The National Basic Research Priorities Program (the so-called Climbing Program), a combination of guidance and mandatory, is a major component of the country’s efforts in basic research during the Eighth Five-Year Pl...The National Basic Research Priorities Program (the so-called Climbing Program), a combination of guidance and mandatory, is a major component of the country’s efforts in basic research during the Eighth Five-Year Plan period (1991-1995). Its objectives are to foster qualified personnel and improve the quality and ability of research workers; to consolidate the academic position of the science community in major areas of basic research and emerging branches of science and technology, keep-展开更多
BACKGROUND Thyroid storm is a life-threatening emergency.Reportedly,the prevalence of thyroid storm is 1%-2%among patients admitted to the hospital for thyrotoxicosis.Burch and Wartofsky(1993)introduced a scoring syst...BACKGROUND Thyroid storm is a life-threatening emergency.Reportedly,the prevalence of thyroid storm is 1%-2%among patients admitted to the hospital for thyrotoxicosis.Burch and Wartofsky(1993)introduced a scoring system using precise clinical criteria to identify thyroid storms.Only 17 cases of thyroid storm with a score>70 points have been reported.Although thyroid storms are uncommon,their clinical findings resemble those of sepsis.CASE SUMMARY A 48-year-old man was referred to the emergency room from a local clinic owing to suspicion of gastric ulcer perforation;medications for hypertension,diabetes mellitus,and hyperthyroidism had been suspended 1 year prior to this visit.We performed an emergency distal gastrectomy with Billroth II anastomosis for gastric cardia cancer perforation,and the patient was referred to the surgical intensive care unit(ICU).On the 2nd d in the ICU,his body temperature(BT)increased to 41.3℃ at 19:00,with the thyroid storm score(90 points)peaking at 18:00(BT;41.2℃,pulse rate;138/min,irritable status).The patient was administered propylthiouracil,intravenous glucocorticoids,acetaminophen,and Lugol’s solution daily.Subsequently,we performed bladder irrigation with cold saline using a Foley catheter and applied a hypothermic blanket to decrease the patient's BT.His vital signs were stable on the 8th day in the ICU.CONCLUSION Thyroid storms are uncommon,with few reports in the literature;however,their clinical findings resemble those of sepsis and require further investigation.Since an untreated thyroid storm results in a high mortality rate,it should be investigated when managing sepsis.展开更多
This study examines the reliability and validity of AI-generated scoring for continuation writing tasks.By comparing GPT-4 with eight experienced human raters across 21 student responses,it evaluates AI’s consistency...This study examines the reliability and validity of AI-generated scoring for continuation writing tasks.By comparing GPT-4 with eight experienced human raters across 21 student responses,it evaluates AI’s consistency,severity,and alignment with human scoring criteria.Results show that AI exhibits high self-consistency and adapts effectively to different scoring roles(e.g.,teacher vs.highstakes rater).However,AI scores were more lenient than human raters and demonstrated divergent evaluation focuses—prioritizing narrative coherence and emotional depth,while teachers emphasized linguistic accuracy and richness of detail.The findings suggest AI’s potential as a supplementary assessment tool,offering rapid,holistic feedback,but highlight the need for further calibration to align with educational standards.Implications include exploring hybrid evaluation models that leverage the strengths of both AI and human raters to achieve more equitable,efficient,and pedagogically meaningful writing assessments.展开更多
Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prog...Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.展开更多
Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential ...Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.展开更多
Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity ver...Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity verification for distributed networking of a drone cluster is limited.Therefore,a lightweight blockchainbased identity authentication model for UAV swarms is designed,and a Credit-score and Grouping-mechanism Practical Byzantine Fault Tolerance(CG-PBFT)algorithm is proposed.CG-PBFT introduces a reputation score evaluation mechanism,classifies the reputation levels of nodes in the network,and optimizes the consensus process based on grouping consensus and BLS aggregate signature technology.Experimental results demonstrate that under identical experimental conditions,compared with the PBFT algorithm,CG-PBFT achieves a 250%increase in average throughput,a 70%reduction in average latency,and simultaneous enhancement in security,thus making it more suitable for UAV swarm networks.展开更多
