BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization r...BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.展开更多
This study investigates extreme rainfall episodes along the eastern foothills of the Taihang Mountains in North China from 30 July to 1 August 2023.It focuses on two types of extreme hourly rainfall rates(HRRs),i.e.,t...This study investigates extreme rainfall episodes along the eastern foothills of the Taihang Mountains in North China from 30 July to 1 August 2023.It focuses on two types of extreme hourly rainfall rates(HRRs),i.e.,the maximum regionalaverage HRR and site-observed HRR,which exhibited sequential development over southern,middle,and northern key regions.These rainfall extremes occurred in an environment where a high-pressure barrier over North China prevented the intrusion of cold air masses from the north while a northward-moving typhoon remnant vortex and its associated low-level jet(LLJ)transported warm and moist airflow from the south.Two distinct echo evolution modes and convection initiation mechanisms are identified for the two types of extreme HRRs.The maximum regional-average HRR occurred when the LLJ arrived to the east of the key regions,while the maximum site-observed HRR occurred when the warmer vortex center influenced the regions.Taking the northern key region as a representation,at the time of the maximum regional-average HRR,slantwise ascent of the airflow along a warm-frontal-like boundary released energy related to symmetrical instability,resulting in stratiform rainfall with weak convective cores.The transport of locally initiated convection over the eastern plain region,where the atmospheric stratification was more potentially unstable,also significantly contributed.When the maximum site-observed HRR occurred,the terrain lifting of warm and moist southeast airflow led to intense convection over the mountain foothills.Overall,the passage of the warm-core typhoon remnant vortex and interaction with Taihang Mountains determined the timing and location of extreme HRRs across the key regions.展开更多
Hot deformation with high strain rate has been paid more attention due to its high efficiency and low cost,however,the strain rate dependent dynamic recrystallization(DRX)and texture evolution in hot deformation proce...Hot deformation with high strain rate has been paid more attention due to its high efficiency and low cost,however,the strain rate dependent dynamic recrystallization(DRX)and texture evolution in hot deformation process,which affect the formability of metals,are lack of study.In this work,the DRX behavior and texture evolution of Mg-8Gd-1Er-0.5Zr alloy hot compressed with strain rates of 0.1 s^(−1),1 s^(−1),10 s^(−1) and 50 s^(−1) are studied,and the corresponding dominant mechanisms for DRX and texture weakening are discussed.Results indicated the DRX fraction was 20%and the whole texture intensity was 16.89 MRD when the strain rate was 0.1 s^(−1),but they were 76%and 6.55 MRD,respectively,when the strain rate increased to 50 s^(−1).The increment of DRX fraction is suggested to result from the reduced DRX critical strain and the increased dislocation density as well as velocity,while the weakened whole texture is attributed to the increased DRX grains.At the low strain rate of 0.1 s^(−1),discontinuous DRX(DDRX)was the dominant,but the whole texture was controlled by the deformed grains with the preferred orientation of{0001}⊥CD,because the number of DDRX grains was limited.At the high strain rate of 50 s^(−1),continuous DRX(CDRX)and twin-induced DRX(TDRX)were promoted,and more DRX grains resulted in orientation randomization.The whole texture was mainly weakened by CDRX and TDRX grains,in which CDRX plays a major role.The results of present work are significant for understanding the hot workability of Mg-RE alloys with a high strain rate.展开更多
The content of soluble sugars is a vital parameter that indicates the quality of fleshy fruits such as apple(Malus domestica Borkh.).Studying the patterns of accumulation of soluble sugars and regulatory mechanisms as...The content of soluble sugars is a vital parameter that indicates the quality of fleshy fruits such as apple(Malus domestica Borkh.).Studying the patterns of accumulation of soluble sugars and regulatory mechanisms associated with fruit development is crucial for breeding improved fruit varieties.Here,we report that MdCIbHLH1,a low temperature-induced b HLH transcription factor,inhibits the accumulation of soluble sugars by regulating sugar-metabolizing enzyme activities,photosynthetic performance,and the expression of sugar-related genes in developing apple fruits.MdCIbHLH1 inhibits MdFBP and MdPEPCK expression,thus blocking the conversion of acids to sugars in apple fruits.We also discovered that MdCIbHLH1 decreases the photosynthetic rate and carbohydrate accumulation in apple leaves.Our results suggest that soluble sugar accumulation in apple fruits is influenced by multiple factors,including metabolic status,photosynthesis,and carbohydrate allocation.MdCIbHLH1 is critically involved in controlling the accumulation of soluble sugars by coordinating carbohydrate synthesis and allocation,thus influencing sugar transport and its metabolism during the development of apple fruits.展开更多
Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrai...Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrained(CU)and drained(CD)triaxial testing elucidated the impact of strain rate(0.005–0.3 mm/min)on strength envelopes,deformation moduli,pore pressures,and dilatancy characteristics of unsaturated and quasi-saturated loess.Under drained conditions with a controlled matric suction of 50 kPa,increasing strain rates from 0.005 mm/min to 0.011 mm/min induced decreases in failure deviatoric stress(qf),initial deformation modulus(Ei),and cohesion(c),while friction angles remained unaffected.Specimens displayed initial contractive volumetric strains transitioning to dilation across varying confining pressures.Higher rates diminished contractive volumetric strains and drainage volumes,indicating reduced densification and strength in the shear zone.Under undrained conditions,both unsaturated and quasi-saturated(pore pressure coefficient B=0.75)loess exhibited deteriorating mechanical properties with increasing rates from 0.03 mm/min to 0.3 mm/min.For unsaturated loess,reduced contractive volumetric strains at higher rates manifested relatively looser structures in the pre-peak stress phase.The strength decrement in quasi-saturated loess arose from elevated excess porewater pressures diminishing effective stresses.Negative porewater pressures emerged in quasi-saturated loess at lower confining pressures and strain rates.Compared to previous studies,the qf and Ei exhibited rate sensitivity below threshold values before attaining minima with marginal subsequent influence.The underlying mechanism mirrors the transition from creep to accelerated deformation phase of landslides.展开更多
Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an...Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an artificial method in a laboratory setting using microbial-induced carbonate precipitation(MICP)to simulate the natural process of cementation of limestone.The artificially cemented sand has a high degree of similarity with the natural weakly limestone in three aspects:(1)the mineral composition of the cemented material is also granular calcite and acicular aragonite;(2)the microstructure in interconnected open pore network can be gradually closed and contracted with cementation.The porosity reaches to approximately 9.2%;(3)both the stress-strain relationship and the unconfined strength closely resemble that of natural weakly limestone.Furthermore,both static and dynamic behaviors of artificial limestone were studied by quasi-static compression tests and Split Hopkinson Pressure Bar(SHPB)tests,finding that the unconfined strength of weakly artifical limestone exponentially increases with increasing strain rate.A rate-dependent bond strength was proposed and implemented in software to reveal the mechanism of strain rate effects.It is found that the loading velocity is too high to keep in sync with the initiation and propagation of cracks under impact loading.This delay-induced viscosity may restrict the movement of the surrounding balls,thus increasing resistance.展开更多
Grain-oriented silicon steels were prepared at different heating rates during high temperature annealing,in which the evolution of magnetic properties,grain orientations and precipitates were studied.To illustrate the...Grain-oriented silicon steels were prepared at different heating rates during high temperature annealing,in which the evolution of magnetic properties,grain orientations and precipitates were studied.To illustrate the Zener factor,the diameter and number density of precipitates of interrupted testing samples were statistically calculated.The effect of precipitate ripening on the Goss texture and magnetic property was investigated.Data indicated that the trend of Zener factor was similar under different heating rates,first increasing and then decreasing,and that the precipitate maturing was greatly inhibited as the heating rate increased.Secondary recrystallization was developed at the temperature of 1010℃when a heating rate of 5℃/h was used,resulting in Goss,Brass and{110}<227>oriented grains growing abnormally and a magnetic induction intensity of 1.90T.Furthermore,increasing the heating rate to 20℃/h would inhibit the development of undesirable oriented grains and obtain a sharp Goss texture.However,when the heating rate was extremely fast,such as 40℃/h,poor secondary recrystallization was developed with many island grains,corresponding to a decrease in magnetic induction intensity to 1.87 T.At a suitable heating rate of 20℃/h,the sharpest Goss texture and the highest magnetic induction of 1.94 T with an onset secondary recrystallization temperature of 1020℃were found among the experimental variables in this study.The heating rate affected the initial temperature of secondary recrystallization by controlling the maturation of precipitates,leading to the deviation and dispersion of Goss texture,thereby reducing the magnetic properties.展开更多
Background To compare neural damage induced by ultra-high dose rate FLASH radiotherapy(FLASH-RT)with that induced by conventional dose rate radiotherapy(CONV-RT)in healthy mice.Methods Eighty adult male C57BL/6J mice ...Background To compare neural damage induced by ultra-high dose rate FLASH radiotherapy(FLASH-RT)with that induced by conventional dose rate radiotherapy(CONV-RT)in healthy mice.Methods Eighty adult male C57BL/6J mice were divided into five groups:Sham,CONV-RT10Gy,CONV-RT20Gy,FLASH-RT10Gy,and FLASH-RT20Gy.Three days post-irradiation,morphological changes in neurons within the dentate gyrus(DG),CA1,and CA3 were observed using hematoxylin and eosin and Nissl staining.The malondialdehyde(MDA),reduced glutathione(GSH),glutathione peroxidase(GSH-PX),superoxide dismutase(SOD),catalase(CAT),and hydroxyl radical(OH^(-))levels were measured using assay kits.Quantitative reverse transcription PCR was used to assess interleukin(IL)-1β,IL-6,inducible nitric oxide synthase(iNOS),and tumor necrosis factor(TNF)-αmRNA expression levels in hippocampus.Immunofluorescence was employed to observe microglial activation in the DG.Results Compared with Sham,CONV-RT10Gy and CONV-RT20Gy exhibited disorganized neuronal arrangements and blurred nucleoli in the DG;the number of Nissl body was reduced,but FLASH-RT10Gy and FLASH-RT20Gy alleviated these abnormalities.Moreover,FLASH-RT20Gy mitigated the upregulation of MDA and downregulation of GSH,GSH-PX,SOD,CAT,and OH^(-)levels in the hippocampus of mice subjected to CONV-RT20Gy.Additionally,FLASH-RT20Gy attenuated the upregulation of IL-1β,IL-6,iNOS,and TNF-αmRNA levels in hippocampus of mice subjected to CONV-RT20Gy and diminished microglial activation in the DG.Conclusion FLASH-RT mitigate the structural and functional disruptions in hippocampal neurons induced by CONV-RT and alleviate oxidative stress and inflammation in hippocampal tissue by reducing microglial activation.展开更多
The graded density impactor(GDI)dynamic loading technique is crucial for acquiring the dynamic physical property parameters of materials used in weapons.The accuracy and timeliness of GDI structural design are key to ...The graded density impactor(GDI)dynamic loading technique is crucial for acquiring the dynamic physical property parameters of materials used in weapons.The accuracy and timeliness of GDI structural design are key to achieving controllable stress-strain rate loading.In this study,we have,for the first time,combined one-dimensional fluid computational software with machine learning methods.We first elucidated the mechanisms by which GDI structures control stress and strain rates.Subsequently,we constructed a machine learning model to create a structure-property response surface.The results show that altering the loading velocity and interlayer thickness has a pronounced regulatory effect on stress and strain rates.In contrast,the impedance distribution index and target thickness have less significant effects on stress regulation,although there is a matching relationship between target thickness and interlayer thickness.Compared with traditional design methods,the machine learning approach offers a10^(4)—10^(5)times increase in efficiency and the potential to achieve a global optimum,holding promise for guiding the design of GDI.展开更多
