To achieve the goals of sustainable development of the energy system and the construction of a lowcarbon society,this study proposes a multi-energy storage collaborative optimization strategy for industrial park that ...To achieve the goals of sustainable development of the energy system and the construction of a lowcarbon society,this study proposes a multi-energy storage collaborative optimization strategy for industrial park that integrates the laddered carbon trading mechanism with demand response.Firstly,a dual dimensional DR model is constructed based on the characteristics of load elasticity.The alternativeDRenables flexible substitution of energy loads through complementary conversion of electricity/heat/cold multi-energy sources,while the price DR relies on timeof-use electricity price signals to guide load spatiotemporal migration;Secondly,the LCT mechanism is introduced to achieve optimal carbon emission costs through a tiered carbon quota allocation mechanism.On this basis,an optimization decision model is established with the core objective of maximizing the annual net profit of the park.The objective function takes into account energy sales revenue,generator unit costs,and investment and operation costs of multiple types of energy storage facilities.Themodel constraint system covers three key dimensions:dynamic operation constraints of power generation units,including unit output limits,ramping capability,and minimum start-stop time;the physical boundary of an electric/hot/cold multi-energy storage system involves energy storage capacity and charge/discharge efficiency;The multi-energy network coupling balance equation ensures that the energy conversion and transmission process satisfies the law of conservation of energy.Using CPLEX mathematical programming solver for simulation verification,construct an energy storage capacity configuration decision process that includes LCT-DR synergistic effect.The research results show that compared with the traditional single energy storage configuration mode,this strategy effectively enhances the economic feasibility and engineering practicality of industrial park operation by coordinating demand side resource scheduling and finely controlling carbon costs,while maintaining stable system operation.Its methodological framework provides a technical path that combines theoretical rigor and practical operability for the low-carbon transformation of regional integrated energy systems.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse event...Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse events,and earlier revision.Therefore,it is essential to try to avoid LLD when implanting a THA.Several studies focus on this issue,including the following:Accelerometer-based portable navigation system,preoperative digital templating,robot-assisted surgery,the anatomical marker positioning method(shoulder-to-shoulder)and the artificial intelligence-based three-dimensional planning software system.The aforementioned methods should be familiar to surgeons who perform THA procedures,as a fundamental objective of this surgical intervention is to avoid LLD.展开更多
BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is ...BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.展开更多
BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favo...BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.展开更多
BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar k...BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.展开更多
Customer segmentation according to load-shape profiles using smart meter data is an increasingly important application to vital the planning and operation of energy systems and to enable citizens’participation in the...Customer segmentation according to load-shape profiles using smart meter data is an increasingly important application to vital the planning and operation of energy systems and to enable citizens’participation in the energy transition.This study proposes an innovative multi-step clustering procedure to segment customers based on load-shape patterns at the daily and intra-daily time horizons.Smart meter data is split between daily and hourly normalized time series to assess monthly,weekly,daily,and hourly seasonality patterns separately.The dimensionality reduction implicit in the splitting allows a direct approach to clustering raw daily energy time series data.The intraday clustering procedure sequentially identifies representative hourly day-unit profiles for each customer and the entire population.For the first time,a step function approach is applied to reduce time series dimensionality.Customer attributes embedded in surveys are employed to build external clustering validation metrics using Cramer’s V correlation factors and to identify statistically significant determinants of load-shape in energy usage.In addition,a time series features engineering approach is used to extract 16 relevant demand flexibility indicators that characterize customers and corresponding clusters along four different axes:available Energy(E),Temporal patterns(T),Consistency(C),and Variability(V).The methodology is implemented on a real-world electricity consumption dataset of 325 Small and Medium-sized Enterprise(SME)customers,identifying 4 daily and 6 hourly easy-to-interpret,well-defined clusters.The application of the methodology includes selecting key parameters via grid search and a thorough comparison of clustering distances and methods to ensure the robustness of the results.Further research can test the scalability of the methodology to larger datasets from various customer segments(households and large commercial)and locations with different weather and socioeconomic conditions.展开更多
BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually be...BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.展开更多
The demand response(DR)market,as a vital complement to the electricity spot market,plays a key role in evoking user-side regulation capability to mitigate system-level supply‒demand imbalances during extreme events.Wh...The demand response(DR)market,as a vital complement to the electricity spot market,plays a key role in evoking user-side regulation capability to mitigate system-level supply‒demand imbalances during extreme events.While the DR market offers the load aggregator(LA)additional profitable opportunities beyond the electricity spot market,it also introduces new trading risks due to the significant uncertainty in users’behaviors.Dispatching energy storage systems(ESSs)is an effective means to enhance the risk management capabilities of LAs;however,coordinating ESS operations with dual-market trading strategies remains an urgent challenge.To this end,this paper proposes a novel systematic risk-aware coordinated trading model for the LA in concurrently participating in the day-ahead electricity spot market and DR market,which incorporates the capacity allocation mechanism of ESS based on market clearing rules to jointly formulate bidding and pricing decisions for the dual market.First,the intrinsic coupling characteristics of the LA participating in the dual market are analyzed,and a joint optimization framework for formulating bidding and pricing strategies that integrates ESS facilities is proposed.Second,an uncertain user response model is developed based on price‒response mechanisms,and actual market settlement rules accounting for under-and over-responses are employed to calculate trading revenues,where possible revenue losses are quantified via conditional value at risk.Third,by imposing these terms and the capacity allocation mechanism of ESS,the risk-aware stochastic coordinated trading model of the LA is built,where the bidding and pricing strategies in the dual model that trade off risk and profit are derived.The simulation results of a case study validate the effectiveness of the proposed trading strategy in controlling trading risk and improving the trading income of the LA.展开更多
BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the p...BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the postoperative life of the patient.Currently,the traditional Roux-en-Y esophagojejunostomy anastomosis is a commonly used method for gastrointestinal reconstruction after total gastrectomy for GC.However,more recent studies have shown that the traditional Roux-en-Y anastomosis is complicated in operation procedure,with more reconstruction steps and longer reconstruction time,and the incidence of postoperative complications such as adhesive intestinal obstruction,internal abdominal hernia and volvulus is high.Moreover,the incidence of Roux stasis syndrome is 10%-30%after traditional Roux-en-Y reconstruction.Thus,we modified the traditional Roux-en-Y alimentary tract reconstruction,and designed a new digestive tract reconstruction method for laparoscopy-assisted Roux-en-Y anastomosis for total gastrectomy of GC.AIM To evaluate the clinical advantages,feasibility,and safety of a modified Roux-en-Y digestive tract reconstruction in laparoscopy-assisted total gastrectomy for the treatment of GC compared with the traditional Roux-en-Y method.METHODS Ninety-seven patients who underwent laparoscopy-assisted D2 radical gastrectomy(total gastrectomy)for GC were divided into two groups:fifty-four in the conventional Roux-en-Y reconstruction group(Orr group)and forty-three in the modified Roux-en-Y reconstruction group(the modified group).Perioperative and short-term outcomes were analyzed,including complications,postoperative weight loss,hemoglobin levels,and nutritional status.RESULTS The Orr group and the modified group showed no statistically significant differences in baseline characteristics.Compared with the Orr group,the modified group had shorter digestive tract reconstruction and operation times,less intraoperative bleeding,and shorter postoperative hospital stays compared to the Orr group.Although both groups had similar amounts of intraoperative blood loss,postoperative recovery times,and hospital expenses,the Orr group experienced longer operation times and digestive tract reconstruction times.Furthermore,the modified Roux-en-Y group demonstrated significantly fewer short-term and long-term complications,with a reduced incidence of reflux esophagitis and improved nutritional status.CONCLUSION The modified Roux-en-Y digestive tract reconstruction method after laparoscopy-assisted total gastrectomy for GC offers safety,simplicity,and a reduction in bile reflux.This method shortens operation times and minimizes postoperative complications,aligns with modern rapid rehabilitation surgery trends and potentially improves patient prognosis and overall survival.This method warrants further clinical application and promotion.展开更多
BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gast...BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.展开更多
Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for thes...Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.展开更多
Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another imp...Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.展开更多
Dear Editor,The food industry emphasizes improving demand forecasting to align production with consumer needs and reduce waste.This letter thus presents a study that integrates artificial intelligence(AI)and digital t...Dear Editor,The food industry emphasizes improving demand forecasting to align production with consumer needs and reduce waste.This letter thus presents a study that integrates artificial intelligence(AI)and digital twin(DT)technologies to enhance decision-making and efficiency in food production.A data-driven DT was implemented in an Italian company for Raspberry production planning,based on a daily demand forecasting tool powered by a dynamic extreme gradient boosting(XGBoost)algorithm.The model achieved a mean absolute percentage error(MAPE)of 16.37%with 1.69 average of absolute extra working hours(AEW)and a tracking signal(TS)range of[−1.9,+4.3].展开更多
The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate ...The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.展开更多
BACKGROUND Although opioids and non-steroidal anti-inflammatory drugs are commonly used as preemptive analgesics in total knee arthroplasty(TKA),their side effects are a major concern.Tapentadol,a synthetic opioid ana...BACKGROUND Although opioids and non-steroidal anti-inflammatory drugs are commonly used as preemptive analgesics in total knee arthroplasty(TKA),their side effects are a major concern.Tapentadol,a synthetic opioid analgesic,is noted for its higher potency,lower abuse potential,and better gastrointestinal tolerability compared to traditional opioids.However,its efficacy and safety as preemptive analgesia in TKA have not been evaluated.AIM To hypothesize that preemptive use of tapentadol significantly reduces postoperative pain and rescue analgesic consumption in TKA patients.Clinically,this may reduce opioid burden and improve recovery protocols.METHODS Ninety patients undergoing unilateral TKA were randomized to receive either tapentadol(single dose of 100 mg sustained-release,n=45)or a matched placebo 1 hour before surgery.Postoperative pain was assessed using the visual analog scale(VAS),and total pain reduction scores were recorded.Total rescue analgesic consumption and side effects were monitored for 24 hours.Blood samples were collected 6 hours postoperatively to measure plasma levels of cholecystokinin(CCK)(a potential biomarker of pain)and tapentadol using enzyme-linked immunosorbent assay and high-performance liquid chromatography,respectively.RESULTS The baseline characteristics of both groups were comparable.The 24-hour VAS scores,the primary outcome,were significantly lower in the tapentadol group median[interquartile range(IQR)][1.0(1.0-3.0)]compared to the placebo group[3.5(2.0-5.0)].Significant differences in VAS scores were observed at 4 hours,6 hours,and 12 hours postoperatively(P<0.05).Requests for rescue analgesia were significantly delayed in the tapentadol group(P=0.01),and the total dose of analgesics used was significantly lower[median(IQR):3(2-4)]compared to the placebo group[4.5(3-5),P=0.001].No major adverse events were observed in either group.Plasma tapentadol concentrations correlated well with pain intensity,whereas no correlation was found between CCK levels and pain intensity.CONCLUSION A preemptive single dose of 100 mg oral tapentadol is safe,effective,and significantly reduces postoperative pain and rescue analgesic requirements in TKA patients.This approach may reduce opioid dependence and support enhanced recovery protocols.展开更多
The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid ...The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid growth in production and consumption.To formulate an effective hydrogen energy development strategy for the future of China,this study employs the departmental scenario analysis method to calculate and evaluate the future consumption of hydrogen energy in China’s heavy industry,transportation,electricity,and other related fields.Multidimensional technical parameters are selected and predicted accurately and reliably in combination with different development scenarios.The findings indicate that the period from 2030 to 2050 will enjoy rapid development of hydrogen energy,having an average annual growth rate of 2%to 4%.The technological progress and breakthroughs scenario has the greatest potential for hydrogen demand scale among the four development scenarios.Under this scenario,the total demand for hydrogen energy is expected to reach 446.37Mt in 2060.Thetransportation sector will be the sector with the greatest potential for hydrogen deployment growth from 2023 to 2060,which is expected to rise from 0.038Mt to about 163.18Mt,with the ambitious growth in the future.Additionally,hydrogen energy has a considerable development potential in the steel sector,and the trend of de-refueling coke by hydrogenation in this sector will be imperative for this energy-intensive industries.展开更多
