Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hosp...Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.展开更多
This study examined the relationship between inclusive leadership and authenticity at work in racial minority groups of South Africa,taking into account the mediating role of psychological safety and the moderator rol...This study examined the relationship between inclusive leadership and authenticity at work in racial minority groups of South Africa,taking into account the mediating role of psychological safety and the moderator role of gender,in that relationship.The sample was composed of 94 employees predominantly working in the professional services sector from South Africa(41.5%females;mean age=37.1),who self-identified as racial minority groups(coloured/black/Indian).Results indicate that inclusive leadership has no direct effect on authenticity at work;however,psychological safety fully mediates this relationship.Regarding the moderation effect of gender,results showed that males are more likely to diminish their self-alienation(a specific component of authenticity at work)when levels of psychological safety are higher.These results are consistent with Social Identity Theory,which posits that individuals derive part of their self-concept from their membership in social groups.In contexts where inclusive leadership fosters psychological safety,individuals(particularly men in traditionally male-dominated work environments)may feel a stronger sense of belonging and group identity,which in turn enhances their willingness to express their authentic selves and reduces self-alienation.Practical implications for companies include the need to improve leadership styles to foster more of an inclusive and psychologically safe culture,where minority groups can be authentic and flourish.展开更多
To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains i...To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains in a subcritical state during routine,normal,and accidental transport conditions.In the event of an accident,the rods within the storage tank may become rearranged,introducing uncertainty that must be accounted for to ensure that criticality analysis results are conservative.Historically,this uncertainty was addressed overly conservatively due to limited research on non-uniform arrangement scenarios,which proved unsuitable for criticality safety analysis of spent fuel packages.This paper introduced three distinct methods to non-uniformly rearrange fuel rods—Uniform Arrangement by Blocks,Layer-by-Layer Determination,and Birdcage Deformation—and meticulously evaluates the influences of rod rearrangement on the effective multiplication factor of neutrons,k eff,utilizing the Monte Carlo method.Ultimately,this study presents a holistic method capable of encompassing the entire spectrum of potential effects stemming from the rearrangement of fuel rods during rods mispositioning accident.By augmenting the safety margin,this approach proves to be adeptly suited for the criticality safety analysis of nuclear fuel transport containers.展开更多
Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
Background:Minimally invasive distal pancreatectomy(MIDP)is increasingly being used,although its oncologic safety for pancreatic ductal adenocarcinoma(PDAC)remains controversial.In Japan,MIDP for PDAC has limited endo...Background:Minimally invasive distal pancreatectomy(MIDP)is increasingly being used,although its oncologic safety for pancreatic ductal adenocarcinoma(PDAC)remains controversial.In Japan,MIDP for PDAC has limited endorsement due to insufficient data.This study aimed to compare the perioperative and long-term outcomes of open distal pancreatectomy(ODP)and MIDP for PDAC.Methods:We retrospectively analyzed patients with resectable pancreatic body and tail cancer treated with ODP or MIDP(laparoscopic or robotic)between January 2007 and July 2022.The surgical procedures(ODP and MIDP)were compared and the patient characteristics,perioperative outcomes,and long-term outcomes were analyzed.We also compared the outcomes of patients with neoadjuvant chemotherapy(NAC)and without NAC.Results:A total of 72 distal pancreatectomies were performed(37 ODPs and 35 MIDPs).In the upfront group,MIDP resulted in significantly less blood loss than ODP(P<0.01),despite similar operative time.There was no statistically significant difference in the 2-year recurrence-free survival(RFS)rates between ODP and MIDP(39.7%vs.57.8%,P=0.60)or in the overall survival(OS)rates(66.7%vs.74.1%,P=0.43).Similarly,in the NAC group,MIDP resulted in significantly less blood loss than ODP(P=0.01);ODP and MIDP had similar 2-year RFS rates(41.7%and 60.0%,P=0.75)and OS rates(50.0%and 70.0%,P=0.36).The interval from surgery to adjuvant chemotherapy initiation did not significantly differ between the ODP and MIDP subgroups in both the upfront group(P=0.13)and the NAC group(P=0.14).The incidence of recurrence was 64.8%for ODP and 42.8%for MIDP(P=0.06).Both procedures showed similar distributions of local and distant recurrence.Conclusions:MIDP caused less blood loss and had similar oncologic safety compared with ODP.MIDP could become a feasible,minimally invasive option with sufficient oncologic safety for pancreatic body and tail cancers.展开更多
