AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including pati...AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.展开更多
Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of kn...Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of knowledge about the underlying modes of action and optimal treatment modalities,a thorough translational investigation of noninvasive brain stimulation in preclinical animal models is urgently needed.Thus,we reviewed the current literature on the mechanistic underpinnings of noninvasive brain stimulation in models of central nervous system impairment,with a particular emphasis on traumatic brain injury and stroke.Due to the lack of translational models in most noninvasive brain stimulation techniques proposed,we found this review to the most relevant techniques used in humans,i.e.,transcranial magnetic stimulation and transcranial direct current stimulation.We searched the literature in Pub Med,encompassing the MEDLINE and PMC databases,for studies published between January 1,2020 and September 30,2024.Thirty-five studies were eligible.Transcranial magnetic stimulation and transcranial direct current stimulation demonstrated distinct strengths in augmenting rehabilitation post-stroke and traumatic brain injury,with emerging mechanistic evidence.Overall,we identified neuronal,inflammatory,microvascular,and apoptotic pathways highlighted in the literature.This review also highlights a lack of translational surrogate parameters to bridge the gap between preclinical findings and their clinical translation.展开更多
Although previous studies have demonstrated that transcranial focused ultrasound stimulation protects the ischemic brain,clear criteria for the stimulation time window and intensity are lacking.Electrical impedance to...Although previous studies have demonstrated that transcranial focused ultrasound stimulation protects the ischemic brain,clear criteria for the stimulation time window and intensity are lacking.Electrical impedance tomography enables real-time monitoring of changes in cerebral blood perfusion within the ischemic brain,but investigating the feasibility of using this method to assess post-stroke rehabilitation in vivo remains critical.In this study,ischemic stroke was induced in rats through middle cerebral artery occlusion surgery.Transcranial focused ultrasound stimulation was used to treat the rat model of ischemia,and electrical impedance tomography was used to measure impedance during both the acute stage of ischemia and the rehabilitation stage following the stimulation.Electrical impedance tomography results indicated that cerebral impedance increased after the onset of ischemia and decreased following transcranial focused ultrasound stimulation.Furthermore,the stimulation promoted motor function recovery,reduced cerebral infarction volume in the rat model of ischemic stroke,and induced the expression of brain-derived neurotrophic factor in the ischemic brain.Our results also revealed a significant correlation between the impedance of the ischemic brain post-intervention and improvements in behavioral scores and infarct volume.This study shows that daily administration of transcranial focused ultrasound stimulation for 20 minutes to the ischemic hemisphere 24 hours after cerebral ischemia enhanced motor recovery in a rat model of ischemia.Additionally,our findings indicate that electrical impedance tomography can serve as a valuable tool for quantitatively evaluating rehabilitation after ischemic stroke in vivo.These findings suggest the feasibility of using impedance data collected via electrical impedance tomography to clinically assess the effects of rehabilitatory interventions for patients with ischemic stroke.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral...BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.展开更多
Temporal interference(TI)is a form of stimulation that epitomizes an innovative and non-invasive approach for profound neuromodulation of the brain,a technique that has been validated in mice.Yet,the thin cranial bone...Temporal interference(TI)is a form of stimulation that epitomizes an innovative and non-invasive approach for profound neuromodulation of the brain,a technique that has been validated in mice.Yet,the thin cranial bone structure of mice has a marginal influence on the effect of the TI technique and may not effectively showcase its effectiveness in larger animals.Based on this,we carried out TI stimulation experiments on rats.Following the TI intervention,analysis of electrophysiological data and immunofluorescence staining indicated the generation of a stimulation focus within the nucleus accumbens(depth,8.5 mm)in rats.Our findings affirm the viability of the TI methodology in the presence of thick cranial bones,furnishing efficacious parameters for profound stimulation with TI administered under such conditions.This experiment not only sheds light on the intervention effects of TI deep in the brain but also furnishes robust evidence in support of its prospective clinical utility.展开更多
Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H...Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.展开更多
The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting...The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting one of the highest mortality rates associated with cancer globally.The delayed onset of symptoms and diagnosis often results in metastasis or local progression of the cancer,thereby constraining treatment options and outcomes.For these patients,prompt tumour identification and treatment strategising are crucial.The present objective of pancreatic cancer research is to examine the correlation between various pathological types and imaging data to facilitate therapeutic decision-making.This study aims to clarify the correlation between diverse pathological markers and imaging in pancreatic cancer patients,with prospective longitudinal studies potentially providing novel insights into the diagnosis and treatment of pancreatic cancer.展开更多