Automated essay scoring(AES)systems have gained significant importance in educational settings,offering a scalable,efficient,and objective method for evaluating student essays.However,developing AES systems for Arabic...Automated essay scoring(AES)systems have gained significant importance in educational settings,offering a scalable,efficient,and objective method for evaluating student essays.However,developing AES systems for Arabic poses distinct challenges due to the language’s complex morphology,diglossia,and the scarcity of annotated datasets.This paper presents a hybrid approach to Arabic AES by combining text-based,vector-based,and embeddingbased similarity measures to improve essay scoring accuracy while minimizing the training data required.Using a large Arabic essay dataset categorized into thematic groups,the study conducted four experiments to evaluate the impact of feature selection,data size,and model performance.Experiment 1 established a baseline using a non-machine learning approach,selecting top-N correlated features to predict essay scores.The subsequent experiments employed 5-fold cross-validation.Experiment 2 showed that combining embedding-based,text-based,and vector-based features in a Random Forest(RF)model achieved an R2 of 88.92%and an accuracy of 83.3%within a 0.5-point tolerance.Experiment 3 further refined the feature selection process,demonstrating that 19 correlated features yielded optimal results,improving R2 to 88.95%.In Experiment 4,an optimal data efficiency training approach was introduced,where training data portions increased from 5%to 50%.The study found that using just 10%of the data achieved near-peak performance,with an R2 of 85.49%,emphasizing an effective trade-off between performance and computational costs.These findings highlight the potential of the hybrid approach for developing scalable Arabic AES systems,especially in low-resource environments,addressing linguistic challenges while ensuring efficient data usage.展开更多
Objective: To analyze the effect of pain nursing combined with exercise and posture intervention on improving Visual Analogue Scale (VAS) scores in patients after kidney stone surgery. Methods: A sample of 80 patients...Objective: To analyze the effect of pain nursing combined with exercise and posture intervention on improving Visual Analogue Scale (VAS) scores in patients after kidney stone surgery. Methods: A sample of 80 patients who underwent kidney stone surgery from October 2024 to October 2025 was randomly divided into groups using a random number table. Group A received pain nursing combined with exercise and posture intervention, while Group B received conventional nursing. Postoperative recovery time, VAS scores, and postoperative complications were compared between the two groups. Results: The postoperative recovery time in Group A was shorter than that in Group B, with p < 0.05. The VAS scores at 12 hours, 24 hours, and 72 hours postoperatively in Group A were all lower than those in Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: Pain nursing combined with exercise and posture intervention in postoperative nursing for kidney stone patients can shorten postoperative recovery time and alleviate pain scores.展开更多
Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accu...Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accuracy,therapeutically relevant explanations,strong calibration,domain generalization,and efficiency.Current Convolutional Neural Network(CNN)and transformer models compromise border precision and global context,generate attention maps that fail to align with expert reasoning,deteriorate during cross-center changes,and exhibit inadequate calibration,hence diminishing clinical trust.Methods:HMA-DER is a hierarchical multi-attention architecture that uses dilation-enhanced residual blocks and an explainability-aware Cognitive Alignment Score(CAS)regularizer to directly align attribution maps with reasoning signals from experts.The framework has additions that make it more resilient and a way to test for accuracy,macro-averaged F1 score,Area Under the Receiver Operating Characteristic Curve(AUROC),calibration(Expected Calibration Error(ECE),Brier Score),explainability(CAS,insertion/deletion