Intrathecal administration of human umbilical cord mesenchymal stem cells may be a promising approach for the treatment of stroke,but its safety,effectiveness,and mechanism remain to be elucidated.In this study,good m...Intrathecal administration of human umbilical cord mesenchymal stem cells may be a promising approach for the treatment of stroke,but its safety,effectiveness,and mechanism remain to be elucidated.In this study,good manufacturing practice-grade human umbilical cord mesenchymal stem cells(5×105 and 1×106 cells)and saline were administered by cerebellomedullary cistern injection 72 hours after stroke induced by middle cerebral artery occlusion in rats.The results showed(1)no significant difference in mortality or general conditions among the three groups.There was no abnormal differentiation or tumor formation in various organs of rats in any group.(2)Compared with saline-treated animals,those treated with human umbilical cord mesenchymal stem cells showed significant functional recovery and reduced infarct volume,with no significant differences between different human umbilical cord mesenchymal stem cell doses.(3)Human umbilical cord mesenchymal stem cells were found in the ischemic brain after 14 and 28 days of follow-up,and the number of positive cells significantly decreased over time.(4)Neuronal nuclei expression in the human umbilical cord mesenchymal stem cell group was greater than that in the saline group,while glial fibrillary acidic protein and ionized calcium binding adaptor molecule 1 expression levels decreased.(5)Human umbilical cord mesenchymal stem cell treatment increased the number of CD31+microvessels and doublecortin-positive cells after ischemic stroke.Human umbilical cord mesenchymal stem cells also upregulated the expression of CD31+/Ki67+.(6)At 14 days after intrathecal administration,brain-derived neurotrophic factor expression in the peri-infarct area and the concentrations of brain-derived neurotrophic factor in the cerebrospinal fluid in both human umbilical cord mesenchymal stem cell groups were significantly greater than those in the saline group and persisted until the 28th day.Taken together,these results indicate that the intrathecal administration of human umbilical cord mesenchymal stem cells via cerebellomedullary cistern injection is safe and effective for the treatment of ischemic stroke in rats.The mechanisms may include alleviating the local inflammatory response in the peri-infarct region,promoting neurogenesis and angiogenesis,and enhancing the production of neurotrophic factors.展开更多
The integration of artificial intelligence(AI)technology,particularly large language models(LLMs),has become essential across various sectors due to their advanced language comprehension and generation capabilities.De...The integration of artificial intelligence(AI)technology,particularly large language models(LLMs),has become essential across various sectors due to their advanced language comprehension and generation capabilities.Despite their transformative impact in fields such as machine translation and intelligent dialogue systems,LLMs face significant challenges.These challenges include safety,security,and privacy concerns that undermine their trustworthiness and effectiveness,such as hallucinations,backdoor attacks,and privacy leakage.Previous works often conflated safety issues with security concerns.In contrast,our study provides clearer and more reasonable definitions for safety,security,and privacy within the context of LLMs.Building on these definitions,we provide a comprehensive overview of the vulnerabilities and defense mechanisms related to safety,security,and privacy in LLMs.Additionally,we explore the unique research challenges posed by LLMs and suggest potential avenues for future research,aiming to enhance the robustness and reliability of LLMs in the face of emerging threats.展开更多
BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for ...BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.展开更多
With the anticipated growth in air traffic complexity in the coming years,future civil aviation transportation system(CATS)is transforming into a complex cyber–physical–social system,surpassing all previous experien...With the anticipated growth in air traffic complexity in the coming years,future civil aviation transportation system(CATS)is transforming into a complex cyber–physical–social system,surpassing all previous experiences in the history of civil aviation safety management.Therefore,a new safety concept based on a system-of-systems(SoS)perspective is proposed for the next-generation aviation.This article begins by elucidating the complexity of existing aviation risks and emphasizing the necessity for an updated safety concept.It then presents the challenges of current safety management and potential solutions from the new SoS perspective.To address future risks,the concept of SoS safety is introduced with the inspiration of the human immune system in terms of capability,logic,and architecture,which can serve as a guiding framework and methodology for safety engineering in complex large-scale CATS.This concept indicates the transition from“process and outcome-oriented”to“capability-oriented”intelligent safety management.Our research highlights the development directions and potential technological areas that need to be addressed at different stages of SoS safety.The integration of SoS design and operation through rapid iterations enabled by artificial intelligence(AI)will ultimately achieve endogenous SoS safety.展开更多