Metabolic-associated steatotic liver disease(MASLD)has become the leading cause of chronic liver disease worldwide,yet reliable tools for prognostication remain limited.Fibrosis-based indices such as the fibrosis-4 an...Metabolic-associated steatotic liver disease(MASLD)has become the leading cause of chronic liver disease worldwide,yet reliable tools for prognostication remain limited.Fibrosis-based indices such as the fibrosis-4 and nonalcoholic fatty liver disease fibrosis score are widely used but primarily reflect structural damage rather than functional decline.The albumin-bilirubin(ALBI)score,originally established to assess hepatic reserve in patients with hepatocellular carcinoma,provides a simple and objective measure of liver function derived from routine laboratory parameters.Recent validation and meta-analytic studies have shown that ALBI predicts liver-related outcomes and all-cause mortality across diverse chronic liver disease populations,including MASLD,and offers complementary prognostic information beyond fibrosis-based models.Its simplicity,cost-effectiveness,and compatibility with automated reporting systems make it feasible for integration into clinical workflows and population-level risk stratification.However,interpretation of ALBI should consider potential confounders such as renal dysfunction,inflammation,and Gilbert syndrome,and threshold calibration across ethnic groups remains necessary.The ALBI score represents a promising functional biomarker that could enhance risk prediction and care pathways in MASLD,although prospective,multiethnic,and longitudinal studies remain needed to confirm its prognostic value and define clinically meaningful cut-offs.展开更多
In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential ...In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential of noninvasive biomarkers for Crohn’s disease(CD)management.This article highlights the significance of the findings,particularly the identification of albumin and fibrinogen amplitude changes as effective,noninvasive biomarkers for predicting endoscopic improvement in CD.The authors introduce a reliable nomogram model,constructed through careful logistic regression analyses,that demonstrates high predictive accuracy across training,internal validation,and external validation cohorts.With further validation through calibration and decision curve analyses,this model shows its clinical relevance and applicability.By incorporating albumin and fibrinogen fluctuations into clinical decision-making,this model addresses a critical gap in noninvasive monitoring tools for CD,offering a practical,patient-centered alternative to guide therapeutic strategies.These findings not only validate the utility of the model but also pave the way for broader integration of biomarker-driven decision-making in the management of CD.This article discusses the broader implications of these advancements,emphasizing their potential to refine patient care and improve outcomes in CD management.展开更多
Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abn...Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abnormal hemoglobin levels can indicate significant health issues.Traditional methods for hemoglobin measurement are invasive,causing pain,risk of infection,and are less convenient for frequent monitoring.PPG is a transformative technology in wearable healthcare for noninvasive monitoring and widely explored for blood pressure,sleep,blood glucose,and stress analysis.In this work,we propose a hemoglobin estimation method using an adaptive lightweight convolutional neural network(HMALCNN)from PPG.The HMALCNN is designed to capture both fine-grained local waveform characteristics and global contextual patterns,ensuring robust performance across acquisition settings.We validated our approach on two multi-regional datasets containing 152 and 68 subjects,respectively,employing a subjectindependent 5-fold cross-validation strategy.The proposed method achieved root mean square errors(RMSE)of 0.90 and 1.20 g/dL for the two datasets,with strong Pearson correlations of 0.82 and 0.72.We conducted extensive posthoc analyses to assess clinical utility and interpretability.A±1 g/dL clinical error tolerance evaluation revealed that 91.3%and 86.7%of predictions for the two datasets fell within the acceptable clinical range.Hemoglobin range-wise analysis demonstrated consistently high accuracy in the normal and low hemoglobin categories.Statistical significance testing using the Wilcoxon signed-rank test confirmed the stability of performance across validation folds(p>0.05 for both RMSE and correlation).Furthermore,model interpretability was enhanced using Gradient-weighted Class Activation Mapping(Grad-CAM),supporting the model’s clinical trustworthiness.The proposed HMALCNN offers a computationally efficient,clinically interpretable,and generalizable framework for noninvasive hemoglobin monitoring,with strong potential for integration into wearable healthcare systems as a practical alternative to invasive measurement techniques.展开更多
This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(A...This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.展开更多
