The Sendai Framework for Disaster Risk Reduction 2015–2030 recommends several actions for early warning systems(EWSs). However, there is a lack of information about their means of implementation. This article used in...The Sendai Framework for Disaster Risk Reduction 2015–2030 recommends several actions for early warning systems(EWSs). However, there is a lack of information about their means of implementation. This article used institutional ethnography to analyze the 2012–2018 implementation of a national warning system in Brazil. The challenges related to daily activities, and the interdisciplinary works in the four axes of EWSs towards multi-hazard and people-centered approaches are discussed. This national experience is then discussed in the light of the global challenges of EWSs considering two main issues:(1) experiences of implementation and barriers related to people-centered warning systems;and(2)types of national/regional warning systems and hazards/threats that are being monitored as an important input for multi-hazard approaches. There are few multi-hazard warning systems in place and EWSs are focused on hydrometeorological hazards, mainly related to floods. The Sendai Framework needs to improve access to data and information, identify views from the frontline, consider political threats and vulnerabilities, and find ways to talk about disaster risk creation processes at a larger scale.展开更多
Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponi...Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.展开更多
The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed patho...The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.展开更多
This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal disease...This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.展开更多
State Councilor and Foreign Minister of the People’s Republic of China at the High-level Segment of the 46th Session of the United Nations Human Rights Council 22 February 2021Mme.President,Colleagues,It gives me gre...State Councilor and Foreign Minister of the People’s Republic of China at the High-level Segment of the 46th Session of the United Nations Human Rights Council 22 February 2021Mme.President,Colleagues,It gives me great pleasure to speak at the46th session of the United Nations Human Rights Council on behalf of the Chinese government.展开更多
Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermato...Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermatology department of a top-three hospital in Jingzhou City from November 2022 to July 2023 were selected and divided into control group and test group with 33 cases in each group by random number table method. The control group received routine health education, and the experimental group received health education based on the HAPA theory. Chronic disease self-efficacy scale, hospital anxiety and depression scale and skin disease quality of life scale were used to evaluate the effect of intervention. Results: After 3 months of intervention, the scores of self-efficacy in experimental group were higher than those in control group (P P Conclusion: Health education based on the theory of HAPA can enhance the self-efficacy of patients with type D personality psoriasis, relieve negative emotions and improve their quality of life.展开更多
Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent soci...Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent social anxiety to provide a theoretical basis for targeted interventions.Methods:3025 Chinese adolescents(Meanage=13.91±1.60 years;47%male)completed self-report measures of physical activity,core self-evaluation,and social anxiety.Variable-centered analyses employed PROCESS Model 4 with 5000 bootstrap samples;covariates were gender,grade,and place of residence.Person-centered analyses used latent profile analysis in Mplus 8.3 to identify subgroups based on social anxiety item profiles.Results:Variable-centered analyses showed that physical activity had a significant negative association with social anxiety(β=−0.224,p<0.001)and a significant positive association with core self-evaluation(β=0.471,p<0.001);core self-evaluation partially mediated this relationship,accounting for 30%of the total effect.Person-centered analyses revealed an optimal two-profile solution:a low social anxiety profile(89.6%)and a high social anxiety profile(10.4%).The high social anxiety profile reported significantly lower physical activity and lower core self-evaluation than the low social anxiety profile.Conclusions:This study integrates variable-centered and person-centered evidence,identifies physical activity and core self-evaluation as key modifiable factors in reducing social anxiety,providing a theoretical basis for targeted and differentiated interventions.展开更多
BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of ...BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.展开更多
In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theore...In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theoretical framework of the production-oriented approach(POA)proposed by Professor Wen Qiufang,designed and implemented a set of IELTS writing teaching plan.This plan takes“motivating,enabling,and assessing”as the core teaching process,and selects typical IELTS argumentative essay topics(such as food diversity)to create real communication scenarios.In the motivating stage,diverse inputs are used to stimulate students’interest and expose their language weaknesses;in the enabling stage,language knowledge,viewpoint generation,and text structure are focused on for targeted input and training;in the assessing stage,a combination of teacher-student cooperation and peer evaluation is adopted to guide students to identify and correct deficiencies in language use.The research results show that the POA model can effectively enhance students’writing interest,active learning awareness,and writing ability,particularly in overcoming vocabulary poverty and material shortages,as well as improving language accuracy and expression richness.This provides an operational theoretical basis and practical path for improving the teaching effect of IELTS writing.展开更多
Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal a...Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal approach.Methods:We compared the patients who underwent robot-assisted hemihepatectomy(Rob-HH)and who had laparoscopic hemihepatectomy(Lap-HH)through dorsal approach between January 2020 and December 2022.A 1:1 propensity score-matching(PSM)analysis was performed to minimize bias and confounding factors.Results:Ninety-six patients were included,41 with Rob-HH and 55 with Lap-HH.Among them,58 underwent left hemihepatectomy(LHH)and 38 underwent right hemihepatectomy(RHH).Compared with LapHH group,patients with Rob-HH had less estimated blood loss(median:100.0 vs.300.0 m L,P=0.016),lower blood transfusion rates(4.9%vs.29.1%,P=0.003)and postoperative complication rates(26.8%vs.54.5%,P=0.016).These significant differences consistently existed after PSM and in the LHH subgroups.Furthermore,robot-assisted LHH was associated with decreased Pringle duration(45 vs.60 min,P=0.047).RHH subgroup analysis showed that compared with Lap-RHH,Rob-RHH was associated with less estimated blood loss(200.0 vs.400.0 m L,P=0.013).No significant differences were found in other perioperative outcomes among pre-and post-PSM cohorts,such as Pringle duration,operative time,and hospital stay.Conclusions:The dorsal approach was a safe and feasible strategy for hemi-hepatectomy with favorable outcomes under robot-assisted system in reducing intraoperative blood loss,transfusion,and postoperative complications.展开更多
Metabolomics utilizes advanced analytical profiling techniques to comprehensively measure small molecules in cells,tissues,and biological fluids.Nutritional metabolomics studies in pigs have reported changes in hundre...Metabolomics utilizes advanced analytical profiling techniques to comprehensively measure small molecules in cells,tissues,and biological fluids.Nutritional metabolomics studies in pigs have reported changes in hundreds of metabolites across various sample types,including plasma,serum,urine,digesta,and feces,following dietary interventions.These findings can help identify biomarkers of gastrointestinal functionality and beyond,as well as investigate mechanistic interactions between diet,host,microbiome,and metabolites.This review aims to summarize the current literature on nutritional metabolomics in pigs and its use to investigate how different dietary approaches impact the gut health of pigs.Here,we critically assessed and categorized the impact of the main macronutrients-carbohydrates,proteins,and fats—along with feed additives such as amino acids,bile acids,and probiotics,as well as feeding strategies like creep feeding,milk replacer introduction,and time-restricted feeding,on the pig metabolome.Additionally,we discuss the potential modes of action of the key affected metabolites on pig gut health.展开更多
Enhancing the mechanical properties is crucial for polyimide films,but the mechanical properties(Young's modulus,tensile strength,and elongation at break)mutually constrain each other,complicating simultaneous enh...Enhancing the mechanical properties is crucial for polyimide films,but the mechanical properties(Young's modulus,tensile strength,and elongation at break)mutually constrain each other,complicating simultaneous enhancement via traditional trial-and-error methods.In this work,we proposed a materials genome approach to design and screen phenylethynyl-terminated polyimides for films with enhanced mechani-cal properties.We first established machine learning models to predict Young's modulus,tensile strength,and elongation at break to explore the chemical space containing thousands of candidate structures.The accuracies of the machine learning models were verified by molecular dynamics simulations on screened polyimides and experimental testing on three representative polyimide films.The performance advantages of the best-selected polyimides were analyzed by comparing well-known polyimides based on molecular dynamics simulations,and the structural rationale was revealed by"gene"analysis and feature importance evaluation.This work provides a cost-effective strategy for designing polyimide films withenhancedmechanical properties.展开更多
In recent years,the production-oriented approach has been applied in the field of teaching Chinese as a foreign language,providing a new perspective for language and cultural instruction.Currently,several issues exist...In recent years,the production-oriented approach has been applied in the field of teaching Chinese as a foreign language,providing a new perspective for language and cultural instruction.Currently,several issues exist in cultural teaching,such as the lack of in-depth cultural input,insufficient training in cross-cultural communication skills,and the over-stylization of cultural teaching in the classroom.The production-oriented approach offers a solution to these challenges.This paper seeks to introduce the production-oriented method into the teaching of Chinese culture as a foreign language,using silk culture as a case study for teaching design.The aim is to implement cultural teaching through a new instructional model and to promote the spread of Chinese silk culture.展开更多