[Objectives]Based on spectrophotometry,a method for determining the total flavonoid content in milk powder was established by optimizing sample pretreatment conditions,and method validation was performed.[Methods]Tota...[Objectives]Based on spectrophotometry,a method for determining the total flavonoid content in milk powder was established by optimizing sample pretreatment conditions,and method validation was performed.[Methods]Total flavonoids in milk powder were extracted with ethanol using 45℃ water bath ultrasonication for 60 min.Flavonoids contain a benzopyran ring structure and react with aluminum nitrate in a potassium acetate environment to form a yellow complex.The absorbance of this complex was measured at 420 nm for quantitative determination.[Results]The method exhibited a good linear relationship within the range of 0.2-1.0 mg.The limit of detection(LOD)was 0.05 g/100 g,and the limit of quantification(LOQ)was 0.3 g/100 g.When the spiked amount of total flavonoids was in the range of 0.3% to 1.0%,the spike recovery rates were 99.3% to 103.4%,and the relative standard deviations(RSD s)were less than 3.0%.[Conclusions]This method offers advantages such as rapidness,accuracy,good stability,and high sensitivity,and can be used for the detection of total flavonoid content in milk powder.展开更多
Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect ...Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus(T2DM)and its underlying mechanism remain unclear.The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1,exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes.This combination demonstrated significant synergistic effects in improving glucose tolerance,reducing fasting blood glucose(FBG),the weight ratio of epididymal white adipose tissue(eWAT),and the homeostasis model assessment of insulin resistance(HOMA-IR)in leptin receptor-deficient(db/db)mice.Subsequently,a T2DM liver-specific network was constructed based on RNA sequencing(RNA-seq)experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions(PPIs).The network recovery index(NRI)score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components.The research identified that activated adenosine 5'-monophosphate-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)signaling in the liver played a crucial role in the synergistic treatment of T2DM,as verified by western blot experiment in db/db mice.These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice,surpassing the efficacy of individual treatments.The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.展开更多
In contemporary power systems,delving into the flexible regulation potential of demand-side resources is of paramount significance for the efficient operation of power grids.This research puts forward an innovative mu...In contemporary power systems,delving into the flexible regulation potential of demand-side resources is of paramount significance for the efficient operation of power grids.This research puts forward an innovative multivariate flexible load aggregation control approach that takes dynamic demand response into full consideration.In the initial stage,using generalized time-domain aggregation modelling for a wide array of heterogeneous flexible loads,including temperature-controlled loads,electric vehicles,and energy storage devices,a novel calculation method for their maximum adjustable capacities is devised.Distinct from conventional methods,this newly developed approach enables more precise and adaptable quantification of the load-adjusting capabilities,thereby enhancing the accuracy and flexibility of demand-side resource management.Subsequently,an SSA-BiLSTM flexible load classification prediction model is established.This model represents an innovative application in the field,effectively combining the advantages of the Sparrow Search Algorithm(SSA)and the Bidirectional Long-Short-Term Memory(BiLSTM)neural network.Furthermore,a parallel Markov chain is introduced to evaluate the switching state transfer probability of flexible loads accurately.This integration allows for a more refined determination of the maximum response capacity range of the flexible load aggregator,significantly improving the precision of capacity assessment compared to existing methods.Finally,in consonance with the intra-day scheduling plan,a newly developed diffuse filling algorithm is implemented to control the activation times of flexible loads precisely,thus achieving real-time dynamic demand response.Through in-depth case analysis and comprehensive comparative studies,the effectiveness of the proposed method is convincingly validated.With its innovative techniques and enhanced performance,it is demonstrated that this method has the potential to substantially enhance the utilization efficiency of demand-side resources in power systems,providing a novel and effective solution for optimizing power grid operation and demand-side management.展开更多
基金funded by Science and Technology Projects from State Grid Corporation of China,(Research on Adaptive Balance Optimization and Simulation Technology of Industrial community Energy System with High Proportion of Distributed Energy,No.:5100-202355752A-3-4-SY).