Atomic surfaces are strictly required by high-performance devices of diamond.Nevertheless,diamond is the hardest material in nature,leading to the low material removal rate(MRR)and high surface roughness during machin...Atomic surfaces are strictly required by high-performance devices of diamond.Nevertheless,diamond is the hardest material in nature,leading to the low material removal rate(MRR)and high surface roughness during machining.Noxious slurries are widely used in conventional chemical mechanical polishing(CMP),resulting in the possible pollution to the environment.Moreover,the traditional slurries normally contain more than four ingredients,causing difficulties to control the process and quality of CMP.To solve these challenges,a novel green CMP for single crystal diamond was developed,consisting of only hydrogen peroxide,diamond abrasive and Prussian blue(PB)/titania catalyst.After CMP,atomic surface is achieved with surface roughness Sa of 0.079 nm,and the MRR is 1168 nm·h^(-1).Thickness of damaged layer is merely 0.66 nm confirmed by transmission electron microscopy(TEM).X-ray photoelectron spectroscopy,electron paramagnetic resonance and TEM reveal that·OH radicals form under ultraviolet irradiation on PB/titania catalyst.The·OH radicals oxidize diamond,transforming it from monocrystalline to amorphous atomic structure,generating a soft amorphous layer.This contributes the high MRR and formation of atomic surface on diamond.The developed novel green CMP offers new insights to achieve atomic surface of diamond for potential use in their high-performance devices.展开更多
For the Sylvester continued fraction expansions of real numbers,FAN et al.(2007)proved that,for almost all real numbers,the nth partial quotient grows exponentially with respect to the product of the first n-1 partial...For the Sylvester continued fraction expansions of real numbers,FAN et al.(2007)proved that,for almost all real numbers,the nth partial quotient grows exponentially with respect to the product of the first n-1 partial quotients.In this paper,we establish the Hausdorff dimension of the exceptional set where the growth rate is a general function.展开更多
The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdraw...The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdrawal rate is a critical parameter affecting the spatial distribution ofγ/γ′eutectic along gravity direction.The results show that theγ/γ′eutectic fraction of the upper platform surface is always higher than that of the lower one,regardless of withdrawal rate.As the withdrawal rate decreases,there is a significant increase inγ/γ′eutectic fraction on the upper surface,while it decreases on the lower surface.The upward accumulation ofγ/γ′eutectic becomes more severe as the withdrawal rate decreases.It is also found that the percentage of Al+Ta is positively correlated with theγ/γ′eutectic fraction.Thermo-solute convection of Al and Ta solutes in the solidification front is the prime reason for the non-uniform distribution of eutectic.The non-uniform distribution ofγ/γ′eutectic cannot be eliminated even after subsequent solution heat treatment,resulting in excess eutectic on the upper surface and thus leading to the scrapping of the blade.展开更多
We consider a single server constant retrial queue,in which a state-dependent service policy is used to control the service rate.Customer arrival follows Poisson process,while service time and retrial time are exponen...We consider a single server constant retrial queue,in which a state-dependent service policy is used to control the service rate.Customer arrival follows Poisson process,while service time and retrial time are exponential distributions.Whenever the server is available,it admits the retrial customers into service based on a first-come first-served rule.The service rate adjusts in real-time based on the retrial queue length.An iterative algorithm is proposed to numerically solve the personal optimal problem in the fully observable scenario.Furthermore,we investigate the impact of parameters on the social optimal threshold.The effectiveness of the results is illustrated by two examples.展开更多
One of the main obstacles to the development of aquaculture in Senegal is the availability of fry and juveniles in sufficient quantities. The objective of our study is to evaluate the effects of treatment with the hor...One of the main obstacles to the development of aquaculture in Senegal is the availability of fry and juveniles in sufficient quantities. The objective of our study is to evaluate the effects of treatment with the hormone 17 alpha methyl testosterone (17-&-MT) and different doses of Nauclea latifolia root powder on the masculinization rates of tilapia Oreochromis niloticus larvae in Senegal. A total of 450 larvae of Oreochromis niloticus, with an average size of 0.012 g, were placed in 15 aquariums, each containing 30 individuals and fed one of the 5 diets in triplicate. These individuals were fed either a diet containing a plant extract at a dose of 180 mg (T180), 200 mg (T200) and 250 mg (T250) per kg of food, or a diet containing 60 mg/kg of the hormone 17-&-MT (TMT), or a diet without either the plant extract or the hormone (T0). Individuals were fed for 30 days with the treatment diets, and then with the industrial feed for the rest of the experiment. At the end of the study, the results of the masculinization rate were: 80.49%, 73.13%, 69.23%, 66.67% and 45.95% for T250;T200, TMT, T180 and T0 respectively. In summary, we can say that the 250 mg/kg dose provides better masculinization, followed by 200mg/kg and then 17 α MT. For the plant, the increase in the percentage of males is dose-dependent. These results also translate into better growth of individuals in this order. However, the relatively lower survival rates observed in batches treated with Nauclea latifolia extract indicate that these treatments could have a deleterious effect on the survival of Oreochromis niloticus larvae. These results suggest the use of N. latifolia extract at a dose of 250 mg/kg feed for better production of male O. niloticus larvae without compromising their growth.展开更多
