The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.展开更多
Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilizatio...Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilization of train adhesion within the total torque command,reduce the train skidding/sliding phenomenon and achieve optimal adhesion utilization for each axle,thus realizing the optimal allocation of the multi-motor electric locomotives.Design/methodology/approach–In this study,a model predictive control(MPC)-based cooperative maximum adhesion tracking control method for multi-motor electric locomotives is presented.Firstly,train traction system with multiple motors is constructed in accordance with Newton’s second law.These equations include the train dynamics equations,the axle dynamics equations,and the wheel-rail adhesion coefficient equations.Then,a new MPC-based multi-axle adhesion co-optimization method is put forward.This method calculates the optimal output torque through real-time iteration based on the known reference slip speed to achieve multi-axle co-optimization under different circumstances.Findings–This paper presents a MPC system designed for the cooperative control of multi-axle adhesion.The results indicate that the proposed control system is able to optimize the adhesion of multiple axles under numerous different conditions and achieve the optimal power distribution based on the reduction of train skidding/sliding.Originality/value–This study presents a novel cooperative adhesion tracking control scheme.It is designed for multi-motor electric locomotives,which has rarely been studied before.And simulations are carried out in different conditions,including variable surfaces and motor failing.展开更多
The synergy between corrosion protection and wear resistance is an effective strategy for the development of multifunctional coating to withstand complex working conditions.This study reports an epoxy resin coating fi...The synergy between corrosion protection and wear resistance is an effective strategy for the development of multifunctional coating to withstand complex working conditions.This study reports an epoxy resin coating filled with benzotriazole loaded metal-organic frameworks(BTA-MOFs)functionalized graphene oxide nanoribbons(GONR)that exhibit active anti-corrosion,act as a barrier to corrosive ion,and enhance wear resistance.The GONR@BTA-MOFs composite is synthesized through chemically etching multi-walled carbon nanotubes and subsequent electrostatic self-assembly corrosion inhibitors loaded MOFs onto the GONR.The composite demonstrates improved compatibility with epoxy resins compared to carbon nanotubes.The anti-corrosion performance of the composite coating is investigated using electrochemical impedance spectroscopy.After immersing in a 3.5 wt.%NaCl solution for 25 d,the alternating current impedance of the composite coating is three orders of magnitude higher than that of pure epoxy resin.Simultaneously,the controlled release of the corrosion inhibitor retards the deterioration of the coating after localized damage occurrence,which functions as active corrosion protection.The GONR@BTA-MOFs/EP composite coating exhibits the highest corrosion potential of-0.188 V and the lowest corrosion current of 3.162×10^(−9)A cm^(−2)in the Tafel test.Tribological studies reveal a reduction in the friction coefficient from 0.62 to 0.08 after incorporating GONR@BTA-MOFs in the coating,with the wear volume being seven times lower than that of pure epoxy resin.The excellent lubrication effect of the nanomaterials reduces the coefficient of friction of the coating,thereby improving the abrasion resistance of the coating.The synergy between the self-lubrication of the two-dimensional layered fillers and the corrosion resistance of the smart inhibitor containers suggests a promising strategy for enhancing the performance of epoxy resins under complex working conditions.展开更多
BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical...BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.展开更多
BACKGROUND Knee osteoarthritis(OA)imposes a substantial burden through pain,functional limitation,and progressive cartilage loss.Bone marrow aspirate concentrate(BMAC)has emerged as a promising regenerative therapy fo...BACKGROUND Knee osteoarthritis(OA)imposes a substantial burden through pain,functional limitation,and progressive cartilage loss.Bone marrow aspirate concentrate(BMAC)has emerged as a promising regenerative therapy for OA due to its rich composition of mesenchymal stromal cells(MSCs)and bioactive factors.While intra-articular BMAC injections provide short-term symptomatic relief,recent literature suggests that targeting the subchondral bone—an area crucial to OA progression—may offer superior and longer-lasting clinical benefits.AIM To compares the outcomes of subchondral vs intra-articular BMAC injections in patients with primary knee OA.METHODS In this unicentric,double-blinded,randomized controlled trial,30 patients with radiologically confirmed primary knee OA(Kellgren-Lawrence grades II and III)will be equally randomized to receive either subchondral(Group A)or intra-articular(Group B)BMAC injections.BMAC will be harvested from the posterior iliac crest,processed using a standardized centrifugation protocol to yield a product with>85%cell viability,and administered under image guidance.The primary outcome is the change in pain intensity at 12 months as measured by the Visual Analog Scale(VAS).Secondary outcomes include functional improvement assessed by Knee Injury and Osteoarthritis Outcome Score(KOOS),International Knee Documentation Committee(IKDC),and Western Ontario and McMaster Universities Arthritis Index(WOMAC)scores,structural changes evaluated through advanced magnetic resonance imaging using(MRI)the whole-organ MRI Score,and safety as determined by the incidence of adverse events.RESULTS This study aims to evaluate pain reduction at 12 months post-injection,using the VAS as the primary outcome.Secondary outcomes include functional improvement(KOOS,WOMAC,IKDC),cartilage regeneration(T2 cartigram),adverse event incidence,patient satisfaction(standardized questionnaires,Likert scale),and quality of life(EQ-5D).Ethical considerations follow the Declaration of Helsinki and Good Clinical Practice,with institutional review board approval and participant informed consent ensured.Confidentiality and data security comply with regulations,and a data safety monitoring board oversees trial safety.Results will be shared via peer-reviewed journals,presentations at international orthopedic conferences,and detailed summaries for stakeholders and participants.The trial is registered under clinical trial registry of India/2024/04/065284.Findings emphasize patient-centered advancements in knee osteoarthritis management.CONCLUSION This trial aims to refine regenerative strategies for knee OA by comparing subchondral vs intra-articular BMAC injections,addressing long-term efficacy,safety,and treatment standardization to guide targeted interventions.This trial will provide critical insights into the comparative efficacy and safety of subchondral vs intra-articular BMAC injections in treating primary knee OA.展开更多
