This study investigates the relationship between atmospheric stratification (i.e., static stability given by N^(2)) and the vertical energy transfer of stationary planetary waves, and further illustrates the underlyin...This study investigates the relationship between atmospheric stratification (i.e., static stability given by N^(2)) and the vertical energy transfer of stationary planetary waves, and further illustrates the underlying physical mechanism. Specifically, for the simplified case of constant stratospheric N^(2), the refractive index square of planetary waves has a theoretical tendency to increase first and then decrease with an increased N^(2), whereas the group velocity weakens. Mechanistically, this behavior can be understood as an intensified suppression of vertical isentropic surface displacement caused by meridional heat transport of planetary waves under strong N^(2) conditions. Observational analysis corroborates this finding, demonstrating a reduction in the vertical-propagation velocity of waves with increased N^(2). A linear, quasi- geostrophic, mid-latitude beta-plane model with a constant background westerly wind and a prescribed N^(2) applicable to the stratosphere is used to obtain analytic solutions. In this model, the planetary waves are initiated by steady energy influx from the lower boundary. The analysis indicates that under strong N^(2) conditions, the amplitude of planetary waves can be sufficiently increased by the effective energy convergence due to the slowing vertical energy transfer, resulting in a streamfunction response in this model that contains more energy. For N^(2) with a quasi-linear vertical variation, the results bear a resemblance to the constant case, except that the wave amplitude and oscillating frequency show some vertical variations.展开更多
Global warming induced by increased CO_(2) has caused marked changes in the ocean.Previous estimates of ocean salinity change in response to global warming have considerable ambiguity,largely attributable to the diver...Global warming induced by increased CO_(2) has caused marked changes in the ocean.Previous estimates of ocean salinity change in response to global warming have considerable ambiguity,largely attributable to the diverse sensitivities of surface fluxes.This study utilizes data from the Flux-Anomaly-Forced Model Intercomparison Project to investigate how ocean salinity responds to perturbations of surface fluxes.The findings indicate the emergence of a sea surface salinity(SSS)dipole pattern predominantly in the North Atlantic and Pacific fresh pools,driven by surface flux perturbations.This results in an intensification of the“salty gets saltier and fresh gets fresher”SSS pattern across the global ocean.The spatial pattern amplification(PA)of SSS under global warming is estimated to be approximately 11.5%,with surface water flux perturbations being the most significant contributor to salinity PA,accounting for 8.1% of the change after 70 years in experiments since pre-industrial control(piControl).Notably,the zonal-depth distribution of salinity in the upper ocean exhibits lighter seawater above the denser water,with bowed isopycnals in the upper 400 m.This stable stratification inhibits vertical mixing of salinity and temperature.In response to the flux perturbations,there is a strong positive feedback due to consequent freshening.It is hypothesized that under global warming,an SSS amplification of 7.2%/℃ and a mixed-layer depth amplification of 12.5%/℃ will occur in the global ocean.It suggests that the salinity effect can exert a more stable ocean to hinder the downward transfer of heat,which provides positive feedback to future global warming.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
Three-dimensional(3D)urban structures play a critical role in informing climate mitigation strategies aimed at the built environment and facilitating sustainable urban development.Regrettably,there exists a significan...Three-dimensional(3D)urban structures play a critical role in informing climate mitigation strategies aimed at the built environment and facilitating sustainable urban development.Regrettably,there exists a significant gap in detailed and consistent data on 3D building space structures with global coverage due to the challenges inherent in the data collection and model calibration processes.In this study,we constructed a global urban structure(GUS-3D)dataset,including building volume,height,and footprint information,at a 500 m spatial resolution using extensive satellite observation products and numerous reference building samples.Our analysis indicated that the total volume of buildings worldwide in2015 exceeded 1×10^(12)m^(3).Over the 1985 to 2015 period,we observed a slight increase in the magnitude of 3D building volume growth(i.e.,it increased from 166.02 km3 during the 1985–2000 period to 175.08km3 during the 2000–2015 period),while the expansion magnitudes of the two-dimensional(2D)building footprint(22.51×10^(3) vs 13.29×10^(3)km^(2))and urban extent(157×10^(3) vs 133.8×10^(3)km^(2))notably decreased.This trend highlights the significant increase in intensive vertical utilization of urban land.Furthermore,we identified significant heterogeneity in building space provision and inequality across cities worldwide.This inequality is particularly pronounced in many populous Asian cities,which has been overlooked in previous studies on economic inequality.The GUS-3D dataset shows great potential to deepen our understanding of the urban environment and creates new horizons for numerous 3D urban studies.展开更多
Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamm...Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamma-carboxy prothrombin(DCP),lack specificity,limiting their utility in risk strati-fication.YKL-40,a glycoprotein involved in extracellular matrix remodeling,hepatic stellate cell activation,and immune modulation,has emerged as a promising biomarker for post-LT surveillance.Elevated serum levels of YKL-40 are associated with advanced liver disease,tumor progression,and poorer post-LT outcomes,highlighting its potential to address gaps in early detection and personalized management of HCC recurrence.This manuscript synthesizes clinical and mechanistic evidence to evaluate YKL-40’s predictive utility in post-LT care.While preliminary findings demonstrate its specificity for liver-related pathologies,challenges remain,including assay standardization,lack of pro-spective validation,and the need to distinguish between malignant and non-malignant causes of elevated levels.Integrating YKL-40 into multi-biomarker panels with AFP and DCP could enhance predictive accuracy and enable tailored therapeutic strategies.Future research should focus on multicenter studies to validate YKL-40’s clinical utility,address confounding factors like graft rejection and systemic inflammation,and explore its role in predictive models driven by emerging technologies such as artificial intelligence.YKL-40 holds transformative potential in reshaping post-LT care through precision medicine,providing a pathway for better outcomes and improved management of high-risk LT recipients.展开更多
