The prognosis of drug-induced acute liver failure(ALF)is poor,with a survival rate of 27.1%without liver transplantation.Liver transplantation significantly improved survival rates to 66.2%.[1]The shortage of availabl...The prognosis of drug-induced acute liver failure(ALF)is poor,with a survival rate of 27.1%without liver transplantation.Liver transplantation significantly improved survival rates to 66.2%.[1]The shortage of available grafts can be addressed by living donor liver transplantation(LDLT),an effective and safe method that expands the donor pool,enhances timely transplantation,and improves patient survival.展开更多
Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patient...Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].展开更多
Background:Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. While liver transplantation (LT) provides the best long-term survival, it is constrained by organ scarcity and strict criteria....Background:Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. While liver transplantation (LT) provides the best long-term survival, it is constrained by organ scarcity and strict criteria. Liver resection (LR) is often the initial treatment for patients with solitary tumors and preserved liver function. The high recurrence rates associated with LR has prompted the exploration of sequential living donor liver transplantation (seq LDLT) after LR as a strategy for HCC patients with high-risk of recurrence.Methods:We analyzed data from 27 adult patients who underwent seq LDLT after LR for HCC at Kaohsiung Chang Gung Memorial Hospital (KCGMH) between June 1994 and December 2023. Patients were selected based on high-risk histopathological features post-LR or as part of downstaging strategy. Outcomes measured included overall survival (OS) and disease-free survival (DFS).Results:Among 765 HCC patients who underwent LDLT, 204 received LR before LDLT, and 27 underwent seqL DLT. Five patients (19%) underwent living donor liver transplantation (LDLT) following LR as a downstaging strategy while the rest received seqL DLT as a preemptive strategy. The median age was 53.5 years with 85%males. Chronic hepatitis B was the predominant underlying disease (74%). The 1-, 3-, and 5-year OS and DFS rates were 100%, 96.0%, 96.0%and 100%, 96.2%, 96.2%, respectively, with two patients experiencing HCC recurrence. One patient died from HCC recurrence. High-risk histopathological features included microvascular invasion (52%), satellite nodules (15%), multiple tumors (26%), tumors> 5 cm(19%), and a total tumor diameter> 10 cm (7%).Conclusions:Seq LDLT offers a promising, tailored approach for managing HCC with adverse histopathologic features. Combining seq LDLT, downstaging strategies, and multidisciplinary treatments can achieve satisfactory OS and DFS in carefully selected patients, highlighting the need for refined criteria to identify the best candidates.展开更多
BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infant...BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infants weighing less than 10 kg.Large-forsize grafts can lead to severe complications,including vascular thrombosis and impaired graft perfusion.Surgical innovations,such as hyper-reduced left lateral segment(HRLLS)grafts and monosegmental grafts(MSG),offer viable solutions by tailoring graft size without compromising vascular or biliary integrity.AIM To analyze the techniques and outcomes of HRLLS and MSG grafts in pediatric liver trabsplantation.METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across PubMed,Scopus,and Google Scholar,including studies up to February 2025.Eligible studies included case-control,observational,and randomized controlled trials reporting clinical outcomes of HRLLS,MSG,or reduced left lateral segment grafts(RLLS)in pediatric LT.The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment.Meta-analysis was performed using MetaXL software to pool survival outcomes and assess complication profiles.RESULTS Eighteen studies involving various graft reduction techniques were included.Both HRLLS and MSG demonstrated comparable one-year survival rates exceeding 80%,with some studies reporting rates above 95%.Complications such as hepatic artery thrombosis,portal vein thrombosis,and sepsis were slightly more frequent in HRLLS/RLLS recipients but remained within acceptable limits.Meta-analysis revealed no significant differences in survivability between graft types.CONCLUSION HRLLS and MSG techniques enable successful liver transplantation in small pediatric recipients,achieving longterm outcomes comparable to standard approaches.These graft modification strategies expand donor pool utilization and optimize patient survival while mitigating large-for-size complications.展开更多
BACKGROUND Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease.Experienced tertiary centers and specialized medical staff are necess...BACKGROUND Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease.Experienced tertiary centers and specialized medical staff are necessary to ensure compatible long-term survival rates and quality-of-life for these children.AIM To report the results and the 10-year learning curve of a pediatric living-donor liver transplantation program.METHODS We conducted a retrospective cohort study of pediatric recipients from 2013 to 2023.Post-transplant outcomes and patient survival rates were compared between two 5-year periods of the program.RESULTS A total of 25 and 48 patients underwent transplantation in the first(2013-2017)and second period(2018-2023),respectively.Portal vein and hepatic artery thrombosis occurred in 11(15.1%)and seven(9.6%)patients,respectively.Biliary complications were observed in 39 of 73 patients(53.4%).A lower warm ischemia time was observed in the second period compared to the first(32.6±8.6 minutes vs 38.4±9.8 minutes,P=0.018,respectively).Patient survival rates at 1 and 5 years were 84%in the first period and 91.7%in the second period,with no significant difference(P=0.32).CONCLUSION The reported indications and outcomes align with the current literature.Our findings provide crucial evidence regarding the feasibility of establishing a living donor program with consistent results over time.展开更多
