological status were collected.The endoscopist assessed DCI using the visual analogue scale.After univariate screening,predictive models were developed using multivariable logistic regression,least absolute shrinkage and selection operator(LASSO)regression,and random forest(RF)algorithms.Model performance was evaluated based on discrimination,calibration,and decision curve analysis(DCA),and results were visualized using nomograms.RESULTS A total of 712 patients(53.8%male;mean age 54.5 years±12.9 years)were included.Logistic regression analysis identified constipation[odds ratio(OR)=2.254,95%confidence interval(CI):1.289-3.931],abdominal circumference(AC)(77.5–91.9 cm,OR=1.895,95%CI:1.065-3.350;AC≥92 cm,OR=1.271,95%CI:0.730-2.188),and anxiety(OR=1.071,95%CI:1.044-1.100)as predictive factors for DCI,validated by LASSO and RF methods.Model performance revealed training/validation sensitivities of 0.826/0.925,0.924/0.868,and 1.000/0.981;specificities of 0.602/0.511,0.510/0.562,and 0.977/0.526;and corresponding area under the receiver operating characteristic curves(AUCs)of 0.780(0.737-0.823)/0.726(0.654-0.799),0.754(0.710-0.798)/0.723(0.656-0.791),and 1.000(1.000-1.000)/0.754(0.688-0.820),respectively.DCA indicated optimal net benefit within probability thresholds of 0-0.9 and 0.05-0.37.The RF model demonstrated superior diagnostic accuracy,reflected by perfect training sensitivity(1.000)and highest validation AUC(0.754),outperforming other methods in clinical applicability.CONCLUSION The RF-based model exhibited superior predictive accuracy for DCI compared to multivariable logistic and LASSO regression models.This approach supports individualized preoperative optimization,enhancing colonoscopy quality through targeted risk stratification.展开更多
Uronic acids are prevalent components of crucial glycoconjugates,pivotal in various biological processes.In nature,NDP-uronic acids,the nucleosides-activated uronic acids,serve as glycosylation donors catalyzed by uro...Uronic acids are prevalent components of crucial glycoconjugates,pivotal in various biological processes.In nature,NDP-uronic acids,the nucleosides-activated uronic acids,serve as glycosylation donors catalyzed by uronosyltransferases(UATs)to construct glycans containing uronic acids.Despite their biological importance,the synthesis of naturally occurring NDP-uronic acids on a large scale remains challenging.Here,we developed an oxidation reaction insertion strategy for the efficient synthesis of NDP-uronic acids,and 11 NDP-uronic acids were successfully prepared in good yield and on a large scale.The prepared NDP-uronic acids can be used to explore new uronosyltransferases and synthesize uronic acids containing carbohydrates for fundamental research.展开更多
[Objective] The aim of this study is to understand the genetic characteristics of a grain shape mutant and its possible role in genetic improvement of grain yield in rice. [Method] On the basis of the collection of T-...[Objective] The aim of this study is to understand the genetic characteristics of a grain shape mutant and its possible role in genetic improvement of grain yield in rice. [Method] On the basis of the collection of T-DNA tag lines, the progeny of homozygous plants carrying T-DNA insertion were screened for mutants with mutated phenotypes. The genetic analysis of the mutant and test for the linkage between the mutated phenotype and the T-DNA insertion were carried out to determine its genetic characteristics. [Result] In the present study, a grain shape mutant induced by T-DNA insertion in rice was identified, which showed small grain. Genetic analysis of the mutant showed that the two types of phenotype, normal and small grain in the segregating populations derived from the T-DNA heterozygotes, fit the ratio of 3∶1. Test for Basta resistance showed that all the mutants were resistant while the normal plants segregated for resistant and susceptible by the ratio of 2∶1. The results indicated that the mutant phenotype cosegregated with Bar gene. The small grain mutant caused by T-DNA insertion was confirmed by PCR amplification aiming at T-DNA. [Conclusion] The grain shape mutant is useful for isolation of the tagged gene and genetic improvement in rice.展开更多
Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC...Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC).Methods:For one ovarian cancer patient with PICC malposition in the coronary sinus(CS)due to PLSVC,multimodal imaging techniques were integrated to accurately locate the catheter tip.The catheter position was adjusted based on evidence(withdrawing 5 cm),and a standardized nursing process was established,including personalized health education,catheter fixation and displacement monitoring,complication monitoring,establishment of a specialized disease information archive system,and formulation of a follow-up plan.Results:The catheter tip was successfully withdrawn from the coronary sinus(at the T8 level)to the middle and lower part of the PLSVC(at the T6 vertebral level),and the catheter functioned normally after adjustment.No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period.Conclusion:The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC(at the T5–T7 vertebral level).This new standard can effectively avoid CS-related complications.The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion.展开更多
Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on ne...Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on needle insertion.It is necessary to summarize and analyze the existing results to promote the future development of theories and applications of needle insertion.Thus,a survey of the state of the art of research is presented on algorithms of needle steering techniques,the surgical robots and devices.Based on the analysis of the needle insertion procedure,the concept of needle steering is defined as a kinematics problem,which is to place the needle at the target and avoid the obstacles.The needle steering techniques,including the artificial potential field method and the nonholonomic model,are introduced to control the needles for improving the accuracy.Based on the quasi-static thinking,the virtual spring model and the cantilever-beam model are developed to calculate the amount of needle deflection and generate the needle path.The phantoms instead of the real tissue are used to verify the models mentioned in most of the experimentations.For the desired needle trajectories,the image-guided robotic devices and some novel needles are presented to achieve the needle steering.Finally,the challenges are provided involving the controllability of the long flexible needle and the properties of soft tissue.The results and investigations can be used for further study on the precision and accuracy of needle insertion.展开更多
Irreversible reductive insertion of Zn2+transforms Mn3O4 such that the resulting Zn0.2Mn3O4 exhibits highly reversible storage properties of chloride ions,thus rendering Zn0.2Mn3O4 an excellent cathode of aqueous dual...Irreversible reductive insertion of Zn2+transforms Mn3O4 such that the resulting Zn0.2Mn3O4 exhibits highly reversible storage properties of chloride ions,thus rendering Zn0.2Mn3O4 an excellent cathode of aqueous dual-ion batteries.With Zn2+trapped,Zn0.2Mn3O4 delivers the chloride-storage capacity over 200 mAh/g at an average potential of 1.6 V vs Zn2+/Zn by reversibly forming a new ionic compound equivalent to Zn0.2Mn3O4Cl1.7.Electrochemical quartz crystal microbalance results suggest chloride as the primary charge carrier in the reversible oxidative anion insertion.The Mn3O4 anion-hosting cathode couples with Zn metal anode in a full-cell dual-ion battery,demonstrating stable cycling in practical pouch cells with an energy density of 150 Wh/kg based on the mass of both electrodes.展开更多
Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （AD...Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （ADRA2B）.Methods A case-control study was carried out in Chinese Han population,including 368 cases of migraine and 517 controls.Genomic DNA was extracted from blood samples,and DNA fragments containing the site of polymorphism were amplified by PCR.Data were adjusted for sex,age,migraine history and family history,and analyzed using a logistic regression model.Results There was no association between indel polymorphism and migraine,at either the allele or the genotype level.Conclusion These findings do not support a functional significance of ADRA2B indel polymorphism at position-4825 relative to the start codon in the far upstream region of the promoter in the present migraine subjects.展开更多
An algorithm of path based timing optimization by buffer insertion is presented.The algorithm adopts a high order model to estimate interconnect delay and a nonlinear delay model based on look up table for gate dela...An algorithm of path based timing optimization by buffer insertion is presented.The algorithm adopts a high order model to estimate interconnect delay and a nonlinear delay model based on look up table for gate delay estimation.And heuristic method of buffer insertion is presented to reduce delay.The algorithm is tested by industral circuit case.Experimental results show that the algorithm can optimize the timing of circuit efficiently and the timing constraint is satisfied.展开更多
A fine-grain sleep transistor insertion technique based on our simplified leakage current and delay models is proposed to reduce leakage current. The key idea is to model the leakage current reduction problem as a mix...A fine-grain sleep transistor insertion technique based on our simplified leakage current and delay models is proposed to reduce leakage current. The key idea is to model the leakage current reduction problem as a mixed-integer linear programming （MLP） problem in order to simultaneously place and size the sleep transistors optimally. Because of better circuit slack utilization, our experimental results show that the MLP model can save leakage by 79.75%, 93.56%, and 94.99% when the circuit slowdown is 0%, 3%, and 5%, respectively. The MLP model also achieves on average 74.79% less area penalty compared to the conventional fixed slowdown method when the circuit slowdown is 7%.展开更多