文摘To achieve the goals of sustainable development of the energy system and the construction of a lowcarbon society,this study proposes a multi-energy storage collaborative optimization strategy for industrial park that integrates the laddered carbon trading mechanism with demand response.Firstly,a dual dimensional DR model is constructed based on the characteristics of load elasticity.The alternativeDRenables flexible substitution of energy loads through complementary conversion of electricity/heat/cold multi-energy sources,while the price DR relies on timeof-use electricity price signals to guide load spatiotemporal migration;Secondly,the LCT mechanism is introduced to achieve optimal carbon emission costs through a tiered carbon quota allocation mechanism.On this basis,an optimization decision model is established with the core objective of maximizing the annual net profit of the park.The objective function takes into account energy sales revenue,generator unit costs,and investment and operation costs of multiple types of energy storage facilities.Themodel constraint system covers three key dimensions:dynamic operation constraints of power generation units,including unit output limits,ramping capability,and minimum start-stop time;the physical boundary of an electric/hot/cold multi-energy storage system involves energy storage capacity and charge/discharge efficiency;The multi-energy network coupling balance equation ensures that the energy conversion and transmission process satisfies the law of conservation of energy.Using CPLEX mathematical programming solver for simulation verification,construct an energy storage capacity configuration decision process that includes LCT-DR synergistic effect.The research results show that compared with the traditional single energy storage configuration mode,this strategy effectively enhances the economic feasibility and engineering practicality of industrial park operation by coordinating demand side resource scheduling and finely controlling carbon costs,while maintaining stable system operation.Its methodological framework provides a technical path that combines theoretical rigor and practical operability for the low-carbon transformation of regional integrated energy systems.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
文摘Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse events,and earlier revision.Therefore,it is essential to try to avoid LLD when implanting a THA.Several studies focus on this issue,including the following:Accelerometer-based portable navigation system,preoperative digital templating,robot-assisted surgery,the anatomical marker positioning method(shoulder-to-shoulder)and the artificial intelligence-based three-dimensional planning software system.The aforementioned methods should be familiar to surgeons who perform THA procedures,as a fundamental objective of this surgical intervention is to avoid LLD.
文摘BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.
文摘BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.
文摘BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.
基金supported by the Spanish Ministry of Science and Innovation under Projects PID2022-137680OB-C32 and PID2022-139187OB-I00.
文摘Customer segmentation according to load-shape profiles using smart meter data is an increasingly important application to vital the planning and operation of energy systems and to enable citizens’participation in the energy transition.This study proposes an innovative multi-step clustering procedure to segment customers based on load-shape patterns at the daily and intra-daily time horizons.Smart meter data is split between daily and hourly normalized time series to assess monthly,weekly,daily,and hourly seasonality patterns separately.The dimensionality reduction implicit in the splitting allows a direct approach to clustering raw daily energy time series data.The intraday clustering procedure sequentially identifies representative hourly day-unit profiles for each customer and the entire population.For the first time,a step function approach is applied to reduce time series dimensionality.Customer attributes embedded in surveys are employed to build external clustering validation metrics using Cramer’s V correlation factors and to identify statistically significant determinants of load-shape in energy usage.In addition,a time series features engineering approach is used to extract 16 relevant demand flexibility indicators that characterize customers and corresponding clusters along four different axes:available Energy(E),Temporal patterns(T),Consistency(C),and Variability(V).The methodology is implemented on a real-world electricity consumption dataset of 325 Small and Medium-sized Enterprise(SME)customers,identifying 4 daily and 6 hourly easy-to-interpret,well-defined clusters.The application of the methodology includes selecting key parameters via grid search and a thorough comparison of clustering distances and methods to ensure the robustness of the results.Further research can test the scalability of the methodology to larger datasets from various customer segments(households and large commercial)and locations with different weather and socioeconomic conditions.
基金Supported by Health Research Project of Hunan Provincial Health Commission,No.D202315018915.
文摘BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.
基金supported by National Natural Science Foundation of China(52407126).