Current research on robot calibration can be roughly classified into two categories,and both of them have certain inherent limitations.Model-based methods are difficult to model and compensate the pose errors arising ...Current research on robot calibration can be roughly classified into two categories,and both of them have certain inherent limitations.Model-based methods are difficult to model and compensate the pose errors arising from configuration-dependent geometric and non-geometric source errors,whereas the accuracy of data-driven methods depends on a large amount of measurement data.Using a 5-DOF(degrees of freedom)hybrid machining robot as an exemplar,this study presents a model data-driven approach for the calibration of robotic manipulators.An f-DOF realistic robot containing various source errors is visualized as a 6-DOF fictitious robot having error-free parameters,but erroneous actuated/virtual joint motions.The calibration process essentially involves four steps:(1)formulating the linear map relating the pose error twist to the joint motion errors,(2)parameterizing the joint motion errors using second-order polynomials in terms of nominal actuated joint variables,(3)identifying the polynomial coefficients using the weighted least squares plus principal component analysis,and(4)compensating the compensable pose errors by updating the nominal actuated joint variables.The merit of this approach is that it enables compensation of the pose errors caused by configuration-dependent geometric and non-geometric source errors using finite measurement configurations.Experimental studies on a prototype machine illustrate the effectiveness of the proposed approach.展开更多
Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the themat...This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the thematic unit of“Movement”as an example,and designs the teaching through the links of“drive-enable-evaluate”.The results show that POA effectively improves students’speaking and writing output,but there are still deficiencies in reading and listening.Accordingly,this study has proposed the strategies of“vocabulary in-depth facilitation”and“accurate matching of listening and writing”to optimize the input materials and skills training,achieve the goal of“learning and using”,and provide a practical path for teaching German for Special Purposes.This provides a practical path for the teaching of German for special purposes.展开更多
This paper focuses on the numerical solution of a tumor growth model under a data-driven approach.Based on the inherent laws of the data and reasonable assumptions,an ordinary differential equation model for tumor gro...This paper focuses on the numerical solution of a tumor growth model under a data-driven approach.Based on the inherent laws of the data and reasonable assumptions,an ordinary differential equation model for tumor growth is established.Nonlinear fitting is employed to obtain the optimal parameter estimation of the mathematical model,and the numerical solution is carried out using the Matlab software.By comparing the clinical data with the simulation results,a good agreement is achieved,which verifies the rationality and feasibility of the model.展开更多
Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors co...Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.展开更多
The societal risk related to rainfalltriggered rapid debris flows is commonly managed in urbanized areas by means of early warning systems based on monitoring of hydrological parameters(such as rainfall or soil moistu...The societal risk related to rainfalltriggered rapid debris flows is commonly managed in urbanized areas by means of early warning systems based on monitoring of hydrological parameters(such as rainfall or soil moisture) and thresholds values.In Alpine catchments,this type of landslides is recurrent and represent one of the major geohazards.Debris flows are typically initiated by high-intensity rainstorms,prolonged rainfall with moderate intensity or snow melting.They frequently happen in situations of temporary infiltration into soils that are initially unsaturated.During significant rainfall events,the rise in pore water pressure can become crucial for the stability of slopes in particular areas.This phenomenon relies on hydraulic and geotechnical characteristics,along with the thickness of the involved soils.This procedure can result in a local drop in shear strength,as both apparent cohesion and effective stress decline,while driving forces rise because of the increase in unit weight.Accordingly,this study estimates Intensity-Duration(I-D) rainfall thresholds at the site-specific and distributed scales by combining empirical and physics-based approaches and modeling of soil coverings involved in soil slips or debris slides inducing debris flows.The approach was tested for mountain slopes of the Valtellina valley(Lombardia region,northern Italy),which suffered several catastrophic landslide events in the last decades.The empirical approach was adopted to reconstruct physics-based slope models of representative source areas of past debris flows events.To such a scope,nonpunctual but distributed data of hydro-mechanical soil properties and thicknesses were considered.Thus,to reconstruct the