A parallel embedding overlapped iterative (EOI) algorithm about classicimplicit equations with asymmetric Saul'yev schemes (CIS-EOI) to solve one-dimensional diffusionequations is discussed to improve the properti...A parallel embedding overlapped iterative (EOI) algorithm about classicimplicit equations with asymmetric Saul'yev schemes (CIS-EOI) to solve one-dimensional diffusionequations is discussed to improve the properties of the segment classic implicit iterative (SCII)algorithm. The structure of CIS-EOI method is given and the stability of scheme and convergence ofiteration are proved by matrix method. The property of gradual-approach convergence is alsodiscussed. It has been shown that the convergent rate is faster and the property of gradual-approachconvergence also becomes better with the increasing of the net point in subsystems than with theSCII algorithm. The simulation examples show that the parallel iterative algorithm with a differentinsertion scheme CIS-EOI is more effective.展开更多
The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) a...The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) andNearest Neighbour Heuristic (NNH). The paper discusses the limitations of current construction tour heuristics,focusing particularly on the significant margin of error in FIH. It then proposes HMIH as an alternative thatminimizes the increase in tour distance and includes more nodes. HMIH improves tour quality by starting withan initial tour consisting of a ‘minimum’ polygon and iteratively adding nodes using our novel Half Max routine.The paper thoroughly examines and compares HMIH with FIH and NNH via rigorous testing on standard TSPbenchmarks. The results indicate that HMIH consistently delivers superior performance, particularly with respectto tour cost and computational efficiency. HMIH’s tours were sometimes 16% shorter than those generated by FIHand NNH, showcasing its potential and value as a novel benchmark for TSP solutions. The study used statisticalmethods, including Friedman’s Non-parametric Test, to validate the performance of HMIH over FIH and NNH.This guarantees that the identified advantages are statistically significant and consistent in various situations. Thiscomprehensive analysis emphasizes the reliability and efficiency of the heuristic, making a compelling case for itsuse in solving TSP issues. The research shows that, in general, HMIH fared better than FIH in all cases studied,except for a few instances (pr439, eil51, and eil101) where FIH either performed equally or slightly better thanHMIH. HMIH’s efficiency is shown by its improvements in error percentage (δ) and goodness values (g) comparedto FIH and NNH. In the att48 instance, HMIH had an error rate of 6.3%, whereas FIH had 14.6% and NNH had20.9%, indicating that HMIH was closer to the optimal solution. HMIH consistently showed superior performanceacross many benchmarks, with lower percentage error and higher goodness values, suggesting a closer match tothe optimal tour costs. This study substantially contributes to combinatorial optimization by enhancing currentinsertion algorithms and presenting a more efficient solution for the Travelling Salesman Problem. It also createsnew possibilities for progress in heuristic design and optimization methodologies.展开更多
Introduction: Literature reveals several peritoneal dialysis laparoscopic catheter insertion techniques developed to improve long-term results for treatment chronic kidney failure with the technic of peritoneal dialys...Introduction: Literature reveals several peritoneal dialysis laparoscopic catheter insertion techniques developed to improve long-term results for treatment chronic kidney failure with the technic of peritoneal dialysis. The purpose of the study is evaluation of developed and recommended minimally invasive laparoscopic technic for chronic peritoneal dialysis catheter placement using specially constructed trocar. Materials and Methods: Retrospective study included 804 patients in 10 departments of surgery. Surgical and non surgical complications related to PD catheter placement were analysed: bleeding, dialysate leak, early SSI, peritonitis, catheter tip migration, catheter obstruction, omental wrapping and visceral perforations. Available software (Microsoft? Excel for Windows 10, MedCalc, Mariakerke, Belgium) was used for statistical analysis (presented as percentages, mean ± SD or median). Conclusions: The presented technique with specially constructed trocar is a simple and effective procedure with fewer complications comparing to literature. The advantages of this method include long rectus sheath tunnel with the deep cuff placed pre-peritoneally, the small size of the entrance into the peritoneum and accurate position and control of catheter tip in the pelvis.展开更多
Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications.However,some in vivo and in vitro studies have sho...Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications.However,some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques.Additionally,inconsistent conclusions have been drawn in various studies due to different population characteristics and methods used to assess the accuracy of screw placement.Moreover,it is not clear whether pedicle screw insertion with navigation techniques decreases the incidence of screw-related complications.Therefore,this study was sought to perform a meta-analysis of all available prospective evidence regarding pedicle screw insertion with or without navigation techniques in human thoracic and lumbar spine.We considered in vivo comparative studies that assessed the results of pedicle screw placement with or without navigation techniques.PubMed,Ovid MEDLINE and EMBASE databases were searched.Three published randomized controlled trials（RCTs） and nine retrospective comparative studies met the inclusion criteria.These studies included a total of 732 patients in whom 4,953 screws were inserted.In conclusion,accuracy of the position of grade I,II,III and IV screws and complication rate related to pedicle screw placement were significantly increased when navigation techniques were used in comparison to conventional techniques.Future research in this area should include RCTs with well-planned methodology to limit bias and report on validated,patient-based outcome measures.展开更多