文摘The demand response(DR)market,as a vital complement to the electricity spot market,plays a key role in evoking user-side regulation capability to mitigate system-level supply‒demand imbalances during extreme events.While the DR market offers the load aggregator(LA)additional profitable opportunities beyond the electricity spot market,it also introduces new trading risks due to the significant uncertainty in users’behaviors.Dispatching energy storage systems(ESSs)is an effective means to enhance the risk management capabilities of LAs;however,coordinating ESS operations with dual-market trading strategies remains an urgent challenge.To this end,this paper proposes a novel systematic risk-aware coordinated trading model for the LA in concurrently participating in the day-ahead electricity spot market and DR market,which incorporates the capacity allocation mechanism of ESS based on market clearing rules to jointly formulate bidding and pricing decisions for the dual market.First,the intrinsic coupling characteristics of the LA participating in the dual market are analyzed,and a joint optimization framework for formulating bidding and pricing strategies that integrates ESS facilities is proposed.Second,an uncertain user response model is developed based on price‒response mechanisms,and actual market settlement rules accounting for under-and over-responses are employed to calculate trading revenues,where possible revenue losses are quantified via conditional value at risk.Third,by imposing these terms and the capacity allocation mechanism of ESS,the risk-aware stochastic coordinated trading model of the LA is built,where the bidding and pricing strategies in the dual model that trade off risk and profit are derived.The simulation results of a case study validate the effectiveness of the proposed trading strategy in controlling trading risk and improving the trading income of the LA.
文摘BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the postoperative life of the patient.Currently,the traditional Roux-en-Y esophagojejunostomy anastomosis is a commonly used method for gastrointestinal reconstruction after total gastrectomy for GC.However,more recent studies have shown that the traditional Roux-en-Y anastomosis is complicated in operation procedure,with more reconstruction steps and longer reconstruction time,and the incidence of postoperative complications such as adhesive intestinal obstruction,internal abdominal hernia and volvulus is high.Moreover,the incidence of Roux stasis syndrome is 10%-30%after traditional Roux-en-Y reconstruction.Thus,we modified the traditional Roux-en-Y alimentary tract reconstruction,and designed a new digestive tract reconstruction method for laparoscopy-assisted Roux-en-Y anastomosis for total gastrectomy of GC.AIM To evaluate the clinical advantages,feasibility,and safety of a modified Roux-en-Y digestive tract reconstruction in laparoscopy-assisted total gastrectomy for the treatment of GC compared with the traditional Roux-en-Y method.METHODS Ninety-seven patients who underwent laparoscopy-assisted D2 radical gastrectomy(total gastrectomy)for GC were divided into two groups:fifty-four in the conventional Roux-en-Y reconstruction group(Orr group)and forty-three in the modified Roux-en-Y reconstruction group(the modified group).Perioperative and short-term outcomes were analyzed,including complications,postoperative weight loss,hemoglobin levels,and nutritional status.RESULTS The Orr group and the modified group showed no statistically significant differences in baseline characteristics.Compared with the Orr group,the modified group had shorter digestive tract reconstruction and operation times,less intraoperative bleeding,and shorter postoperative hospital stays compared to the Orr group.Although both groups had similar amounts of intraoperative blood loss,postoperative recovery times,and hospital expenses,the Orr group experienced longer operation times and digestive tract reconstruction times.Furthermore,the modified Roux-en-Y group demonstrated significantly fewer short-term and long-term complications,with a reduced incidence of reflux esophagitis and improved nutritional status.CONCLUSION The modified Roux-en-Y digestive tract reconstruction method after laparoscopy-assisted total gastrectomy for GC offers safety,simplicity,and a reduction in bile reflux.This method shortens operation times and minimizes postoperative complications,aligns with modern rapid rehabilitation surgery trends and potentially improves patient prognosis and overall survival.This method warrants further clinical application and promotion.
文摘BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.
文摘Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.
文摘Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.
基金supported by European Union’s Horizon Europe Research and Innovation Programme(101092043)project AGILEHAND(Smart Grading,Handling and Packaging Solutions for Soft and Deformable Products in Agile and Reconfigurable Lines).