To address the problem of multi-missile cooperative interception against maneuvering targets at a prespecified impact time and desired Line-of-Sight(LOS)angles in ThreeDimensional(3D)space,this paper proposes a 3D lea...To address the problem of multi-missile cooperative interception against maneuvering targets at a prespecified impact time and desired Line-of-Sight(LOS)angles in ThreeDimensional(3D)space,this paper proposes a 3D leader-following cooperative interception guidance law.First,in the LOS direction of the leader,an impact time-controlled guidance law is derived based on the fixed-time stability theory,which enables the leader to complete the interception task at a prespecified impact time.Next,in the LOS direction of the followers,by introducing a time consensus tracking error function,a fixed-time consensus tracking guidance law is investigated to guarantee the consensus tracking convergence of the time-to-go.Then,in the direction normal to the LOS,by combining the designed global integral sliding mode surface and the second-order Sliding Mode Control(SMC)theory,an innovative 3D LOS-angle-constrained interception guidance law is developed,which eliminates the reaching phase in the traditional sliding mode guidance laws and effectively saves energy consumption.Moreover,it effectively suppresses the chattering phenomenon while avoiding the singularity issue,and compensates for unknown interference caused by target maneuvering online,making it convenient for practical engineering applications.Finally,theoretical proof analysis and multiple sets of numerical simulation results verify the effectiveness,superiority,and robustness of the investigated guidance law.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serio...Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.展开更多
Liposarcoma is one of the most common soft tissue sarcomas,however,its occurrence rate is still rare compared to other cancers.Due to its rarity,in vitro experiments are an essential approach to elucidate liposarcoma ...Liposarcoma is one of the most common soft tissue sarcomas,however,its occurrence rate is still rare compared to other cancers.Due to its rarity,in vitro experiments are an essential approach to elucidate liposarcoma pathobiology.Conventional cell culture-based research(2D cell culture)is still playing a pivotal role,while several shortcomings have been recently under discussion.In vivo,mouse models are usually adopted for pre-clinical analyses with expectations to overcome the issues of 2D cell culture.However,they do not fully recapitulate human dedifferentiated liposarcoma(DDLPS)characteristics.Therefore,three-dimensional(3D)culture systems have been the recent research focus in the cell biology field with the expectation to overcome at the same time the disadvantages of 2D cell culture and in vivo animal models and fill in the gap between them.Given the liposarcoma rarity,we believe that 3D cell culture techniques,including 3D cell cultures/co-cultures,and Patient-Derived tumor Organoids(PDOs),represent a promising approach to facilitate liposarcoma investigation and elucidate its molecular mechanisms and effective therapy development.In this review,we first provide a general overview of 3D cell cultures compared to 2D cell cultures.We then focus on one of the recent 3D cell culture applications,Patient-Derived Organoids(PDOs),summarizing and discussing several PDO methodologies.Finally,we discuss the current and future applications of PDOs to sarcoma,particularly in the field of liposarcoma.展开更多
The development of minimally invasive surgery has transformed the management of gastrointestinal cancer.Notably,three-dimensional visualization systems have increased surgical precision.This editorial discusses a rece...The development of minimally invasive surgery has transformed the management of gastrointestinal cancer.Notably,three-dimensional visualization systems have increased surgical precision.This editorial discusses a recent study by Shen and Zhang,which compared the clinical applications of naked-eye threedimensional laparoscopic systems vs traditional optical systems in radical surgery for gastric and colorectal cancer.Both systems appeared to yield comparable surgical and oncological outcomes in terms of safety parameters,operating times,and quality of lymph node dissection.However,the spectacle-free system’s technical and logistical limitations hindered its effects on the surgical team’s overall competency.This editorial examines the authors’findings within the broader context of the evolution of oncologic laparoscopy,discusses the relevance of the results in light of the current literature,and proposes future research directions focused on multicenter validation,comprehensive ergonomic analysis,and technological advancements aimed at enhancing intraoperative collaboration.As technology continues to evolve,clinical implementation of new methods must be supported by robust scientific evidence and standardized criteria,to ensure tangible improvements in efficiency,safety,and oncologic outcomes.展开更多
The mathematical model for non-Newtonian magnetohydrodynamics flows across a vertically stretched surface with non-linear thermal radiation,mass and heat transfer rates,thermophoretic and Brownian movements,bio-convec...The mathematical model for non-Newtonian magnetohydrodynamics flows across a vertically stretched surface with non-linear thermal radiation,mass and heat transfer rates,thermophoretic and Brownian movements,bio-convection,and motile microbes considered in the present work.It is possible to regulate the nanomaterial suspension in the nanofluid using the growth of microbes.With the use of boundary layer approximation,highly nonlinear partial differential equations were derived for the present flow model.The nonlinear partial differential equations are converted into ordinary differential equations by utilizing similarity transmutations,which simplify them.Numerical elixirs for ordinary differential equations are found through bvp4c.This guarantees accurate results for profiles of temperature,concentration,velocity,and motile density.There is a good match between the numerical values shown graphically and the existing data.As the thermal radiation parameter rises,the flow temperature grows.Increasing Lewis number values is a sharp drop in the nanoparticle volume fraction.Bioconvection Lewis number reduces microorganism profiles.The research work focused on electrical systems,heat transfer,acoustics,chemical processing,rigid body dynamics,fluid mechanics,and solid mechanics,among others.展开更多