AUC),cross-dataset transfer,and throughput.Results:HMA-DER gets Dice Similarity Coefficient scores of 89.5%and 86.0%on Kvasir-SEG and CVC-ClinicDB,beating the strongest baseline by+1.9 and+1.7 points.It gets 86.4%and 85.3%macro-F1 and 94.0%and 93.4%AUROC on HyperKvasir and GastroVision,which is better than the baseline by+1.4/+1.6macro-F1 and+1.2/+1.1AUROC.Ablation study shows that hierarchical attention gives the highest(+3.0),followed by CAS regularization(+2–3),dilatation(+1.5–2.0),and residual connections(+2–3).Cross-dataset validation demonstrates competitive zero-shot transfer(e.g.,KS→CVC Dice 82.7%),whereas multi-dataset training diminishes the domain gap,yielding an 88.1%primary-metric average.HMA-DER’s mixed-precision inference can handle 155 pictures per second,which helps with calibration.Conclusion:HMA-DER strikes a compromise between accuracy,explainability,robustness,and efficiency for the use of reliable GI computer-aided diagnosis in real-world clinical settings.展开更多
According to public information of the Ministry of Industry and Information Technology(MIIT),in Q1 2019,the nonferrous industry in China realized stable operation,enhanced industry confidence and mitigated performance...According to public information of the Ministry of Industry and Information Technology(MIIT),in Q1 2019,the nonferrous industry in China realized stable operation,enhanced industry confidence and mitigated performance decline.First,the production was basically stable.展开更多
BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyro...BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.展开更多
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocomp...BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocompromised patients.It carries high morbidity and mortality,requiring early diagnosis and timely intervention.Various prognostic scoring systems help in triaging critically ill patients.The National Early Warning Score 2(NEWS 2)scoring system is a widely used physiological assessment tool that evaluates clinical deterioration based on vital parameters,but its standard form lacks specificity for risk stratification in EPN,necessitating modifications to improve treatment decisionmaking and prognostic accuracy in this critical condition.AIM To highlight the need to modify the NEWS 2 score to enable more intense monitoring and better treatment outcomes.METHODS This prospective study was done on all EPN patients admitted to our hospital over the past 12 years.A weighted average risk-stratification index was calculated for each of the three groups,mortality risk was calculated for each of the NEWS 2 scores,and the need for intervention for each of the three groups was calculated.The NEWS 2 score was subsequently modified with 0-6,7-14 and 15-20 scores included in groups 1,2 and 3,respectively.RESULTS A total of 171 patients with EPN were included in the study,with a predominant association with diabetes(90.6%)and a female-to-male ratio of 1.5:1.The combined prognostic scoring of the three groups was 10.7,13.0,and 21.9,respectively(P<0.01).All patients managed conservatively belonged to group 1(P<0.01).Eight patients underwent early nephrectomy,with six from group 3(P<0.01).Overall mortality was 8(4.7%),with seven from group 3(87.5%).The cutoff NEWS 2 score for mortality was identified to be 15,with a sensitivity of 87.5%,specificity of 96.9%,and an overall accuracy rate of 96.5%.The area under the curve to predict mortality based on the NEWS 2 score was 0.98,with a confidence interval of(0.97,1.0)and P<0.001.CONCLUSION Modified NEWS 2(mNEWS 2)score dramatically aids in the appropriate assessment of treatment-related outcomes.MNEWS 2 scores should become the practice standard to reduce the morbidity and mortality associated with this dreaded illness.展开更多
BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identif...BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identify potential high-risk PHLF patients as early as possible through preoperative evaluation.AIM To identify risk factors for PHLF and develop a prediction model.METHODS This study included 248 patients with HCC at The Second Affiliated Hospital of Air Force Medical University between January 2014 and December 2023;these patients were divided into a training group(n=164)and a validation group(n=84)via random sampling.The independent variables for the occurrence of PHLF were identified by univariate and multivariate analyses and visualized as nomograms.Ultimately,comparisons were made with traditional models via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS In this study,portal vein width[odds ratio(OR)=1.603,95%CI:1.288-1.994,P≤0.001],the preoperative neutrophil-to-lymphocyte ratio(NLR)(OR=1.495,95%CI:1.126-1.984,P=0.005),and the albumin-bilirubin(ALBI)score(OR=8.868,95%CI:2.144-36.678,P=0.003)were independent risk factors for PHLF.A nomogram prediction model was developed using these factors.ROC and DCA analyses revealed that the predictive efficacy and clinical value of this model were better than those of traditional models.CONCLUSION A new Nomogram model for predicting PHLF in HCC patients was successfully established based on portal vein width,the NLR,and the ALBI score,which outperforms the traditional model.展开更多
Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low...Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low risk of meta-stasis,current guidelines recommend endoscopic resection for small lesions.The GATIS predicting score,proposed by Zeng et al,represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs,analyzing the relationship between clinicopathological features and patient prog-noses.The authors identified tumor grade,T stage,tumor size,age,and progno-stic nutritional index as key prognostic factors,demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system.Nevertheless,further larger prospective studies are necessary,and the scientific community's efforts in this context should be directed toward developing interna-tional multicentric prospective studies,with the ultimate aim of accurately de-fining and understanding the behavior of these conditions.展开更多
The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associat...The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.展开更多
OBJECTIVE:To investigate the clinical efficacy of using a Jiedu formula(解毒方) as an adjunctive therapy in patients with hepatocellular carcinoma(HCC) after hepatectomy.METHODS:In total,354 patients were included in ...OBJECTIVE:To investigate the clinical efficacy of using a Jiedu formula(解毒方) as an adjunctive therapy in patients with hepatocellular carcinoma(HCC) after hepatectomy.METHODS:In total,354 patients were included in this study.All patients were categorized into the traditional herbal medicine(THM) group(n = 115) or the non-THM treatment(nTHM) group(n = 239),with the Jiedu formula administered twice a day to the patients in the THM group.The primary outcome was recurrence-free survival(RFS).Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors associated with RFS.Then,the high risk of recurrence among patients was identified,and propensity score matching(PSM) and RFS analysis were performed to analyze the prognostic factors for the outcomes of patients at a high risk of recurrence in different groups.RESULTS:The one,two,three,and five-year RFS rates of the THM and nTHM groups were 76.4% vs 66.1%,65.5% vs 48.8%,57.9% vs 39.9%,and 43.9% vs 29.2%,respectively.The results of the Multivariate Cox analysis showed that giant tumors [hazard ratio(HR),1.54,P = 0.04],poor degree of differentiation,microsatellite,or microvascular invasion(HR,1.29,P = 0.09) increased the risk of recurrence.In the population with a high risk of recurrence,after PSM,the one,two,three,and five-year survival rates were 70.6% vs 68.0%,63.0% vs 43.1%,59.6% vs 33.3%,and 41.9% vs 26.4%,respectively.CONCLUSION:In this study,THM was found to be an effective agent for adjuvant therapy for HCC to prevent early recurrence of HCC after hepatic resection.展开更多
Google Gemini 1.5 Flash scores were compared with ChatGPT 4o-mini on evaluations of(a)51 of the author’s journal articles and(b)up to 200 articles in each of 34 field-based Units of Assessment(UoAs)from the UK Resear...Google Gemini 1.5 Flash scores were compared with ChatGPT 4o-mini on evaluations of(a)51 of the author’s journal articles and(b)up to 200 articles in each of 34 field-based Units of Assessment(UoAs)from the UK Research Excellence Framework(REF)2021.From(a),the results suggest that Gemini 1.5 Flash,unlike ChatGPT 4o-mini,may work better when fed with a PDF or article full text,rather than just the title and abstract.From(b),Gemini 1.5 Flash seems to be marginally less able to predict an article’s research quality(using a departmental quality proxy indicator)than ChatGPT 4o-mini,although the differences are small,and both have similar disciplinary variations in this ability.Averaging multiple runs of Gemini 1.5 Flash improves the scores.展开更多