Sleeping site selection is essential for understanding primate behavioral ecology and survival.Identifying where species sleep helps determine priority areas and critical resources for targeted conservation efforts.Ho...Sleeping site selection is essential for understanding primate behavioral ecology and survival.Identifying where species sleep helps determine priority areas and critical resources for targeted conservation efforts.However,observing sleeping sites at night is challenging,especially for species sensitive to human disturbance.Thermal infrared imaging(TIR)with drones is increasingly used for detecting and counting primates,yet it has not been utilized to investigate ecological strategies.This study investigates the sleeping site selection of the Critically Endangered black-shanked douc langur(Pygathrix nigripes)in Cát Tiên National Park,Vietnam.Our aim is to assess the feasibility of using a TIR drone to test sleeping site selection strategies in non-nesting primates,specifically examining hypotheses related to predation avoidance and food proximity.Between January and April 2023,we conducted 120 drone flights along 22 transects(~1-km long)and identified 114 sleeping sites via thermal imaging.We established 116 forest structure plots along 29 transects in non-selected sites and 65 plots within douc langur sleeping sites.Our observations reveal that douc langurs selected tall and large trees that may provide protection against predators.Additionally,they selected sleeping sites with increased access to food,such as Afzelia xylocarpa,which serves as a preferred food source during the dry season.These results highlight the effective use of TIR drones for studying douc langur sleeping site selection with minimal disturbance.Besides offering valuable insights into habitat selection and behavioral ecology for conservation,TIR drones hold great promise for the noninvasive and long-term monitoring of large-bodied arboreal species.展开更多
BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid er...BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.展开更多
Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in...Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in tumor patients,noninvasive imaging technologies play pivotal roles in the risk stratification,early diagnosis,monitoring and follow-up for CTR-CVT.In recent years,the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies,with several pertinent guidelines and expert consensus documents issued in China and abroad.However,there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology.Therefore,the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology,the Ultrasound Branch of the Chinese Medical Association,and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity".Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad,and in conjunction with data derived from evidence-based medical research in China,this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT,aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.展开更多
Nonalcoholic fatty liver disease,recently termed metabolic dysfunction-associated steatotic liver disease,affects 25%of adults globally,with a prevalence reaching 93%in obese individuals.The MANPOWER study,a post hoc ...Nonalcoholic fatty liver disease,recently termed metabolic dysfunction-associated steatotic liver disease,affects 25%of adults globally,with a prevalence reaching 93%in obese individuals.The MANPOWER study,a post hoc analysis of 2843 Russian patients with newly diagnosed nonalcoholic fatty liver disease,evaluated Essentiale Forte N®[essential phospholipids(EPLs)]therapy and a liver enzymebased staging algorithm.Using generalized linear regression and McNemar tests,EPLs reduced liver enzyme levels(alanine aminotransferase:-20.4 U/L,aspartate aminotransferase:-16.9 U/L,gamma-glutamyl transferase:-17.1 U/L at 24 weeks,P<0.001)and improved ultrasonography findings(76.8%reduction in hyperechogenicity,P<0.001).A logistic regression algorithm using alanine aminotransferase,aspartate aminotransferase,and gamma-glutamyl transferase levels achieved 72.3%accuracy,75.6%sensitivity,71.0%specificity,and an area under the receiver operating characteristic curve of 0.74(95%confidence interval:0.71-0.77)for identifying nonalcoholic steatohepatitis.These findings advocate EPLs as a safe,effective therapy and propose a scalable diagnostic tool,urging validation to reduce the reliance on biopsy.展开更多
BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature...BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature,there has been growing interest in identifying noninvasive alternatives.Transient elastography offers a promising approach for measuring liver stiffness and spleen stiffness,which can help estimate the likelihood of decompensation in patients with chronic liver disease.AIM To investigate the predictive ability of the liver stiffness measurement(LSM)and spleen stiffness measurement(SSM)in conjunction with other noninvasive indicators for clinical decompensation in patients suffering from compensatory cirrhosis and portal hypertension.METHODS This study was a retrospective analysis of the clinical data of 200 patients who were diagnosed with viral cirrhosis and who received computed tomography,transient elastography,ultrasound,and endoscopic examinations at The Second Affiliated Hospital of Xi’an Jiaotong University between March 2020 and November 2022.Patient classification was performed in accordance with the Baveno VI consensus.The area under the curve was used to evaluate and compare the predictive accuracy across different patient groups.The diagnostic effectiveness of several models,including the liver stiffness-spleen diameter-platelet ratio,variceal risk index,aspartate