A recent single-center retrospective study proposed novel combinations of hematological parameters and scoring systems for predicting severe acute pancre-atitis.While these combinations showed promising predictive per...A recent single-center retrospective study proposed novel combinations of hematological parameters and scoring systems for predicting severe acute pancre-atitis.While these combinations showed promising predictive performance,several limitations warrant consideration,including the lack of calibration,the absence of key inflammatory markers such as procalcitonin,and practical challenges in integrating these models into routine clinical workflows.To improve predictive accuracy and clinical applicability,prospective validation and the inclusion of additional variables are recommended.展开更多
The three-dimensional particle electrode system exhibits significant potential for application in the treatment of wastewater.Nonetheless,the advancement of effective granular electrodes characterized by elevated cata...The three-dimensional particle electrode system exhibits significant potential for application in the treatment of wastewater.Nonetheless,the advancement of effective granular electrodes characterized by elevated catalytic activity and minimal energy consumption continues to pose a significant challenge.In this research,Fluorine-doped copper-carbon(F/Cu-GAC)particle electrodes were effectively synthesized through an impregnationcalcination technique,utilizing granular activated carbon as the carrier and fluorinedoped modified copper oxides as the catalytic agents.The particle electrodes were subsequently utilized to promote the degradation of 2,4,6-trichlorophenol(2,4,6-TCP)in a threedimensional electrocatalytic reactor(3DER).The F/Cu-GAC particle electrodes were polarized under the action of electric field,which promoted the heterogeneous Fenton-like reaction in which H2O2 generated by two-electron oxygen reduction reaction(2e-ORR)of O_(2) was catalytically decomposed to·OH.The 3DER equipped with F/Cu-GAC particle electrodes showed 100%removal of 2,4,6-TCP and 79.24%removal of TOC with a specific energy consumption(EC)of approximately 0.019 kWh/g·COD after 2 h of operation.The F/Cu-GAC particle electrodes exhibited an overpotential of 0.38 V and an electrochemically active surface area(ECSA)of 715 cm^(2),as determined through linear sweep voltammetry(LSV)and cyclic voltammetry(CV)assessments.These findings suggest a high level of electrocatalytic performance.Furthermore,the catalytic mechanism of the 3DER equipped with F/Cu-GAC particle electrodes was elucidated through the application of X-ray photoelectron spectroscopy(XPS),electron spin resonance(ESR),and active species capture experiments.This investigation offers a novel approach for the effective degradation of 2,4,6-TCP.展开更多
Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heter...Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heterogeneity among patients.Traditional clinical criteria often fail to identify those most likely to benefit from surgery.Methods:This nationwide retrospective study in China included 2,167 ICH patients from 31 hospitals.Using machine learning techniques,we integrated clinical and radiomic data to perform unsupervised clustering and identify distinct phenogroups.Dimensionality reduction and cross-validation were applied to minimize overfitting.External validation was conducted using data from the INTERACT3 trial,and a prospective cohort was used to assess real-world applicability.Results:Three phenogroups were identified.Among them,only Phenogroup 1-characterized by older age,moderate hematoma volume,and intermediate Glasgow Coma Scale scores-showed significant benefit from early surgical intervention,with a 42%reduction in 3-month mortality and improved functional outcomes.In contrast,surgery did not significantly affect outcomes in Phenogroups 0 and 2.These findings were consistent across multiple machine learning models and validated externally.Conclusion:Machine learning-driven phenotypic stratification can effectively identify ICH patients who are most likely to benefit from surgical treatment.This approach supports personalized treatment strategies and may improve clinical decision-making in ICH management.Further validation in diverse populations is warranted.展开更多
The variable salinity in stored reservoirs connected by a long channel attracts the attention of scientists worldwide,having applications in environmental and geophysical engineering.This study explores the impact of ...The variable salinity in stored reservoirs connected by a long channel attracts the attention of scientists worldwide,having applications in environmental and geophysical engineering.This study explores the impact of Navier slip conditions on exchange flows within a long channel connecting two large reservoirs of differing salinity.These horizontal density gradients drive the flow.We modify the recent one-dimensional theory,developed to avoid runaway stratification,to account for the presence of uniform slip walls.By adjusting the parameters of the horizontal density gradient based on the slip factor,we resolve analytically various flow regimes ranging from high diffusion to transitional high advection.These regimes are governed by physical parameters like channel aspect ratio,slip factor,Schmidt number,and gravitational Reynolds number.Our solutions align perfectly with ones in the no-slip limit.More importantly,under the conditions of no net flow across the channel and high Schmidt number(where stratification is concentrated near the channel’s mid-layer),we derive a closed-form solution for the slip parameter,aspect ratio,and gravitational Reynolds number that describes the interface’s behavior as a sharp interface separating two distinct zones.This interface,arising from hydrostatic wall gradients,ultimately detaches the low-and high-density regimes throughout the channel when the gravitational Reynolds number is inversely proportional to the aspect ratio for a fixed slip parameter.This phenomenon,observed previously in 2D numerical simulations with no-slip walls in the literature,is thus confirmed by our theoretical results.Our findings further demonstrate that wall slip leads to distinct and diverse flow regimes.展开更多
Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The mos...Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.展开更多
