Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient co...Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient content adaptability,a single implementation method,and a lack of coordination mechanisms.Based on Piaget’s Cognitive Development Theory and the STSE(Science,Technology,Society,Environment)educational concept,this study constructed a four-in-one strategy system of“content development-teaching implementation-collaborative linkage-guarantee support”through literature analysis,action research,and empirical comparison.An empirical study was conducted in two primary schools for one academic year.The results show that this strategy system can increase students’interest in participating in chemistry science popularization by 42 percentage points,the compliance rate of observation ability reaches 85%,and the collaborative participation of families,schools,and society rises to 85%.The core strategies formed in the study,including“age-appropriate content screening,interactive teaching implementation,three-dimensional collaborative promotion,and full-process guarantee support,”provide a replicable practical model for the standardized and efficient development of chemistry science popularization for lower grades in primary schools.They also offer empirical references for fulfilling the requirement of“strengthening the pertinence and effectiveness of science popularization”in the Law of the People’s Republic of China on Popularization of Science and Technology(revised in 2024).展开更多
BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it d...BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it difficult to apply the constructed models in clinical practice.We developed and validated an interpretable ML model based on magnetic resonance imaging(MRI)radiomics and clinical features for the preoperative prediction of the pathological grades of hepatocellular carcinomas(HCCs).This model will help clinicians better understand the situation and develop personalized treatment plans.AIM To develop and validate an interpretable ML model for preoperative pathological grade prediction in HCC patients via a combination of multisequence MRI radiomics and clinical features.METHODS MRI and clinical data derived from 125 patients with HCCs confirmed by postoperative pathological examinations were retrospectively analyzed.The patients were randomly split into training and validation groups(7:3 ratio).Univariate and multivariate logistic regression analyses were performed to identify independent clinical predictors.The tumor lesions observed on axial fatsuppressed T2-weighted imaging(FS-T2WI),arterial phase(AP),and portal venous phase(PVP)images were delineated in a slice-by-slice manner using 3D-slicer to generate volumetric regions of interest,and radiomic features were extracted.Interclass correlation coefficients were calculated,and least absolute selection and shrinkage operator regression were conducted for feature selection purposes.Six predictive models were subsequently developed for pathological grade prediction:FS-T2WI,AP,PVP,integrated radiomics,clinical,and combined radiomics-clinical(RC)models.The effectiveness of these models was assessed by calculating their area under the receiver operating characteristic curve(AUC)values.The clinical applicability of the models was evaluated via decision curve analysis.Finally,the contributions of the different features contained in the model with optimal performance were interpreted via a SHapley Additive exPlanations analysis.RESULTS Among the 125 patients,87 were assigned to the training group,and 38 were assigned to the validation group.The maximum tumor diameter,hepatitis B virus status,and monocyte count were identified as independent predictors of pathological grade.Twelve optimal radiomic features were ultimately selected.The AUC values obtained for the FS-T2WI model,AP model,PVP model,radiomics model,clinical model,and combined RC model in the training group were 0.761[95%confidence interval(CI):0.562-0.857],0.870(95%CI:0.714-0.918),0.868(95%CI:0.714-0.959),0.917(95%CI:0.857-0.959),0.869(95%CI:0.643-0.973),and 0.941(95%CI:0.857-0.945),respectively;in the validation group,the AUC values were 0.724(95%CI:0.625-0.833),0.802(95%CI:0.686-1.000),0.797(95%CI:0.688-1.000),0.901(95%CI:0.833-0.906),0.865(95%CI:0.594-1.000),and 0.932(95%CI:0.812-1.000),respectively.The combined RC model demonstrated the best performance.Additionally,the decision curve analysis revealed that the combined RC model had satisfactory prediction efficiency,and the SHapley Additive exPlanations value analysis revealed that the“FS-T2WI-wavelet-HLL_gldm_Large Dependence High Gray Level Emphasis”feature contributed the most to the model,exhibiting a positive effect.CONCLUSION An interpretable ML model based on MRI radiomics provides a noninvasive tool for predicting the pathological grade of HCCs,which will help clinicians develop personalized treatment plans.展开更多
目的对中医药治疗冠状动脉临界病变的随机对照研究进行系统评价与Meta分析,评价中医药疗效与安全性,并评估现有研究的证据等级。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、...目的对中医药治疗冠状动脉临界病变的随机对照研究进行系统评价与Meta分析,评价中医药疗效与安全性,并评估现有研究的证据等级。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、维普和万方数据库中医药治疗冠状动脉临界病变的随机对照研究,采用Cochrane 5.1.0偏倚风险评估工具进行方法学质量评价,运用RevMan 5.3软件进行Meta分析,运用GRADE(grading of recommendations,assessment,development and evaluation)系统对有统计学意义结局指标的证据质量进行评价。结果最终纳入文献18篇,涉及样本量1799例。结果显示,相较于单纯西医治疗,中西医结合治疗可显著改善中医证候有效率、心绞痛有效率、心电图有效率、西雅图心绞痛量表的各项评分,降低超敏C反应蛋白、白细胞介素-6等炎症因子水平,降低总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平,提升高密度脂蛋白胆固醇水平,降低冠状动脉直径平均狭窄程度,减少平板运动阳性人数,提高左室射血分数,降低主要不良心脏事件发生率。GRADE证据等级评价提示,中医药改善冠状动脉临界病变患者心绞痛症状总有效率、中医证候总有效率、主要不良心脏事件、低密度脂蛋白胆固醇、西雅图心绞痛量表-躯体活动、左室射血分数为高质量证据,其余指标为极低质量、低质量或中等质量证据。结论中医药治疗冠状动脉临界病变具有一定优势,但在证据产出方面还存在较多局限,未来应尽快构建适合中医药临床试验的冠状动脉临界病变核心指标集,开展大样本随机对照研究,为该领域提供更多高质量循证医学证据。展开更多