aminotransferase-alanine aminotransferase ratio,Baveno Ⅵ criteria,and newly developed models,was assessed.Additionally,decision curve analysis was carried out across a range of threshold probabilities to evaluate the clinical utility of these predictive factors.RESULTS Univariate and multivariate analyses demonstrated that SSM,LSM,and the spleen length diameter(SLD)were linked to clinical decompensation in individuals with viral cirrhosis.On the basis of these findings,a predictive model was developed via logistic regression:Ln[P/(1-P)]=-4.969-0.279×SSM+0.348×LSM+0.272×SLD.The model exhibited strong performance,with an area under the curve of 0.944.At a cutoff value of 0.56,the sensitivity,specificity,positive predictive value,and negative predictive value for predicting clinical decompensation were 85.29%,88.89%,87.89%,and 86.47%,respectively.The newly developed model demonstrated enhanced accuracy in forecasting clinical decompensation among patients suffering from viral cirrhosis when compared to four previously established models.CONCLUSION Noninvasive models utilizing SSM,LSM,and SLD are effective in predicting clinical decompensation among patients with viral cirrhosis,thereby reducing the need for unnecessary hepatic venous pressure gradient testing.展开更多
BACKGROUND The early diagnosis rate of pancreatic ductal adenocarcinoma(PDAC)is low and the prognosis is poor.It is important to develop an interpretable noninvasive early diagnostic model in clinical practice.AIM To ...BACKGROUND The early diagnosis rate of pancreatic ductal adenocarcinoma(PDAC)is low and the prognosis is poor.It is important to develop an interpretable noninvasive early diagnostic model in clinical practice.AIM To develop an interpretable noninvasive early diagnostic model for PDAC using plasma extracellular vesicle long RNA(EvlRNA).METHODS The diagnostic model was constructed based on plasma EvlRNA data.During the process of establishing the model,EvlRNA-index was introduced,and four algorithms were adopted to calculate EvlRNA-index.After the model was successfully constructed,performance evaluation was conducted.A series of bioinformatics methods were adopted to explore the potential mechanism of EvlRNA-index as the input feature of the model.And the relationship between key characteristics and PDAC were explored at the single-cell level.RESULTS A novel interpretable machine learning framework was developed based on plasma EvlRNA.In this framework,a two-layer classifier was established.A new concept was proposed:EvlRNA-index.Based on EvlRNA-index,a cancer diagnostic model was established,and a good diagnostic effect was achieved.The accuracy of PDACandCPvsHealth-Probabilistic PCA Index-SVM(PDAC and chronic pancreatitis vs health-probabilistic principal component analysis index-support vector machine)(1-18)was 91.51%,with Mathew’s correlation coefficient 0.7760 and area under the curve 0.9560.In the second layer of the model,the accuracy of PDACvsCP-Probabilistic PCA Index-RF(PDAC vs chronic pancreatitis-probabilistic principal component analysis index-random forest)(2-17)was 93.83%,with Mathew’s correlation coefficient 0.8422 and area under the curve 0.9698.Forty-nine PDAC-related genes were identified,among which 16 were known,inferring that the remaining ones were also PDAC-related genes.CONCLUSION An interpretable two-layer machine learning framework was proposed for early diagnosis and prediction of PDAC based on plasma EvlRNA,providing new insights into the clinical value of EvlRNA.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performa...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performance of noninvasive steatosis biomarkers in diag-nosing NAFLD using magnetic resonance imaging proton density fat fraction(MRI-PDFF)as the gold standard.METHODS A total of 131 suspected NAFLD patients(60%male,median age 36 years)under-going MRI-PDFF were consecutively recruited from a tertiary hospital.Steatosis grades determined by MRI-PDFF were classified as none(<5%),mild(5%-11%),moderate(11%-17%),and severe(≥17%).Six steatosis biomarkers were calculated according to clinical parameters and laboratory tests,including fatty liver index,hepatic steatosis index,ZJU index,Framingham steatosis index,triglycerides and glucose index,and visceral adiposity index.The accuracy of these biomarkers in detecting hepatic steatosis was evaluated using the area under the receiver operating characteristic curves(AUCs).The Youden index was used to determine the optimal cut-off for each biomarker.The linear trend analysis of each biomarker across the steatosis grades was conducted by Mantel-Haenszelχ2 test.Spearman's rank correlation assessed the relationship between steatosis biomarkers and MRI-PDFF.RESULTS Steatosis grades based on MRI-PDFF prevalence were:None 27%,mild 40%,moderate 15%and severe 18%.Six steatosis biomarkers showed a linear trend across the steatosis grades and a significant positive correlation with MRI-PDFF.The six steatosis biomarkers demonstrated AUCs near 0.90(range:0.857-0.912,all P<0.001)for diagnosing NAFLD by MRI-PDFF≥5%.The optimal cut-offs showed sensitivity between 84.4%-91.7%and specificity between 71.4%-85.7%.The diagnostic performance of these biomarkers in detecting moderate-to-severe and severe steatosis was relatively weaker.CONCLUSION These noninvasive steatosis biomarkers accurately diagnosed NAFLD and correlated well with MRI-PDFF for detecting NAFLD,but they did not effectively detect moderate or severe steatosis.展开更多
Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as t...Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.展开更多
文摘AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.