BACKGROUND Acute pancreatitis(AP)is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment.An accurate assessment and precise staging of severity are essential in initial...BACKGROUND Acute pancreatitis(AP)is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment.An accurate assessment and precise staging of severity are essential in initial intensive therapy.AIM To explore the prognostic value of inflammatory markers and several scoring systems[Acute Physiology and Chronic Health Evaluation II,the bedside index of severity in AP(BISAP),Ranson’s score,the computed tomography severity index(CTSI)and sequential organ failure assessment]in severity stratification of earlyphase AP.METHODS A total of 463 patients with AP admitted to our hospital between 1 January 2021 and 30 June 2024 were retrospectively enrolled in this study.Inflammation marker and scoring system levels were calculated and compared between different severity groups.Relationships between severity and several predictors were evaluated using univariate and multivariate logistic regression models.Predictive ability was estimated using receiver operating characteristic curves.RESULTS Of the 463 patients,50(10.80%)were classified as having severe AP(SAP).The results revealed that the white cell count significantly increased,whereas the prognostic nutritional index measured within 48 hours(PNI48)and calcium(Ca^(2+))were decreased as the severity of AP increased(P<0.001).According to multivariate logistic regression,C-reactive protein measured within 48 hours(CRP_(48)),Ca^(2+)levels,and PNI48 were independent risk factors for predicting SAP.The area under the curve(AUC)values for the CRP_(48),Ca^(2+),PNI48,Acute Physiology and Chronic Health Evaluation II,sequential organ failure assessment,BISAP,CTSI,and Ranson scores for the prediction of SAP were 0.802,0.736,0.871,0.799,0.783,0.895,0.931 and 0.914,respectively.The AUC for the combined CRP_(48)+Ca^(2+)+PNI48 model was 0.892.The combination of PNI48 and Ranson achieved an AUC of 0.936.CONCLUSION Independent risk factors for developing SAP include CRP_(48),Ca^(2+),and PNI48.CTSI,BISAP,and the combination of PNI48 and the Ranson score can act as reliable predictors of SAP.展开更多
Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitme...Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitment,suboptimal adherence,and time-consuming endpoint confirmations.Against this backdrop,artificial intelligence(AI)emerges as a powerful game-changer,offering streamlined trial design,predictive enrollment matching,dynamic endpoint assessment,and realworld data integration.This review synthesizes AI-driven advancements across the GI cancer research continuum.It covers precise patient stratification,automated efficacy evaluations,and remote compliance management.The analysis also addresses persistent challenges in data standardization,privacy protection,and regulatory oversight.We underscore the need for synergistic clinician–AI collaboration,alongside robust frameworks that ensure interpretability and ethical deployment.By illuminating the potential of AI to accelerate trial timelines,refine patient selection,and enhance outcome measurement,we aim to inspire new strategies that can significantly reduce the global burden of GI malignancies.Ultimately,this work provides a blueprint for stakeholders seeking to harness AI’s transformative capabilities,fostering a future in which GI cancer clinical research becomes more agile,personalized,and impactful for patients and healthcare systems alike.展开更多
In this study,CiteSpace software is used to carry out visual analysis on the three-dimensional research literature on urban recreation space from the perspective of compact city theory in the past 20 years,exploring t...In this study,CiteSpace software is used to carry out visual analysis on the three-dimensional research literature on urban recreation space from the perspective of compact city theory in the past 20 years,exploring the scientific development trend and research hotspots in this field.The results show that the number of published documents shows a fluctuating upward trend,and the significant growth rate reflects the role of policy orientation in promoting the concept of compact city.The co-occurrence analysis of keywords reveals the research hotspots of“compact city”,“recreation space”and“urban park”,while the emergence of new keywords such as“vertical city”and“spatial justice”indicates the new trend of recent research.The cluster analysis and timeline map further show the evolution of research themes,with“compact city”being the largest cluster and having rich connections with other themes such as“urban design”and“urban park”.展开更多
BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major...BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major blood vessels remains a substantial clinical challenge.Traditionally,these cases often require open abdominal surgery or combined organ resections,and in some instances,the tumors are considered unresectable.Currently,no reports have described the resection of such tumors via laparoscopy.CASE SUMMARY A 35-year-old woman was admitted to our hospital after the incidental discovery of a retroperitoneal space-occupying lesion.Imaging revealed a mass with the celiac axis and superior mesenteric artery passing through it.A neurogenic tumor was suspected,with ganglioneuroma being the most likely diagnosis.Following comprehensive preoperative preparation,the retroperitoneal tumor was resected using a three-dimensional laparoscopy combined with an organ suspension technique.The surgical approach involved incising the tumor along the vascular axis and conducting meticulous,vascular-preserving tumor excision.The operation lasted approximately 458 minutes,with an estimated blood loss of 50 mL.The patient was discharged on the 8th postoperative day.A transient liver injury occurred after surgery but improved rapidly.After 11 months of postoperative follow-up,no complications or tumor recurrence were observed.CONCLUSION This case illustrates the feasibility of minimally invasive laparoscopic resection for retroperitoneal ganglioneuromas encasing major blood vessels.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.42261134532,42405059,and U2342212)。
文摘This study investigates the relationship between atmospheric stratification (i.e., static stability given by N^(2)) and the vertical energy transfer of stationary planetary waves, and further illustrates the underlying physical mechanism. Specifically, for the simplified case of constant stratospheric N^(2), the refractive index square of planetary waves has a theoretical tendency to increase first and then decrease with an increased N^(2), whereas the group velocity weakens. Mechanistically, this behavior can be understood as an intensified suppression of vertical isentropic surface displacement caused by meridional heat transport of planetary waves under strong N^(2) conditions. Observational analysis corroborates this finding, demonstrating a reduction in the vertical-propagation velocity of waves with increased N^(2). A linear, quasi- geostrophic, mid-latitude beta-plane model with a constant background westerly wind and a prescribed N^(2) applicable to the stratosphere is used to obtain analytic solutions. In this model, the planetary waves are initiated by steady energy influx from the lower boundary. The analysis indicates that under strong N^(2) conditions, the amplitude of planetary waves can be sufficiently increased by the effective energy convergence due to the slowing vertical energy transfer, resulting in a streamfunction response in this model that contains more energy. For N^(2) with a quasi-linear vertical variation, the results bear a resemblance to the constant case, except that the wave amplitude and oscillating frequency show some vertical variations.