Batteries play a crucial role in the storage and application of sustainable energy,yet their inherent safety risks are non-negligible.Traditional monitoring methods often suffer from high costs,time consumption,and li...Batteries play a crucial role in the storage and application of sustainable energy,yet their inherent safety risks are non-negligible.Traditional monitoring methods often suffer from high costs,time consumption,and limited scalability,making it increasingly difficult to meet the evolving demands of modern society.In this context,recent advancements in machine learning technology have emerged as a promising solution for predicting and monitoring battery states,offering innovative approaches to battery management systems(BMS).By transforming raw operational data into actionable insights,machine learning has shifted the paradigm from reactive to predictive battery safety management,significantly enhancing system reliability and risk mitigation capabilities.This review delves into the implementation of machine learning in battery state prediction,including dataset selection,feature extraction,and model training.It also highlights the latest progress of these models in key applications such as state of health(SOH),state of charge(SOC),thermal runaway warning,fault detection,and remaining useful life(RUL).Finally,we critically examined the challenges and opportunities associated with leveraging machine learning to improve battery safety and performance,providing a comprehensive perspective for future research in this rapidly advancing field.展开更多
BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,...BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.展开更多
BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invas...BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques,such as transcatheter arterial chemoembolization(TACE)and microwave ablation(MWA).AIM To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.METHODS This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024.Eighty-two patients with hepatic hemangiomas>5 cm were divided into two groups:Observation(TACE+MWA,n=50)and control(TACE,n=32).Tumor diameter and treatment outcomes were evaluated at baseline,12 months,and>3 years.Appropriate statistical tests were chosen based on the type and distribution of the data.RESULTS At baseline,the median tumor diameter was 8.3(range:5.0-19.2)cm in the observation group and 8.5(range:5.0-20.0)cm in the control group.The median follow up duration was 44.6(95%confidence interval:36.7-52.5)months.At 12 months post-treatment,the observation group demonstrated a higher tumor reduction ratio compared to the control group(50.98%vs 23.28%,respectively;P<0.001).The objective response rate was 93.94%in the observation group,which was significantly higher than that in the control group(33.33%)(P<0.001).No recurrence occurred in the observation group,while one case occurred in the control group.Notably,no cases of hemoglobinuria or acute kidney injury were reported in the observation group.CONCLUSION Combination treatment enhances tumor shrinkage,promotes long-term tumor control,and reduces the complications associated with MWA,thereby presenting a promising alternative to surgical resection.展开更多
Surface engineering plays a crucial role in improving the performance of high energy materials,and polydopamine(PDA)is widely used in the field of energetic materials for surface modification and functionalization.In ...Surface engineering plays a crucial role in improving the performance of high energy materials,and polydopamine(PDA)is widely used in the field of energetic materials for surface modification and functionalization.In order to obtain high-quality HMX@PDA-based PBX explosives with high sphericity and a narrow particle size distribution,composite microspheres were prepared using co-axial droplet microfluidic technology.The formation mechanism,thermal behavior,mechanical sensitivity,electrostatic spark sensitivity,compressive strength,and combustion performance of the microspheres were investigated.The results show that PDA can effectively enhance the interfacial interaction between the explosive particles and the binder under the synergistic effect of chemical bonds and the physical"mechanical interlocking"structure.Interface reinforcement causes the thermal decomposition temperature of the sample microspheres to move to a higher temperature,with the sensitivity to impact,friction,and electrostatic sparks(for S-1)increasing by 12.5%,31.3%,and 81.5%respectively,and the compressive strength also increased by 30.7%,effectively enhancing the safety performance of the microspheres.Therefore,this study provides an effective and universal strategy for preparing high-quality functional explosives,and also provides some reference for the safe use of energetic materials in practical applications.展开更多
Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-bli...Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.展开更多
Battery technology plays a crucial role across various sectors,powering devices from smartphones to electric vehicles and supporting grid-scale energy storage.To ensure their safety and efficiency,batteries must be ev...Battery technology plays a crucial role across various sectors,powering devices from smartphones to electric vehicles and supporting grid-scale energy storage.To ensure their safety and efficiency,batteries must be evaluated under diverse operating conditions.Traditional modeling techniques,which often rely on first principles and atomic-level calculations,struggle with practical applications due to incomplete or noisy data.Furthermore,the complexity of battery dynamics,shaped by physical,chemical,and electrochemical interactions,presents substantial challenges for precise and efficient modeling.The Transformer model,originally designed for natural language processing,has proven effective in time-series analysis and forecasting.It adeptly handles the extensive,complex datasets produced during battery cycles,efficiently filtering out noise and identifying critical features without extensive preprocessing.This capability positions Transformers as potent tools for tackling the intricacies of battery data.This review explores the application of customized Transformers in battery state estimation,emphasizing crucial aspects such as charging,health assessment,lifetime prediction,and safety monitoring.It highlights the distinct advantages of Transformer-based models and addresses ongoing challenges and future opportunities in the field.By combining data-driven AI techniques with empirical insights from battery analysis,these pre-trained models can deliver precise diagnostics and comprehensive monitoring,enhancing performance metrics like health monitoring,anomaly detection,and early-warning systems.This integrated approach promises significant improvements in battery technology management and application.展开更多
文摘Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.
文摘This study examined the relationship between inclusive leadership and authenticity at work in racial minority groups of South Africa,taking into account the mediating role of psychological safety and the moderator role of gender,in that relationship.The sample was composed of 94 employees predominantly working in the professional services sector from South Africa(41.5%females;mean age=37.1),who self-identified as racial minority groups(coloured/black/Indian).Results indicate that inclusive leadership has no direct effect on authenticity at work;however,psychological safety fully mediates this relationship.Regarding the moderation effect of gender,results showed that males are more likely to diminish their self-alienation(a specific component of authenticity at work)when levels of psychological safety are higher.These results are consistent with Social Identity Theory,which posits that individuals derive part of their self-concept from their membership in social groups.In contexts where inclusive leadership fosters psychological safety,individuals(particularly men in traditionally male-dominated work environments)may feel a stronger sense of belonging and group identity,which in turn enhances their willingness to express their authentic selves and reduces self-alienation.Practical implications for companies include the need to improve leadership styles to foster more of an inclusive and psychologically safe culture,where minority groups can be authentic and flourish.
文摘To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains in a subcritical state during routine,normal,and accidental transport conditions.In the event of an accident,the rods within the storage tank may become rearranged,introducing uncertainty that must be accounted for to ensure that criticality analysis results are conservative.Historically,this uncertainty was addressed overly conservatively due to limited research on non-uniform arrangement scenarios,which proved unsuitable for criticality safety analysis of spent fuel packages.This paper introduced three distinct methods to non-uniformly rearrange fuel rods—Uniform Arrangement by Blocks,Layer-by-Layer Determination,and Birdcage Deformation—and meticulously evaluates the influences of rod rearrangement on the effective multiplication factor of neutrons,k eff,utilizing the Monte Carlo method.Ultimately,this study presents a holistic method capable of encompassing the entire spectrum of potential effects stemming from the rearrangement of fuel rods during rods mispositioning accident.By augmenting the safety margin,this approach proves to be adeptly suited for the criticality safety analysis of nuclear fuel transport containers.