AIM It is well known that colonoscopy can bedifficult due to abdominal pain induced duringcolonoscope insertion,if sedative agents are notgiven.Recently,an extra-flexible,small-diameter colonoscope(CF-SV,Olympus Inc.,...AIM It is well known that colonoscopy can bedifficult due to abdominal pain induced duringcolonoscope insertion,if sedative agents are notgiven.Recently,an extra-flexible,small-diameter colonoscope(CF-SV,Olympus Inc.,Japan)was developed in order to improve safetyand comfort.The aim of this study was toaccess the usefulness of the CF-SV.METHODS One hundred patients undergoingsigmoidoscopy were recruited and colonoscopywas performed by one experiencedcolonoscopist.First,a routine-type colonoscope(CF-2301)was inserted into the colon withoutsedation.When the patient complained ofabdominal pain(even if mild),the scope wasnot advanced further and was withdrawn afterthe anatomic location of its tip was determinedfluoroscopically.Then,the CF-SV was inserteduntil it reached the cecun or the site whereabdominal pain occurred.Previous abdominalsurgery and abdominal disease were consideredas unfavorable factors(UF)and the relationshipbetween abdominal pain and UF,age and genderwere investigated.Furthermore,the colonicinsertion pressures in 36 patients with abdominalpain were measured with a force gauge.RESULTS Thirty-four cases(34%)felt no painwith the CF-2301 and successful pancolon-0scopies to the cecum were performed.Sixty-six cases(66%)complained of abdominal pain.The procedure was painless for 47% of men and24% of women,respectively.The CF-2301 scopefailed to reach the sigmoid-descending colon junctions in 59(89.4%)of the 66 patientscomplaining of abdominal pain.However,CF-SVreached proximal area in 94.9% of those whofailed with CF-2301.The median pressure forpain-inducing was 700 g/cm^2.CONCLUSION Unsedated patients with UFwere prone to complain of pain when thestandard-type CF-2301 scope was used.Thenewly developed extra-flexible CF-SV is usefulfor the aged and for those with UF or being proneto suffer from abdominal pain.Sedative agentsmay be unnecessary if this new type ofcolonoscope is used.展开更多
A rice （Oryza sativa） T-DNA insertion population, which included more than 63 000 independent transgenic lines and 8 840 identified flanking sequence tags （FSTs） that were mapped onto the rice genome, was develope...A rice （Oryza sativa） T-DNA insertion population, which included more than 63 000 independent transgenic lines and 8 840 identified flanking sequence tags （FSTs） that were mapped onto the rice genome, was developed to systemi- cally study the rice seed quality control. Genome-wide analysis of the FST distribution showed that T-DNA insertions were positively correlated with expressed genes, but negatively with transposable elements and small RNAs. In addition, the recovered T-DNAs were preferentially located at the untranslated region of the expressed genes. More than 11 000 putative homozygous lines were obtained through multi-generations of planting and resistance screening, and measurement of seed quality of around half of them, including the contents of starch, amylose, protein and fat, with a nondestructive near-infrared spectroscopy method, identified 551 mutants with unique or multiple altered param- eters of seed quality. Analysis of the corresponding FSTs showed that genes participating in diverse functions, including metabolic processes and transcriptional regulation, were involved, indicating that seed quality is regulated by a complex network.展开更多
文摘An efficient TfOH-catalyzed O—H insertion reaction of α-aryl diazoesters with carboxylic acids is reported.This metal-free protocol provides an operationally simple method for a one-pot assembly of diverse α-acyloxy esters in moderate to high yields with a broad substrate scope.All starting materials are readily available,and the reactions can be conducted in the open air at room temperature.
文摘A blue light-induced formal insertion reaction ofα-siloxy carbene into the C—H bond of 1,3-diketones has been reported.Under the irradiation of blue light,acylsilane converts toα-siloxy carbene,which then undergoes formal C—H bond insertion reaction with the enol form of 1,3-diketone.This method uses readily available and relative stable acylsilane as car-bene precursor,which features a simple and metal-free approach under mild conditions.Moreover,the synthetic potential of this protocol has been demonstrated by performing the reaction on a gram scale with comparable high yield.