The accuracy of spot centroid positioning has a significant impact on the tracking accuracy of the system and the stability of the laser link construction.In satellite laser communication systems,the use of short-wave...The accuracy of spot centroid positioning has a significant impact on the tracking accuracy of the system and the stability of the laser link construction.In satellite laser communication systems,the use of short-wave infrared wavelengths as beacon light can reduce atmospheric absorption and signal attenuation.However,there are strong non-uniformity and blind pixels in the short-wave infrared image,which makes the image distorted and leads to the decrease of spot centroid positioning accuracy.Therefore,the high-precision localization of the spot centroid of the short-wave infrared images is of great research significance.A high-precision spot centroid positioning model for short-wave infrared is proposed to correct for non-uniformity and blind pixels in short-wave infrared images and quantify the localization errors caused by the two,further model-based localization error simulations are performed,and a novel spot centroid positioning payload for satellite laser communications has been designed using the latest 640×512 planar array InGaAs shortwave infrared detector.The experimental results show that the non-uniformity of the corrected image is reduced from 7%to 0.6%,the blind pixels rejection rate reaches 100%,the frame rate can be up to 2000 Hz,and the spot centroid localization accuracy is as high as 0.1 pixel point,which realizes high-precision spot centroid localization of high-frame-frequency short-wave infrared images.展开更多
Dual-ion batteries(DIBs)usually use carbon-based materials as electrodes,showing advantages in high operating volt-age,potential low cost,and environmental friendliness.Different from conventional“rocking chair”type...Dual-ion batteries(DIBs)usually use carbon-based materials as electrodes,showing advantages in high operating volt-age,potential low cost,and environmental friendliness.Different from conventional“rocking chair”type secondary batter-ies,DIBs perform a unique working mechanism,which employ both cation and anion taking part in capacity contribution at an anode and a cathode,respectively,during electrochemical reactions.Graphite has been identified as a suitable cathode material for anion intercalation at high voltages(>4.8 V)with fast reaction kinetics.However,the development of DIBs is being hindered by dynamic mismatch between a cathode and an anode due to sluggish Li+diffusion at a high rate.Herein,we prepared phyllostachys edulis derived carbon(PEC)through microstructure regulation strategy and investigated the carbonized temperature effect,which effectively tailored the rich short-range ordered graphite microdomains and disor-dered amorphous regions,as well as a unique nano-pore hierarchical structure.The pore size distribution of nano-pores was concentrated in 0.5-5 nm,providing suitable channels for rapid Li+transportation.It was found that PEC-500(carbon-ized at 500℃)achieved a high capacity of 436 mAh·g^(-1)at 300 mA·g^(-1)and excellent rate performance(maintaining a high capacity of 231 mAh·g^(-1)at 3 A·g^(-1)).The assembled dual-carbon PEC-500||graphite full battery delivered 114 mAh·g^(-1)at 10 C with 96%capacity retention after 3000 cycles and outstanding rate capability,providing 74 mAh·g^(-1)at 50 C.展开更多
In this paper,we study the optimal investment problem of an insurer whose surplus process follows the diffusion approximation of the classical Cramer-Lundberg model.Investment in the foreign markets is allowed,and the...In this paper,we study the optimal investment problem of an insurer whose surplus process follows the diffusion approximation of the classical Cramer-Lundberg model.Investment in the foreign markets is allowed,and therefore,the foreign exchange rate model is incorporated.Under the allowing of selling and borrowing,the problem of maximizing the expected exponential utility of terminal wealth is studied.By solving the corresponding Hamilton-Jacobi-Bellman equations,the optimal investment strategies and value functions are obtained.Finally,numerical analysis is presented.展开更多
Based on simplified calculations of one-dimensional wave systems,loading pressure platform curves of Al-Cu gradient materials(GMs)impactor were designed.The Al-Cu GMs were prepared using tape-pressing sintering,and th...Based on simplified calculations of one-dimensional wave systems,loading pressure platform curves of Al-Cu gradient materials(GMs)impactor were designed.The Al-Cu GMs were prepared using tape-pressing sintering,and their acoustic properties were characterized to match the design path.The parallelism of the Al-Cu GM was confirmed using a three-dimensional surface profilometry machine.A one-stage light-gas gun was used to launch the Al-Cu GM,impacting an Al-LiF target at a velocity of 400 m/s.The results of the experimental strain rate demonstrate that the Al-Cu GMs can realize the precise control of the strain rate within the range of 10^(4)‒10^(5)/s in the high-speed impact experiments.展开更多
Strain rate is a critical factor influencing the mechanical response of hexagonal close-packed titanium under cryogenic conditions.In this study,uniaxial tensile tests were performed on commercially pure titanium at 7...Strain rate is a critical factor influencing the mechanical response of hexagonal close-packed titanium under cryogenic conditions.In this study,uniaxial tensile tests were performed on commercially pure titanium at 77 K over a broad strain rate range from 0.001 to 1 s^(-1).A critical strain rate of approximately 0.5 s^(-1)was identified,above which ductility exhibits a pronounced reduction,whereas below this threshold,ductility remains relatively stable.Through comprehensive analyses of strain evolution,deformed microstructure,and fracture morphology,this behavior is attributed to severe localized adiabatic heating resulting from inhomogeneous deformation,rather than conventional twin or shear mechanisms.展开更多
This letter addresses the recent systematic review and meta-analysis by Wang et al,which evaluated the role of artificial intelligence-based computer-aided de-tection(CADe)in reducing adenoma and polyp miss rates duri...This letter addresses the recent systematic review and meta-analysis by Wang et al,which evaluated the role of artificial intelligence-based computer-aided de-tection(CADe)in reducing adenoma and polyp miss rates during colonoscopy.We commend the authors for highlighting adenoma miss rate(AMR)as a more clinically meaningful endpoint than the traditionally used adenoma detection rate.Their findings demonstrate a significant reduction in AMR and polyp miss rate with CADe-assisted colonoscopy,particularly in small and sessile serrated lesions.However,limitations,including limited study numbers,tandem study design of included studies,and heterogeneity of CADe systems,warrant cautious interpretation.We discuss the broader implications of these findings for real-world practice and future research directions.This letter reinforces the importance of AMR as a performance metric and supports the continued integration and eva-luation of artificial intelligence technologies in endoscopic practice to enhance colorectal cancer prevention strategies.展开更多
文摘BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.