With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and developm...With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and development trends of arable land quality. It is also an important measure for protecting the quality of arable land. in the present study, the distribution and changes of arable lands of different gradient types and grades in Lingchuan County, Guangxi Zhuang Autonomous Region in 2015 were monitored and evaluated, to analyze the trends and reasons for the changes in the quality and productivity of arable lands, and to provide references for dynamic monitoring of the quality of arable land.展开更多
目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由...目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由2名研究者独立进行文献筛选、信息提取、偏倚风险评估及方法学质量评价,并对纳入研究的总有效率、中医证候积分、第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1/FVC)、哮喘控制测试(ACT)评分等结局指标进行Meta分析,最终依照GRADE评估证据质量。结果:共纳入14项研究,合计1263例患者。结果显示:(1)培土生金中药联合常规西医疗法可有效改善患者总有效率,降低患者中医证候积分,改善患者FEV1水平、FEV1/FVC及ACT评分。(2)总有效率证据质量较优,可信度高,其余指标证据质量较低,尚待更多高质量的研究支持以提升证据级别。结论:培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证优于单用西医常规治疗,且在总有效率上证据质量较高,具有一定的循证学意义。展开更多
Functionally graded cellular structures(FGCSs)have a multitude of applications to a wide range of industries.Utilising the ever-progressing technology of additive manufacturing(AM),FGCSs can be applied to control mate...Functionally graded cellular structures(FGCSs)have a multitude of applications to a wide range of industries.Utilising the ever-progressing technology of additive manufacturing(AM),FGCSs can be applied to control material grading and achieve the desired mechanical properties.The current study explores the design and optimisation of FGCSs for AM,with a focus on improving the compression and impact performance of below knee(BK)prosthetic limbs made of thermoplastic polyurethane(TPU).A multiscale research methodology integrating topology optimization(TO),finite element analysis(FEA),and design of experiments(Do E)was adopted to optimise lattice structures in terms of stiffness and lightweight properties.Two-unit cell designs were considered in the study:Schwarz P gyroid and body-centered cubic(BCC).Response surface methodology(RSM)was implemented to analyse the effect of minimum and maximum cell wall thickness,cell size,and unit cell type on the mechanical performance of TPU FGCS structures.The results indicated that a Schwarz P FGCS structure with cell size,minimum and maximum cell wall thickness of 6,0.9 and 2.8 mm,respectively,could be optimal for a compromise between performance and weight.In this optimized case,stiffness and volume fraction values of 684 N/mm and 0.64 were obtained,respectively.The study also presents a proof-of-concept design for a BK prosthetic damper,highlighting the potential of FGCSs to enhance patient comfort,reduce manufacturing costs,and enable personalised designs through 3D scanning and AM.The obtained results could be a step forward towards the incorporation of AM technologies in prosthetics,offering a pathway to lightweight,cost-effective,and functionally tailored solutions.展开更多
Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.S...Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.Standard classification methods fail to address these dual challenges,limiting their real-world performance.In this paper,a novel,three-phase training framework is proposed that learns a robust ordinal classifier directly from noisy labels.The approach synergistically combines a rank-based ordinal regression backbone with a cooperative,semi-supervised learning strategy to dynamically partition the data into clean and noisy subsets.A hybrid training objective is then employed,applying a supervised ordinal loss to the clean set.The noisy set is simultaneously trained using a dualobjective that combines a semi-supervised ordinal loss with a parallel,label-agnostic contrastive loss.This design allows themodel to learn fromthe entire noisy subset while using contrastive learning to mitigate the risk of error propagation frompotentially corrupt supervision.Extensive experiments on a new,large-scale,multi-site clinical dataset validate our approach.Themethod achieves state-of-the-art performance with 80.71%accuracy and a 76.86%F1-score,significantly outperforming existing approaches,including a 2.26%improvement over the strongest baseline method.This work provides not only a robust solution for a practical medical imaging problem but also a generalizable framework for other tasks plagued by noisy ordinal labels.展开更多
This study explores the dynamic contact response of a viscoelastic functionally graded material(FGM)-coated half-plane under a rigid flat punch subjected to a time-harmonic vertical force.The elastic modulus and mass ...This study explores the dynamic contact response of a viscoelastic functionally graded material(FGM)-coated half-plane under a rigid flat punch subjected to a time-harmonic vertical force.The elastic modulus and mass density of the FGM coating vary exponentially along the thickness direction.The FGM coating and the homogeneous half-plane possess viscoelastic properties,which are described by a linearly hysteretic damping model.By applying the asymptotic method and the Fourier integral transform technique,the contact problem is converted into a Cauchy singular integral equation.The effects of excitation frequency,gradient index,damping factor ratio,and punch width on the vertical impedance and dynamic contact stress are analyzed.The results indicate that adjusting the gradient index of the FGM coating can significantly affect the contact stress and vertical impedance.展开更多