文摘Dear Editor,The food industry emphasizes improving demand forecasting to align production with consumer needs and reduce waste.This letter thus presents a study that integrates artificial intelligence(AI)and digital twin(DT)technologies to enhance decision-making and efficiency in food production.A data-driven DT was implemented in an Italian company for Raspberry production planning,based on a daily demand forecasting tool powered by a dynamic extreme gradient boosting(XGBoost)algorithm.The model achieved a mean absolute percentage error(MAPE)of 16.37%with 1.69 average of absolute extra working hours(AEW)and a tracking signal(TS)range of[−1.9,+4.3].
基金supported by the National Science Foundation for Distinguished Young Scholars(No.42425107)Ecological Civilization Special Project of Key Research&and Development Program in Gansu Province(No.24YFFA009)the Top Talent Project of Gansu Province,Chinese Academy of Sciences Young Crossover Team Project(No.JCTD-2022-18)。
文摘The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.
文摘BACKGROUND Although opioids and non-steroidal anti-inflammatory drugs are commonly used as preemptive analgesics in total knee arthroplasty(TKA),their side effects are a major concern.Tapentadol,a synthetic opioid analgesic,is noted for its higher potency,lower abuse potential,and better gastrointestinal tolerability compared to traditional opioids.However,its efficacy and safety as preemptive analgesia in TKA have not been evaluated.AIM To hypothesize that preemptive use of tapentadol significantly reduces postoperative pain and rescue analgesic consumption in TKA patients.Clinically,this may reduce opioid burden and improve recovery protocols.METHODS Ninety patients undergoing unilateral TKA were randomized to receive either tapentadol(single dose of 100 mg sustained-release,n=45)or a matched placebo 1 hour before surgery.Postoperative pain was assessed using the visual analog scale(VAS),and total pain reduction scores were recorded.Total rescue analgesic consumption and side effects were monitored for 24 hours.Blood samples were collected 6 hours postoperatively to measure plasma levels of cholecystokinin(CCK)(a potential biomarker of pain)and tapentadol using enzyme-linked immunosorbent assay and high-performance liquid chromatography,respectively.RESULTS The baseline characteristics of both groups were comparable.The 24-hour VAS scores,the primary outcome,were significantly lower in the tapentadol group median[interquartile range(IQR)][1.0(1.0-3.0)]compared to the placebo group[3.5(2.0-5.0)].Significant differences in VAS scores were observed at 4 hours,6 hours,and 12 hours postoperatively(P<0.05).Requests for rescue analgesia were significantly delayed in the tapentadol group(P=0.01),and the total dose of analgesics used was significantly lower[median(IQR):3(2-4)]compared to the placebo group[4.5(3-5),P=0.001].No major adverse events were observed in either group.Plasma tapentadol concentrations correlated well with pain intensity,whereas no correlation was found between CCK levels and pain intensity.CONCLUSION A preemptive single dose of 100 mg oral tapentadol is safe,effective,and significantly reduces postoperative pain and rescue analgesic requirements in TKA patients.This approach may reduce opioid dependence and support enhanced recovery protocols.
基金supported by the National Natural Science Foundation of China(No.71704178)Beijing Municipal Excellent Talents Foundation(No.2017000020124G133)Major consulting project of the Chinese Academy of Engineering(Nos.2023-JB-08,2022-PP-03).
文摘The proposal of carbon neutrality target makes decarbonization and hydrogenation typical features of future energy development in China.With a wide range of application scenarios,hydrogen energy will experience rapid growth in production and consumption.To formulate an effective hydrogen energy development strategy for the future of China,this study employs the departmental scenario analysis method to calculate and evaluate the future consumption of hydrogen energy in China’s heavy industry,transportation,electricity,and other related fields.Multidimensional technical parameters are selected and predicted accurately and reliably in combination with different development scenarios.The findings indicate that the period from 2030 to 2050 will enjoy rapid development of hydrogen energy,having an average annual growth rate of 2%to 4%.The technological progress and breakthroughs scenario has the greatest potential for hydrogen demand scale among the four development scenarios.Under this scenario,the total demand for hydrogen energy is expected to reach 446.37Mt in 2060.Thetransportation sector will be the sector with the greatest potential for hydrogen deployment growth from 2023 to 2060,which is expected to rise from 0.038Mt to about 163.18Mt,with the ambitious growth in the future.Additionally,hydrogen energy has a considerable development potential in the steel sector,and the trend of de-refueling coke by hydrogenation in this sector will be imperative for this energy-intensive industries.