基金supported by the Laoshan Laboratory[grant number LSKJ202202403]the National Natural Science Foundation of China[grant number 42030410]+1 种基金additionally supported by the Startup Foundation for Introducing Talent of NUISTJiangsu Innovation Research Group[grant number JSSCTD202346]。
文摘Global warming induced by increased CO_(2) has caused marked changes in the ocean.Previous estimates of ocean salinity change in response to global warming have considerable ambiguity,largely attributable to the diverse sensitivities of surface fluxes.This study utilizes data from the Flux-Anomaly-Forced Model Intercomparison Project to investigate how ocean salinity responds to perturbations of surface fluxes.The findings indicate the emergence of a sea surface salinity(SSS)dipole pattern predominantly in the North Atlantic and Pacific fresh pools,driven by surface flux perturbations.This results in an intensification of the“salty gets saltier and fresh gets fresher”SSS pattern across the global ocean.The spatial pattern amplification(PA)of SSS under global warming is estimated to be approximately 11.5%,with surface water flux perturbations being the most significant contributor to salinity PA,accounting for 8.1% of the change after 70 years in experiments since pre-industrial control(piControl).Notably,the zonal-depth distribution of salinity in the upper ocean exhibits lighter seawater above the denser water,with bowed isopycnals in the upper 400 m.This stable stratification inhibits vertical mixing of salinity and temperature.In response to the flux perturbations,there is a strong positive feedback due to consequent freshening.It is hypothesized that under global warming,an SSS amplification of 7.2%/℃ and a mixed-layer depth amplification of 12.5%/℃ will occur in the global ocean.It suggests that the salinity effect can exert a more stable ocean to hinder the downward transfer of heat,which provides positive feedback to future global warming.
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 the National Science Fund for Distinguished Young Scholars(42225107)the National Natural Science Foundation of China(42001326,42371414,42171409,and 42271419)+1 种基金the Natural Science Foundation of Guangdong Province of China(2022A1515012207)the Basic and Applied Basic Research Project of Guangzhou Science and Technology Planning(202201011539)。
文摘Three-dimensional(3D)urban structures play a critical role in informing climate mitigation strategies aimed at the built environment and facilitating sustainable urban development.Regrettably,there exists a significant gap in detailed and consistent data on 3D building space structures with global coverage due to the challenges inherent in the data collection and model calibration processes.In this study,we constructed a global urban structure(GUS-3D)dataset,including building volume,height,and footprint information,at a 500 m spatial resolution using extensive satellite observation products and numerous reference building samples.Our analysis indicated that the total volume of buildings worldwide in2015 exceeded 1×10^(12)m^(3).Over the 1985 to 2015 period,we observed a slight increase in the magnitude of 3D building volume growth(i.e.,it increased from 166.02 km3 during the 1985–2000 period to 175.08km3 during the 2000–2015 period),while the expansion magnitudes of the two-dimensional(2D)building footprint(22.51×10^(3) vs 13.29×10^(3)km^(2))and urban extent(157×10^(3) vs 133.8×10^(3)km^(2))notably decreased.This trend highlights the significant increase in intensive vertical utilization of urban land.Furthermore,we identified significant heterogeneity in building space provision and inequality across cities worldwide.This inequality is particularly pronounced in many populous Asian cities,which has been overlooked in previous studies on economic inequality.The GUS-3D dataset shows great potential to deepen our understanding of the urban environment and creates new horizons for numerous 3D urban studies.