基金supported by the National Key R&D Program of China(2022YFC3003903)Natural Science Foundation of Beijing(Grant No.8222079)and of China(Grant No.42475014,U2442204)the Basic Research Fund of CAMS(2023Z001).
文摘This study investigates extreme rainfall episodes along the eastern foothills of the Taihang Mountains in North China from 30 July to 1 August 2023.It focuses on two types of extreme hourly rainfall rates(HRRs),i.e.,the maximum regionalaverage HRR and site-observed HRR,which exhibited sequential development over southern,middle,and northern key regions.These rainfall extremes occurred in an environment where a high-pressure barrier over North China prevented the intrusion of cold air masses from the north while a northward-moving typhoon remnant vortex and its associated low-level jet(LLJ)transported warm and moist airflow from the south.Two distinct echo evolution modes and convection initiation mechanisms are identified for the two types of extreme HRRs.The maximum regional-average HRR occurred when the LLJ arrived to the east of the key regions,while the maximum site-observed HRR occurred when the warmer vortex center influenced the regions.Taking the northern key region as a representation,at the time of the maximum regional-average HRR,slantwise ascent of the airflow along a warm-frontal-like boundary released energy related to symmetrical instability,resulting in stratiform rainfall with weak convective cores.The transport of locally initiated convection over the eastern plain region,where the atmospheric stratification was more potentially unstable,also significantly contributed.When the maximum site-observed HRR occurred,the terrain lifting of warm and moist southeast airflow led to intense convection over the mountain foothills.Overall,the passage of the warm-core typhoon remnant vortex and interaction with Taihang Mountains determined the timing and location of extreme HRRs across the key regions.
基金supported by the Nation Key Research and Development Program of China(No.2021YFB3701100).
文摘Hot deformation with high strain rate has been paid more attention due to its high efficiency and low cost,however,the strain rate dependent dynamic recrystallization(DRX)and texture evolution in hot deformation process,which affect the formability of metals,are lack of study.In this work,the DRX behavior and texture evolution of Mg-8Gd-1Er-0.5Zr alloy hot compressed with strain rates of 0.1 s^(−1),1 s^(−1),10 s^(−1) and 50 s^(−1) are studied,and the corresponding dominant mechanisms for DRX and texture weakening are discussed.Results indicated the DRX fraction was 20%and the whole texture intensity was 16.89 MRD when the strain rate was 0.1 s^(−1),but they were 76%and 6.55 MRD,respectively,when the strain rate increased to 50 s^(−1).The increment of DRX fraction is suggested to result from the reduced DRX critical strain and the increased dislocation density as well as velocity,while the weakened whole texture is attributed to the increased DRX grains.At the low strain rate of 0.1 s^(−1),discontinuous DRX(DDRX)was the dominant,but the whole texture was controlled by the deformed grains with the preferred orientation of{0001}⊥CD,because the number of DDRX grains was limited.At the high strain rate of 50 s^(−1),continuous DRX(CDRX)and twin-induced DRX(TDRX)were promoted,and more DRX grains resulted in orientation randomization.The whole texture was mainly weakened by CDRX and TDRX grains,in which CDRX plays a major role.The results of present work are significant for understanding the hot workability of Mg-RE alloys with a high strain rate.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.32122080,31972375)Shandong Province(Grant No.ZR2020YQ25)。
文摘The content of soluble sugars is a vital parameter that indicates the quality of fleshy fruits such as apple(Malus domestica Borkh.).Studying the patterns of accumulation of soluble sugars and regulatory mechanisms associated with fruit development is crucial for breeding improved fruit varieties.Here,we report that MdCIbHLH1,a low temperature-induced b HLH transcription factor,inhibits the accumulation of soluble sugars by regulating sugar-metabolizing enzyme activities,photosynthetic performance,and the expression of sugar-related genes in developing apple fruits.MdCIbHLH1 inhibits MdFBP and MdPEPCK expression,thus blocking the conversion of acids to sugars in apple fruits.We also discovered that MdCIbHLH1 decreases the photosynthetic rate and carbohydrate accumulation in apple leaves.Our results suggest that soluble sugar accumulation in apple fruits is influenced by multiple factors,including metabolic status,photosynthesis,and carbohydrate allocation.MdCIbHLH1 is critically involved in controlling the accumulation of soluble sugars by coordinating carbohydrate synthesis and allocation,thus influencing sugar transport and its metabolism during the development of apple fruits.
文摘Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrained(CU)and drained(CD)triaxial testing elucidated the impact of strain rate(0.005–0.3 mm/min)on strength envelopes,deformation moduli,pore pressures,and dilatancy characteristics of unsaturated and quasi-saturated loess.Under drained conditions with a controlled matric suction of 50 kPa,increasing strain rates from 0.005 mm/min to 0.011 mm/min induced decreases in failure deviatoric stress(qf),initial deformation modulus(Ei),and cohesion(c),while friction angles remained unaffected.Specimens displayed initial contractive volumetric strains transitioning to dilation across varying confining pressures.Higher rates diminished contractive volumetric strains and drainage volumes,indicating reduced densification and strength in the shear zone.Under undrained conditions,both unsaturated and quasi-saturated(pore pressure coefficient B=0.75)loess exhibited deteriorating mechanical properties with increasing rates from 0.03 mm/min to 0.3 mm/min.For unsaturated loess,reduced contractive volumetric strains at higher rates manifested relatively looser structures in the pre-peak stress phase.The strength decrement in quasi-saturated loess arose from elevated excess porewater pressures diminishing effective stresses.Negative porewater pressures emerged in quasi-saturated loess at lower confining pressures and strain rates.Compared to previous studies,the qf and Ei exhibited rate sensitivity below threshold values before attaining minima with marginal subsequent influence.The underlying mechanism mirrors the transition from creep to accelerated deformation phase of landslides.