The gut microbiome,a complex ecosystem of microorganisms,has a significant role in modulating pain,particularly within orthopaedic conditions.Its impact on immune and neurological functions is underscored by the gut-b...The gut microbiome,a complex ecosystem of microorganisms,has a significant role in modulating pain,particularly within orthopaedic conditions.Its impact on immune and neurological functions is underscored by the gut-brain axis,which influences inflammation,pain perception,and systemic immune responses.This integrative review examines current research on how gut dysbiosis is associated with various pain pathways,notably nociceptive and neuroinflammatory mechanisms linked to central sensitization.We highlight advancements in meta-omics technologies,such as metagenomics and metaproteomics,which deepen our understanding of microbiome-host interactions and their implications in pain.Recent studies emphasize that gut-derived short-chain fatty acids and microbial metabolites play roles in modulating neuroinflammation and nociception,contributing to pain management.Probiotics,prebiotics,synbiotics,and faecal microbiome transplants are explored as potential therapeutic strategies to alleviate pain through gut microbiome modulation,offering an adjunct or alternative to opioids.However,variability in individual microbiomes poses challenges to standardizing these treatments,necessitating further rigorous clinical trials.A multidisciplinary approach combining microbiology,immunology,neurology,and orthopaedics is essential to develop innovative,personalized pain management strategies rooted in gut health,with potential to transform orthopaedic pain care.展开更多
BACKGROUND Osteoarthritis(OA)of the knee is a prevalent degenerative joint disease that significantly impairs quality of life and functional mobility.Emerging regenerative therapies,such as stromal vascular fraction(S...BACKGROUND Osteoarthritis(OA)of the knee is a prevalent degenerative joint disease that significantly impairs quality of life and functional mobility.Emerging regenerative therapies,such as stromal vascular fraction(SVF)and nanofat,have demonstrated potential in cartilage repair and symptom alleviation.However,comparative clinical evidence evaluating their efficacy and safety remains limited.AIM To compare the clinical outcomes of SVF vs nanofat therapy in patients with primary knee OA.METHODS Conducted at Mother Cell Regenerative Centre,Trichy,over 18 months(June 2025 to December 2026),the study will enroll 30 patients,randomly assigned to two groups of 15 each.Both interventions will be administered as a single intra-articular injection under sterile conditions,with cell viability(>85%)confirmed by a standardized assay.Group A will receive autologous SVF injections,while Group B will receive autologous nanofat injections.The primary outcome measure is the change in pain scores at 12 months using the visual analog scale(VAS).Secondary outcomes include functional improvement assessed by Osteoarthritis Outcome Score(KOOS),Western Ontario and McMaster Universities(WOMAC),and International Knee Documentation Committee(IKDC)scores,cartilage regeneration evaluated via magnetic resonance imaging with colour coded mapping of the cartilage volume(MR cartigram),and monitoring of adverse events.RESULTS This study aims to evaluate pain reduction at 12 months post-injection,using the VAS as the primary outcome.Secondary outcomes include functional improvement(KOOS,WOMAC,IKDC),cartilage regeneration(T2 cartigram),adverse event incidence,patient satisfaction(standardized questionnaires,Likert scale),and quality of life(EQ-5D).Ethical considerations follow the Declaration of Helsinki and Good Clinical Practice,with IRB approval and participant informed consent ensured.Confidentiality and data security comply with regulations,and a Data Safety Monitoring Board oversees trial safety.Results will be shared via peer-reviewed journals,presentations at international orthopedic conferences,and detailed summaries for stakeholders and participants.The trial is registered under CTRI/2024/03/064076.Findings emphasize patient-centered advancements in knee osteoarthritis management.CONCLUSION This trial evaluates the efficacy and safety of SVF and nanofat therapies in knee OA,addressing a significant evidence gap.It employs robust methods to enhance cartilage repair and patient quality of life.Future research should standardize dosages,protocols,and injection techniques,explore autologous/allogenic preparations,and advance radiological tools,broadening accessibility and clinical applications.展开更多
Lithium iron phosphate(LFP)has found many applications in the field of electric vehicles and energy storage systems.However,the increasing volume of end-of-life LFP batteries poses an urgent challenge in terms of envi...Lithium iron phosphate(LFP)has found many applications in the field of electric vehicles and energy storage systems.However,the increasing volume of end-of-life LFP batteries poses an urgent challenge in terms of environmental sustainability and resource management.Therefore,the development and implementation of efficient LFP battery recycling methods are crucial to address these challenges.This article presents a novel,comprehensive evaluation framework for comparing different lithium iron phosphate relithiation techniques.The framework includes three main sets of criteria:direct production cost,electrochemical performance,and environmental impact.Each criterion is scored on a scale of 0–100,with higher scores indicating better performance.The direct production cost is rated based on material costs,energy consumption,key equipment costs,process duration and space requirements.Electrochemical performance is assessed by rate capability and cycle stability.Environmental impact is assessed based on CO_(2)emissions.The framework provides a standardized technique for researchers and industry professionals to objectively compare relithiation methods,facilitating the identification of the most promising approaches for further development and scale-up.The total average score across the three criterion groups for electrochemical,chemical,and hydrothermal relithiation methods was approximately 60 points,while sintering scored 39 points,making it the least attractive relithiation technique.Combining approaches outlined in publications with scores exceeding 60,a relithiation scheme was proposed to achieve optimal electrochemical performance with minimal resource consumption and environmental impact.The results demonstrate the framework’s applicability and highlight areas for future research and optimization in lithium iron phosphate cathode recycling.展开更多