基金funded by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation):project ID 431549029-SFB 1451the Marga-und-Walter-Boll-Stiftung(#210-10-15)(to MAR)a stipend from the'Gerok Program'(Faculty of Medicine,University of Cologne,Germany)。
文摘Noninvasive brain stimulation techniques offer promising therapeutic and regenerative prospects in neurological diseases by modulating brain activity and improving cognitive and motor functions.Given the paucity of knowledge about the underlying modes of action and optimal treatment modalities,a thorough translational investigation of noninvasive brain stimulation in preclinical animal models is urgently needed.Thus,we reviewed the current literature on the mechanistic underpinnings of noninvasive brain stimulation in models of central nervous system impairment,with a particular emphasis on traumatic brain injury and stroke.Due to the lack of translational models in most noninvasive brain stimulation techniques proposed,we found this review to the most relevant techniques used in humans,i.e.,transcranial magnetic stimulation and transcranial direct current stimulation.We searched the literature in Pub Med,encompassing the MEDLINE and PMC databases,for studies published between January 1,2020 and September 30,2024.Thirty-five studies were eligible.Transcranial magnetic stimulation and transcranial direct current stimulation demonstrated distinct strengths in augmenting rehabilitation post-stroke and traumatic brain injury,with emerging mechanistic evidence.Overall,we identified neuronal,inflammatory,microvascular,and apoptotic pathways highlighted in the literature.This review also highlights a lack of translational surrogate parameters to bridge the gap between preclinical findings and their clinical translation.
基金supported by the Fundamental Research Funds for the Central Universities,Nos.G2021KY05107,G2021KY05101the National Natural Science Foundation of China,Nos.32071316,32211530049+1 种基金the Natural Science Foundation of Shaanxi Province,No.2022-JM482the Education and Teaching Reform Funds for the Central Universities,No.23GZ230102(all to LL and HH).
文摘Although previous studies have demonstrated that transcranial focused ultrasound stimulation protects the ischemic brain,clear criteria for the stimulation time window and intensity are lacking.Electrical impedance tomography enables real-time monitoring of changes in cerebral blood perfusion within the ischemic brain,but investigating the feasibility of using this method to assess post-stroke rehabilitation in vivo remains critical.In this study,ischemic stroke was induced in rats through middle cerebral artery occlusion surgery.Transcranial focused ultrasound stimulation was used to treat the rat model of ischemia,and electrical impedance tomography was used to measure impedance during both the acute stage of ischemia and the rehabilitation stage following the stimulation.Electrical impedance tomography results indicated that cerebral impedance increased after the onset of ischemia and decreased following transcranial focused ultrasound stimulation.Furthermore,the stimulation promoted motor function recovery,reduced cerebral infarction volume in the rat model of ischemic stroke,and induced the expression of brain-derived neurotrophic factor in the ischemic brain.Our results also revealed a significant correlation between the impedance of the ischemic brain post-intervention and improvements in behavioral scores and infarct volume.This study shows that daily administration of transcranial focused ultrasound stimulation for 20 minutes to the ischemic hemisphere 24 hours after cerebral ischemia enhanced motor recovery in a rat model of ischemia.Additionally,our findings indicate that electrical impedance tomography can serve as a valuable tool for quantitatively evaluating rehabilitation after ischemic stroke in vivo.These findings suggest the feasibility of using impedance data collected via electrical impedance tomography to clinically assess the effects of rehabilitatory interventions for patients with ischemic stroke.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金Supported by the Shaanxi Provincial Key Research and Development Plan Project,No.2020ZDLSF01-02.
文摘BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.
基金supported by the National Key Research and Development Program Project(2021YFC2400203)the Shaanxi Province Key Research and Development Program Project(2023-YBSF-120)+1 种基金the Shandong Provincial Natural Science Foundation(ZR2024QF287)the National Natural Science Foundation of China(31972907).
文摘Temporal interference(TI)is a form of stimulation that epitomizes an innovative and non-invasive approach for profound neuromodulation of the brain,a technique that has been validated in mice.Yet,the thin cranial bone structure of mice has a marginal influence on the effect of the TI technique and may not effectively showcase its effectiveness in larger animals.Based on this,we carried out TI stimulation experiments on rats.Following the TI intervention,analysis of electrophysiological data and immunofluorescence staining indicated the generation of a stimulation focus within the nucleus accumbens(depth,8.5 mm)in rats.Our findings affirm the viability of the TI methodology in the presence of thick cranial bones,furnishing efficacious parameters for profound stimulation with TI administered under such conditions.This experiment not only sheds light on the intervention effects of TI deep in the brain but also furnishes robust evidence in support of its prospective clinical utility.
文摘Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.
基金Supported by the National Health Commission’s Key Laboratory of Gastrointestinal Tumor Diagnosis and Treatment for The Year 2022,National Health Commission’s Master’s and Doctoral/Postdoctoral Fund Project,No.NHCDP2022001Gansu Provincial People’s Hospital Doctoral Supervisor Training Project,No.22GSSYA-3.
文摘The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting one of the highest mortality rates associated with cancer globally.The delayed onset of symptoms and diagnosis often results in metastasis or local progression of the cancer,thereby constraining treatment options and outcomes.For these patients,prompt tumour identification and treatment strategising are crucial.The present objective of pancreatic cancer research is to examine the correlation between various pathological types and imaging data to facilitate therapeutic decision-making.This study aims to clarify the correlation between diverse pathological markers and imaging in pancreatic cancer patients,with prospective longitudinal studies potentially providing novel insights into the diagnosis and treatment of pancreatic cancer.