基金The authors would like to acknowledge the support of the National Natural Science Foundation of China(No.52279097,No.51779264)Blue and Green Project of Jiangsu Province.
文摘Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an artificial method in a laboratory setting using microbial-induced carbonate precipitation(MICP)to simulate the natural process of cementation of limestone.The artificially cemented sand has a high degree of similarity with the natural weakly limestone in three aspects:(1)the mineral composition of the cemented material is also granular calcite and acicular aragonite;(2)the microstructure in interconnected open pore network can be gradually closed and contracted with cementation.The porosity reaches to approximately 9.2%;(3)both the stress-strain relationship and the unconfined strength closely resemble that of natural weakly limestone.Furthermore,both static and dynamic behaviors of artificial limestone were studied by quasi-static compression tests and Split Hopkinson Pressure Bar(SHPB)tests,finding that the unconfined strength of weakly artifical limestone exponentially increases with increasing strain rate.A rate-dependent bond strength was proposed and implemented in software to reveal the mechanism of strain rate effects.It is found that the loading velocity is too high to keep in sync with the initiation and propagation of cracks under impact loading.This delay-induced viscosity may restrict the movement of the surrounding balls,thus increasing resistance.
文摘Grain-oriented silicon steels were prepared at different heating rates during high temperature annealing,in which the evolution of magnetic properties,grain orientations and precipitates were studied.To illustrate the Zener factor,the diameter and number density of precipitates of interrupted testing samples were statistically calculated.The effect of precipitate ripening on the Goss texture and magnetic property was investigated.Data indicated that the trend of Zener factor was similar under different heating rates,first increasing and then decreasing,and that the precipitate maturing was greatly inhibited as the heating rate increased.Secondary recrystallization was developed at the temperature of 1010℃when a heating rate of 5℃/h was used,resulting in Goss,Brass and{110}<227>oriented grains growing abnormally and a magnetic induction intensity of 1.90T.Furthermore,increasing the heating rate to 20℃/h would inhibit the development of undesirable oriented grains and obtain a sharp Goss texture.However,when the heating rate was extremely fast,such as 40℃/h,poor secondary recrystallization was developed with many island grains,corresponding to a decrease in magnetic induction intensity to 1.87 T.At a suitable heating rate of 20℃/h,the sharpest Goss texture and the highest magnetic induction of 1.94 T with an onset secondary recrystallization temperature of 1020℃were found among the experimental variables in this study.The heating rate affected the initial temperature of secondary recrystallization by controlling the maturation of precipitates,leading to the deviation and dispersion of Goss texture,thereby reducing the magnetic properties.
文摘Background To compare neural damage induced by ultra-high dose rate FLASH radiotherapy(FLASH-RT)with that induced by conventional dose rate radiotherapy(CONV-RT)in healthy mice.Methods Eighty adult male C57BL/6J mice were divided into five groups:Sham,CONV-RT10Gy,CONV-RT20Gy,FLASH-RT10Gy,and FLASH-RT20Gy.Three days post-irradiation,morphological changes in neurons within the dentate gyrus(DG),CA1,and CA3 were observed using hematoxylin and eosin and Nissl staining.The malondialdehyde(MDA),reduced glutathione(GSH),glutathione peroxidase(GSH-PX),superoxide dismutase(SOD),catalase(CAT),and hydroxyl radical(OH^(-))levels were measured using assay kits.Quantitative reverse transcription PCR was used to assess interleukin(IL)-1β,IL-6,inducible nitric oxide synthase(iNOS),and tumor necrosis factor(TNF)-αmRNA expression levels in hippocampus.Immunofluorescence was employed to observe microglial activation in the DG.Results Compared with Sham,CONV-RT10Gy and CONV-RT20Gy exhibited disorganized neuronal arrangements and blurred nucleoli in the DG;the number of Nissl body was reduced,but FLASH-RT10Gy and FLASH-RT20Gy alleviated these abnormalities.Moreover,FLASH-RT20Gy mitigated the upregulation of MDA and downregulation of GSH,GSH-PX,SOD,CAT,and OH^(-)levels in the hippocampus of mice subjected to CONV-RT20Gy.Additionally,FLASH-RT20Gy attenuated the upregulation of IL-1β,IL-6,iNOS,and TNF-αmRNA levels in hippocampus of mice subjected to CONV-RT20Gy and diminished microglial activation in the DG.Conclusion FLASH-RT mitigate the structural and functional disruptions in hippocampal neurons induced by CONV-RT and alleviate oxidative stress and inflammation in hippocampal tissue by reducing microglial activation.
基金supported by the Guangdong Major Project of Basic and Applied Basic Research(Grant No.2021B0301030001)the National Key Research and Development Program of China(Grant No.2021YFB3802300)the Foundation of National Key Laboratory of Shock Wave and Detonation Physics(Grant No.JCKYS2022212004)。
文摘The graded density impactor(GDI)dynamic loading technique is crucial for acquiring the dynamic physical property parameters of materials used in weapons.The accuracy and timeliness of GDI structural design are key to achieving controllable stress-strain rate loading.In this study,we have,for the first time,combined one-dimensional fluid computational software with machine learning methods.We first elucidated the mechanisms by which GDI structures control stress and strain rates.Subsequently,we constructed a machine learning model to create a structure-property response surface.The results show that altering the loading velocity and interlayer thickness has a pronounced regulatory effect on stress and strain rates.In contrast,the impedance distribution index and target thickness have less significant effects on stress regulation,although there is a matching relationship between target thickness and interlayer thickness.Compared with traditional design methods,the machine learning approach offers a10^(4)—10^(5)times increase in efficiency and the potential to achieve a global optimum,holding promise for guiding the design of GDI.