BACKGROUND Orthopedic training,one of the most useful but under-represented specialties in undergraduate medical curricula,has some difficulties in clinical teaching.AIM To determine if simulation-based learning(SBL)w...BACKGROUND Orthopedic training,one of the most useful but under-represented specialties in undergraduate medical curricula,has some difficulties in clinical teaching.AIM To determine if simulation-based learning(SBL)was effective in enhancing procedural accuracy,skill confidence,and knowledge recall in final-year medical students.METHODS This was a cross-sectional observational study performed in the Department of Orthopaedics in a tertiary care teaching hospital with simulation training facilities.The trial was conducted over 2 months(January 2025-February 2025)and was designed to determine the effect of SBL on procedural skills,knowledge retention,and self-perceived confidence in a group of final-year medical students.The inclusion criterion was undergraduate medical students in their final year who had clinical postings in orthopedics.Convenience sampling was used to recruit 106 students.The sample size was estimated to achieve a post-training 50%improvement ratio in procedural accuracy,a confidence interval of 95%,and an absolute precision of 10%.The simulation sessions included exercises with synthetic bone models,cast equipment,and procedural packs[orthopedic skills:(1)Closed fracture reduction;(2)Application of plaster;and(3)Traction].Each session consisted of an instructor-led demonstration,practice under supervision,and immediate feedback.RESULTS In our study involving 106 final-year medical students,SBL significantly improved procedural accuracy with scores rising from 62.5%to 84.9%(P<0.001).Knowledge retention also improved markedly with post-test scores increasing from 63.4%to 78.2%(P<0.001).Self-reported confidence levels showed a substantial gain,increasing from 4.6 to 8.2 on a 10-point scale.Prior simulation exposure and academic performance≥75%were significantly associated with higher post-training accuracy.Gender had no significant influence on outcomes.CONCLUSION The current study attested to the value of SBL in the enhancement of procedural skills,knowledge retention,and self-confidence of final-year medical students in orthopedics.展开更多
Up-conversion(UC)luminescent materials doped with Ln^(3+)ions possess excellent optical properties and extensive applications in the formulation of multifunctional fluorescence ink.Printing technology offers various m...Up-conversion(UC)luminescent materials doped with Ln^(3+)ions possess excellent optical properties and extensive applications in the formulation of multifunctional fluorescence ink.Printing technology offers various methods for the preparation of UC fluorescent inks.This study introduced the optical properties of luminescent materials doped with Ln^(3+)ions,including luminescence characteristics and spectral characteristics,which provide a basis for the subsequent printing process.We also reviewed different printing techniques,including direct writing,screen printing,laser printing,inkjet printing,and aerosol jet printing(AJP),developed so far in the literature and explored the printing process of ink characteristics.However,the printing process of inks was explored and their potential for various applications was maximized.Therefore,the printing technology of UC fluorescent inks still faces challenges in different aspects.This review also points out the direction for future in-depth research,which is expected to promote further development and innovation in the field.展开更多
High-concentration single-atom doping remains a formidable challenge due to the propensity for single atoms to form clusters or aggregate at elevated concentrations.Herein,high-concentration (10.8 wt%) Zn singleatom-d...High-concentration single-atom doping remains a formidable challenge due to the propensity for single atoms to form clusters or aggregate at elevated concentrations.Herein,high-concentration (10.8 wt%) Zn singleatom-doped porous tubular g-C_(3)N_(4)(ZCN) was successfully obtained via a template-free,one-step calcination method,exhibiting excellent photocatalytic performance.The confinement of the pore walls suppresses the Zn atom'smigration and aggregation,enhancing the Zn single-atom stability.ZCN exhibited excellent photodegradation performance against tetracycline with outstanding stability.Moreover,ZCN displayed remarkable sterilization performance,achieving a 100%inactivation of Staphylococcus aureus within 90 min of visible-light exposure.Density functional theory calculations demonstrated that the Zn single-atom sites act as pivotal photocatalytic active sites,with the presence of Zn single atoms notably augmenting charge separation efficiency.This work provides a novel approach for managing photocatalytic efficiency through enlarging single-atom doping,offering an avenue for pollutant photodegradation and sterilization.展开更多
Cu-SSZ-13 small-pore zeolites have been commercialized for NO_(x) abatement in diesel engines,while they still suffer fromhydrothermal deactivation.To identify the changes occurring in catalysts during the whole hydro...Cu-SSZ-13 small-pore zeolites have been commercialized for NO_(x) abatement in diesel engines,while they still suffer fromhydrothermal deactivation.To identify the changes occurring in catalysts during the whole hydrothermal aging(HTA)process,the selective catalytic reduction by ammonia(NH3-SCR)performance of hydrothermally aged catalysts was investigated until total deactivation occurred.Through precisely identifying the alterations in the zeolite framework and active Cu sites during HTA,three stages were distinguished under progressively more severe HTA conditions,which were dealumination/transformation of active Cu species,CuO_(x) accumulation,and structural collapse.These three stages were found to cause a slight decrease,serious attenuation,and total deactivation of the deNO_(x) efficiency,which stemmed from the loss of Bronsted acid sites,reduction in the number of active Cu ion sites and structural collapse,respectively.This work also depicted simulated deactivation curves of Cu-SSZ-13 with various compositions during the HTA process,which helps in understanding the hydrothermal aging limits of catalysts with various Si/Al ratios and Cu loadings.展开更多
Congenital heart disease(CHD)is the mnost comman birth defect,with 34%of cases attrib utedto genetic variants.NOTCH1,a multi-domain transmembrane protein,regulates heart developmert bycontrolling the differantiation a...Congenital heart disease(CHD)is the mnost comman birth defect,with 34%of cases attrib utedto genetic variants.NOTCH1,a multi-domain transmembrane protein,regulates heart developmert bycontrolling the differantiation and migration of myocardial mesoderm cells,and different variants are presentin differnt types of CHD.In this review,we aim to provide a detailed description of NOTCH1 structuraldomains and their functions,highlighting NOTCH1 variants in CHD and the molecular mechanisms throughwhich they contribute to CHD occurrence,NOTCH1 has two main domains,the NOTCH extracellulardomain(NBCD)and the NOTCH intracellular domain(NICD).NECD facilitates ligand binding and NICDformation,while the NICD functions as a transcrip tion factor,forming complexes with co-factors in thenucleus to initiate gene transcription.Amnong the NOTCH1 variants associated with CHD occurrence,most are loss-of-function variants.Moreover,most of the variants are located in theEGF-like domain.Themolecular mechanism behind the NOTCH1 variant-associated CHD occurrence appears to be either due to aloss-of-function or missense variant.In the loss-of-function mutations,NOTCH1 haploinsufficiency is notedand directly reduces theNICD production,causing CHD ocaurrence.In the less common case of missensevariant,only a mild NOTCH1 malfuncticn is observed,but insufficient to directly lead to CHD occurrence.However,when a missense variant is combined with a risk factor,such as exposure to an environmentaltoxin,the cumulative effect can lead to CHD.Understanding the genetic and molecular mechanisms linkingNOTCH1 variants to CHD is crucial for improving clinical management and patient quality of life.展开更多