Thermomagnetic generation(TMG),a heat-to-electricity conversion technology based on the thermomagnetic effect,offers high reliability and broad adaptability to diverse heat sources.By exploiting the temperature-depend...Thermomagnetic generation(TMG),a heat-to-electricity conversion technology based on the thermomagnetic effect,offers high reliability and broad adaptability to diverse heat sources.By exploiting the temperature-dependent magnetization of thermomagnetic materials,TMG converts thermal energy into electrical energy through cyclic changes in magnetic flux based on Faraday's law.The performance of TMG systems is largely governed by the intrinsic properties of the working materials and the design of device architecture.Ideal TMG materials exhibit sharp and reversible magnetization transitions near the operating temperature,low thermal hysteresis,and high thermal conductivity.Device configurations can be broadly categorized into active and passive systems:active TMG devices rely on controlled thermal cycling and optimized magnetic circuits for enhanced output,whereas passive devices utilize self-actuated mechanical motion to generate electricity.In this topical review,we provide a comprehensive overview of recent advances in TMG materials and device configurations.Furthermore,we discuss future development trends and offer perspectives on experimental strategies to advance this field.展开更多
Sandwich functionally graded(FG)auxetic beams are extensively utilized in aerospace,automotive,and biomedical industries due to their excellent strength-toweight ratio,impact resistance,and tunable mechanical properti...Sandwich functionally graded(FG)auxetic beams are extensively utilized in aerospace,automotive,and biomedical industries due to their excellent strength-toweight ratio,impact resistance,and tunable mechanical properties.The integration of FG materials with auxetic structures enhances their adaptability in advanced engineering applications.However,understanding their dynamic behavior under external excitations is essential for optimal design and structural reliability.Nonlinear interactions in such structures pose significant challenges in vibration analysis,necessitating robust analytical methods.This study presents a closed-form solution for the nonlinear forced vibration analysis of sandwich FG auxetic beams,offering an accurate and efficient method for predicting their dynamic response.The beam consists of two FG face sheets with material properties varying through the thickness and a re-entrant honeycomb auxetic core with an adjustable Poisson's ratio.The governing nonlinear equations of motion are derived using the first-order shear deformation theory(FSDT),the modified Gibson model,and the von Kármán relations,formulated through Hamilton's principle.A closed-form solution is obtained via the Galerkin method and multiple-scale technique.The results demonstrate that FG layers enable control of the overweight and dynamic response amplitude,with positive power law indexes reducing weight.Comparisons with finite element results confirm the accuracy of the proposed formulation.展开更多
This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfact...This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfactometry-mass spectrometry(GC-O-MS).A total of 54 aroma-active compounds were detected.Principal component analysis showed that JZ1,JZ2,and JZ3 were well separated from each other.JZ1 as the premium-grade Baijiu had the highest aroma intensities,concentrations.According to aroma intensities and concentrations,dimethyl trisulfide,butanoic acid,phenylacetaldehyde,2-furylmethanethiol,ethyl hexanoate,2,6-dimethylpyrazine,etc.could be potentially applied as volatile makers to distinguish the three different grades of sesame-flavor Baijiu as their significant difference(P<0.05)in three Baijiu samples.Roasted aroma had the significant difference(P<0.05)in three sample base on aroma profiles.Meanwhile,2-furylmethanethiol,2,6-dimethylpyrazine were related to the roasted aroma,they may be had a significant contribution to the differences of three different grades of sesame-flavor Baijiu.This study has provided a comprehensive understanding of the differences of three different grades of sesame-flavor Baijiu.展开更多
Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades...Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades of precipitation during the period 1960-2010 was analyzed and the possible link with anthropogenic aerosols examined.Statistical analysis showed that drizzle and small precipitation has significantly decreased,whereas medium to heavy precipitation has increased slightly over the past 50 years （although not statistically significant）.Further data analysis suggested that the decline in drizzle and small precipitation probably has a strong link to increased concentrations of anthropogenic aerosols produced by large-scale human activities related to the rapid socioeconomic development of the PRD region.These aerosols may also have led to the obvious decreasing trend in horizontal visibility and sunshine duration in SC,which is statistically significant according to the t-test.展开更多
AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were s...AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were studied.All patients underwent radical surgery(between 2004 and 2010)after 30-Gy/10-fraction preoperative radiotherapy(preRT).All 190 patients received a short course of preRT and were reassessed for disease recurrence and survival;the slides of surgical specimens were reviewed and classified according to Mandard TRG.We compared patients with good response(Mandard TRG1 or TRG2)vs patients with bad/poor response(Mandard TRG3-5).Outcomes evaluated were 5-year overall survival(OS),5-year disease-free survival(DFS),and local,distant and mixed recurrence.Fisher’s exact test orχ2 test,logrank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.RESULTS:One hundred and sixty-six of 190 patients(87.4%)were identified as Mandard bad responders(TRG3-5).High Mandard grade was correlated with tumor height(41.7%<6 cm vs 58.3%≥6 cm,P=0.050),yp T stage(75%yp T0-2 vs 25%yp T3-4,P=0.000),and yp N stage(75%yp N0 vs 25%yp N1,P=0.031).In univariate survival analysis,Mandard grade bad responders had significantly worse OS and DFSthan good responders(TRG1/2)(OS,83.1%vs 96.4%,P=0.000;DFS,72.3%vs 92.0%,P=0.002).In multivariate survival analysis,Mandard bad responders had significantly worse DFS than Mandard good responders(DFS 3.8 years(95%CI:1.2-12.2 years,P=0.026).CONCLUSION:Mandard grade good responders had a favorable prognosis.TRG may be a potential predictor for DFS in LARA after pre-RT.展开更多
Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air pa...Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,展开更多
AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who...AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015.The objective of this study was to assess the efficacy of this treatment for GradesⅡandⅢhemorrhoids.Preoperative and postoperative symptoms,complications and success rate were all assessed retrospectively.Follow-up consisted of a simple questionnaire,physical examination and an anoscopy.Patients were followed-up at one day,one week,two weeks,one month,one year,two years,three years,four years and five years after the ALTA sclerotherapy.RESULTS:One hundred and sixty-nine patients were diagnosed with GradeⅡhemorrhoids and 435 patients were diagnosed with GradeⅢhemorrhoids.The one year,three year and five year cumulative success rates of ALTA sclerotherapy for GradesⅡandⅢhemo-rrhoids were 95.9%and 93.1%;89.3%and 83.7%;and 89.3%and 78.2%,respectively.No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between GradesⅡandⅢhemorrhoids(P=0.09).There were forty-seven post-operative complications(low grade fever;anal pain;urinary retention;rectal ulcer;and others).No serious or life-threatening complications occurred and all cases improved through conservative treatment.At univariate analysis there were no predictive factors of failure.CONCLUSION:ALTA sclerotherapy has had a high success rate for GradeⅡandⅢhemorrhoids during five years of post-operative treatment.However,additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.展开更多
Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists inclu...Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists including practitioners (nurse-midwives),clinical managers,academic educators and obstetricians completed a two-round Delphi study through an electronic survey that was supplemented by an expert panel meeting for discussion of comments and suggestions.Results:All panellists completed two rounds of Delphi study and at least 75% of them achieved a consensus on 224 items (W1 =0.150,W2 =0.173).Seven domains were established,namely,'Professional quality','Antenatal care','Intrapartum care','Postnatal care','Neonatal care','Gynaecological care','Public health care & Integrative competency'.Generalised maternal and neonatal knowledge and perinatal care skills were set for'junior'midwives,pathological care for'senior'ones and supervisory abilities and promotion of discipline for'expert'ones.Conclusions:This research developed three grades of essential competencies for midwives in China.The next step will be assessment in clinical settings for further response.The set was in line with the concepts of International Confederation of Midwives under the domestic context.This set could be adopted as a reference in developing normalised midwifery practice,education and certification.展开更多
基金Projects of Shaanxi Provincial Department of Science and Technology(2020JQ-886,2022JM-075)Education Science Planning Project of Shaanxi Province during the“14th Five-Year Plan”Period(SGH22Y1392)+6 种基金Scientific Research Program of Shaanxi Provincial Department of Education(23JP146,23JP147)Science and Technology Program of Xi’an(No.22GXFW0112)Three-Year Action Plan Project of Xi’an University(21XJZZ0001-11)Basic Education Research Project of Xi’an in 2022(2022JYZX28)2022“Xi’an University-Xi’an Academy of Social Sciences”Strategic Cooperation Projects(22ZL10,22ZL11)Doctoral Start-up Fund of Xi’an University(06005017)Key Discipline of Analytical Chemistry in Shaanxi Province(09009001)。
文摘Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient content adaptability,a single implementation method,and a lack of coordination mechanisms.Based on Piaget’s Cognitive Development Theory and the STSE(Science,Technology,Society,Environment)educational concept,this study constructed a four-in-one strategy system of“content development-teaching implementation-collaborative linkage-guarantee support”through literature analysis,action research,and empirical comparison.An empirical study was conducted in two primary schools for one academic year.The results show that this strategy system can increase students’interest in participating in chemistry science popularization by 42 percentage points,the compliance rate of observation ability reaches 85%,and the collaborative participation of families,schools,and society rises to 85%.The core strategies formed in the study,including“age-appropriate content screening,interactive teaching implementation,three-dimensional collaborative promotion,and full-process guarantee support,”provide a replicable practical model for the standardized and efficient development of chemistry science popularization for lower grades in primary schools.They also offer empirical references for fulfilling the requirement of“strengthening the pertinence and effectiveness of science popularization”in the Law of the People’s Republic of China on Popularization of Science and Technology(revised in 2024).