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
文摘Background:Minimally invasive distal pancreatectomy(MIDP)is increasingly being used,although its oncologic safety for pancreatic ductal adenocarcinoma(PDAC)remains controversial.In Japan,MIDP for PDAC has limited endorsement due to insufficient data.This study aimed to compare the perioperative and long-term outcomes of open distal pancreatectomy(ODP)and MIDP for PDAC.Methods:We retrospectively analyzed patients with resectable pancreatic body and tail cancer treated with ODP or MIDP(laparoscopic or robotic)between January 2007 and July 2022.The surgical procedures(ODP and MIDP)were compared and the patient characteristics,perioperative outcomes,and long-term outcomes were analyzed.We also compared the outcomes of patients with neoadjuvant chemotherapy(NAC)and without NAC.Results:A total of 72 distal pancreatectomies were performed(37 ODPs and 35 MIDPs).In the upfront group,MIDP resulted in significantly less blood loss than ODP(P<0.01),despite similar operative time.There was no statistically significant difference in the 2-year recurrence-free survival(RFS)rates between ODP and MIDP(39.7%vs.57.8%,P=0.60)or in the overall survival(OS)rates(66.7%vs.74.1%,P=0.43).Similarly,in the NAC group,MIDP resulted in significantly less blood loss than ODP(P=0.01);ODP and MIDP had similar 2-year RFS rates(41.7%and 60.0%,P=0.75)and OS rates(50.0%and 70.0%,P=0.36).The interval from surgery to adjuvant chemotherapy initiation did not significantly differ between the ODP and MIDP subgroups in both the upfront group(P=0.13)and the NAC group(P=0.14).The incidence of recurrence was 64.8%for ODP and 42.8%for MIDP(P=0.06).Both procedures showed similar distributions of local and distant recurrence.Conclusions:MIDP caused less blood loss and had similar oncologic safety compared with ODP.MIDP could become a feasible,minimally invasive option with sufficient oncologic safety for pancreatic body and tail cancers.
基金supported by the Medicine-Engineering Interdisciplinary Project of Sun Yat-sen Memorial Hospital,China,No.YXYGRH202203(to YW)Key-Area Research and Development Program of Guangdong Province,China,No.2023B1111050003(to HC)Guangzhou Science and Technology Talent Project of China,No.201909020006(to HC).
文摘Intrathecal administration of human umbilical cord mesenchymal stem cells may be a promising approach for the treatment of stroke,but its safety,effectiveness,and mechanism remain to be elucidated.In this study,good manufacturing practice-grade human umbilical cord mesenchymal stem cells(5×105 and 1×106 cells)and saline were administered by cerebellomedullary cistern injection 72 hours after stroke induced by middle cerebral artery occlusion in rats.The results showed(1)no significant difference in mortality or general conditions among the three groups.There was no abnormal differentiation or tumor formation in various organs of rats in any group.(2)Compared with saline-treated animals,those treated with human umbilical cord mesenchymal stem cells showed significant functional recovery and reduced infarct volume,with no significant differences between different human umbilical cord mesenchymal stem cell doses.(3)Human umbilical cord mesenchymal stem cells were found in the ischemic brain after 14 and 28 days of follow-up,and the number of positive cells significantly decreased over time.(4)Neuronal nuclei expression in the human umbilical cord mesenchymal stem cell group was greater than that in the saline group,while glial fibrillary acidic protein and ionized calcium binding adaptor molecule 1 expression levels decreased.(5)Human umbilical cord mesenchymal stem cell treatment increased the number of CD31+microvessels and doublecortin-positive cells after ischemic stroke.Human umbilical cord mesenchymal stem cells also upregulated the expression of CD31+/Ki67+.(6)At 14 days after intrathecal administration,brain-derived neurotrophic factor expression in the peri-infarct area and the concentrations of brain-derived neurotrophic factor in the cerebrospinal fluid in both human umbilical cord mesenchymal stem cell groups were significantly greater than those in the saline group and persisted until the 28th day.Taken together,these results indicate that the intrathecal administration of human umbilical cord mesenchymal stem cells via cerebellomedullary cistern injection is safe and effective for the treatment of ischemic stroke in rats.The mechanisms may include alleviating the local inflammatory response in the peri-infarct region,promoting neurogenesis and angiogenesis,and enhancing the production of neurotrophic factors.