OBJECTIVE:To screen the target population with symptomatic bradyarrhythmia for pharmacotherapy.METHODS:This study use database from clinical trial that use Yuanjiang decoction(元姜方),a traditional Chinese medicinal p...OBJECTIVE:To screen the target population with symptomatic bradyarrhythmia for pharmacotherapy.METHODS:This study use database from clinical trial that use Yuanjiang decoction(元姜方),a traditional Chinese medicinal prescription.Eligible participants were recruited and treated with Yuanjiang decoction(composed of 6 Chinese herbal medicines),200 m L twice daily.Cross-contingency analysis,logistic regression analysis,interaction analysis,discriminant analysis and 10-fold cross validation methods were used to establish discriminant model.RESULTS:This study concluded that the clinical treatment of bradyarrhythmia has a clear effect.Low minimum heart rate,high maximum heart rate are risk factors that affect the efficacy.Patients with only one comorbid disease did not significantly affect the efficacy,but patient with two or more diseases of coronary heart disease,hypertension,paroxysmal atrial fibrillation,premature ventricular contraction and premature atrial contraction at the same time did not have a good effect.Using the discriminant analysis method to establish a efficacy prediction model,y=0.07X1+0.16X2-0.65X3-1.12X4-0.71X5-0.75X6-0.91X7(X1=24 h mean heart rate,X2=minimum heart rate,X3=coronary heart disease,X4=paroxysmal atrial fibrillation,X5=premature ventricular contraction,X6=sinus block,X7=atrioventricular block).CONCLUSION:Our model based on the clinical features of patients with bradyarrhythmia.Should be useful aid for predicting pharmacotherapy response and could screen the optimal pharmacotherapy target.展开更多
Pelvic organ prolapse(POP),whose etiology is influenced by genetic and clinical risk factors,considerably impacts women’s quality of life.However,the genetic underpinnings in non-European populations and comprehensiv...Pelvic organ prolapse(POP),whose etiology is influenced by genetic and clinical risk factors,considerably impacts women’s quality of life.However,the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored.This study constructed the first polygenic risk score(PRS)for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study.We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls.Results showed that the case group exhibited a significantly higher PRS than the control group.Moreover,the odds ratio of the top 10%risk group was 2.6 times higher than that of the bottom 10%.A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths.As far as we know,the integrated prediction model,which combined PRS and clinical risk factors,demonstrated better predictive accuracy than other existing PRS models.This combined risk assessment model serves as a robust tool for POP risk prediction and stratification,thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.展开更多
Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock...Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.展开更多
AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pan...AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not significant.CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis.展开更多
Results showed that ammonia loss from urea broadcast into floodwater and incorporated into soil at transplanting was as high as 40% of applied N,and the corresponding total nitrogen (N) loss was 56%.Ammonia loss was m...Results showed that ammonia loss from urea broadcast into floodwater and incorporated into soil at transplanting was as high as 40% of applied N,and the corresponding total nitrogen (N) loss was 56%.Ammonia loss was measured with simplified micrometeorological method (ammonia sampler),and total N loss was concurrently measured using ^15N balance technique.The experiment was conducted under strong sunshine conditions on acid paddy soil derived from Quaternary red clay.The ammonia loss in this particular condition was much greater than those obtained from previous studies when urea was also applied to acid paddy soil but under cloudy conditions.It is concluded that the strong sunshine conditions with high temperature and shallow floodwater during the period of present experiment favoured ammonia volatilization.Application of stearyl alcohol on the surface of the floodwater reduced ammonia loss to 23% of applied N.However,the effect of stearyl alcohol was short-lived,probably due to the microbiological decomposition.展开更多
This report examined electrochemical remediation of copper contaminated kaolinite by controlling electrolytes′ pH for both of anolyte and catholyte simultaneously. Results showed that electrokinetic process and remed...This report examined electrochemical remediation of copper contaminated kaolinite by controlling electrolytes′ pH for both of anolyte and catholyte simultaneously. Results showed that electrokinetic process and remediation efficiency varied obviously when different buffer systems, including citric acid (test 1), nitric acid + EDTA (test 2) and nitric acid (test 3), were used to control catholyte pH and Na_2CO_3 was used at the same time to control all anolyte one. It was found that under such pH condition soil′s pH in soil column kept at 3.0—7.0 successfully, and correspondingly no copper precipitation and decrease of soil electroconductivity appeared, which are usually observed in electrokinetic process due to OH - introduction into soil column by electrochemical reaction occurred in cathode. Electroosmosis flow rates were almost equal for these three tests, indicating that these buffers did not affect Zeta-potential of kaolinite within the examined duration. More acid and basic solution was added into electrokinetic cell when nitric acid was used as buffer than when nitric acid + EDTA and then citric acid were used. Due to introduction of large amounts of ions into soil column, significant higher current was observed for test 3 than other two. Analysis of copper speciation and total quantity in kaolinite indicated that 22.5%, 23.74% and 55.65% Cu were removed from kaolinite for test 1, test 2 and test 3 respectively after only 10 days′ electrokinetic remediation.展开更多
In 1999 aerosol samples were collected by cascade at Meteorological Tower in Beijing. The 12 group aerosol samples obtained were analyzed using PIXE method, which resulted in 20 elemental concentrations and size dist...In 1999 aerosol samples were collected by cascade at Meteorological Tower in Beijing. The 12 group aerosol samples obtained were analyzed using PIXE method, which resulted in 20 elemental concentrations and size distribution of elemental concentrations. From the observation, the elemental concentrations, size distribution of elemental concentrations and their variations are analyzed. It shows that concentrations of the most elements in aerosols increase greatly compared with those in the past except that the concentrations of V, K, Sr, and the source of aerosols has changed greatly in the past decade. Fine mode aerosols increase more rapidly in the past decade, which may be due to the contribution of coal combustion and automobile exhaust. Pb content in aerosol is much higher than that at the beginning of 1980s, and has a decreasing trend in recent years because of using non leaded gasoline.展开更多
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.