文摘BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it difficult to apply the constructed models in clinical practice.We developed and validated an interpretable ML model based on magnetic resonance imaging(MRI)radiomics and clinical features for the preoperative prediction of the pathological grades of hepatocellular carcinomas(HCCs).This model will help clinicians better understand the situation and develop personalized treatment plans.AIM To develop and validate an interpretable ML model for preoperative pathological grade prediction in HCC patients via a combination of multisequence MRI radiomics and clinical features.METHODS MRI and clinical data derived from 125 patients with HCCs confirmed by postoperative pathological examinations were retrospectively analyzed.The patients were randomly split into training and validation groups(7:3 ratio).Univariate and multivariate logistic regression analyses were performed to identify independent clinical predictors.The tumor lesions observed on axial fatsuppressed T2-weighted imaging(FS-T2WI),arterial phase(AP),and portal venous phase(PVP)images were delineated in a slice-by-slice manner using 3D-slicer to generate volumetric regions of interest,and radiomic features were extracted.Interclass correlation coefficients were calculated,and least absolute selection and shrinkage operator regression were conducted for feature selection purposes.Six predictive models were subsequently developed for pathological grade prediction:FS-T2WI,AP,PVP,integrated radiomics,clinical,and combined radiomics-clinical(RC)models.The effectiveness of these models was assessed by calculating their area under the receiver operating characteristic curve(AUC)values.The clinical applicability of the models was evaluated via decision curve analysis.Finally,the contributions of the different features contained in the model with optimal performance were interpreted via a SHapley Additive exPlanations analysis.RESULTS Among the 125 patients,87 were assigned to the training group,and 38 were assigned to the validation group.The maximum tumor diameter,hepatitis B virus status,and monocyte count were identified as independent predictors of pathological grade.Twelve optimal radiomic features were ultimately selected.The AUC values obtained for the FS-T2WI model,AP model,PVP model,radiomics model,clinical model,and combined RC model in the training group were 0.761[95%confidence interval(CI):0.562-0.857],0.870(95%CI:0.714-0.918),0.868(95%CI:0.714-0.959),0.917(95%CI:0.857-0.959),0.869(95%CI:0.643-0.973),and 0.941(95%CI:0.857-0.945),respectively;in the validation group,the AUC values were 0.724(95%CI:0.625-0.833),0.802(95%CI:0.686-1.000),0.797(95%CI:0.688-1.000),0.901(95%CI:0.833-0.906),0.865(95%CI:0.594-1.000),and 0.932(95%CI:0.812-1.000),respectively.The combined RC model demonstrated the best performance.Additionally,the decision curve analysis revealed that the combined RC model had satisfactory prediction efficiency,and the SHapley Additive exPlanations value analysis revealed that the“FS-T2WI-wavelet-HLL_gldm_Large Dependence High Gray Level Emphasis”feature contributed the most to the model,exhibiting a positive effect.CONCLUSION An interpretable ML model based on MRI radiomics provides a noninvasive tool for predicting the pathological grade of HCCs,which will help clinicians develop personalized treatment plans.
文摘目的对中医药治疗冠状动脉临界病变的随机对照研究进行系统评价与Meta分析,评价中医药疗效与安全性,并评估现有研究的证据等级。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、维普和万方数据库中医药治疗冠状动脉临界病变的随机对照研究,采用Cochrane 5.1.0偏倚风险评估工具进行方法学质量评价,运用RevMan 5.3软件进行Meta分析,运用GRADE(grading of recommendations,assessment,development and evaluation)系统对有统计学意义结局指标的证据质量进行评价。结果最终纳入文献18篇,涉及样本量1799例。结果显示,相较于单纯西医治疗,中西医结合治疗可显著改善中医证候有效率、心绞痛有效率、心电图有效率、西雅图心绞痛量表的各项评分,降低超敏C反应蛋白、白细胞介素-6等炎症因子水平,降低总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平,提升高密度脂蛋白胆固醇水平,降低冠状动脉直径平均狭窄程度,减少平板运动阳性人数,提高左室射血分数,降低主要不良心脏事件发生率。GRADE证据等级评价提示,中医药改善冠状动脉临界病变患者心绞痛症状总有效率、中医证候总有效率、主要不良心脏事件、低密度脂蛋白胆固醇、西雅图心绞痛量表-躯体活动、左室射血分数为高质量证据,其余指标为极低质量、低质量或中等质量证据。结论中医药治疗冠状动脉临界病变具有一定优势,但在证据产出方面还存在较多局限,未来应尽快构建适合中医药临床试验的冠状动脉临界病变核心指标集,开展大样本随机对照研究,为该领域提供更多高质量循证医学证据。
文摘With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and development trends of arable land quality. It is also an important measure for protecting the quality of arable land. in the present study, the distribution and changes of arable lands of different gradient types and grades in Lingchuan County, Guangxi Zhuang Autonomous Region in 2015 were monitored and evaluated, to analyze the trends and reasons for the changes in the quality and productivity of arable lands, and to provide references for dynamic monitoring of the quality of arable land.