基金supported by the National Key R&D Program of China under Grant No.2022YFB3103500the National Natural Science Foundation of China under Grants No.62402087 and No.62020106013+3 种基金the Sichuan Science and Technology Program under Grant No.2023ZYD0142the Chengdu Science and Technology Program under Grant No.2023-XT00-00002-GXthe Fundamental Research Funds for Chinese Central Universities under Grants No.ZYGX2020ZB027 and No.Y030232063003002the Postdoctoral Innovation Talents Support Program under Grant No.BX20230060.
文摘The integration of artificial intelligence(AI)technology,particularly large language models(LLMs),has become essential across various sectors due to their advanced language comprehension and generation capabilities.Despite their transformative impact in fields such as machine translation and intelligent dialogue systems,LLMs face significant challenges.These challenges include safety,security,and privacy concerns that undermine their trustworthiness and effectiveness,such as hallucinations,backdoor attacks,and privacy leakage.Previous works often conflated safety issues with security concerns.In contrast,our study provides clearer and more reasonable definitions for safety,security,and privacy within the context of LLMs.Building on these definitions,we provide a comprehensive overview of the vulnerabilities and defense mechanisms related to safety,security,and privacy in LLMs.Additionally,we explore the unique research challenges posed by LLMs and suggest potential avenues for future research,aiming to enhance the robustness and reliability of LLMs in the face of emerging threats.
文摘BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.
基金supported by the National Natural Science Foundation of China(72225012)the National Key Research and Development Program of China(2023YFB4302901)+1 种基金the National Natural Science Foundation of China(72288101,71822101,and 62201577)the Safety Capability Building Fund of the Civil Aviation Administration of China(ASSA2023/19).
文摘With the anticipated growth in air traffic complexity in the coming years,future civil aviation transportation system(CATS)is transforming into a complex cyber–physical–social system,surpassing all previous experiences in the history of civil aviation safety management.Therefore,a new safety concept based on a system-of-systems(SoS)perspective is proposed for the next-generation aviation.This article begins by elucidating the complexity of existing aviation risks and emphasizing the necessity for an updated safety concept.It then presents the challenges of current safety management and potential solutions from the new SoS perspective.To address future risks,the concept of SoS safety is introduced with the inspiration of the human immune system in terms of capability,logic,and architecture,which can serve as a guiding framework and methodology for safety engineering in complex large-scale CATS.This concept indicates the transition from“process and outcome-oriented”to“capability-oriented”intelligent safety management.Our research highlights the development directions and potential technological areas that need to be addressed at different stages of SoS safety.The integration of SoS design and operation through rapid iterations enabled by artificial intelligence(AI)will ultimately achieve endogenous SoS safety.
基金supported by the National Key Research and Development Program of China(No.2021YFF0500600)Natural Science Foundation of Henan Province(No.252300421176)+1 种基金National Natural Science Foundation of China(No.22478361 and No.22108256)Frontier Exploration Projects of Longmen Laboratory(No.LMQYTSKT021)。
文摘Batteries play a crucial role in the storage and application of sustainable energy,yet their inherent safety risks are non-negligible.Traditional monitoring methods often suffer from high costs,time consumption,and limited scalability,making it increasingly difficult to meet the evolving demands of modern society.In this context,recent advancements in machine learning technology have emerged as a promising solution for predicting and monitoring battery states,offering innovative approaches to battery management systems(BMS).By transforming raw operational data into actionable insights,machine learning has shifted the paradigm from reactive to predictive battery safety management,significantly enhancing system reliability and risk mitigation capabilities.This review delves into the implementation of machine learning in battery state prediction,including dataset selection,feature extraction,and model training.It also highlights the latest progress of these models in key applications such as state of health(SOH),state of charge(SOC),thermal runaway warning,fault detection,and remaining useful life(RUL).Finally,we critically examined the challenges and opportunities associated with leveraging machine learning to improve battery safety and performance,providing a comprehensive perspective for future research in this rapidly advancing field.
基金Supported by the Wu Jieping Medical Fund,No.320.6750.2022-09-14the Climbing Fund of PhD Workstation,Zhangzhou Affiliated Hospital of Fujian Medical University,No.PDB202412。
文摘BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.