unsaturated/saturated critical conditions leading the slope instability,a combined hydrological modeling and infinite-slope stability analysis was adopted.This combined hydromechanical numerical model was used to attempt to determine a three-dimensional Intensity-Duration threshold for landslide initiation considering plausible rainfall for the Valtellina valley.Due to the lack of reliable records of past landslide hindering a thorough empirical analysis,the presented approach can be considered as a feasible approach for establishing a warning standard in urbanized areas at risk of shallow landslides triggered by rainfall.Moreover,findings highlight the importance of having access to spatially distributed soil characteristics to define and enhance input data for physics-based modelling.Finally,the proposed approach can aid an early warning system for the onset of shallow landslides by utilizing real-time rainfall monitoring or now-casting through a meteorological radar technique.展开更多
Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fr...Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fracture who were hospitalized from August 2023 to January 2025 were selected and randomly divided into two groups of 50 cases each.The control group was operated by purely trans-tarsal sinus approach,and the observation group added dalteparin sodium and furosemide on this basis.Postoperative limb swelling,pain,coagulation and inflammation indexes,fracture healing time,foot function and complications were compared between the two groups.Results:In the observation group,postoperative limb swelling subsided faster,pain score was lower,coagulation and inflammation indexes improved more significantly,fracture healing time was shorter,foot function recovery was better,and complication rate was lower,P<0.05.Conclusion:The treatment of heel fracture by trans-tarsal sinus approach combined with sodium heparin and furosemide can significantly accelerate the patient’s recovery and reduce the occurrence of complications,which has high clinical application value.展开更多
基金the S?o Paulo Research Foundation–Fapesp (Grant Number 2018/06093-4)。
文摘The Sendai Framework for Disaster Risk Reduction 2015–2030 recommends several actions for early warning systems(EWSs). However, there is a lack of information about their means of implementation. This article used institutional ethnography to analyze the 2012–2018 implementation of a national warning system in Brazil. The challenges related to daily activities, and the interdisciplinary works in the four axes of EWSs towards multi-hazard and people-centered approaches are discussed. This national experience is then discussed in the light of the global challenges of EWSs considering two main issues:(1) experiences of implementation and barriers related to people-centered warning systems;and(2)types of national/regional warning systems and hazards/threats that are being monitored as an important input for multi-hazard approaches. There are few multi-hazard warning systems in place and EWSs are focused on hydrometeorological hazards, mainly related to floods. The Sendai Framework needs to improve access to data and information, identify views from the frontline, consider political threats and vulnerabilities, and find ways to talk about disaster risk creation processes at a larger scale.
文摘Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.
基金supported by Singapore National Medical Research Council(NMRC)grants,including CS-IRG,HLCA2022(to ZDZ),STaR,OF LCG 000207(to EKT)a Clinical Translational Research Programme in Parkinson's DiseaseDuke-Duke-NUS collaboration pilot grant(to ZDZ)。
文摘The progressive loss of dopaminergic neurons in affected patient brains is one of the pathological features of Parkinson's disease,the second most common human neurodegenerative disease.Although the detailed pathogenesis accounting for dopaminergic neuron degeneration in Parkinson's disease is still unclear,the advancement of stem cell approaches has shown promise for Parkinson's disease research and therapy.The induced pluripotent stem cells have been commonly used to generate dopaminergic neurons,which has provided valuable insights to improve our understanding of Parkinson's disease pathogenesis and contributed to anti-Parkinson's disease therapies.The current review discusses the practical approaches and potential applications of induced pluripotent stem cell techniques for generating and differentiating dopaminergic neurons from induced pluripotent stem cells.The benefits of induced pluripotent stem cell-based research are highlighted.Various dopaminergic neuron differentiation protocols from induced pluripotent stem cells are compared.The emerging three-dimension-based brain organoid models compared with conventional two-dimensional cell culture are evaluated.Finally,limitations,challenges,and future directions of induced pluripotent stem cell–based approaches are analyzed and proposed,which will be significant to the future application of induced pluripotent stem cell-related techniques for Parkinson's disease.
基金Supported by National Research Foundation of Korea,No.NRF-2021S1A5A8062526.
文摘This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.
文摘State Councilor and Foreign Minister of the People’s Republic of China at the High-level Segment of the 46th Session of the United Nations Human Rights Council 22 February 2021Mme.President,Colleagues,It gives me great pleasure to speak at the46th session of the United Nations Human Rights Council on behalf of the Chinese government.