文摘目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由2名研究者独立进行文献筛选、信息提取、偏倚风险评估及方法学质量评价,并对纳入研究的总有效率、中医证候积分、第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1/FVC)、哮喘控制测试(ACT)评分等结局指标进行Meta分析,最终依照GRADE评估证据质量。结果:共纳入14项研究,合计1263例患者。结果显示:(1)培土生金中药联合常规西医疗法可有效改善患者总有效率,降低患者中医证候积分,改善患者FEV1水平、FEV1/FVC及ACT评分。(2)总有效率证据质量较优,可信度高,其余指标证据质量较低,尚待更多高质量的研究支持以提升证据级别。结论:培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证优于单用西医常规治疗,且在总有效率上证据质量较高,具有一定的循证学意义。
基金financially supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(No.IMSIU-DDRSP2503)。
文摘Functionally graded cellular structures(FGCSs)have a multitude of applications to a wide range of industries.Utilising the ever-progressing technology of additive manufacturing(AM),FGCSs can be applied to control material grading and achieve the desired mechanical properties.The current study explores the design and optimisation of FGCSs for AM,with a focus on improving the compression and impact performance of below knee(BK)prosthetic limbs made of thermoplastic polyurethane(TPU).A multiscale research methodology integrating topology optimization(TO),finite element analysis(FEA),and design of experiments(Do E)was adopted to optimise lattice structures in terms of stiffness and lightweight properties.Two-unit cell designs were considered in the study:Schwarz P gyroid and body-centered cubic(BCC).Response surface methodology(RSM)was implemented to analyse the effect of minimum and maximum cell wall thickness,cell size,and unit cell type on the mechanical performance of TPU FGCS structures.The results indicated that a Schwarz P FGCS structure with cell size,minimum and maximum cell wall thickness of 6,0.9 and 2.8 mm,respectively,could be optimal for a compromise between performance and weight.In this optimized case,stiffness and volume fraction values of 684 N/mm and 0.64 were obtained,respectively.The study also presents a proof-of-concept design for a BK prosthetic damper,highlighting the potential of FGCSs to enhance patient comfort,reduce manufacturing costs,and enable personalised designs through 3D scanning and AM.The obtained results could be a step forward towards the incorporation of AM technologies in prosthetics,offering a pathway to lightweight,cost-effective,and functionally tailored solutions.
文摘Automated grading of dandruff severity is a clinically significant but challenging task due to the inherent ordinal nature of severity levels and the high prevalence of label noise from subjective expert annotations.Standard classification methods fail to address these dual challenges,limiting their real-world performance.In this paper,a novel,three-phase training framework is proposed that learns a robust ordinal classifier directly from noisy labels.The approach synergistically combines a rank-based ordinal regression backbone with a cooperative,semi-supervised learning strategy to dynamically partition the data into clean and noisy subsets.A hybrid training objective is then employed,applying a supervised ordinal loss to the clean set.The noisy set is simultaneously trained using a dualobjective that combines a semi-supervised ordinal loss with a parallel,label-agnostic contrastive loss.This design allows themodel to learn fromthe entire noisy subset while using contrastive learning to mitigate the risk of error propagation frompotentially corrupt supervision.Extensive experiments on a new,large-scale,multi-site clinical dataset validate our approach.Themethod achieves state-of-the-art performance with 80.71%accuracy and a 76.86%F1-score,significantly outperforming existing approaches,including a 2.26%improvement over the strongest baseline method.This work provides not only a robust solution for a practical medical imaging problem but also a generalizable framework for other tasks plagued by noisy ordinal labels.