基金Supported by the Peking Union Medical College Hospital Central High-Level Hospital Clinical Research Project,No.2022-PUMCH-B-069。
文摘BACKGROUND Hepatic hemangiomas represent the most prevalent benign liver tumors.Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques,such as transcatheter arterial chemoembolization(TACE)and microwave ablation(MWA).AIM To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.METHODS This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024.Eighty-two patients with hepatic hemangiomas>5 cm were divided into two groups:Observation(TACE+MWA,n=50)and control(TACE,n=32).Tumor diameter and treatment outcomes were evaluated at baseline,12 months,and>3 years.Appropriate statistical tests were chosen based on the type and distribution of the data.RESULTS At baseline,the median tumor diameter was 8.3(range:5.0-19.2)cm in the observation group and 8.5(range:5.0-20.0)cm in the control group.The median follow up duration was 44.6(95%confidence interval:36.7-52.5)months.At 12 months post-treatment,the observation group demonstrated a higher tumor reduction ratio compared to the control group(50.98%vs 23.28%,respectively;P<0.001).The objective response rate was 93.94%in the observation group,which was significantly higher than that in the control group(33.33%)(P<0.001).No recurrence occurred in the observation group,while one case occurred in the control group.Notably,no cases of hemoglobinuria or acute kidney injury were reported in the observation group.CONCLUSION Combination treatment enhances tumor shrinkage,promotes long-term tumor control,and reduces the complications associated with MWA,thereby presenting a promising alternative to surgical resection.
基金supported by the National Natural Science Foundation of China(Grant No.22005275).
文摘Surface engineering plays a crucial role in improving the performance of high energy materials,and polydopamine(PDA)is widely used in the field of energetic materials for surface modification and functionalization.In order to obtain high-quality HMX@PDA-based PBX explosives with high sphericity and a narrow particle size distribution,composite microspheres were prepared using co-axial droplet microfluidic technology.The formation mechanism,thermal behavior,mechanical sensitivity,electrostatic spark sensitivity,compressive strength,and combustion performance of the microspheres were investigated.The results show that PDA can effectively enhance the interfacial interaction between the explosive particles and the binder under the synergistic effect of chemical bonds and the physical"mechanical interlocking"structure.Interface reinforcement causes the thermal decomposition temperature of the sample microspheres to move to a higher temperature,with the sensitivity to impact,friction,and electrostatic sparks(for S-1)increasing by 12.5%,31.3%,and 81.5%respectively,and the compressive strength also increased by 30.7%,effectively enhancing the safety performance of the microspheres.Therefore,this study provides an effective and universal strategy for preparing high-quality functional explosives,and also provides some reference for the safe use of energetic materials in practical applications.
基金funded by the National Key Research and Development Plan of the Traditional Chinese Medicine Modernization Research Key Project(2018YFC1706800).
文摘Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.
基金the support provided by the California Department of Transportation(Caltrans)through the Fiscal Year 2023-24 grant(65A0686)for the research project titled‘Revolutions in Battery technologies and Future Electric Vehicles’。
文摘Battery technology plays a crucial role across various sectors,powering devices from smartphones to electric vehicles and supporting grid-scale energy storage.To ensure their safety and efficiency,batteries must be evaluated under diverse operating conditions.Traditional modeling techniques,which often rely on first principles and atomic-level calculations,struggle with practical applications due to incomplete or noisy data.Furthermore,the complexity of battery dynamics,shaped by physical,chemical,and electrochemical interactions,presents substantial challenges for precise and efficient modeling.The Transformer model,originally designed for natural language processing,has proven effective in time-series analysis and forecasting.It adeptly handles the extensive,complex datasets produced during battery cycles,efficiently filtering out noise and identifying critical features without extensive preprocessing.This capability positions Transformers as potent tools for tackling the intricacies of battery data.This review explores the application of customized Transformers in battery state estimation,emphasizing crucial aspects such as charging,health assessment,lifetime prediction,and safety monitoring.It highlights the distinct advantages of Transformer-based models and addresses ongoing challenges and future opportunities in the field.By combining data-driven AI techniques with empirical insights from battery analysis,these pre-trained models can deliver precise diagnostics and comprehensive monitoring,enhancing performance metrics like health monitoring,anomaly detection,and early-warning systems.This integrated approach promises significant improvements in battery technology management and application.