基金supported by Scientific Research Projects of China Association of Metros(CAMET-KY-2022039)State Key Laboratory of Traction and Control System of EMU and Locomotive(2023YJ386).
文摘Purpose–This study aims to propose a cooperative adhesion control method for trains with multiple motors electric locomotives.The method is intended to optimize the output torque of each motor,maximize the utilization of train adhesion within the total torque command,reduce the train skidding/sliding phenomenon and achieve optimal adhesion utilization for each axle,thus realizing the optimal allocation of the multi-motor electric locomotives.Design/methodology/approach–In this study,a model predictive control(MPC)-based cooperative maximum adhesion tracking control method for multi-motor electric locomotives is presented.Firstly,train traction system with multiple motors is constructed in accordance with Newton’s second law.These equations include the train dynamics equations,the axle dynamics equations,and the wheel-rail adhesion coefficient equations.Then,a new MPC-based multi-axle adhesion co-optimization method is put forward.This method calculates the optimal output torque through real-time iteration based on the known reference slip speed to achieve multi-axle co-optimization under different circumstances.Findings–This paper presents a MPC system designed for the cooperative control of multi-axle adhesion.The results indicate that the proposed control system is able to optimize the adhesion of multiple axles under numerous different conditions and achieve the optimal power distribution based on the reduction of train skidding/sliding.Originality/value–This study presents a novel cooperative adhesion tracking control scheme.It is designed for multi-motor electric locomotives,which has rarely been studied before.And simulations are carried out in different conditions,including variable surfaces and motor failing.
基金supported by the National Natural Science Foundation of China(No.52475216)the Guangdong Basic and Applied Basic Research Foundation(No.2023A1515240030)+2 种基金the Natural Science Foundation of Shaanxi Province(No.2024RSCXTD-62)the Research Fund of the State Key Laboratory of Solidification Processing(NPU)(No.2022-QZ-04)We would like to thank the Analytical&Testing Center of Northwestern Polytechnical University and the Shaanxi Materials Analysis and Research Center.
文摘The synergy between corrosion protection and wear resistance is an effective strategy for the development of multifunctional coating to withstand complex working conditions.This study reports an epoxy resin coating filled with benzotriazole loaded metal-organic frameworks(BTA-MOFs)functionalized graphene oxide nanoribbons(GONR)that exhibit active anti-corrosion,act as a barrier to corrosive ion,and enhance wear resistance.The GONR@BTA-MOFs composite is synthesized through chemically etching multi-walled carbon nanotubes and subsequent electrostatic self-assembly corrosion inhibitors loaded MOFs onto the GONR.The composite demonstrates improved compatibility with epoxy resins compared to carbon nanotubes.The anti-corrosion performance of the composite coating is investigated using electrochemical impedance spectroscopy.After immersing in a 3.5 wt.%NaCl solution for 25 d,the alternating current impedance of the composite coating is three orders of magnitude higher than that of pure epoxy resin.Simultaneously,the controlled release of the corrosion inhibitor retards the deterioration of the coating after localized damage occurrence,which functions as active corrosion protection.The GONR@BTA-MOFs/EP composite coating exhibits the highest corrosion potential of-0.188 V and the lowest corrosion current of 3.162×10^(−9)A cm^(−2)in the Tafel test.Tribological studies reveal a reduction in the friction coefficient from 0.62 to 0.08 after incorporating GONR@BTA-MOFs in the coating,with the wear volume being seven times lower than that of pure epoxy resin.The excellent lubrication effect of the nanomaterials reduces the coefficient of friction of the coating,thereby improving the abrasion resistance of the coating.The synergy between the self-lubrication of the two-dimensional layered fillers and the corrosion resistance of the smart inhibitor containers suggests a promising strategy for enhancing the performance of epoxy resins under complex working conditions.
文摘BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.
文摘BACKGROUND Knee osteoarthritis(OA)imposes a substantial burden through pain,functional limitation,and progressive cartilage loss.Bone marrow aspirate concentrate(BMAC)has emerged as a promising regenerative therapy for OA due to its rich composition of mesenchymal stromal cells(MSCs)and bioactive factors.While intra-articular BMAC injections provide short-term symptomatic relief,recent literature suggests that targeting the subchondral bone—an area crucial to OA progression—may offer superior and longer-lasting clinical benefits.AIM To compares the outcomes of subchondral vs intra-articular BMAC injections in patients with primary knee OA.METHODS In this unicentric,double-blinded,randomized controlled trial,30 patients with radiologically confirmed primary knee OA(Kellgren-Lawrence grades II and III)will be equally randomized to receive either subchondral(Group A)or intra-articular(Group B)BMAC injections.BMAC will be harvested from the posterior iliac crest,processed using a standardized centrifugation protocol to yield a product with>85%cell viability,and administered under image guidance.The primary outcome is the change in pain intensity at 12 months as measured by the Visual Analog Scale(VAS).Secondary outcomes include functional improvement assessed by Knee Injury and Osteoarthritis Outcome Score(KOOS),International Knee Documentation Committee(IKDC),and Western Ontario and McMaster Universities Arthritis Index(WOMAC)scores,structural changes evaluated through advanced magnetic resonance imaging using(MRI)the whole-organ MRI Score,and safety as determined by the incidence of adverse events.RESULTS This study aims to evaluate pain reduction at 12 months post-injection,using the VAS as the primary outcome.Secondary outcomes include functional improvement(KOOS,WOMAC,IKDC),cartilage regeneration(T2 cartigram),adverse event incidence,patient satisfaction(standardized questionnaires,Likert scale),and quality of life(EQ-5D).Ethical considerations follow the Declaration of Helsinki and Good Clinical Practice,with institutional review board approval and participant informed consent ensured.Confidentiality and data security comply with regulations,and a data safety monitoring board oversees trial safety.Results will be shared via peer-reviewed journals,presentations at international orthopedic conferences,and detailed summaries for stakeholders and participants.The trial is registered under clinical trial registry of India/2024/04/065284.Findings emphasize patient-centered advancements in knee osteoarthritis management.CONCLUSION This trial aims to refine regenerative strategies for knee OA by comparing subchondral vs intra-articular BMAC injections,addressing long-term efficacy,safety,and treatment standardization to guide targeted interventions.This trial will provide critical insights into the comparative efficacy and safety of subchondral vs intra-articular BMAC injections in treating primary knee OA.