基金Project supported by the National Natural Science Foundation of China(Nos.12021002,12192212,and 12462007)。
文摘This study explores the dynamic contact response of a viscoelastic functionally graded material(FGM)-coated half-plane under a rigid flat punch subjected to a time-harmonic vertical force.The elastic modulus and mass density of the FGM coating vary exponentially along the thickness direction.The FGM coating and the homogeneous half-plane possess viscoelastic properties,which are described by a linearly hysteretic damping model.By applying the asymptotic method and the Fourier integral transform technique,the contact problem is converted into a Cauchy singular integral equation.The effects of excitation frequency,gradient index,damping factor ratio,and punch width on the vertical impedance and dynamic contact stress are analyzed.The results indicate that adjusting the gradient index of the FGM coating can significantly affect the contact stress and vertical impedance.
基金supported by the National Natural Science Foundation of China(Grant Nos.52171169 and 52101210)the National Key Research and Development Program of China(Grant No.2021YFB3501204)+3 种基金the State Key Laboratory for Advanced Metals and Materials(Grant No.2023-ZD01)USTB Concept Verification Funding Project(Grant No.GNYZ-2024-6)Fundamental Research Funds for the Central Universities(Grant No.FRF-TP-24-004A)USTB Research Center for International People-to-people Exchange in Science,Technology and Civilization(Grant Nos.2024KFZD001 and 2024KFYB004)。
文摘Thermomagnetic generation(TMG),a heat-to-electricity conversion technology based on the thermomagnetic effect,offers high reliability and broad adaptability to diverse heat sources.By exploiting the temperature-dependent magnetization of thermomagnetic materials,TMG converts thermal energy into electrical energy through cyclic changes in magnetic flux based on Faraday's law.The performance of TMG systems is largely governed by the intrinsic properties of the working materials and the design of device architecture.Ideal TMG materials exhibit sharp and reversible magnetization transitions near the operating temperature,low thermal hysteresis,and high thermal conductivity.Device configurations can be broadly categorized into active and passive systems:active TMG devices rely on controlled thermal cycling and optimized magnetic circuits for enhanced output,whereas passive devices utilize self-actuated mechanical motion to generate electricity.In this topical review,we provide a comprehensive overview of recent advances in TMG materials and device configurations.Furthermore,we discuss future development trends and offer perspectives on experimental strategies to advance this field.
文摘Sandwich functionally graded(FG)auxetic beams are extensively utilized in aerospace,automotive,and biomedical industries due to their excellent strength-toweight ratio,impact resistance,and tunable mechanical properties.The integration of FG materials with auxetic structures enhances their adaptability in advanced engineering applications.However,understanding their dynamic behavior under external excitations is essential for optimal design and structural reliability.Nonlinear interactions in such structures pose significant challenges in vibration analysis,necessitating robust analytical methods.This study presents a closed-form solution for the nonlinear forced vibration analysis of sandwich FG auxetic beams,offering an accurate and efficient method for predicting their dynamic response.The beam consists of two FG face sheets with material properties varying through the thickness and a re-entrant honeycomb auxetic core with an adjustable Poisson's ratio.The governing nonlinear equations of motion are derived using the first-order shear deformation theory(FSDT),the modified Gibson model,and the von Kármán relations,formulated through Hamilton's principle.A closed-form solution is obtained via the Galerkin method and multiple-scale technique.The results demonstrate that FG layers enable control of the overweight and dynamic response amplitude,with positive power law indexes reducing weight.Comparisons with finite element results confirm the accuracy of the proposed formulation.
基金supported by the National Natural Science Foundation of China (32172340)
文摘This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfactometry-mass spectrometry(GC-O-MS).A total of 54 aroma-active compounds were detected.Principal component analysis showed that JZ1,JZ2,and JZ3 were well separated from each other.JZ1 as the premium-grade Baijiu had the highest aroma intensities,concentrations.According to aroma intensities and concentrations,dimethyl trisulfide,butanoic acid,phenylacetaldehyde,2-furylmethanethiol,ethyl hexanoate,2,6-dimethylpyrazine,etc.could be potentially applied as volatile makers to distinguish the three different grades of sesame-flavor Baijiu as their significant difference(P<0.05)in three Baijiu samples.Roasted aroma had the significant difference(P<0.05)in three sample base on aroma profiles.Meanwhile,2-furylmethanethiol,2,6-dimethylpyrazine were related to the roasted aroma,they may be had a significant contribution to the differences of three different grades of sesame-flavor Baijiu.This study has provided a comprehensive understanding of the differences of three different grades of sesame-flavor Baijiu.
基金supported by the Knowledge Innovation Program of the Chinese Academy of Sciences (Grant No. KZCX2-EW-QN208)the National Basic Research Program of China (Grant No. 2010CB428502)+3 种基金the open fund of the State Key Laboratory of Remote Sensing Science (Grant No. OFSLRSS201113)the CAS Strategic Priority Research Program (Grant No. XDA05110103)the R&D Special Fund for Public Welfare Industry (meteorology) by the Ministry of Financethe Ministry of Science and Technology (Grant No. GYHY20100601404)
文摘Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades of precipitation during the period 1960-2010 was analyzed and the possible link with anthropogenic aerosols examined.Statistical analysis showed that drizzle and small precipitation has significantly decreased,whereas medium to heavy precipitation has increased slightly over the past 50 years （although not statistically significant）.Further data analysis suggested that the decline in drizzle and small precipitation probably has a strong link to increased concentrations of anthropogenic aerosols produced by large-scale human activities related to the rapid socioeconomic development of the PRD region.These aerosols may also have led to the obvious decreasing trend in horizontal visibility and sunshine duration in SC,which is statistically significant according to the t-test.