文摘The National Basic Research Priorities Program (the so-called Climbing Program), a combination of guidance and mandatory, is a major component of the country’s efforts in basic research during the Eighth Five-Year Plan period (1991-1995). Its objectives are to foster qualified personnel and improve the quality and ability of research workers; to consolidate the academic position of the science community in major areas of basic research and emerging branches of science and technology, keep-
文摘BACKGROUND Thyroid storm is a life-threatening emergency.Reportedly,the prevalence of thyroid storm is 1%-2%among patients admitted to the hospital for thyrotoxicosis.Burch and Wartofsky(1993)introduced a scoring system using precise clinical criteria to identify thyroid storms.Only 17 cases of thyroid storm with a score>70 points have been reported.Although thyroid storms are uncommon,their clinical findings resemble those of sepsis.CASE SUMMARY A 48-year-old man was referred to the emergency room from a local clinic owing to suspicion of gastric ulcer perforation;medications for hypertension,diabetes mellitus,and hyperthyroidism had been suspended 1 year prior to this visit.We performed an emergency distal gastrectomy with Billroth II anastomosis for gastric cardia cancer perforation,and the patient was referred to the surgical intensive care unit(ICU).On the 2nd d in the ICU,his body temperature(BT)increased to 41.3℃ at 19:00,with the thyroid storm score(90 points)peaking at 18:00(BT;41.2℃,pulse rate;138/min,irritable status).The patient was administered propylthiouracil,intravenous glucocorticoids,acetaminophen,and Lugol’s solution daily.Subsequently,we performed bladder irrigation with cold saline using a Foley catheter and applied a hypothermic blanket to decrease the patient's BT.His vital signs were stable on the 8th day in the ICU.CONCLUSION Thyroid storms are uncommon,with few reports in the literature;however,their clinical findings resemble those of sepsis and require further investigation.Since an untreated thyroid storm results in a high mortality rate,it should be investigated when managing sepsis.
文摘This study examines the reliability and validity of AI-generated scoring for continuation writing tasks.By comparing GPT-4 with eight experienced human raters across 21 student responses,it evaluates AI’s consistency,severity,and alignment with human scoring criteria.Results show that AI exhibits high self-consistency and adapts effectively to different scoring roles(e.g.,teacher vs.highstakes rater).However,AI scores were more lenient than human raters and demonstrated divergent evaluation focuses—prioritizing narrative coherence and emotional depth,while teachers emphasized linguistic accuracy and richness of detail.The findings suggest AI’s potential as a supplementary assessment tool,offering rapid,holistic feedback,but highlight the need for further calibration to align with educational standards.Implications include exploring hybrid evaluation models that leverage the strengths of both AI and human raters to achieve more equitable,efficient,and pedagogically meaningful writing assessments.
文摘Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.
基金The National Natural Science Foundation of China-Regional Science“Identification of novel drug targets for lung cancer via Mendelian randomization analysis based on blood proteomics”(62362062)The 2025 Xinjiang University Excellent Graduate Innovation Project“Research on identification of therapeutic targets and predictive factors for mental disorders based on proteomics”(XJDX2025YJS151)。
文摘Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.
基金supported by the following projects:Fund for technical areas of infrastructure strengthening plan projects under Grant 2023-JCJQ-JJ-0772.
文摘Aiming at the challenges of low throughput,excessive consensus latency and high communication complexity in the Practical Byzantine Fault Tolerance(PBFT)algorithm in blockchain networks,its application in identity verification for distributed networking of a drone cluster is limited.Therefore,a lightweight blockchainbased identity authentication model for UAV swarms is designed,and a Credit-score and Grouping-mechanism Practical Byzantine Fault Tolerance(CG-PBFT)algorithm is proposed.CG-PBFT introduces a reputation score evaluation mechanism,classifies the reputation levels of nodes in the network,and optimizes the consensus process based on grouping consensus and BLS aggregate signature technology.Experimental results demonstrate that under identical experimental conditions,compared with the PBFT algorithm,CG-PBFT achieves a 250%increase in average throughput,a 70%reduction in average latency,and simultaneous enhancement in security,thus making it more suitable for UAV swarm networks.