文摘Objective: To explore the effect of Health Action Process Approach (HAPA) theory in patients with type D personality psoriasis. Methods: A total of 66 patients with type D personality psoriasis admitted to the dermatology department of a top-three hospital in Jingzhou City from November 2022 to July 2023 were selected and divided into control group and test group with 33 cases in each group by random number table method. The control group received routine health education, and the experimental group received health education based on the HAPA theory. Chronic disease self-efficacy scale, hospital anxiety and depression scale and skin disease quality of life scale were used to evaluate the effect of intervention. Results: After 3 months of intervention, the scores of self-efficacy in experimental group were higher than those in control group (P P Conclusion: Health education based on the theory of HAPA can enhance the self-efficacy of patients with type D personality psoriasis, relieve negative emotions and improve their quality of life.
基金The Ministry of Education of China supported this work under the Humanities and Social Sciences Research Project for Young Scholars(Grant No.20YJC890020).
文摘Background:Social anxiety is prevalent among adolescents and severely impacts their mental health and social functioning.This study aims to explore the underlying mechanisms and subgroup differences in adolescent social anxiety to provide a theoretical basis for targeted interventions.Methods:3025 Chinese adolescents(Meanage=13.91±1.60 years;47%male)completed self-report measures of physical activity,core self-evaluation,and social anxiety.Variable-centered analyses employed PROCESS Model 4 with 5000 bootstrap samples;covariates were gender,grade,and place of residence.Person-centered analyses used latent profile analysis in Mplus 8.3 to identify subgroups based on social anxiety item profiles.Results:Variable-centered analyses showed that physical activity had a significant negative association with social anxiety(β=−0.224,p<0.001)and a significant positive association with core self-evaluation(β=0.471,p<0.001);core self-evaluation partially mediated this relationship,accounting for 30%of the total effect.Person-centered analyses revealed an optimal two-profile solution:a low social anxiety profile(89.6%)and a high social anxiety profile(10.4%).The high social anxiety profile reported significantly lower physical activity and lower core self-evaluation than the low social anxiety profile.Conclusions:This study integrates variable-centered and person-centered evidence,identifies physical activity and core self-evaluation as key modifiable factors in reducing social anxiety,providing a theoretical basis for targeted and differentiated interventions.
文摘BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.
文摘In response to the common problems in college English writing teaching,such as the separation of learning and application,students’low interest in writing,and difficulties in expression,this paper,based on the theoretical framework of the production-oriented approach(POA)proposed by Professor Wen Qiufang,designed and implemented a set of IELTS writing teaching plan.This plan takes“motivating,enabling,and assessing”as the core teaching process,and selects typical IELTS argumentative essay topics(such as food diversity)to create real communication scenarios.In the motivating stage,diverse inputs are used to stimulate students’interest and expose their language weaknesses;in the enabling stage,language knowledge,viewpoint generation,and text structure are focused on for targeted input and training;in the assessing stage,a combination of teacher-student cooperation and peer evaluation is adopted to guide students to identify and correct deficiencies in language use.The research results show that the POA model can effectively enhance students’writing interest,active learning awareness,and writing ability,particularly in overcoming vocabulary poverty and material shortages,as well as improving language accuracy and expression richness.This provides an operational theoretical basis and practical path for improving the teaching effect of IELTS writing.
基金supported by grants from the National Nat-ural Science Foundation of China(82173129)the Innova-tive and Entrepreneurial Talent Doctor of Jiangsu Province,China(JSSCBS20221872)。
文摘Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal approach.Methods:We compared the patients who underwent robot-assisted hemihepatectomy(Rob-HH)and who had laparoscopic hemihepatectomy(Lap-HH)through dorsal approach between January 2020 and December 2022.A 1:1 propensity score-matching(PSM)analysis was performed to minimize bias and confounding factors.Results:Ninety-six patients were included,41 with Rob-HH and 55 with Lap-HH.Among them,58 underwent left hemihepatectomy(LHH)and 38 underwent right hemihepatectomy(RHH).Compared with LapHH group,patients with Rob-HH had less estimated blood loss(median:100.0 vs.300.0 m L,P=0.016),lower blood transfusion rates(4.9%vs.29.1%,P=0.003)and postoperative complication rates(26.8%vs.54.5%,P=0.016).These significant differences consistently existed after PSM and in the LHH subgroups.Furthermore,robot-assisted LHH was associated with decreased Pringle duration(45 vs.60 min,P=0.047).RHH subgroup analysis showed that compared with Lap-RHH,Rob-RHH was associated with less estimated blood loss(200.0 vs.400.0 m L,P=0.013).No significant differences were found in other perioperative outcomes among pre-and post-PSM cohorts,such as Pringle duration,operative time,and hospital stay.Conclusions:The dorsal approach was a safe and feasible strategy for hemi-hepatectomy with favorable outcomes under robot-assisted system in reducing intraoperative blood loss,transfusion,and postoperative complications.