基金Supported by National Natural Science Foundation of China,No.81372593,No.81030040 and No.81201965Beijing Natural Science Foundation,No.7132052+2 种基金the National High Technology Research and Development Program of China(863 Program),No.2012AA02A506 and No.SS2014AA020801Beijing Municipal Administration of Hospitals Special Fund for Clinical Medicine Development,No.ZY201410Beijing Science and Technology Commission,No.D0905001000011 and No.D101100050010068
文摘AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were studied.All patients underwent radical surgery(between 2004 and 2010)after 30-Gy/10-fraction preoperative radiotherapy(preRT).All 190 patients received a short course of preRT and were reassessed for disease recurrence and survival;the slides of surgical specimens were reviewed and classified according to Mandard TRG.We compared patients with good response(Mandard TRG1 or TRG2)vs patients with bad/poor response(Mandard TRG3-5).Outcomes evaluated were 5-year overall survival(OS),5-year disease-free survival(DFS),and local,distant and mixed recurrence.Fisher’s exact test orχ2 test,logrank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.RESULTS:One hundred and sixty-six of 190 patients(87.4%)were identified as Mandard bad responders(TRG3-5).High Mandard grade was correlated with tumor height(41.7%<6 cm vs 58.3%≥6 cm,P=0.050),yp T stage(75%yp T0-2 vs 25%yp T3-4,P=0.000),and yp N stage(75%yp N0 vs 25%yp N1,P=0.031).In univariate survival analysis,Mandard grade bad responders had significantly worse OS and DFSthan good responders(TRG1/2)(OS,83.1%vs 96.4%,P=0.000;DFS,72.3%vs 92.0%,P=0.002).In multivariate survival analysis,Mandard bad responders had significantly worse DFS than Mandard good responders(DFS 3.8 years(95%CI:1.2-12.2 years,P=0.026).CONCLUSION:Mandard grade good responders had a favorable prognosis.TRG may be a potential predictor for DFS in LARA after pre-RT.
基金supported by the Development Foundation of Shanghai Meteorological and Health Key Laboratory [QXJK201606]the Investigation of Science&Technology Basic Resources Program of China [2017FY101206]the General Program Foundation of Hebei Meteorological Bureau [17KY10]
文摘Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,
文摘AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015.The objective of this study was to assess the efficacy of this treatment for GradesⅡandⅢhemorrhoids.Preoperative and postoperative symptoms,complications and success rate were all assessed retrospectively.Follow-up consisted of a simple questionnaire,physical examination and an anoscopy.Patients were followed-up at one day,one week,two weeks,one month,one year,two years,three years,four years and five years after the ALTA sclerotherapy.RESULTS:One hundred and sixty-nine patients were diagnosed with GradeⅡhemorrhoids and 435 patients were diagnosed with GradeⅢhemorrhoids.The one year,three year and five year cumulative success rates of ALTA sclerotherapy for GradesⅡandⅢhemo-rrhoids were 95.9%and 93.1%;89.3%and 83.7%;and 89.3%and 78.2%,respectively.No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between GradesⅡandⅢhemorrhoids(P=0.09).There were forty-seven post-operative complications(low grade fever;anal pain;urinary retention;rectal ulcer;and others).No serious or life-threatening complications occurred and all cases improved through conservative treatment.At univariate analysis there were no predictive factors of failure.CONCLUSION:ALTA sclerotherapy has had a high success rate for GradeⅡandⅢhemorrhoids during five years of post-operative treatment.However,additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.
基金the UNFPA(CHN7U204)Chinese Maternal and Child Health Association for financial support.
文摘Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists including practitioners (nurse-midwives),clinical managers,academic educators and obstetricians completed a two-round Delphi study through an electronic survey that was supplemented by an expert panel meeting for discussion of comments and suggestions.Results:All panellists completed two rounds of Delphi study and at least 75% of them achieved a consensus on 224 items (W1 =0.150,W2 =0.173).Seven domains were established,namely,'Professional quality','Antenatal care','Intrapartum care','Postnatal care','Neonatal care','Gynaecological care','Public health care & Integrative competency'.Generalised maternal and neonatal knowledge and perinatal care skills were set for'junior'midwives,pathological care for'senior'ones and supervisory abilities and promotion of discipline for'expert'ones.Conclusions:This research developed three grades of essential competencies for midwives in China.The next step will be assessment in clinical settings for further response.The set was in line with the concepts of International Confederation of Midwives under the domestic context.This set could be adopted as a reference in developing normalised midwifery practice,education and certification.