基金CAMS Innovation Fund for Medical Sciences(CIFMS)(Nos.2022-I2M-1-013,2022-I2M-1-014,2022-I2M-2-002).
文摘The switchable cross-coupling of indoles and pyridotriazoles through carbene insertion at C_(2)-or C_(3)-positon has been developed in this paper.This highly site-selective C-H carbenoid functionalization is determined by both the Rh-catalyst species and auxiliary groups.[Cp∗RhCl_(2)]_(2) and coordinating pyrimidyl group direct the C-H carbenoid functionalization to occur at the C_(2)-position,while Rh2OAc4 and noncoordinating benzyl group lead the reaction to occur at the C_(3)-position of the indoles.This regioselective C−H functionalization strategy is of significant importance for the discovery of indole drugs.
基金Supported by the Young and Middle-Aged Talents Program of Wuxi Health Commission,No.BJ2020011Cohort Research Program of Wuxi Medical Center,Nanjing Medical University,No.WMCC202314Wuxi People’s Hospital 2024“Wild Goose Array Talent”Reserve Discipline Leader,No.2024-YZ-HBDTR-YC-2024.
文摘BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.
基金the Chinese Clinical Trial Registry(No.ChiCTR2000040109)approved by the Hospital Ethics Committee(No.20210130017).
文摘BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intraoperative strategies.AIM To evaluate the predictive performance of machine learning(ML)algorithms for DCI by comparing three modeling approaches,identify factors influencing DCI,and develop a preoperative prediction model using ML algorithms to enhance colonoscopy quality and efficiency.METHODS This cross-sectional study enrolled 712 patients who underwent colonoscopy at a tertiary hospital between June 2020 and May 2021.Demographic data,past medical history,medication use,and psychological status were collected.The endoscopist assessed DCI using the visual analogue scale.After univariate screening,predictive models were developed using multivariable logistic regression,least absolute shrinkage and selection operator(LASSO)regression,and random forest(RF)algorithms.Model performance was evaluated based on discrimination,calibration,and decision curve analysis(DCA),and results were visualized using nomograms.RESULTS A total of 712 patients(53.8%male;mean age 54.5 years±12.9 years)were included.Logistic regression analysis identified constipation[odds ratio(OR)=2.254,95%confidence interval(CI):1.289-3.931],abdominal circumference(AC)(77.5–91.9 cm,OR=1.895,95%CI:1.065-3.350;AC≥92 cm,OR=1.271,95%CI:0.730-2.188),and anxiety(OR=1.071,95%CI:1.044-1.100)as predictive factors for DCI,validated by LASSO and RF methods.Model performance revealed training/validation sensitivities of 0.826/0.925,0.924/0.868,and 1.000/0.981;specificities of 0.602/0.511,0.510/0.562,and 0.977/0.526;and corresponding area under the receiver operating characteristic curves(AUCs)of 0.780(0.737-0.823)/0.726(0.654-0.799),0.754(0.710-0.798)/0.723(0.656-0.791),and 1.000(1.000-1.000)/0.754(0.688-0.820),respectively.DCA indicated optimal net benefit within probability thresholds of 0-0.9 and 0.05-0.37.The RF model demonstrated superior diagnostic accuracy,reflected by perfect training sensitivity(1.000)and highest validation AUC(0.754),outperforming other methods in clinical applicability.CONCLUSION The RF-based model exhibited superior predictive accuracy for DCI compared to multivariable logistic and LASSO regression models.This approach supports individualized preoperative optimization,enhancing colonoscopy quality through targeted risk stratification.
基金financially supported by National Natural Science Foundation of China(No.22207113 to J.Zhang)Guangdong Basic and Applied Basic Research Foundation(No.2021A1515110588to J.Zhang)Natural Science Foundation of Shanghai Municipality(No.22ZR1474000 to L.Wen)。
文摘Uronic acids are prevalent components of crucial glycoconjugates,pivotal in various biological processes.In nature,NDP-uronic acids,the nucleosides-activated uronic acids,serve as glycosylation donors catalyzed by uronosyltransferases(UATs)to construct glycans containing uronic acids.Despite their biological importance,the synthesis of naturally occurring NDP-uronic acids on a large scale remains challenging.Here,we developed an oxidation reaction insertion strategy for the efficient synthesis of NDP-uronic acids,and 11 NDP-uronic acids were successfully prepared in good yield and on a large scale.The prepared NDP-uronic acids can be used to explore new uronosyltransferases and synthesize uronic acids containing carbohydrates for fundamental research.