文摘The gut microbiome,a complex ecosystem of microorganisms,has a significant role in modulating pain,particularly within orthopaedic conditions.Its impact on immune and neurological functions is underscored by the gut-brain axis,which influences inflammation,pain perception,and systemic immune responses.This integrative review examines current research on how gut dysbiosis is associated with various pain pathways,notably nociceptive and neuroinflammatory mechanisms linked to central sensitization.We highlight advancements in meta-omics technologies,such as metagenomics and metaproteomics,which deepen our understanding of microbiome-host interactions and their implications in pain.Recent studies emphasize that gut-derived short-chain fatty acids and microbial metabolites play roles in modulating neuroinflammation and nociception,contributing to pain management.Probiotics,prebiotics,synbiotics,and faecal microbiome transplants are explored as potential therapeutic strategies to alleviate pain through gut microbiome modulation,offering an adjunct or alternative to opioids.However,variability in individual microbiomes poses challenges to standardizing these treatments,necessitating further rigorous clinical trials.A multidisciplinary approach combining microbiology,immunology,neurology,and orthopaedics is essential to develop innovative,personalized pain management strategies rooted in gut health,with potential to transform orthopaedic pain care.
文摘BACKGROUND Osteoarthritis(OA)of the knee is a prevalent degenerative joint disease that significantly impairs quality of life and functional mobility.Emerging regenerative therapies,such as stromal vascular fraction(SVF)and nanofat,have demonstrated potential in cartilage repair and symptom alleviation.However,comparative clinical evidence evaluating their efficacy and safety remains limited.AIM To compare the clinical outcomes of SVF vs nanofat therapy in patients with primary knee OA.METHODS Conducted at Mother Cell Regenerative Centre,Trichy,over 18 months(June 2025 to December 2026),the study will enroll 30 patients,randomly assigned to two groups of 15 each.Both interventions will be administered as a single intra-articular injection under sterile conditions,with cell viability(>85%)confirmed by a standardized assay.Group A will receive autologous SVF injections,while Group B will receive autologous nanofat injections.The primary outcome measure is the change in pain scores at 12 months using the visual analog scale(VAS).Secondary outcomes include functional improvement assessed by Osteoarthritis Outcome Score(KOOS),Western Ontario and McMaster Universities(WOMAC),and International Knee Documentation Committee(IKDC)scores,cartilage regeneration evaluated via magnetic resonance imaging with colour coded mapping of the cartilage volume(MR cartigram),and monitoring of adverse events.RESULTS This study aims to evaluate pain reduction at 12 months post-injection,using the VAS as the primary outcome.Secondary outcomes include functional improvement(KOOS,WOMAC,IKDC),cartilage regeneration(T2 cartigram),adverse event incidence,patient satisfaction(standardized questionnaires,Likert scale),and quality of life(EQ-5D).Ethical considerations follow the Declaration of Helsinki and Good Clinical Practice,with IRB approval and participant informed consent ensured.Confidentiality and data security comply with regulations,and a Data Safety Monitoring Board oversees trial safety.Results will be shared via peer-reviewed journals,presentations at international orthopedic conferences,and detailed summaries for stakeholders and participants.The trial is registered under CTRI/2024/03/064076.Findings emphasize patient-centered advancements in knee osteoarthritis management.CONCLUSION This trial evaluates the efficacy and safety of SVF and nanofat therapies in knee OA,addressing a significant evidence gap.It employs robust methods to enhance cartilage repair and patient quality of life.Future research should standardize dosages,protocols,and injection techniques,explore autologous/allogenic preparations,and advance radiological tools,broadening accessibility and clinical applications.
基金state assignments of Federal Research Center of Problems of Chemical Physics and Medicinal Chemistry,Russian Academy of Sciences(No.124013000692-4 and 122112100037-4).
文摘Lithium iron phosphate(LFP)has found many applications in the field of electric vehicles and energy storage systems.However,the increasing volume of end-of-life LFP batteries poses an urgent challenge in terms of environmental sustainability and resource management.Therefore,the development and implementation of efficient LFP battery recycling methods are crucial to address these challenges.This article presents a novel,comprehensive evaluation framework for comparing different lithium iron phosphate relithiation techniques.The framework includes three main sets of criteria:direct production cost,electrochemical performance,and environmental impact.Each criterion is scored on a scale of 0–100,with higher scores indicating better performance.The direct production cost is rated based on material costs,energy consumption,key equipment costs,process duration and space requirements.Electrochemical performance is assessed by rate capability and cycle stability.Environmental impact is assessed based on CO_(2)emissions.The framework provides a standardized technique for researchers and industry professionals to objectively compare relithiation methods,facilitating the identification of the most promising approaches for further development and scale-up.The total average score across the three criterion groups for electrochemical,chemical,and hydrothermal relithiation methods was approximately 60 points,while sintering scored 39 points,making it the least attractive relithiation technique.Combining approaches outlined in publications with scores exceeding 60,a relithiation scheme was proposed to achieve optimal electrochemical performance with minimal resource consumption and environmental impact.The results demonstrate the framework’s applicability and highlight areas for future research and optimization in lithium iron phosphate cathode recycling.