To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical ...To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical and nonsurgical factors.These complications include bile leakage,biliary stricture,and choledocholithiasis,with a reported incidence of biliary stricture in pediatric living donor liver recip-ients ranging from 10%to 35%[2].Commonly employed thera-peutic approaches for biliary complications are endoscopic retro-grade cholangiopancreatography(ERCP),percutaneous transhepatic cholangioscopic lithotomy(PTCSL),and surgery,with ERCP often being the preferred initial treatment.展开更多
With the advances in transplant oncology in recent years, the role of liver transplantation has expanded to make curative treatment a possibility for a wider patient population. We highlight strategies in Hong Kong, C...With the advances in transplant oncology in recent years, the role of liver transplantation has expanded to make curative treatment a possibility for a wider patient population. We highlight strategies in Hong Kong, China that have enabled preoperative prognostication for judicious patient selection, downstaging therapy to definitive treatment, and postoperative therapies that have provided a growing role for liver transplantation in patients with more advanced hepatocellular carcinoma.展开更多
Face liveness detection is essential for securing biometric authentication systems against spoofing attacks,including printed photos,replay videos,and 3D masks.This study systematically evaluates pre-trained CNN model...Face liveness detection is essential for securing biometric authentication systems against spoofing attacks,including printed photos,replay videos,and 3D masks.This study systematically evaluates pre-trained CNN models—DenseNet201,VGG16,InceptionV3,ResNet50,VGG19,MobileNetV2,Xception,and InceptionResNetV2—leveraging transfer learning and fine-tuning to enhance liveness detection performance.The models were trained and tested on NUAA and Replay-Attack datasets,with cross-dataset generalization validated on SiW-MV2 to assess real-world adaptability.Performance was evaluated using accuracy,precision,recall,FAR,FRR,HTER,and specialized spoof detection metrics(APCER,NPCER,ACER).Fine-tuning significantly improved detection accuracy,with DenseNet201 achieving the highest performance(98.5%on NUAA,97.71%on Replay-Attack),while MobileNetV2 proved the most efficient model for real-time applications(latency:15 ms,memory usage:45 MB,energy consumption:30 mJ).A statistical significance analysis(paired t-tests,confidence intervals)validated these improvements.Cross-dataset experiments identified DenseNet201 and MobileNetV2 as the most generalizable architectures,with DenseNet201 achieving 86.4%accuracy on Replay-Attack when trained on NUAA,demonstrating robust feature extraction and adaptability.In contrast,ResNet50 showed lower generalization capabilities,struggling with dataset variability and complex spoofing attacks.These findings suggest that MobileNetV2 is well-suited for low-power applications,while DenseNet201 is ideal for high-security environments requiring superior accuracy.This research provides a framework for improving real-time face liveness detection,enhancing biometric security,and guiding future advancements in AI-driven anti-spoofing techniques.展开更多
1 Originally published in 1993,To Live,a novel by Chinese author Yu Hua has since gained international recognition for its raw emotional depth and exploration of themes like fate,endurance and the essence of humanity....1 Originally published in 1993,To Live,a novel by Chinese author Yu Hua has since gained international recognition for its raw emotional depth and exploration of themes like fate,endurance and the essence of humanity.2 The novel follows the life of Xu Fugui,a once⁃wealthy landowner who lost his fortune through gambling(赌博).As his status shifted to that of a peasant,he witnessed the rapid changes of society.Despite enduring relentless hardship,Fugui survived,finding moments of comfort in small and everyday acts of perseverance.展开更多
With the rise of live streaming on social media, platforms like Facebook, Instagram, and YouTube have become powerful business tools. They enable users to share live videos, fostering direct connections between busine...With the rise of live streaming on social media, platforms like Facebook, Instagram, and YouTube have become powerful business tools. They enable users to share live videos, fostering direct connections between businesses and their customers. This critical literature review paper explores the impact of live streaming on businesses, focusing on its role in attracting and satisfying consumers by promoting products tailored to their needs and wants. It emphasizes live streaming’s crucial role in engaging customers, a key to business growth. The study also provides viable strategies for businesses to leverage live streaming for growth and customer engagement, underscoring its importance in the business landscape.展开更多
Duangsamorn Wattanapathitiwong—usually called by her Chinese name Wang Ximei these days—never expected a Chinese television drama to lead her to a life in China,a marriage rooted in cross-cultural understanding,and ...Duangsamorn Wattanapathitiwong—usually called by her Chinese name Wang Ximei these days—never expected a Chinese television drama to lead her to a life in China,a marriage rooted in cross-cultural understanding,and a profession that now bridges two nations.From a university student in Thailand puzzled by Chinese dialogue to a Thai language lecturer in China influencing the next generation of Thailand-China communicators,Wang’s journey is a story of resilience,romance,and responsibility.展开更多
基金approved by the Ethics Committee of the Second Affiliated Hospital,Zhejiang University School of Medicine(2024-0690).