文摘[Objective] The aim of this study is to understand the genetic characteristics of a grain shape mutant and its possible role in genetic improvement of grain yield in rice. [Method] On the basis of the collection of T-DNA tag lines, the progeny of homozygous plants carrying T-DNA insertion were screened for mutants with mutated phenotypes. The genetic analysis of the mutant and test for the linkage between the mutated phenotype and the T-DNA insertion were carried out to determine its genetic characteristics. [Result] In the present study, a grain shape mutant induced by T-DNA insertion in rice was identified, which showed small grain. Genetic analysis of the mutant showed that the two types of phenotype, normal and small grain in the segregating populations derived from the T-DNA heterozygotes, fit the ratio of 3∶1. Test for Basta resistance showed that all the mutants were resistant while the normal plants segregated for resistant and susceptible by the ratio of 2∶1. The results indicated that the mutant phenotype cosegregated with Bar gene. The small grain mutant caused by T-DNA insertion was confirmed by PCR amplification aiming at T-DNA. [Conclusion] The grain shape mutant is useful for isolation of the tagged gene and genetic improvement in rice.
文摘Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC).Methods:For one ovarian cancer patient with PICC malposition in the coronary sinus(CS)due to PLSVC,multimodal imaging techniques were integrated to accurately locate the catheter tip.The catheter position was adjusted based on evidence(withdrawing 5 cm),and a standardized nursing process was established,including personalized health education,catheter fixation and displacement monitoring,complication monitoring,establishment of a specialized disease information archive system,and formulation of a follow-up plan.Results:The catheter tip was successfully withdrawn from the coronary sinus(at the T8 level)to the middle and lower part of the PLSVC(at the T6 vertebral level),and the catheter functioned normally after adjustment.No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period.Conclusion:The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC(at the T5–T7 vertebral level).This new standard can effectively avoid CS-related complications.The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion.
基金supported by National Natural Science Foundation of China (Grant Nos. 51165040,50775119)Visiting Scholar Foundation of Key Lab in University of China (Grant No. GZKF-201020)
文摘Needle insertion is a common surgical procedure used in diagnosis and treatment.The needle steering technologies make continuous developments in theoretical and practical aspects along with the in-depth research on needle insertion.It is necessary to summarize and analyze the existing results to promote the future development of theories and applications of needle insertion.Thus,a survey of the state of the art of research is presented on algorithms of needle steering techniques,the surgical robots and devices.Based on the analysis of the needle insertion procedure,the concept of needle steering is defined as a kinematics problem,which is to place the needle at the target and avoid the obstacles.The needle steering techniques,including the artificial potential field method and the nonholonomic model,are introduced to control the needles for improving the accuracy.Based on the quasi-static thinking,the virtual spring model and the cantilever-beam model are developed to calculate the amount of needle deflection and generate the needle path.The phantoms instead of the real tissue are used to verify the models mentioned in most of the experimentations.For the desired needle trajectories,the image-guided robotic devices and some novel needles are presented to achieve the needle steering.Finally,the challenges are provided involving the controllability of the long flexible needle and the properties of soft tissue.The results and investigations can be used for further study on the precision and accuracy of needle insertion.
文摘Irreversible reductive insertion of Zn2+transforms Mn3O4 such that the resulting Zn0.2Mn3O4 exhibits highly reversible storage properties of chloride ions,thus rendering Zn0.2Mn3O4 an excellent cathode of aqueous dual-ion batteries.With Zn2+trapped,Zn0.2Mn3O4 delivers the chloride-storage capacity over 200 mAh/g at an average potential of 1.6 V vs Zn2+/Zn by reversibly forming a new ionic compound equivalent to Zn0.2Mn3O4Cl1.7.Electrochemical quartz crystal microbalance results suggest chloride as the primary charge carrier in the reversible oxidative anion insertion.The Mn3O4 anion-hosting cathode couples with Zn metal anode in a full-cell dual-ion battery,demonstrating stable cycling in practical pouch cells with an energy density of 150 Wh/kg based on the mass of both electrodes.
基金supported by the National Natural Science Foundation of China(No.30800621)China Postdoctoral Science Foundation(No.20080431121,200902530)
文摘Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （ADRA2B）.Methods A case-control study was carried out in Chinese Han population,including 368 cases of migraine and 517 controls.Genomic DNA was extracted from blood samples,and DNA fragments containing the site of polymorphism were amplified by PCR.Data were adjusted for sex,age,migraine history and family history,and analyzed using a logistic regression model.Results There was no association between indel polymorphism and migraine,at either the allele or the genotype level.Conclusion These findings do not support a functional significance of ADRA2B indel polymorphism at position-4825 relative to the start codon in the far upstream region of the promoter in the present migraine subjects.