基金financial support from the National Key Research and Development Program of China(2018YFA0703400)the Fundamental Research Funds for the Provincial Universities of Zhejiang(GK239909299001021)+1 种基金the Ninth China Association for Science and Technology Youth Talent Lift Project Support Plan(KYZ015324002)the Changjiang Scholars Program of Chinese Ministry of Education。
文摘Atomic surfaces are strictly required by high-performance devices of diamond.Nevertheless,diamond is the hardest material in nature,leading to the low material removal rate(MRR)and high surface roughness during machining.Noxious slurries are widely used in conventional chemical mechanical polishing(CMP),resulting in the possible pollution to the environment.Moreover,the traditional slurries normally contain more than four ingredients,causing difficulties to control the process and quality of CMP.To solve these challenges,a novel green CMP for single crystal diamond was developed,consisting of only hydrogen peroxide,diamond abrasive and Prussian blue(PB)/titania catalyst.After CMP,atomic surface is achieved with surface roughness Sa of 0.079 nm,and the MRR is 1168 nm·h^(-1).Thickness of damaged layer is merely 0.66 nm confirmed by transmission electron microscopy(TEM).X-ray photoelectron spectroscopy,electron paramagnetic resonance and TEM reveal that·OH radicals form under ultraviolet irradiation on PB/titania catalyst.The·OH radicals oxidize diamond,transforming it from monocrystalline to amorphous atomic structure,generating a soft amorphous layer.This contributes the high MRR and formation of atomic surface on diamond.The developed novel green CMP offers new insights to achieve atomic surface of diamond for potential use in their high-performance devices.
基金Supported by Projects from Chongqing Municipal Science and Technology Commission(CSTB2022NSCQ-MSX0445)。
文摘For the Sylvester continued fraction expansions of real numbers,FAN et al.(2007)proved that,for almost all real numbers,the nth partial quotient grows exponentially with respect to the product of the first n-1 partial quotients.In this paper,we establish the Hausdorff dimension of the exceptional set where the growth rate is a general function.
基金Shenzhen Science and Technology Program(JSGG20220831092800001)。
文摘The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdrawal rate is a critical parameter affecting the spatial distribution ofγ/γ′eutectic along gravity direction.The results show that theγ/γ′eutectic fraction of the upper platform surface is always higher than that of the lower one,regardless of withdrawal rate.As the withdrawal rate decreases,there is a significant increase inγ/γ′eutectic fraction on the upper surface,while it decreases on the lower surface.The upward accumulation ofγ/γ′eutectic becomes more severe as the withdrawal rate decreases.It is also found that the percentage of Al+Ta is positively correlated with theγ/γ′eutectic fraction.Thermo-solute convection of Al and Ta solutes in the solidification front is the prime reason for the non-uniform distribution of eutectic.The non-uniform distribution ofγ/γ′eutectic cannot be eliminated even after subsequent solution heat treatment,resulting in excess eutectic on the upper surface and thus leading to the scrapping of the blade.
基金supported by the National Natural Science Foundation of China(Grant No.11971486)。
文摘We consider a single server constant retrial queue,in which a state-dependent service policy is used to control the service rate.Customer arrival follows Poisson process,while service time and retrial time are exponential distributions.Whenever the server is available,it admits the retrial customers into service based on a first-come first-served rule.The service rate adjusts in real-time based on the retrial queue length.An iterative algorithm is proposed to numerically solve the personal optimal problem in the fully observable scenario.Furthermore,we investigate the impact of parameters on the social optimal threshold.The effectiveness of the results is illustrated by two examples.
文摘One of the main obstacles to the development of aquaculture in Senegal is the availability of fry and juveniles in sufficient quantities. The objective of our study is to evaluate the effects of treatment with the hormone 17 alpha methyl testosterone (17-&-MT) and different doses of Nauclea latifolia root powder on the masculinization rates of tilapia Oreochromis niloticus larvae in Senegal. A total of 450 larvae of Oreochromis niloticus, with an average size of 0.012 g, were placed in 15 aquariums, each containing 30 individuals and fed one of the 5 diets in triplicate. These individuals were fed either a diet containing a plant extract at a dose of 180 mg (T180), 200 mg (T200) and 250 mg (T250) per kg of food, or a diet containing 60 mg/kg of the hormone 17-&-MT (TMT), or a diet without either the plant extract or the hormone (T0). Individuals were fed for 30 days with the treatment diets, and then with the industrial feed for the rest of the experiment. At the end of the study, the results of the masculinization rate were: 80.49%, 73.13%, 69.23%, 66.67% and 45.95% for T250;T200, TMT, T180 and T0 respectively. In summary, we can say that the 250 mg/kg dose provides better masculinization, followed by 200mg/kg and then 17 α MT. For the plant, the increase in the percentage of males is dose-dependent. These results also translate into better growth of individuals in this order. However, the relatively lower survival rates observed in batches treated with Nauclea latifolia extract indicate that these treatments could have a deleterious effect on the survival of Oreochromis niloticus larvae. These results suggest the use of N. latifolia extract at a dose of 250 mg/kg feed for better production of male O. niloticus larvae without compromising their growth.