文摘Metabolic-associated steatotic liver disease(MASLD)has become the leading cause of chronic liver disease worldwide,yet reliable tools for prognostication remain limited.Fibrosis-based indices such as the fibrosis-4 and nonalcoholic fatty liver disease fibrosis score are widely used but primarily reflect structural damage rather than functional decline.The albumin-bilirubin(ALBI)score,originally established to assess hepatic reserve in patients with hepatocellular carcinoma,provides a simple and objective measure of liver function derived from routine laboratory parameters.Recent validation and meta-analytic studies have shown that ALBI predicts liver-related outcomes and all-cause mortality across diverse chronic liver disease populations,including MASLD,and offers complementary prognostic information beyond fibrosis-based models.Its simplicity,cost-effectiveness,and compatibility with automated reporting systems make it feasible for integration into clinical workflows and population-level risk stratification.However,interpretation of ALBI should consider potential confounders such as renal dysfunction,inflammation,and Gilbert syndrome,and threshold calibration across ethnic groups remains necessary.The ALBI score represents a promising functional biomarker that could enhance risk prediction and care pathways in MASLD,although prospective,multiethnic,and longitudinal studies remain needed to confirm its prognostic value and define clinically meaningful cut-offs.
文摘In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential of noninvasive biomarkers for Crohn’s disease(CD)management.This article highlights the significance of the findings,particularly the identification of albumin and fibrinogen amplitude changes as effective,noninvasive biomarkers for predicting endoscopic improvement in CD.The authors introduce a reliable nomogram model,constructed through careful logistic regression analyses,that demonstrates high predictive accuracy across training,internal validation,and external validation cohorts.With further validation through calibration and decision curve analyses,this model shows its clinical relevance and applicability.By incorporating albumin and fibrinogen fluctuations into clinical decision-making,this model addresses a critical gap in noninvasive monitoring tools for CD,offering a practical,patient-centered alternative to guide therapeutic strategies.These findings not only validate the utility of the model but also pave the way for broader integration of biomarker-driven decision-making in the management of CD.This article discusses the broader implications of these advancements,emphasizing their potential to refine patient care and improve outcomes in CD management.
基金funded by the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2025).
文摘Hemoglobin is a vital protein in red blood cells responsible for transporting oxygen throughout the body.Its accurate measurement is crucial for diagnosing and managing conditions such as anemia and diabetes,where abnormal hemoglobin levels can indicate significant health issues.Traditional methods for hemoglobin measurement are invasive,causing pain,risk of infection,and are less convenient for frequent monitoring.PPG is a transformative technology in wearable healthcare for noninvasive monitoring and widely explored for blood pressure,sleep,blood glucose,and stress analysis.In this work,we propose a hemoglobin estimation method using an adaptive lightweight convolutional neural network(HMALCNN)from PPG.The HMALCNN is designed to capture both fine-grained local waveform characteristics and global contextual patterns,ensuring robust performance across acquisition settings.We validated our approach on two multi-regional datasets containing 152 and 68 subjects,respectively,employing a subjectindependent 5-fold cross-validation strategy.The proposed method achieved root mean square errors(RMSE)of 0.90 and 1.20 g/dL for the two datasets,with strong Pearson correlations of 0.82 and 0.72.We conducted extensive posthoc analyses to assess clinical utility and interpretability.A±1 g/dL clinical error tolerance evaluation revealed that 91.3%and 86.7%of predictions for the two datasets fell within the acceptable clinical range.Hemoglobin range-wise analysis demonstrated consistently high accuracy in the normal and low hemoglobin categories.Statistical significance testing using the Wilcoxon signed-rank test confirmed the stability of performance across validation folds(p>0.05 for both RMSE and correlation).Furthermore,model interpretability was enhanced using Gradient-weighted Class Activation Mapping(Grad-CAM),supporting the model’s clinical trustworthiness.The proposed HMALCNN offers a computationally efficient,clinically interpretable,and generalizable framework for noninvasive hemoglobin monitoring,with strong potential for integration into wearable healthcare systems as a practical alternative to invasive measurement techniques.
文摘This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.
基金financial support of the Belgian National Fund for Scientific Research(FNRS)the Duesberg Foundation,and the University of Liège.