文摘BACKGROUND Orthopedic training,one of the most useful but under-represented specialties in undergraduate medical curricula,has some difficulties in clinical teaching.AIM To determine if simulation-based learning(SBL)was effective in enhancing procedural accuracy,skill confidence,and knowledge recall in final-year medical students.METHODS This was a cross-sectional observational study performed in the Department of Orthopaedics in a tertiary care teaching hospital with simulation training facilities.The trial was conducted over 2 months(January 2025-February 2025)and was designed to determine the effect of SBL on procedural skills,knowledge retention,and self-perceived confidence in a group of final-year medical students.The inclusion criterion was undergraduate medical students in their final year who had clinical postings in orthopedics.Convenience sampling was used to recruit 106 students.The sample size was estimated to achieve a post-training 50%improvement ratio in procedural accuracy,a confidence interval of 95%,and an absolute precision of 10%.The simulation sessions included exercises with synthetic bone models,cast equipment,and procedural packs[orthopedic skills:(1)Closed fracture reduction;(2)Application of plaster;and(3)Traction].Each session consisted of an instructor-led demonstration,practice under supervision,and immediate feedback.RESULTS In our study involving 106 final-year medical students,SBL significantly improved procedural accuracy with scores rising from 62.5%to 84.9%(P<0.001).Knowledge retention also improved markedly with post-test scores increasing from 63.4%to 78.2%(P<0.001).Self-reported confidence levels showed a substantial gain,increasing from 4.6 to 8.2 on a 10-point scale.Prior simulation exposure and academic performance≥75%were significantly associated with higher post-training accuracy.Gender had no significant influence on outcomes.CONCLUSION The current study attested to the value of SBL in the enhancement of procedural skills,knowledge retention,and self-confidence of final-year medical students in orthopedics.
基金Project supported by National Natural Science Foundation of China(51962006)the High-level Talents Research Initiation Project of JXUST(205200100545)+1 种基金the Young Elite Scientists Sponsorship Program by CAST(2022QNRC001)Jiangxi Natural Science Foundation of China(20224BAB214029,20232BAB204021)。
文摘Up-conversion(UC)luminescent materials doped with Ln^(3+)ions possess excellent optical properties and extensive applications in the formulation of multifunctional fluorescence ink.Printing technology offers various methods for the preparation of UC fluorescent inks.This study introduced the optical properties of luminescent materials doped with Ln^(3+)ions,including luminescence characteristics and spectral characteristics,which provide a basis for the subsequent printing process.We also reviewed different printing techniques,including direct writing,screen printing,laser printing,inkjet printing,and aerosol jet printing(AJP),developed so far in the literature and explored the printing process of ink characteristics.However,the printing process of inks was explored and their potential for various applications was maximized.Therefore,the printing technology of UC fluorescent inks still faces challenges in different aspects.This review also points out the direction for future in-depth research,which is expected to promote further development and innovation in the field.
基金financially supported by the National Key Research and Development Program of China(No.2023YFF0612601)the Key Research and Development Program of Zhejiang Province(No.2023C02038)+2 种基金the Key Research and Development Program of Ningbo(No.2022Z178)China Construction Technology Research and Development Project(No.CSCEC-2021-Z-5)Zhejiang Provincial Natural Science Foundation of China(No.LQ23B010003)
文摘High-concentration single-atom doping remains a formidable challenge due to the propensity for single atoms to form clusters or aggregate at elevated concentrations.Herein,high-concentration (10.8 wt%) Zn singleatom-doped porous tubular g-C_(3)N_(4)(ZCN) was successfully obtained via a template-free,one-step calcination method,exhibiting excellent photocatalytic performance.The confinement of the pore walls suppresses the Zn atom'smigration and aggregation,enhancing the Zn single-atom stability.ZCN exhibited excellent photodegradation performance against tetracycline with outstanding stability.Moreover,ZCN displayed remarkable sterilization performance,achieving a 100%inactivation of Staphylococcus aureus within 90 min of visible-light exposure.Density functional theory calculations demonstrated that the Zn single-atom sites act as pivotal photocatalytic active sites,with the presence of Zn single atoms notably augmenting charge separation efficiency.This work provides a novel approach for managing photocatalytic efficiency through enlarging single-atom doping,offering an avenue for pollutant photodegradation and sterilization.
基金supported by the National Key R&D Program of China(No.2023YFC3707201)the National Natural Science Foundation of China(No.52270112)the National Energy-Saving and Low-Carbon Materials Production and Application Demonstration Platform Program(No.TC220H06N).
文摘Cu-SSZ-13 small-pore zeolites have been commercialized for NO_(x) abatement in diesel engines,while they still suffer fromhydrothermal deactivation.To identify the changes occurring in catalysts during the whole hydrothermal aging(HTA)process,the selective catalytic reduction by ammonia(NH3-SCR)performance of hydrothermally aged catalysts was investigated until total deactivation occurred.Through precisely identifying the alterations in the zeolite framework and active Cu sites during HTA,three stages were distinguished under progressively more severe HTA conditions,which were dealumination/transformation of active Cu species,CuO_(x) accumulation,and structural collapse.These three stages were found to cause a slight decrease,serious attenuation,and total deactivation of the deNO_(x) efficiency,which stemmed from the loss of Bronsted acid sites,reduction in the number of active Cu ion sites and structural collapse,respectively.This work also depicted simulated deactivation curves of Cu-SSZ-13 with various compositions during the HTA process,which helps in understanding the hydrothermal aging limits of catalysts with various Si/Al ratios and Cu loadings.
基金the National Natural Science Foundation of China,GrantNos.82100321 and 82370353.
文摘Congenital heart disease(CHD)is the mnost comman birth defect,with 34%of cases attrib utedto genetic variants.NOTCH1,a multi-domain transmembrane protein,regulates heart developmert bycontrolling the differantiation and migration of myocardial mesoderm cells,and different variants are presentin differnt types of CHD.In this review,we aim to provide a detailed description of NOTCH1 structuraldomains and their functions,highlighting NOTCH1 variants in CHD and the molecular mechanisms throughwhich they contribute to CHD occurrence,NOTCH1 has two main domains,the NOTCH extracellulardomain(NBCD)and the NOTCH intracellular domain(NICD).NECD facilitates ligand binding and NICDformation,while the NICD functions as a transcrip tion factor,forming complexes with co-factors in thenucleus to initiate gene transcription.Amnong the NOTCH1 variants associated with CHD occurrence,most are loss-of-function variants.Moreover,most of the variants are located in theEGF-like domain.Themolecular mechanism behind the NOTCH1 variant-associated CHD occurrence appears to be either due to aloss-of-function or missense variant.In the loss-of-function mutations,NOTCH1 haploinsufficiency is notedand directly reduces theNICD production,causing CHD ocaurrence.In the less common case of missensevariant,only a mild NOTCH1 malfuncticn is observed,but insufficient to directly lead to CHD occurrence.However,when a missense variant is combined with a risk factor,such as exposure to an environmentaltoxin,the cumulative effect can lead to CHD.Understanding the genetic and molecular mechanisms linkingNOTCH1 variants to CHD is crucial for improving clinical management and patient quality of life.