基金Supported by the Short-wave Infrared Camera Systems(B025F40622024)。
文摘The accuracy of spot centroid positioning has a significant impact on the tracking accuracy of the system and the stability of the laser link construction.In satellite laser communication systems,the use of short-wave infrared wavelengths as beacon light can reduce atmospheric absorption and signal attenuation.However,there are strong non-uniformity and blind pixels in the short-wave infrared image,which makes the image distorted and leads to the decrease of spot centroid positioning accuracy.Therefore,the high-precision localization of the spot centroid of the short-wave infrared images is of great research significance.A high-precision spot centroid positioning model for short-wave infrared is proposed to correct for non-uniformity and blind pixels in short-wave infrared images and quantify the localization errors caused by the two,further model-based localization error simulations are performed,and a novel spot centroid positioning payload for satellite laser communications has been designed using the latest 640×512 planar array InGaAs shortwave infrared detector.The experimental results show that the non-uniformity of the corrected image is reduced from 7%to 0.6%,the blind pixels rejection rate reaches 100%,the frame rate can be up to 2000 Hz,and the spot centroid localization accuracy is as high as 0.1 pixel point,which realizes high-precision spot centroid localization of high-frame-frequency short-wave infrared images.
基金supported by the National Natural Science Foundation of China(Grant Nos.52272208,22309057)the Natural Science Foundation of Hubei Province(Grant No.2023AFB355)the Fundamental Research Funds for the Central Universities of China(Grant No.2662022LXQD001).
文摘Dual-ion batteries(DIBs)usually use carbon-based materials as electrodes,showing advantages in high operating volt-age,potential low cost,and environmental friendliness.Different from conventional“rocking chair”type secondary batter-ies,DIBs perform a unique working mechanism,which employ both cation and anion taking part in capacity contribution at an anode and a cathode,respectively,during electrochemical reactions.Graphite has been identified as a suitable cathode material for anion intercalation at high voltages(>4.8 V)with fast reaction kinetics.However,the development of DIBs is being hindered by dynamic mismatch between a cathode and an anode due to sluggish Li+diffusion at a high rate.Herein,we prepared phyllostachys edulis derived carbon(PEC)through microstructure regulation strategy and investigated the carbonized temperature effect,which effectively tailored the rich short-range ordered graphite microdomains and disor-dered amorphous regions,as well as a unique nano-pore hierarchical structure.The pore size distribution of nano-pores was concentrated in 0.5-5 nm,providing suitable channels for rapid Li+transportation.It was found that PEC-500(carbon-ized at 500℃)achieved a high capacity of 436 mAh·g^(-1)at 300 mA·g^(-1)and excellent rate performance(maintaining a high capacity of 231 mAh·g^(-1)at 3 A·g^(-1)).The assembled dual-carbon PEC-500||graphite full battery delivered 114 mAh·g^(-1)at 10 C with 96%capacity retention after 3000 cycles and outstanding rate capability,providing 74 mAh·g^(-1)at 50 C.
基金supported by the National Natural Science Foundation of China(Grant No.12301603).
文摘In this paper,we study the optimal investment problem of an insurer whose surplus process follows the diffusion approximation of the classical Cramer-Lundberg model.Investment in the foreign markets is allowed,and therefore,the foreign exchange rate model is incorporated.Under the allowing of selling and borrowing,the problem of maximizing the expected exponential utility of terminal wealth is studied.By solving the corresponding Hamilton-Jacobi-Bellman equations,the optimal investment strategies and value functions are obtained.Finally,numerical analysis is presented.
基金Natural Science Foundation of Hubei Province(2024AFB432)National Natural Science Foundation of China(52171045,12302436,52302095)Research Fund of Jianghan University(2023JCYJ05)。
文摘Based on simplified calculations of one-dimensional wave systems,loading pressure platform curves of Al-Cu gradient materials(GMs)impactor were designed.The Al-Cu GMs were prepared using tape-pressing sintering,and their acoustic properties were characterized to match the design path.The parallelism of the Al-Cu GM was confirmed using a three-dimensional surface profilometry machine.A one-stage light-gas gun was used to launch the Al-Cu GM,impacting an Al-LiF target at a velocity of 400 m/s.The results of the experimental strain rate demonstrate that the Al-Cu GMs can realize the precise control of the strain rate within the range of 10^(4)‒10^(5)/s in the high-speed impact experiments.
基金financially supported by the National Key Research&Development Plan(No.2022YFE0110600)the National Natural Science Foundation of China(Nos.52171117,52371113,92263201 and 52175306)+3 种基金Qing Lan Project(No.54944004)the Basic Research Program of Jiangsu(Nos.BK20232011 and BK20232025)the Postdoctoral Fellowship Program of CPSF(No.GZC20233481)Tuoyuan project of Nanjing Tech University(No.20230113)
文摘Strain rate is a critical factor influencing the mechanical response of hexagonal close-packed titanium under cryogenic conditions.In this study,uniaxial tensile tests were performed on commercially pure titanium at 77 K over a broad strain rate range from 0.001 to 1 s^(-1).A critical strain rate of approximately 0.5 s^(-1)was identified,above which ductility exhibits a pronounced reduction,whereas below this threshold,ductility remains relatively stable.Through comprehensive analyses of strain evolution,deformed microstructure,and fracture morphology,this behavior is attributed to severe localized adiabatic heating resulting from inhomogeneous deformation,rather than conventional twin or shear mechanisms.
文摘This letter addresses the recent systematic review and meta-analysis by Wang et al,which evaluated the role of artificial intelligence-based computer-aided de-tection(CADe)in reducing adenoma and polyp miss rates during colonoscopy.We commend the authors for highlighting adenoma miss rate(AMR)as a more clinically meaningful endpoint than the traditionally used adenoma detection rate.Their findings demonstrate a significant reduction in AMR and polyp miss rate with CADe-assisted colonoscopy,particularly in small and sessile serrated lesions.However,limitations,including limited study numbers,tandem study design of included studies,and heterogeneity of CADe systems,warrant cautious interpretation.We discuss the broader implications of these findings for real-world practice and future research directions.This letter reinforces the importance of AMR as a performance metric and supports the continued integration and eva-luation of artificial intelligence technologies in endoscopic practice to enhance colorectal cancer prevention strategies.