文摘An algorithm of path based timing optimization by buffer insertion is presented.The algorithm adopts a high order model to estimate interconnect delay and a nonlinear delay model based on look up table for gate delay estimation.And heuristic method of buffer insertion is presented to reduce delay.The algorithm is tested by industral circuit case.Experimental results show that the algorithm can optimize the timing of circuit efficiently and the timing constraint is satisfied.
文摘A fine-grain sleep transistor insertion technique based on our simplified leakage current and delay models is proposed to reduce leakage current. The key idea is to model the leakage current reduction problem as a mixed-integer linear programming （MLP） problem in order to simultaneously place and size the sleep transistors optimally. Because of better circuit slack utilization, our experimental results show that the MLP model can save leakage by 79.75%, 93.56%, and 94.99% when the circuit slowdown is 0%, 3%, and 5%, respectively. The MLP model also achieves on average 74.79% less area penalty compared to the conventional fixed slowdown method when the circuit slowdown is 7%.
文摘A parallel embedding overlapped iterative (EOI) algorithm about classicimplicit equations with asymmetric Saul'yev schemes (CIS-EOI) to solve one-dimensional diffusionequations is discussed to improve the properties of the segment classic implicit iterative (SCII)algorithm. The structure of CIS-EOI method is given and the stability of scheme and convergence ofiteration are proved by matrix method. The property of gradual-approach convergence is alsodiscussed. It has been shown that the convergent rate is faster and the property of gradual-approachconvergence also becomes better with the increasing of the net point in subsystems than with theSCII algorithm. The simulation examples show that the parallel iterative algorithm with a differentinsertion scheme CIS-EOI is more effective.
基金the Centre of Excellence in Mobile and e-Services,the University of Zululand,Kwadlangezwa,South Africa.
文摘The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) andNearest Neighbour Heuristic (NNH). The paper discusses the limitations of current construction tour heuristics,focusing particularly on the significant margin of error in FIH. It then proposes HMIH as an alternative thatminimizes the increase in tour distance and includes more nodes. HMIH improves tour quality by starting withan initial tour consisting of a ‘minimum’ polygon and iteratively adding nodes using our novel Half Max routine.The paper thoroughly examines and compares HMIH with FIH and NNH via rigorous testing on standard TSPbenchmarks. The results indicate that HMIH consistently delivers superior performance, particularly with respectto tour cost and computational efficiency. HMIH’s tours were sometimes 16% shorter than those generated by FIHand NNH, showcasing its potential and value as a novel benchmark for TSP solutions. The study used statisticalmethods, including Friedman’s Non-parametric Test, to validate the performance of HMIH over FIH and NNH.This guarantees that the identified advantages are statistically significant and consistent in various situations. Thiscomprehensive analysis emphasizes the reliability and efficiency of the heuristic, making a compelling case for itsuse in solving TSP issues. The research shows that, in general, HMIH fared better than FIH in all cases studied,except for a few instances (pr439, eil51, and eil101) where FIH either performed equally or slightly better thanHMIH. HMIH’s efficiency is shown by its improvements in error percentage (δ) and goodness values (g) comparedto FIH and NNH. In the att48 instance, HMIH had an error rate of 6.3%, whereas FIH had 14.6% and NNH had20.9%, indicating that HMIH was closer to the optimal solution. HMIH consistently showed superior performanceacross many benchmarks, with lower percentage error and higher goodness values, suggesting a closer match tothe optimal tour costs. This study substantially contributes to combinatorial optimization by enhancing currentinsertion algorithms and presenting a more efficient solution for the Travelling Salesman Problem. It also createsnew possibilities for progress in heuristic design and optimization methodologies.