文摘The prognosis of drug-induced acute liver failure(ALF)is poor,with a survival rate of 27.1%without liver transplantation.Liver transplantation significantly improved survival rates to 66.2%.[1]The shortage of available grafts can be addressed by living donor liver transplantation(LDLT),an effective and safe method that expands the donor pool,enhances timely transplantation,and improves patient survival.
文摘Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].
文摘Background:Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. While liver transplantation (LT) provides the best long-term survival, it is constrained by organ scarcity and strict criteria. Liver resection (LR) is often the initial treatment for patients with solitary tumors and preserved liver function. The high recurrence rates associated with LR has prompted the exploration of sequential living donor liver transplantation (seq LDLT) after LR as a strategy for HCC patients with high-risk of recurrence.Methods:We analyzed data from 27 adult patients who underwent seq LDLT after LR for HCC at Kaohsiung Chang Gung Memorial Hospital (KCGMH) between June 1994 and December 2023. Patients were selected based on high-risk histopathological features post-LR or as part of downstaging strategy. Outcomes measured included overall survival (OS) and disease-free survival (DFS).Results:Among 765 HCC patients who underwent LDLT, 204 received LR before LDLT, and 27 underwent seqL DLT. Five patients (19%) underwent living donor liver transplantation (LDLT) following LR as a downstaging strategy while the rest received seqL DLT as a preemptive strategy. The median age was 53.5 years with 85%males. Chronic hepatitis B was the predominant underlying disease (74%). The 1-, 3-, and 5-year OS and DFS rates were 100%, 96.0%, 96.0%and 100%, 96.2%, 96.2%, respectively, with two patients experiencing HCC recurrence. One patient died from HCC recurrence. High-risk histopathological features included microvascular invasion (52%), satellite nodules (15%), multiple tumors (26%), tumors> 5 cm(19%), and a total tumor diameter> 10 cm (7%).Conclusions:Seq LDLT offers a promising, tailored approach for managing HCC with adverse histopathologic features. Combining seq LDLT, downstaging strategies, and multidisciplinary treatments can achieve satisfactory OS and DFS in carefully selected patients, highlighting the need for refined criteria to identify the best candidates.
文摘BACKGROUND Pediatric liver transplantation(LT)is the definitive treatment for end-stage liver disease and acute liver failure in children.However,graft size mismatch poses significant challenges,particularly in infants weighing less than 10 kg.Large-forsize grafts can lead to severe complications,including vascular thrombosis and impaired graft perfusion.Surgical innovations,such as hyper-reduced left lateral segment(HRLLS)grafts and monosegmental grafts(MSG),offer viable solutions by tailoring graft size without compromising vascular or biliary integrity.AIM To analyze the techniques and outcomes of HRLLS and MSG grafts in pediatric liver trabsplantation.METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a comprehensive literature search was conducted across PubMed,Scopus,and Google Scholar,including studies up to February 2025.Eligible studies included case-control,observational,and randomized controlled trials reporting clinical outcomes of HRLLS,MSG,or reduced left lateral segment grafts(RLLS)in pediatric LT.The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment.Meta-analysis was performed using MetaXL software to pool survival outcomes and assess complication profiles.RESULTS Eighteen studies involving various graft reduction techniques were included.Both HRLLS and MSG demonstrated comparable one-year survival rates exceeding 80%,with some studies reporting rates above 95%.Complications such as hepatic artery thrombosis,portal vein thrombosis,and sepsis were slightly more frequent in HRLLS/RLLS recipients but remained within acceptable limits.Meta-analysis revealed no significant differences in survivability between graft types.CONCLUSION HRLLS and MSG techniques enable successful liver transplantation in small pediatric recipients,achieving longterm outcomes comparable to standard approaches.These graft modification strategies expand donor pool utilization and optimize patient survival while mitigating large-for-size complications.