基金funded by Deanship of Graduate studies and Scientific Research at Jouf University under grant No.(DGSSR-2024-02-01264).
文摘Automated essay scoring(AES)systems have gained significant importance in educational settings,offering a scalable,efficient,and objective method for evaluating student essays.However,developing AES systems for Arabic poses distinct challenges due to the language’s complex morphology,diglossia,and the scarcity of annotated datasets.This paper presents a hybrid approach to Arabic AES by combining text-based,vector-based,and embeddingbased similarity measures to improve essay scoring accuracy while minimizing the training data required.Using a large Arabic essay dataset categorized into thematic groups,the study conducted four experiments to evaluate the impact of feature selection,data size,and model performance.Experiment 1 established a baseline using a non-machine learning approach,selecting top-N correlated features to predict essay scores.The subsequent experiments employed 5-fold cross-validation.Experiment 2 showed that combining embedding-based,text-based,and vector-based features in a Random Forest(RF)model achieved an R2 of 88.92%and an accuracy of 83.3%within a 0.5-point tolerance.Experiment 3 further refined the feature selection process,demonstrating that 19 correlated features yielded optimal results,improving R2 to 88.95%.In Experiment 4,an optimal data efficiency training approach was introduced,where training data portions increased from 5%to 50%.The study found that using just 10%of the data achieved near-peak performance,with an R2 of 85.49%,emphasizing an effective trade-off between performance and computational costs.These findings highlight the potential of the hybrid approach for developing scalable Arabic AES systems,especially in low-resource environments,addressing linguistic challenges while ensuring efficient data usage.
文摘Objective: To analyze the effect of pain nursing combined with exercise and posture intervention on improving Visual Analogue Scale (VAS) scores in patients after kidney stone surgery. Methods: A sample of 80 patients who underwent kidney stone surgery from October 2024 to October 2025 was randomly divided into groups using a random number table. Group A received pain nursing combined with exercise and posture intervention, while Group B received conventional nursing. Postoperative recovery time, VAS scores, and postoperative complications were compared between the two groups. Results: The postoperative recovery time in Group A was shorter than that in Group B, with p < 0.05. The VAS scores at 12 hours, 24 hours, and 72 hours postoperatively in Group A were all lower than those in Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: Pain nursing combined with exercise and posture intervention in postoperative nursing for kidney stone patients can shorten postoperative recovery time and alleviate pain scores.
文摘Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accuracy,therapeutically relevant explanations,strong calibration,domain generalization,and efficiency.Current Convolutional Neural Network(CNN)and transformer models compromise border precision and global context,generate attention maps that fail to align with expert reasoning,deteriorate during cross-center changes,and exhibit inadequate calibration,hence diminishing clinical trust.Methods:HMA-DER is a hierarchical multi-attention architecture that uses dilation-enhanced residual blocks and an explainability-aware Cognitive Alignment Score(CAS)regularizer to directly align attribution maps with reasoning signals from experts.The framework has additions that make it more resilient and a way to test for accuracy,macro-averaged F1 score,Area Under the Receiver Operating Characteristic Curve(AUROC),calibration(Expected Calibration Error(ECE),Brier Score),explainability(CAS,insertion/deletion AUC),cross-dataset transfer,and throughput.Results:HMA-DER gets Dice Similarity Coefficient scores of 89.5%and 86.0%on Kvasir-SEG and CVC-ClinicDB,beating the strongest baseline by+1.9 and+1.7 points.It gets 86.4%and 85.3%macro-F1 and 94.0%and 93.4%AUROC on HyperKvasir and GastroVision,which is better than the baseline by+1.4/+1.6macro-F1 and+1.2/+1.1AUROC.Ablation study shows that hierarchical attention gives the highest(+3.0),followed by CAS regularization(+2–3),dilatation(+1.5–2.0),and residual connections(+2–3).Cross-dataset validation demonstrates competitive zero-shot transfer(e.g.,KS→CVC Dice 82.7%),whereas multi-dataset training diminishes the domain gap,yielding an 88.1%primary-metric average.HMA-DER’s mixed-precision inference can handle 155 pictures per second,which helps with calibration.Conclusion:HMA-DER strikes a compromise between accuracy,explainability,robustness,and efficiency for the use of reliable GI computer-aided diagnosis in real-world clinical settings.