基金Supported by Key Research and Development and Achievement Transformation Plan Project of Inner Mongolia Autonomous Region(2023YFHH0093).
文摘[Objectives]Based on spectrophotometry,a method for determining the total flavonoid content in milk powder was established by optimizing sample pretreatment conditions,and method validation was performed.[Methods]Total flavonoids in milk powder were extracted with ethanol using 45℃ water bath ultrasonication for 60 min.Flavonoids contain a benzopyran ring structure and react with aluminum nitrate in a potassium acetate environment to form a yellow complex.The absorbance of this complex was measured at 420 nm for quantitative determination.[Results]The method exhibited a good linear relationship within the range of 0.2-1.0 mg.The limit of detection(LOD)was 0.05 g/100 g,and the limit of quantification(LOQ)was 0.3 g/100 g.When the spiked amount of total flavonoids was in the range of 0.3% to 1.0%,the spike recovery rates were 99.3% to 103.4%,and the relative standard deviations(RSD s)were less than 3.0%.[Conclusions]This method offers advantages such as rapidness,accuracy,good stability,and high sensitivity,and can be used for the detection of total flavonoid content in milk powder.
基金supported by the Pioneer and Leading Goose R&D Program of Zhejiang Province(No.2024C03106)the National Natural Science Foundation of China(No.U23A20513)+1 种基金Ningbo Top Medical and Health Research Program(No.2022030309)the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine(No.ZYYCXTD-D-202002).
文摘Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus(T2DM)and its underlying mechanism remain unclear.The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1,exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes.This combination demonstrated significant synergistic effects in improving glucose tolerance,reducing fasting blood glucose(FBG),the weight ratio of epididymal white adipose tissue(eWAT),and the homeostasis model assessment of insulin resistance(HOMA-IR)in leptin receptor-deficient(db/db)mice.Subsequently,a T2DM liver-specific network was constructed based on RNA sequencing(RNA-seq)experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions(PPIs).The network recovery index(NRI)score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components.The research identified that activated adenosine 5'-monophosphate-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)signaling in the liver played a crucial role in the synergistic treatment of T2DM,as verified by western blot experiment in db/db mice.These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice,surpassing the efficacy of individual treatments.The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.
基金the Science and Technology Project of State Grid Shanxi Electric Power Co.,Ltd.,with the project number 52051L240001.
文摘In contemporary power systems,delving into the flexible regulation potential of demand-side resources is of paramount significance for the efficient operation of power grids.This research puts forward an innovative multivariate flexible load aggregation control approach that takes dynamic demand response into full consideration.In the initial stage,using generalized time-domain aggregation modelling for a wide array of heterogeneous flexible loads,including temperature-controlled loads,electric vehicles,and energy storage devices,a novel calculation method for their maximum adjustable capacities is devised.Distinct from conventional methods,this newly developed approach enables more precise and adaptable quantification of the load-adjusting capabilities,thereby enhancing the accuracy and flexibility of demand-side resource management.Subsequently,an SSA-BiLSTM flexible load classification prediction model is established.This model represents an innovative application in the field,effectively combining the advantages of the Sparrow Search Algorithm(SSA)and the Bidirectional Long-Short-Term Memory(BiLSTM)neural network.Furthermore,a parallel Markov chain is introduced to evaluate the switching state transfer probability of flexible loads accurately.This integration allows for a more refined determination of the maximum response capacity range of the flexible load aggregator,significantly improving the precision of capacity assessment compared to existing methods.Finally,in consonance with the intra-day scheduling plan,a newly developed diffuse filling algorithm is implemented to control the activation times of flexible loads precisely,thus achieving real-time dynamic demand response.Through in-depth case analysis and comprehensive comparative studies,the effectiveness of the proposed method is convincingly validated.With its innovative techniques and enhanced performance,it is demonstrated that this method has the potential to substantially enhance the utilization efficiency of demand-side resources in power systems,providing a novel and effective solution for optimizing power grid operation and demand-side management.