文摘BACKGROUND Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease.Experienced tertiary centers and specialized medical staff are necessary to ensure compatible long-term survival rates and quality-of-life for these children.AIM To report the results and the 10-year learning curve of a pediatric living-donor liver transplantation program.METHODS We conducted a retrospective cohort study of pediatric recipients from 2013 to 2023.Post-transplant outcomes and patient survival rates were compared between two 5-year periods of the program.RESULTS A total of 25 and 48 patients underwent transplantation in the first(2013-2017)and second period(2018-2023),respectively.Portal vein and hepatic artery thrombosis occurred in 11(15.1%)and seven(9.6%)patients,respectively.Biliary complications were observed in 39 of 73 patients(53.4%).A lower warm ischemia time was observed in the second period compared to the first(32.6±8.6 minutes vs 38.4±9.8 minutes,P=0.018,respectively).Patient survival rates at 1 and 5 years were 84%in the first period and 91.7%in the second period,with no significant difference(P=0.32).CONCLUSION The reported indications and outcomes align with the current literature.Our findings provide crucial evidence regarding the feasibility of establishing a living donor program with consistent results over time.
文摘To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical and nonsurgical factors.These complications include bile leakage,biliary stricture,and choledocholithiasis,with a reported incidence of biliary stricture in pediatric living donor liver recip-ients ranging from 10%to 35%[2].Commonly employed thera-peutic approaches for biliary complications are endoscopic retro-grade cholangiopancreatography(ERCP),percutaneous transhepatic cholangioscopic lithotomy(PTCSL),and surgery,with ERCP often being the preferred initial treatment.
文摘With the advances in transplant oncology in recent years, the role of liver transplantation has expanded to make curative treatment a possibility for a wider patient population. We highlight strategies in Hong Kong, China that have enabled preoperative prognostication for judicious patient selection, downstaging therapy to definitive treatment, and postoperative therapies that have provided a growing role for liver transplantation in patients with more advanced hepatocellular carcinoma.
基金funded by Centre for Advanced Modelling and Geospatial Information Systems(CAMGIS),Faculty of Engineering and IT,University of Technology Sydney.Moreover,Ongoing Research Funding Program(ORF-2025-14)King Saud University,Riyadh,Saudi Arabia,under Project ORF-2025-。
文摘Face liveness detection is essential for securing biometric authentication systems against spoofing attacks,including printed photos,replay videos,and 3D masks.This study systematically evaluates pre-trained CNN models—DenseNet201,VGG16,InceptionV3,ResNet50,VGG19,MobileNetV2,Xception,and InceptionResNetV2—leveraging transfer learning and fine-tuning to enhance liveness detection performance.The models were trained and tested on NUAA and Replay-Attack datasets,with cross-dataset generalization validated on SiW-MV2 to assess real-world adaptability.Performance was evaluated using accuracy,precision,recall,FAR,FRR,HTER,and specialized spoof detection metrics(APCER,NPCER,ACER).Fine-tuning significantly improved detection accuracy,with DenseNet201 achieving the highest performance(98.5%on NUAA,97.71%on Replay-Attack),while MobileNetV2 proved the most efficient model for real-time applications(latency:15 ms,memory usage:45 MB,energy consumption:30 mJ).A statistical significance analysis(paired t-tests,confidence intervals)validated these improvements.Cross-dataset experiments identified DenseNet201 and MobileNetV2 as the most generalizable architectures,with DenseNet201 achieving 86.4%accuracy on Replay-Attack when trained on NUAA,demonstrating robust feature extraction and adaptability.In contrast,ResNet50 showed lower generalization capabilities,struggling with dataset variability and complex spoofing attacks.These findings suggest that MobileNetV2 is well-suited for low-power applications,while DenseNet201 is ideal for high-security environments requiring superior accuracy.This research provides a framework for improving real-time face liveness detection,enhancing biometric security,and guiding future advancements in AI-driven anti-spoofing techniques.
文摘1 Originally published in 1993,To Live,a novel by Chinese author Yu Hua has since gained international recognition for its raw emotional depth and exploration of themes like fate,endurance and the essence of humanity.2 The novel follows the life of Xu Fugui,a once⁃wealthy landowner who lost his fortune through gambling(赌博).As his status shifted to that of a peasant,he witnessed the rapid changes of society.Despite enduring relentless hardship,Fugui survived,finding moments of comfort in small and everyday acts of perseverance.
文摘With the rise of live streaming on social media, platforms like Facebook, Instagram, and YouTube have become powerful business tools. They enable users to share live videos, fostering direct connections between businesses and their customers. This critical literature review paper explores the impact of live streaming on businesses, focusing on its role in attracting and satisfying consumers by promoting products tailored to their needs and wants. It emphasizes live streaming’s crucial role in engaging customers, a key to business growth. The study also provides viable strategies for businesses to leverage live streaming for growth and customer engagement, underscoring its importance in the business landscape.
文摘Duangsamorn Wattanapathitiwong—usually called by her Chinese name Wang Ximei these days—never expected a Chinese television drama to lead her to a life in China,a marriage rooted in cross-cultural understanding,and a profession that now bridges two nations.From a university student in Thailand puzzled by Chinese dialogue to a Thai language lecturer in China influencing the next generation of Thailand-China communicators,Wang’s journey is a story of resilience,romance,and responsibility.