基金National Natural Science Foundation of China(No.82004352)National Medicine Master's Inheritance Studio Construction Project of the State Administration of Traditional Chinese Medicine(Weng Weiliang Academic Succession Studio)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ14-YQ-006)。
文摘OBJECTIVE:To screen the target population with symptomatic bradyarrhythmia for pharmacotherapy.METHODS:This study use database from clinical trial that use Yuanjiang decoction(元姜方),a traditional Chinese medicinal prescription.Eligible participants were recruited and treated with Yuanjiang decoction(composed of 6 Chinese herbal medicines),200 m L twice daily.Cross-contingency analysis,logistic regression analysis,interaction analysis,discriminant analysis and 10-fold cross validation methods were used to establish discriminant model.RESULTS:This study concluded that the clinical treatment of bradyarrhythmia has a clear effect.Low minimum heart rate,high maximum heart rate are risk factors that affect the efficacy.Patients with only one comorbid disease did not significantly affect the efficacy,but patient with two or more diseases of coronary heart disease,hypertension,paroxysmal atrial fibrillation,premature ventricular contraction and premature atrial contraction at the same time did not have a good effect.Using the discriminant analysis method to establish a efficacy prediction model,y=0.07X1+0.16X2-0.65X3-1.12X4-0.71X5-0.75X6-0.91X7(X1=24 h mean heart rate,X2=minimum heart rate,X3=coronary heart disease,X4=paroxysmal atrial fibrillation,X5=premature ventricular contraction,X6=sinus block,X7=atrioventricular block).CONCLUSION:Our model based on the clinical features of patients with bradyarrhythmia.Should be useful aid for predicting pharmacotherapy response and could screen the optimal pharmacotherapy target.
基金funded by the National Natural Science Foundation of China(Nos.82171621 to Lei Li,82271656 to Lan Zhu,82171614 to Na Chen)the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-A-231 to Lei Li)+2 种基金the National Key Research and Development Program of China(Nos.2023YFC2706000,2023YFC2706001,2021YFC2701301 to Lan Zhu,2021YFC2701400 to Shan Deng)Beijing Natural Science Foundation(No.7232125 to Na Chen)CAMS Initiative Fund to Medical Sciences(No.2022-I2M-C&T-B-029 to Na Chen).
文摘Pelvic organ prolapse(POP),whose etiology is influenced by genetic and clinical risk factors,considerably impacts women’s quality of life.However,the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored.This study constructed the first polygenic risk score(PRS)for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study.We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls.Results showed that the case group exhibited a significantly higher PRS than the control group.Moreover,the odds ratio of the top 10%risk group was 2.6 times higher than that of the bottom 10%.A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths.As far as we know,the integrated prediction model,which combined PRS and clinical risk factors,demonstrated better predictive accuracy than other existing PRS models.This combined risk assessment model serves as a robust tool for POP risk prediction and stratification,thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
文摘Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.
文摘AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not significant.CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis.
文摘Results showed that ammonia loss from urea broadcast into floodwater and incorporated into soil at transplanting was as high as 40% of applied N,and the corresponding total nitrogen (N) loss was 56%.Ammonia loss was measured with simplified micrometeorological method (ammonia sampler),and total N loss was concurrently measured using ^15N balance technique.The experiment was conducted under strong sunshine conditions on acid paddy soil derived from Quaternary red clay.The ammonia loss in this particular condition was much greater than those obtained from previous studies when urea was also applied to acid paddy soil but under cloudy conditions.It is concluded that the strong sunshine conditions with high temperature and shallow floodwater during the period of present experiment favoured ammonia volatilization.Application of stearyl alcohol on the surface of the floodwater reduced ammonia loss to 23% of applied N.However,the effect of stearyl alcohol was short-lived,probably due to the microbiological decomposition.
文摘This report examined electrochemical remediation of copper contaminated kaolinite by controlling electrolytes′ pH for both of anolyte and catholyte simultaneously. Results showed that electrokinetic process and remediation efficiency varied obviously when different buffer systems, including citric acid (test 1), nitric acid + EDTA (test 2) and nitric acid (test 3), were used to control catholyte pH and Na_2CO_3 was used at the same time to control all anolyte one. It was found that under such pH condition soil′s pH in soil column kept at 3.0—7.0 successfully, and correspondingly no copper precipitation and decrease of soil electroconductivity appeared, which are usually observed in electrokinetic process due to OH - introduction into soil column by electrochemical reaction occurred in cathode. Electroosmosis flow rates were almost equal for these three tests, indicating that these buffers did not affect Zeta-potential of kaolinite within the examined duration. More acid and basic solution was added into electrokinetic cell when nitric acid was used as buffer than when nitric acid + EDTA and then citric acid were used. Due to introduction of large amounts of ions into soil column, significant higher current was observed for test 3 than other two. Analysis of copper speciation and total quantity in kaolinite indicated that 22.5%, 23.74% and 55.65% Cu were removed from kaolinite for test 1, test 2 and test 3 respectively after only 10 days′ electrokinetic remediation.
文摘In 1999 aerosol samples were collected by cascade at Meteorological Tower in Beijing. The 12 group aerosol samples obtained were analyzed using PIXE method, which resulted in 20 elemental concentrations and size distribution of elemental concentrations. From the observation, the elemental concentrations, size distribution of elemental concentrations and their variations are analyzed. It shows that concentrations of the most elements in aerosols increase greatly compared with those in the past except that the concentrations of V, K, Sr, and the source of aerosols has changed greatly in the past decade. Fine mode aerosols increase more rapidly in the past decade, which may be due to the contribution of coal combustion and automobile exhaust. Pb content in aerosol is much higher than that at the beginning of 1980s, and has a decreasing trend in recent years because of using non leaded gasoline.