文摘Introduction: Literature reveals several peritoneal dialysis laparoscopic catheter insertion techniques developed to improve long-term results for treatment chronic kidney failure with the technic of peritoneal dialysis. The purpose of the study is evaluation of developed and recommended minimally invasive laparoscopic technic for chronic peritoneal dialysis catheter placement using specially constructed trocar. Materials and Methods: Retrospective study included 804 patients in 10 departments of surgery. Surgical and non surgical complications related to PD catheter placement were analysed: bleeding, dialysate leak, early SSI, peritonitis, catheter tip migration, catheter obstruction, omental wrapping and visceral perforations. Available software (Microsoft? Excel for Windows 10, MedCalc, Mariakerke, Belgium) was used for statistical analysis (presented as percentages, mean ± SD or median). Conclusions: The presented technique with specially constructed trocar is a simple and effective procedure with fewer complications comparing to literature. The advantages of this method include long rectus sheath tunnel with the deep cuff placed pre-peritoneally, the small size of the entrance into the peritoneum and accurate position and control of catheter tip in the pelvis.
文摘Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications.However,some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques.Additionally,inconsistent conclusions have been drawn in various studies due to different population characteristics and methods used to assess the accuracy of screw placement.Moreover,it is not clear whether pedicle screw insertion with navigation techniques decreases the incidence of screw-related complications.Therefore,this study was sought to perform a meta-analysis of all available prospective evidence regarding pedicle screw insertion with or without navigation techniques in human thoracic and lumbar spine.We considered in vivo comparative studies that assessed the results of pedicle screw placement with or without navigation techniques.PubMed,Ovid MEDLINE and EMBASE databases were searched.Three published randomized controlled trials（RCTs） and nine retrospective comparative studies met the inclusion criteria.These studies included a total of 732 patients in whom 4,953 screws were inserted.In conclusion,accuracy of the position of grade I,II,III and IV screws and complication rate related to pedicle screw placement were significantly increased when navigation techniques were used in comparison to conventional techniques.Future research in this area should include RCTs with well-planned methodology to limit bias and report on validated,patient-based outcome measures.
基金Sasagawa Medical Scholarship Foundation(from 1999-2000)
文摘AIM It is well known that colonoscopy can bedifficult due to abdominal pain induced duringcolonoscope insertion,if sedative agents are notgiven.Recently,an extra-flexible,small-diameter colonoscope(CF-SV,Olympus Inc.,Japan)was developed in order to improve safetyand comfort.The aim of this study was toaccess the usefulness of the CF-SV.METHODS One hundred patients undergoingsigmoidoscopy were recruited and colonoscopywas performed by one experiencedcolonoscopist.First,a routine-type colonoscope(CF-2301)was inserted into the colon withoutsedation.When the patient complained ofabdominal pain(even if mild),the scope wasnot advanced further and was withdrawn afterthe anatomic location of its tip was determinedfluoroscopically.Then,the CF-SV was inserteduntil it reached the cecun or the site whereabdominal pain occurred.Previous abdominalsurgery and abdominal disease were consideredas unfavorable factors(UF)and the relationshipbetween abdominal pain and UF,age and genderwere investigated.Furthermore,the colonicinsertion pressures in 36 patients with abdominalpain were measured with a force gauge.RESULTS Thirty-four cases(34%)felt no painwith the CF-2301 and successful pancolon-0scopies to the cecum were performed.Sixty-six cases(66%)complained of abdominal pain.The procedure was painless for 47% of men and24% of women,respectively.The CF-2301 scopefailed to reach the sigmoid-descending colon junctions in 59(89.4%)of the 66 patientscomplaining of abdominal pain.However,CF-SVreached proximal area in 94.9% of those whofailed with CF-2301.The median pressure forpain-inducing was 700 g/cm^2.CONCLUSION Unsedated patients with UFwere prone to complain of pain when thestandard-type CF-2301 scope was used.Thenewly developed extra-flexible CF-SV is usefulfor the aged and for those with UF or being proneto suffer from abdominal pain.Sedative agentsmay be unnecessary if this new type ofcolonoscope is used.
文摘A rice （Oryza sativa） T-DNA insertion population, which included more than 63 000 independent transgenic lines and 8 840 identified flanking sequence tags （FSTs） that were mapped onto the rice genome, was developed to systemi- cally study the rice seed quality control. Genome-wide analysis of the FST distribution showed that T-DNA insertions were positively correlated with expressed genes, but negatively with transposable elements and small RNAs. In addition, the recovered T-DNAs were preferentially located at the untranslated region of the expressed genes. More than 11 000 putative homozygous lines were obtained through multi-generations of planting and resistance screening, and measurement of seed quality of around half of them, including the contents of starch, amylose, protein and fat, with a nondestructive near-infrared spectroscopy method, identified 551 mutants with unique or multiple altered param- eters of seed quality. Analysis of the corresponding FSTs showed that genes participating in diverse functions, including metabolic processes and transcriptional regulation, were involved, indicating that seed quality is regulated by a complex network.