文摘According to public information of the Ministry of Industry and Information Technology(MIIT),in Q1 2019,the nonferrous industry in China realized stable operation,enhanced industry confidence and mitigated performance decline.First,the production was basically stable.
文摘BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘BACKGROUND Emphysematous pyelonephritis(EPN)is a life-threatening necrotizing renal parenchyma infection characterized by gas formation due to severe bacterial infection,predominantly affecting diabetic and immunocompromised patients.It carries high morbidity and mortality,requiring early diagnosis and timely intervention.Various prognostic scoring systems help in triaging critically ill patients.The National Early Warning Score 2(NEWS 2)scoring system is a widely used physiological assessment tool that evaluates clinical deterioration based on vital parameters,but its standard form lacks specificity for risk stratification in EPN,necessitating modifications to improve treatment decisionmaking and prognostic accuracy in this critical condition.AIM To highlight the need to modify the NEWS 2 score to enable more intense monitoring and better treatment outcomes.METHODS This prospective study was done on all EPN patients admitted to our hospital over the past 12 years.A weighted average risk-stratification index was calculated for each of the three groups,mortality risk was calculated for each of the NEWS 2 scores,and the need for intervention for each of the three groups was calculated.The NEWS 2 score was subsequently modified with 0-6,7-14 and 15-20 scores included in groups 1,2 and 3,respectively.RESULTS A total of 171 patients with EPN were included in the study,with a predominant association with diabetes(90.6%)and a female-to-male ratio of 1.5:1.The combined prognostic scoring of the three groups was 10.7,13.0,and 21.9,respectively(P<0.01).All patients managed conservatively belonged to group 1(P<0.01).Eight patients underwent early nephrectomy,with six from group 3(P<0.01).Overall mortality was 8(4.7%),with seven from group 3(87.5%).The cutoff NEWS 2 score for mortality was identified to be 15,with a sensitivity of 87.5%,specificity of 96.9%,and an overall accuracy rate of 96.5%.The area under the curve to predict mortality based on the NEWS 2 score was 0.98,with a confidence interval of(0.97,1.0)and P<0.001.CONCLUSION Modified NEWS 2(mNEWS 2)score dramatically aids in the appropriate assessment of treatment-related outcomes.MNEWS 2 scores should become the practice standard to reduce the morbidity and mortality associated with this dreaded illness.
基金Supported by Shaanxi Provincial Social Development Fund,No.2024SF-YBXM-140.
文摘BACKGROUND Post-hepatectomy liver failure(PHLF)after liver resection is one of the main complications causing postoperative death in patients with hepatocellular carcinoma(HCC).It is crucial to help clinicians identify potential high-risk PHLF patients as early as possible through preoperative evaluation.AIM To identify risk factors for PHLF and develop a prediction model.METHODS This study included 248 patients with HCC at The Second Affiliated Hospital of Air Force Medical University between January 2014 and December 2023;these patients were divided into a training group(n=164)and a validation group(n=84)via random sampling.The independent variables for the occurrence of PHLF were identified by univariate and multivariate analyses and visualized as nomograms.Ultimately,comparisons were made with traditional models via receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS In this study,portal vein width[odds ratio(OR)=1.603,95%CI:1.288-1.994,P≤0.001],the preoperative neutrophil-to-lymphocyte ratio(NLR)(OR=1.495,95%CI:1.126-1.984,P=0.005),and the albumin-bilirubin(ALBI)score(OR=8.868,95%CI:2.144-36.678,P=0.003)were independent risk factors for PHLF.A nomogram prediction model was developed using these factors.ROC and DCA analyses revealed that the predictive efficacy and clinical value of this model were better than those of traditional models.CONCLUSION A new Nomogram model for predicting PHLF in HCC patients was successfully established based on portal vein width,the NLR,and the ALBI score,which outperforms the traditional model.