文摘Sleeping site selection is essential for understanding primate behavioral ecology and survival.Identifying where species sleep helps determine priority areas and critical resources for targeted conservation efforts.However,observing sleeping sites at night is challenging,especially for species sensitive to human disturbance.Thermal infrared imaging(TIR)with drones is increasingly used for detecting and counting primates,yet it has not been utilized to investigate ecological strategies.This study investigates the sleeping site selection of the Critically Endangered black-shanked douc langur(Pygathrix nigripes)in Cát Tiên National Park,Vietnam.Our aim is to assess the feasibility of using a TIR drone to test sleeping site selection strategies in non-nesting primates,specifically examining hypotheses related to predation avoidance and food proximity.Between January and April 2023,we conducted 120 drone flights along 22 transects(~1-km long)and identified 114 sleeping sites via thermal imaging.We established 116 forest structure plots along 29 transects in non-selected sites and 65 plots within douc langur sleeping sites.Our observations reveal that douc langurs selected tall and large trees that may provide protection against predators.Additionally,they selected sleeping sites with increased access to food,such as Afzelia xylocarpa,which serves as a preferred food source during the dry season.These results highlight the effective use of TIR drones for studying douc langur sleeping site selection with minimal disturbance.Besides offering valuable insights into habitat selection and behavioral ecology for conservation,TIR drones hold great promise for the noninvasive and long-term monitoring of large-bodied arboreal species.
文摘BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.
基金National Key Research and Development Program of China(2022YFC 3602400)Shanghai Municipal Health Commission“Top Priority Research Center”(2023-ZZ02021)+2 种基金Shanghai Public Health Key Discipline Construction Project(GWVI-11.1-26)Shanghai Academic/Technology Research Leader(21XD1432100)Key Research and Development Program of Shandong Province(2021SFGC0503)。
文摘Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in tumor patients,noninvasive imaging technologies play pivotal roles in the risk stratification,early diagnosis,monitoring and follow-up for CTR-CVT.In recent years,the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies,with several pertinent guidelines and expert consensus documents issued in China and abroad.However,there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology.Therefore,the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology,the Ultrasound Branch of the Chinese Medical Association,and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity".Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad,and in conjunction with data derived from evidence-based medical research in China,this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT,aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.
文摘Nonalcoholic fatty liver disease,recently termed metabolic dysfunction-associated steatotic liver disease,affects 25%of adults globally,with a prevalence reaching 93%in obese individuals.The MANPOWER study,a post hoc analysis of 2843 Russian patients with newly diagnosed nonalcoholic fatty liver disease,evaluated Essentiale Forte N®[essential phospholipids(EPLs)]therapy and a liver enzymebased staging algorithm.Using generalized linear regression and McNemar tests,EPLs reduced liver enzyme levels(alanine aminotransferase:-20.4 U/L,aspartate aminotransferase:-16.9 U/L,gamma-glutamyl transferase:-17.1 U/L at 24 weeks,P<0.001)and improved ultrasonography findings(76.8%reduction in hyperechogenicity,P<0.001).A logistic regression algorithm using alanine aminotransferase,aspartate aminotransferase,and gamma-glutamyl transferase levels achieved 72.3%accuracy,75.6%sensitivity,71.0%specificity,and an area under the receiver operating characteristic curve of 0.74(95%confidence interval:0.71-0.77)for identifying nonalcoholic steatohepatitis.These findings advocate EPLs as a safe,effective therapy and propose a scalable diagnostic tool,urging validation to reduce the reliance on biopsy.
基金Supported by Xi’an Science and Technology Plan,No.23YXYJ0172.
文摘BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature,there has been growing interest in identifying noninvasive alternatives.Transient elastography offers a promising approach for measuring liver stiffness and spleen stiffness,which can help estimate the likelihood of decompensation in patients with chronic liver disease.AIM To investigate the predictive ability of the liver stiffness measurement(LSM)and spleen stiffness measurement(SSM)in conjunction with other noninvasive indicators for clinical decompensation in patients suffering from compensatory cirrhosis and portal hypertension.METHODS This study was a retrospective analysis of the clinical data of 200 patients who were diagnosed with viral cirrhosis and who received computed tomography,transient elastography,ultrasound,and endoscopic examinations at The Second Affiliated Hospital of Xi’an Jiaotong University between March 2020 and November 2022.Patient classification was performed in accordance with the Baveno VI consensus.The area under the curve was used to evaluate and compare the predictive accuracy across different patient groups.The diagnostic effectiveness of several models,including the liver stiffness-spleen diameter-platelet ratio,variceal risk index,aspartate aminotransferase-alanine aminotransferase ratio,Baveno Ⅵ criteria,and newly developed models,was assessed.Additionally,decision curve analysis was carried out across a range of threshold probabilities to evaluate the clinical utility of these predictive factors.RESULTS Univariate and multivariate analyses demonstrated that SSM,LSM,and the spleen length diameter(SLD)were linked to clinical decompensation in individuals with viral cirrhosis.On the basis of these findings,a predictive model was developed via logistic regression:Ln[P/(1-P)]=-4.969-0.279×SSM+0.348×LSM+0.272×SLD.The model exhibited strong performance,with an area under the curve of 0.944.At a cutoff value of 0.56,the sensitivity,specificity,positive predictive value,and negative predictive value for predicting clinical decompensation were 85.29%,88.89%,87.89%,and 86.47%,respectively.The newly developed model demonstrated enhanced accuracy in forecasting clinical decompensation among patients suffering from viral cirrhosis when compared to four previously established models.CONCLUSION Noninvasive models utilizing SSM,LSM,and SLD are effective in predicting clinical decompensation among patients with viral cirrhosis,thereby reducing the need for unnecessary hepatic venous pressure gradient testing.