文摘Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamma-carboxy prothrombin(DCP),lack specificity,limiting their utility in risk strati-fication.YKL-40,a glycoprotein involved in extracellular matrix remodeling,hepatic stellate cell activation,and immune modulation,has emerged as a promising biomarker for post-LT surveillance.Elevated serum levels of YKL-40 are associated with advanced liver disease,tumor progression,and poorer post-LT outcomes,highlighting its potential to address gaps in early detection and personalized management of HCC recurrence.This manuscript synthesizes clinical and mechanistic evidence to evaluate YKL-40’s predictive utility in post-LT care.While preliminary findings demonstrate its specificity for liver-related pathologies,challenges remain,including assay standardization,lack of pro-spective validation,and the need to distinguish between malignant and non-malignant causes of elevated levels.Integrating YKL-40 into multi-biomarker panels with AFP and DCP could enhance predictive accuracy and enable tailored therapeutic strategies.Future research should focus on multicenter studies to validate YKL-40’s clinical utility,address confounding factors like graft rejection and systemic inflammation,and explore its role in predictive models driven by emerging technologies such as artificial intelligence.YKL-40 holds transformative potential in reshaping post-LT care through precision medicine,providing a pathway for better outcomes and improved management of high-risk LT recipients.
文摘To address the problem of multi-missile cooperative interception against maneuvering targets at a prespecified impact time and desired Line-of-Sight(LOS)angles in ThreeDimensional(3D)space,this paper proposes a 3D leader-following cooperative interception guidance law.First,in the LOS direction of the leader,an impact time-controlled guidance law is derived based on the fixed-time stability theory,which enables the leader to complete the interception task at a prespecified impact time.Next,in the LOS direction of the followers,by introducing a time consensus tracking error function,a fixed-time consensus tracking guidance law is investigated to guarantee the consensus tracking convergence of the time-to-go.Then,in the direction normal to the LOS,by combining the designed global integral sliding mode surface and the second-order Sliding Mode Control(SMC)theory,an innovative 3D LOS-angle-constrained interception guidance law is developed,which eliminates the reaching phase in the traditional sliding mode guidance laws and effectively saves energy consumption.Moreover,it effectively suppresses the chattering phenomenon while avoiding the singularity issue,and compensates for unknown interference caused by target maneuvering online,making it convenient for practical engineering applications.Finally,theoretical proof analysis and multiple sets of numerical simulation results verify the effectiveness,superiority,and robustness of the investigated guidance law.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.
文摘Liposarcoma is one of the most common soft tissue sarcomas,however,its occurrence rate is still rare compared to other cancers.Due to its rarity,in vitro experiments are an essential approach to elucidate liposarcoma pathobiology.Conventional cell culture-based research(2D cell culture)is still playing a pivotal role,while several shortcomings have been recently under discussion.In vivo,mouse models are usually adopted for pre-clinical analyses with expectations to overcome the issues of 2D cell culture.However,they do not fully recapitulate human dedifferentiated liposarcoma(DDLPS)characteristics.Therefore,three-dimensional(3D)culture systems have been the recent research focus in the cell biology field with the expectation to overcome at the same time the disadvantages of 2D cell culture and in vivo animal models and fill in the gap between them.Given the liposarcoma rarity,we believe that 3D cell culture techniques,including 3D cell cultures/co-cultures,and Patient-Derived tumor Organoids(PDOs),represent a promising approach to facilitate liposarcoma investigation and elucidate its molecular mechanisms and effective therapy development.In this review,we first provide a general overview of 3D cell cultures compared to 2D cell cultures.We then focus on one of the recent 3D cell culture applications,Patient-Derived Organoids(PDOs),summarizing and discussing several PDO methodologies.Finally,we discuss the current and future applications of PDOs to sarcoma,particularly in the field of liposarcoma.
文摘The development of minimally invasive surgery has transformed the management of gastrointestinal cancer.Notably,three-dimensional visualization systems have increased surgical precision.This editorial discusses a recent study by Shen and Zhang,which compared the clinical applications of naked-eye threedimensional laparoscopic systems vs traditional optical systems in radical surgery for gastric and colorectal cancer.Both systems appeared to yield comparable surgical and oncological outcomes in terms of safety parameters,operating times,and quality of lymph node dissection.However,the spectacle-free system’s technical and logistical limitations hindered its effects on the surgical team’s overall competency.This editorial examines the authors’findings within the broader context of the evolution of oncologic laparoscopy,discusses the relevance of the results in light of the current literature,and proposes future research directions focused on multicenter validation,comprehensive ergonomic analysis,and technological advancements aimed at enhancing intraoperative collaboration.As technology continues to evolve,clinical implementation of new methods must be supported by robust scientific evidence and standardized criteria,to ensure tangible improvements in efficiency,safety,and oncologic outcomes.
基金U.F.-G.was supported by the Mobility Lab Foundation,a governmental organization of the Provincial Council of Araba,and the local council of Vitoria-Gasteiz.S.Noeiaghdam was supported by the Henan Academy of Sciences(Project No.241819246).
文摘The mathematical model for non-Newtonian magnetohydrodynamics flows across a vertically stretched surface with non-linear thermal radiation,mass and heat transfer rates,thermophoretic and Brownian movements,bio-convection,and motile microbes considered in the present work.It is possible to regulate the nanomaterial suspension in the nanofluid using the growth of microbes.With the use of boundary layer approximation,highly nonlinear partial differential equations were derived for the present flow model.The nonlinear partial differential equations are converted into ordinary differential equations by utilizing similarity transmutations,which simplify them.Numerical elixirs for ordinary differential equations are found through bvp4c.This guarantees accurate results for profiles of temperature,concentration,velocity,and motile density.There is a good match between the numerical values shown graphically and the existing data.As the thermal radiation parameter rises,the flow temperature grows.Increasing Lewis number values is a sharp drop in the nanoparticle volume fraction.Bioconvection Lewis number reduces microorganism profiles.The research work focused on electrical systems,heat transfer,acoustics,chemical processing,rigid body dynamics,fluid mechanics,and solid mechanics,among others.