基金the PIG-PARADIGM project,funded by the Novo Nordisk Foundation(Grant No.NNFSA210073688).
文摘Metabolomics utilizes advanced analytical profiling techniques to comprehensively measure small molecules in cells,tissues,and biological fluids.Nutritional metabolomics studies in pigs have reported changes in hundreds of metabolites across various sample types,including plasma,serum,urine,digesta,and feces,following dietary interventions.These findings can help identify biomarkers of gastrointestinal functionality and beyond,as well as investigate mechanistic interactions between diet,host,microbiome,and metabolites.This review aims to summarize the current literature on nutritional metabolomics in pigs and its use to investigate how different dietary approaches impact the gut health of pigs.Here,we critically assessed and categorized the impact of the main macronutrients-carbohydrates,proteins,and fats—along with feed additives such as amino acids,bile acids,and probiotics,as well as feeding strategies like creep feeding,milk replacer introduction,and time-restricted feeding,on the pig metabolome.Additionally,we discuss the potential modes of action of the key affected metabolites on pig gut health.
基金supported by the National Key R&D Program of China(No.2022YFB3707302)the National Natural Science Foundation of China(Nos.52394271 , 52394270).
文摘Enhancing the mechanical properties is crucial for polyimide films,but the mechanical properties(Young's modulus,tensile strength,and elongation at break)mutually constrain each other,complicating simultaneous enhancement via traditional trial-and-error methods.In this work,we proposed a materials genome approach to design and screen phenylethynyl-terminated polyimides for films with enhanced mechani-cal properties.We first established machine learning models to predict Young's modulus,tensile strength,and elongation at break to explore the chemical space containing thousands of candidate structures.The accuracies of the machine learning models were verified by molecular dynamics simulations on screened polyimides and experimental testing on three representative polyimide films.The performance advantages of the best-selected polyimides were analyzed by comparing well-known polyimides based on molecular dynamics simulations,and the structural rationale was revealed by"gene"analysis and feature importance evaluation.This work provides a cost-effective strategy for designing polyimide films withenhancedmechanical properties.
文摘In recent years,the production-oriented approach has been applied in the field of teaching Chinese as a foreign language,providing a new perspective for language and cultural instruction.Currently,several issues exist in cultural teaching,such as the lack of in-depth cultural input,insufficient training in cross-cultural communication skills,and the over-stylization of cultural teaching in the classroom.The production-oriented approach offers a solution to these challenges.This paper seeks to introduce the production-oriented method into the teaching of Chinese culture as a foreign language,using silk culture as a case study for teaching design.The aim is to implement cultural teaching through a new instructional model and to promote the spread of Chinese silk culture.
基金Supported by National Natural Science Foundation of China(Grant Nos.52325501,U24B2047).
文摘Current research on robot calibration can be roughly classified into two categories,and both of them have certain inherent limitations.Model-based methods are difficult to model and compensate the pose errors arising from configuration-dependent geometric and non-geometric source errors,whereas the accuracy of data-driven methods depends on a large amount of measurement data.Using a 5-DOF(degrees of freedom)hybrid machining robot as an exemplar,this study presents a model data-driven approach for the calibration of robotic manipulators.An f-DOF realistic robot containing various source errors is visualized as a 6-DOF fictitious robot having error-free parameters,but erroneous actuated/virtual joint motions.The calibration process essentially involves four steps:(1)formulating the linear map relating the pose error twist to the joint motion errors,(2)parameterizing the joint motion errors using second-order polynomials in terms of nominal actuated joint variables,(3)identifying the polynomial coefficients using the weighted least squares plus principal component analysis,and(4)compensating the compensable pose errors by updating the nominal actuated joint variables.The merit of this approach is that it enables compensation of the pose errors caused by configuration-dependent geometric and non-geometric source errors using finite measurement configurations.Experimental studies on a prototype machine illustrate the effectiveness of the proposed approach.