基金Supported by Talent Scientific Research Start-up Foundation of Wannan Medical College,No.WYRCQD2023045.
文摘BACKGROUND The early diagnosis rate of pancreatic ductal adenocarcinoma(PDAC)is low and the prognosis is poor.It is important to develop an interpretable noninvasive early diagnostic model in clinical practice.AIM To develop an interpretable noninvasive early diagnostic model for PDAC using plasma extracellular vesicle long RNA(EvlRNA).METHODS The diagnostic model was constructed based on plasma EvlRNA data.During the process of establishing the model,EvlRNA-index was introduced,and four algorithms were adopted to calculate EvlRNA-index.After the model was successfully constructed,performance evaluation was conducted.A series of bioinformatics methods were adopted to explore the potential mechanism of EvlRNA-index as the input feature of the model.And the relationship between key characteristics and PDAC were explored at the single-cell level.RESULTS A novel interpretable machine learning framework was developed based on plasma EvlRNA.In this framework,a two-layer classifier was established.A new concept was proposed:EvlRNA-index.Based on EvlRNA-index,a cancer diagnostic model was established,and a good diagnostic effect was achieved.The accuracy of PDACandCPvsHealth-Probabilistic PCA Index-SVM(PDAC and chronic pancreatitis vs health-probabilistic principal component analysis index-support vector machine)(1-18)was 91.51%,with Mathew’s correlation coefficient 0.7760 and area under the curve 0.9560.In the second layer of the model,the accuracy of PDACvsCP-Probabilistic PCA Index-RF(PDAC vs chronic pancreatitis-probabilistic principal component analysis index-random forest)(2-17)was 93.83%,with Mathew’s correlation coefficient 0.8422 and area under the curve 0.9698.Forty-nine PDAC-related genes were identified,among which 16 were known,inferring that the remaining ones were also PDAC-related genes.CONCLUSION An interpretable two-layer machine learning framework was proposed for early diagnosis and prediction of PDAC based on plasma EvlRNA,providing new insights into the clinical value of EvlRNA.
基金Supported by the Leap-forward Development Program for Beijing Biopharmaceutical Industry(G20),No.Z171100001717008the Fundamental Research Funds for the Central Universities and Research projects on biomedical transformation of China-Japan Friendship Hospital,No.PYBZ1815.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disea-se.The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.AIM To assess the diagnostic performance of noninvasive steatosis biomarkers in diag-nosing NAFLD using magnetic resonance imaging proton density fat fraction(MRI-PDFF)as the gold standard.METHODS A total of 131 suspected NAFLD patients(60%male,median age 36 years)under-going MRI-PDFF were consecutively recruited from a tertiary hospital.Steatosis grades determined by MRI-PDFF were classified as none(<5%),mild(5%-11%),moderate(11%-17%),and severe(≥17%).Six steatosis biomarkers were calculated according to clinical parameters and laboratory tests,including fatty liver index,hepatic steatosis index,ZJU index,Framingham steatosis index,triglycerides and glucose index,and visceral adiposity index.The accuracy of these biomarkers in detecting hepatic steatosis was evaluated using the area under the receiver operating characteristic curves(AUCs).The Youden index was used to determine the optimal cut-off for each biomarker.The linear trend analysis of each biomarker across the steatosis grades was conducted by Mantel-Haenszelχ2 test.Spearman's rank correlation assessed the relationship between steatosis biomarkers and MRI-PDFF.RESULTS Steatosis grades based on MRI-PDFF prevalence were:None 27%,mild 40%,moderate 15%and severe 18%.Six steatosis biomarkers showed a linear trend across the steatosis grades and a significant positive correlation with MRI-PDFF.The six steatosis biomarkers demonstrated AUCs near 0.90(range:0.857-0.912,all P<0.001)for diagnosing NAFLD by MRI-PDFF≥5%.The optimal cut-offs showed sensitivity between 84.4%-91.7%and specificity between 71.4%-85.7%.The diagnostic performance of these biomarkers in detecting moderate-to-severe and severe steatosis was relatively weaker.CONCLUSION These noninvasive steatosis biomarkers accurately diagnosed NAFLD and correlated well with MRI-PDFF for detecting NAFLD,but they did not effectively detect moderate or severe steatosis.
基金supported by the National Natural Science Foundation of China(82172018 and 62333002).
文摘Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.