文摘A recent single-center retrospective study proposed novel combinations of hematological parameters and scoring systems for predicting severe acute pancre-atitis.While these combinations showed promising predictive performance,several limitations warrant consideration,including the lack of calibration,the absence of key inflammatory markers such as procalcitonin,and practical challenges in integrating these models into routine clinical workflows.To improve predictive accuracy and clinical applicability,prospective validation and the inclusion of additional variables are recommended.
基金supported by Guangxi Science and Technology Major Program(No.AA23073008)Hubei Key Laboratory of Water System Science for Sponge City Construction(Wuhan University)(No.2023–05)Nanning Innovation and Entrepreneur Leading Talent Project(No.2021001).
文摘The three-dimensional particle electrode system exhibits significant potential for application in the treatment of wastewater.Nonetheless,the advancement of effective granular electrodes characterized by elevated catalytic activity and minimal energy consumption continues to pose a significant challenge.In this research,Fluorine-doped copper-carbon(F/Cu-GAC)particle electrodes were effectively synthesized through an impregnationcalcination technique,utilizing granular activated carbon as the carrier and fluorinedoped modified copper oxides as the catalytic agents.The particle electrodes were subsequently utilized to promote the degradation of 2,4,6-trichlorophenol(2,4,6-TCP)in a threedimensional electrocatalytic reactor(3DER).The F/Cu-GAC particle electrodes were polarized under the action of electric field,which promoted the heterogeneous Fenton-like reaction in which H2O2 generated by two-electron oxygen reduction reaction(2e-ORR)of O_(2) was catalytically decomposed to·OH.The 3DER equipped with F/Cu-GAC particle electrodes showed 100%removal of 2,4,6-TCP and 79.24%removal of TOC with a specific energy consumption(EC)of approximately 0.019 kWh/g·COD after 2 h of operation.The F/Cu-GAC particle electrodes exhibited an overpotential of 0.38 V and an electrochemically active surface area(ECSA)of 715 cm^(2),as determined through linear sweep voltammetry(LSV)and cyclic voltammetry(CV)assessments.These findings suggest a high level of electrocatalytic performance.Furthermore,the catalytic mechanism of the 3DER equipped with F/Cu-GAC particle electrodes was elucidated through the application of X-ray photoelectron spectroscopy(XPS),electron spin resonance(ESR),and active species capture experiments.This investigation offers a novel approach for the effective degradation of 2,4,6-TCP.
基金supported by the Shanghai Municipal Health Commission(201840063,201801075)the Science and Technology Commission of Shanghai Municipality(18441903300).
文摘Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heterogeneity among patients.Traditional clinical criteria often fail to identify those most likely to benefit from surgery.Methods:This nationwide retrospective study in China included 2,167 ICH patients from 31 hospitals.Using machine learning techniques,we integrated clinical and radiomic data to perform unsupervised clustering and identify distinct phenogroups.Dimensionality reduction and cross-validation were applied to minimize overfitting.External validation was conducted using data from the INTERACT3 trial,and a prospective cohort was used to assess real-world applicability.Results:Three phenogroups were identified.Among them,only Phenogroup 1-characterized by older age,moderate hematoma volume,and intermediate Glasgow Coma Scale scores-showed significant benefit from early surgical intervention,with a 42%reduction in 3-month mortality and improved functional outcomes.In contrast,surgery did not significantly affect outcomes in Phenogroups 0 and 2.These findings were consistent across multiple machine learning models and validated externally.Conclusion:Machine learning-driven phenotypic stratification can effectively identify ICH patients who are most likely to benefit from surgical treatment.This approach supports personalized treatment strategies and may improve clinical decision-making in ICH management.Further validation in diverse populations is warranted.
文摘The variable salinity in stored reservoirs connected by a long channel attracts the attention of scientists worldwide,having applications in environmental and geophysical engineering.This study explores the impact of Navier slip conditions on exchange flows within a long channel connecting two large reservoirs of differing salinity.These horizontal density gradients drive the flow.We modify the recent one-dimensional theory,developed to avoid runaway stratification,to account for the presence of uniform slip walls.By adjusting the parameters of the horizontal density gradient based on the slip factor,we resolve analytically various flow regimes ranging from high diffusion to transitional high advection.These regimes are governed by physical parameters like channel aspect ratio,slip factor,Schmidt number,and gravitational Reynolds number.Our solutions align perfectly with ones in the no-slip limit.More importantly,under the conditions of no net flow across the channel and high Schmidt number(where stratification is concentrated near the channel’s mid-layer),we derive a closed-form solution for the slip parameter,aspect ratio,and gravitational Reynolds number that describes the interface’s behavior as a sharp interface separating two distinct zones.This interface,arising from hydrostatic wall gradients,ultimately detaches the low-and high-density regimes throughout the channel when the gravitational Reynolds number is inversely proportional to the aspect ratio for a fixed slip parameter.This phenomenon,observed previously in 2D numerical simulations with no-slip walls in the literature,is thus confirmed by our theoretical results.Our findings further demonstrate that wall slip leads to distinct and diverse flow regimes.
文摘Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.