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
文摘This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the thematic unit of“Movement”as an example,and designs the teaching through the links of“drive-enable-evaluate”.The results show that POA effectively improves students’speaking and writing output,but there are still deficiencies in reading and listening.Accordingly,this study has proposed the strategies of“vocabulary in-depth facilitation”and“accurate matching of listening and writing”to optimize the input materials and skills training,achieve the goal of“learning and using”,and provide a practical path for teaching German for Special Purposes.This provides a practical path for the teaching of German for special purposes.
基金National Natural Science Foundation of China(Project No.:12371428)Projects of the Provincial College Students’Innovation and Training Program in 2024(Project No.:S202413023106,S202413023110)。
文摘This paper focuses on the numerical solution of a tumor growth model under a data-driven approach.Based on the inherent laws of the data and reasonable assumptions,an ordinary differential equation model for tumor growth is established.Nonlinear fitting is employed to obtain the optimal parameter estimation of the mathematical model,and the numerical solution is carried out using the Matlab software.By comparing the clinical data with the simulation results,a good agreement is achieved,which verifies the rationality and feasibility of the model.
文摘Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.
文摘The societal risk related to rainfalltriggered rapid debris flows is commonly managed in urbanized areas by means of early warning systems based on monitoring of hydrological parameters(such as rainfall or soil moisture) and thresholds values.In Alpine catchments,this type of landslides is recurrent and represent one of the major geohazards.Debris flows are typically initiated by high-intensity rainstorms,prolonged rainfall with moderate intensity or snow melting.They frequently happen in situations of temporary infiltration into soils that are initially unsaturated.During significant rainfall events,the rise in pore water pressure can become crucial for the stability of slopes in particular areas.This phenomenon relies on hydraulic and geotechnical characteristics,along with the thickness of the involved soils.This procedure can result in a local drop in shear strength,as both apparent cohesion and effective stress decline,while driving forces rise because of the increase in unit weight.Accordingly,this study estimates Intensity-Duration(I-D) rainfall thresholds at the site-specific and distributed scales by combining empirical and physics-based approaches and modeling of soil coverings involved in soil slips or debris slides inducing debris flows.The approach was tested for mountain slopes of the Valtellina valley(Lombardia region,northern Italy),which suffered several catastrophic landslide events in the last decades.The empirical approach was adopted to reconstruct physics-based slope models of representative source areas of past debris flows events.To such a scope,nonpunctual but distributed data of hydro-mechanical soil properties and thicknesses were considered.Thus,to reconstruct the unsaturated/saturated critical conditions leading the slope instability,a combined hydrological modeling and infinite-slope stability analysis was adopted.This combined hydromechanical numerical model was used to attempt to determine a three-dimensional Intensity-Duration threshold for landslide initiation considering plausible rainfall for the Valtellina valley.Due to the lack of reliable records of past landslide hindering a thorough empirical analysis,the presented approach can be considered as a feasible approach for establishing a warning standard in urbanized areas at risk of shallow landslides triggered by rainfall.Moreover,findings highlight the importance of having access to spatially distributed soil characteristics to define and enhance input data for physics-based modelling.Finally,the proposed approach can aid an early warning system for the onset of shallow landslides by utilizing real-time rainfall monitoring or now-casting through a meteorological radar technique.
文摘Objective:To investigate the therapeutic effect of trans-tarsal sinus approach surgery combined with dalteparin sodium and furosemide in the treatment of heel bone fracture.Methods:A hundred patients with heel bone fracture who were hospitalized from August 2023 to January 2025 were selected and randomly divided into two groups of 50 cases each.The control group was operated by purely trans-tarsal sinus approach,and the observation group added dalteparin sodium and furosemide on this basis.Postoperative limb swelling,pain,coagulation and inflammation indexes,fracture healing time,foot function and complications were compared between the two groups.Results:In the observation group,postoperative limb swelling subsided faster,pain score was lower,coagulation and inflammation indexes improved more significantly,fracture healing time was shorter,foot function recovery was better,and complication rate was lower,P<0.05.Conclusion:The treatment of heel fracture by trans-tarsal sinus approach combined with sodium heparin and furosemide can significantly accelerate the patient’s recovery and reduce the occurrence of complications,which has high clinical application value.