文摘Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low risk of meta-stasis,current guidelines recommend endoscopic resection for small lesions.The GATIS predicting score,proposed by Zeng et al,represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs,analyzing the relationship between clinicopathological features and patient prog-noses.The authors identified tumor grade,T stage,tumor size,age,and progno-stic nutritional index as key prognostic factors,demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system.Nevertheless,further larger prospective studies are necessary,and the scientific community's efforts in this context should be directed toward developing interna-tional multicentric prospective studies,with the ultimate aim of accurately de-fining and understanding the behavior of these conditions.
文摘The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.
基金Natural Science Foundation-funded Project:Mechanism of Action of Detoxification Formula to Inhibit Hypoxia-Inducible Factor 1 Alpha-Exosomal MicroRNA-130b-3p-Sterile Alpha Motif Domain-Containing Protein 90-mediated Macrophage M2-type Polarisation to Improve the Immunosuppressive Microenvironment in Hepatocellular Carcinoma (No.82374540)Medical Innovation Research Project of Shanghai Science and Technology Commission:a Multicenter Prospective Randomized Controlled Study of “Arsenic Target” Combination Therapy for Unresectable Hepatocellular Carcinoma (No.22Y11921200)。
文摘OBJECTIVE:To investigate the clinical efficacy of using a Jiedu formula(解毒方) as an adjunctive therapy in patients with hepatocellular carcinoma(HCC) after hepatectomy.METHODS:In total,354 patients were included in this study.All patients were categorized into the traditional herbal medicine(THM) group(n = 115) or the non-THM treatment(nTHM) group(n = 239),with the Jiedu formula administered twice a day to the patients in the THM group.The primary outcome was recurrence-free survival(RFS).Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors associated with RFS.Then,the high risk of recurrence among patients was identified,and propensity score matching(PSM) and RFS analysis were performed to analyze the prognostic factors for the outcomes of patients at a high risk of recurrence in different groups.RESULTS:The one,two,three,and five-year RFS rates of the THM and nTHM groups were 76.4% vs 66.1%,65.5% vs 48.8%,57.9% vs 39.9%,and 43.9% vs 29.2%,respectively.The results of the Multivariate Cox analysis showed that giant tumors [hazard ratio(HR),1.54,P = 0.04],poor degree of differentiation,microsatellite,or microvascular invasion(HR,1.29,P = 0.09) increased the risk of recurrence.In the population with a high risk of recurrence,after PSM,the one,two,three,and five-year survival rates were 70.6% vs 68.0%,63.0% vs 43.1%,59.6% vs 33.3%,and 41.9% vs 26.4%,respectively.CONCLUSION:In this study,THM was found to be an effective agent for adjuvant therapy for HCC to prevent early recurrence of HCC after hepatic resection.
文摘Google Gemini 1.5 Flash scores were compared with ChatGPT 4o-mini on evaluations of(a)51 of the author’s journal articles and(b)up to 200 articles in each of 34 field-based Units of Assessment(UoAs)from the UK Research Excellence Framework(REF)2021.From(a),the results suggest that Gemini 1.5 Flash,unlike ChatGPT 4o-mini,may work better when fed with a PDF or article full text,rather than just the title and abstract.From(b),Gemini 1.5 Flash seems to be marginally less able to predict an article’s research quality(using a departmental quality proxy indicator)than ChatGPT 4o-mini,although the differences are small,and both have similar disciplinary variations in this ability.Averaging multiple runs of Gemini 1.5 Flash improves the scores.