文摘BACKGROUND Acute pancreatitis(AP)is an emergency gastrointestinal disease that requires immediate diagnosis and urgent clinical treatment.An accurate assessment and precise staging of severity are essential in initial intensive therapy.AIM To explore the prognostic value of inflammatory markers and several scoring systems[Acute Physiology and Chronic Health Evaluation II,the bedside index of severity in AP(BISAP),Ranson’s score,the computed tomography severity index(CTSI)and sequential organ failure assessment]in severity stratification of earlyphase AP.METHODS A total of 463 patients with AP admitted to our hospital between 1 January 2021 and 30 June 2024 were retrospectively enrolled in this study.Inflammation marker and scoring system levels were calculated and compared between different severity groups.Relationships between severity and several predictors were evaluated using univariate and multivariate logistic regression models.Predictive ability was estimated using receiver operating characteristic curves.RESULTS Of the 463 patients,50(10.80%)were classified as having severe AP(SAP).The results revealed that the white cell count significantly increased,whereas the prognostic nutritional index measured within 48 hours(PNI48)and calcium(Ca^(2+))were decreased as the severity of AP increased(P<0.001).According to multivariate logistic regression,C-reactive protein measured within 48 hours(CRP_(48)),Ca^(2+)levels,and PNI48 were independent risk factors for predicting SAP.The area under the curve(AUC)values for the CRP_(48),Ca^(2+),PNI48,Acute Physiology and Chronic Health Evaluation II,sequential organ failure assessment,BISAP,CTSI,and Ranson scores for the prediction of SAP were 0.802,0.736,0.871,0.799,0.783,0.895,0.931 and 0.914,respectively.The AUC for the combined CRP_(48)+Ca^(2+)+PNI48 model was 0.892.The combination of PNI48 and Ranson achieved an AUC of 0.936.CONCLUSION Independent risk factors for developing SAP include CRP_(48),Ca^(2+),and PNI48.CTSI,BISAP,and the combination of PNI48 and the Ranson score can act as reliable predictors of SAP.
文摘Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitment,suboptimal adherence,and time-consuming endpoint confirmations.Against this backdrop,artificial intelligence(AI)emerges as a powerful game-changer,offering streamlined trial design,predictive enrollment matching,dynamic endpoint assessment,and realworld data integration.This review synthesizes AI-driven advancements across the GI cancer research continuum.It covers precise patient stratification,automated efficacy evaluations,and remote compliance management.The analysis also addresses persistent challenges in data standardization,privacy protection,and regulatory oversight.We underscore the need for synergistic clinician–AI collaboration,alongside robust frameworks that ensure interpretability and ethical deployment.By illuminating the potential of AI to accelerate trial timelines,refine patient selection,and enhance outcome measurement,we aim to inspire new strategies that can significantly reduce the global burden of GI malignancies.Ultimately,this work provides a blueprint for stakeholders seeking to harness AI’s transformative capabilities,fostering a future in which GI cancer clinical research becomes more agile,personalized,and impactful for patients and healthcare systems alike.
基金Sponsored by the Project of Sichuan Landscape and Recreation Research Center(JGYQ2020037).
文摘In this study,CiteSpace software is used to carry out visual analysis on the three-dimensional research literature on urban recreation space from the perspective of compact city theory in the past 20 years,exploring the scientific development trend and research hotspots in this field.The results show that the number of published documents shows a fluctuating upward trend,and the significant growth rate reflects the role of policy orientation in promoting the concept of compact city.The co-occurrence analysis of keywords reveals the research hotspots of“compact city”,“recreation space”and“urban park”,while the emergence of new keywords such as“vertical city”and“spatial justice”indicates the new trend of recent research.The cluster analysis and timeline map further show the evolution of research themes,with“compact city”being the largest cluster and having rich connections with other themes such as“urban design”and“urban park”.
基金Supported by the Zhejiang Medical Science and Technology Project,No.2022KY1325 and No.2023KY381Public Welfare Project of Jinhua Science and Technology Plan,No.2023-4-084Major Project of Jinhua Science and Technology Plan,No.2023-3-066.
文摘BACKGROUND Ganglioneuroma is a rare,well-differentiated,slow-growing benign tumor of the peripheral nerves,with surgical resection being the only curative treatment.Surgical resection of ganglioneuromas encasing major blood vessels remains a substantial clinical challenge.Traditionally,these cases often require open abdominal surgery or combined organ resections,and in some instances,the tumors are considered unresectable.Currently,no reports have described the resection of such tumors via laparoscopy.CASE SUMMARY A 35-year-old woman was admitted to our hospital after the incidental discovery of a retroperitoneal space-occupying lesion.Imaging revealed a mass with the celiac axis and superior mesenteric artery passing through it.A neurogenic tumor was suspected,with ganglioneuroma being the most likely diagnosis.Following comprehensive preoperative preparation,the retroperitoneal tumor was resected using a three-dimensional laparoscopy combined with an organ suspension technique.The surgical approach involved incising the tumor along the vascular axis and conducting meticulous,vascular-preserving tumor excision.The operation lasted approximately 458 minutes,with an estimated blood loss of 50 mL.The patient was discharged on the 8th postoperative day.A transient liver injury occurred after surgery but improved rapidly.After 11 months of postoperative follow-up,no complications or tumor recurrence were observed.CONCLUSION This case illustrates the feasibility of minimally invasive laparoscopic resection for retroperitoneal ganglioneuromas encasing major blood vessels.
