BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patie...BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.展开更多
Laser-induced aerosols,predominantly submicron in size,pose significant environmental and health risks during the decommissioning of nuclear reactors.This study experimentally investigated the removal of laser-generat...Laser-induced aerosols,predominantly submicron in size,pose significant environmental and health risks during the decommissioning of nuclear reactors.This study experimentally investigated the removal of laser-generated aerosol particles using a water spray system integrated with an innovative system for pre-injecting electrically charged mist in our facility.To simulate aerosol generation in reactor decommissioning,a high-power laser was used to irradiate various materials(including stainless steel,carbon steel,and concrete),generating aerosol particles that were agglomerated with injected water mist and subsequently scavenged by water spray.Experimental results demonstrate enhanced aerosol removal via aerosol-mist agglomeration,with charged mist significantly improving particle capture by increasing wettability and size.The average improvements for the stainless steel,carbon steel,and concrete were 40%,44%,and 21%,respectively.The results of experiments using charged mist with different polarities(both positive and negative)and different surface coatings reveal that the dominant polarity of aerosols varies with the irradiated materials,influenced by their crystal structure and electron emission properties.Notably,surface coatings such as ZrO_(2)and CeO_(2)were found to possibly alter aerosol charging characteristics,thereby affecting aerosol removal efficiency with charged mist configurations.The innovative aerosol-mist agglomeration approach shows promise in mitigating radiation exposure,ensuring environmental safety,and reducing contaminated water during reactor dismantling.This study contributes critical knowledge for the development of advanced aerosol management strategies for nuclear reactor decommissioning.The understanding obtained in this work is also expected to be useful for various environmental and chemical engineering applications such as gas decontamination,air purification,and pollution control.展开更多
A redox-active monolayer on an optically transparent electrode constitutes a typical platform for spectroelectrochemical sensing.The necessity for its sophistication arises from the availability of multi-dimensional s...A redox-active monolayer on an optically transparent electrode constitutes a typical platform for spectroelectrochemical sensing.The necessity for its sophistication arises from the availability of multi-dimensional sensing signals.Simultaneous monitoring of the redox current and color change synchronized with the oxidation state change significantly enhances sen-sitivity and selectivity.This study aimed to elucidate the modification of an indium tin oxide(ITO)electrode with a viologen monolayer with an ordered orientation.Novel methods were developed to immobilize a viologen molecule bearing a car-boxyl group to form assembled monolayers through a condensation reaction using 1-ethyl-3-(3-dimethylaminopropyl)-car-bodiimide with N-hydroxy-succinimide(EDC/NHS).In the two methods of immobilization,one utilizes a two-step process to firstly form an aromatic siloxane base layer and subsequently attach the viologen derivative through an amide linkage by post-amidation.The other employs a direct ester linkage between the hydroxyl groups of the ITO surface and the car-boxyl group of the viologen derivative.The latter method was also applied to immobilize a ferrocenyl group at a very short distance from the ITO surface.Potential-modulated UV-visible transmission absorption spectral measurement techniques with oblique incidence of plane-polarized light were employed to determine the orientation of the longitudinal axis of the reduced form of the viologen.The frequency dependence data of the potential-modulated transmission absorption signals were utilized to analyze the electron transfer kinetics.The performance of the two viologen-modified electrodes was com-pared to that of an ITO modified by post-amidation to the most commonly used base layer prepared with 3-aminopropyl triethoxysilane.展开更多
Several physical mechanisms of earthquake nucleation,such as pre-slip,cascade triggering,aseismic slip,and fluid-driven models,have been proposed.However,it is still not clear which model plays the most important role...Several physical mechanisms of earthquake nucleation,such as pre-slip,cascade triggering,aseismic slip,and fluid-driven models,have been proposed.However,it is still not clear which model plays the most important role in driving foreshocks and mainshock nucleation for given cases.In this study,we focus on the relationship between an intensive earthquake swarm that started beneath the Noto Peninsula in Central Japan since November 2020 and the nucleation of the 2024 M 7.6 Noto Hanto earthquake.We relocate earthquakes listed in the standard Japan Meteorological Agency(JMA)catalog since 2018 with the double-different relocation method.Relocated seismicity revealed that the 2024 M 7.6 mainshock likely ruptured a thrust fault above a parallel fault where the M 6.5 Suzu earthquake occurred in May 2023.We find possible along-strike and along-dip expansion of seismicity in the first few months at the beginning of the swarm sequence,while no obvious migration pattern in the last few days before the M 7.6 mainshock was observed.Several smaller events occurred in between the M 5.5 and M 4.6 foreshocks that occurred about 4min and 2 min before the M 7.6 mainshock.The Coulomb stress changes from the M 5.5 foreshock were negative at the hypocenter of the M 7.6 mainshock,which is inconsistent with a simple cascade triggering model.Moreover,an M 5.9 foreshock was identified in the JMA catalog 14 s before the mainshock.Results from backprojection of high-frequency teleseismic P waves show a prolonged initial rupture process near the mainshock hypocenter lasting for~25 s,before propagating bilaterally outward.Our results suggest a complex evolution process linking the earthquake swarm to the nucleation of the M 7.6 mainshock at a region of complex structures associated with the bend of a mapped large-scale reverse fault.A combination of fluid migration,aseismic slip and elastic stress triggering likely work in concert to drive both the prolonged earthquake swarm and the nucleation of the M 7.6 mainshock.展开更多
Understanding the dynamic responses of hard rocks is crucial during deep mining and tunneling activities and when constructing nuclear waste repositories. However, the response of deep massive rocks with openings of d...Understanding the dynamic responses of hard rocks is crucial during deep mining and tunneling activities and when constructing nuclear waste repositories. However, the response of deep massive rocks with openings of different shapes and orientations to dynamic loading is not well understood. Therefore, this study investigates the dynamic responses of hard rocks of deep underground excavation activities. Split Hopkins Pressure Bar (SHPB) tests on granite with holes of different shapes (rectangle, circle, vertical ellipse (elliptical short (ES) axis parallel to the impact load direction), and horizontal ellipse (elliptical long (EL) axis parallel to the impact load direction)) were carried out. The influence of hole shape and location on the dynamic responses was analyzed to reveal the rocks' dynamic strengths and cracking characteristics. We used the ResNet18 (convolutional neural network-based) network to recognize crack types using high-speed photographs. Moreover, a prediction model for the stress-strain response of rocks with different openings was established using Deep Neural Network (DNN). The results show that the dynamic strengths of the granite with EL and ES holes are the highest and lowest, respectively. The strength-weakening coefficient decreases first and then increases with an increase of thickness-span ratio (h/L). The weakening of the granite with ES holes is the most obvious. The ResNet18 network can improve the analyzing efficiency of the cracking mechanism, and the trained model's recognition accuracy reaches 99%. Finally, the dynamic stress-strain prediction model can predict the complete stress-strain curve well, with an accuracy above 85%.展开更多
BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lea...BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lead to the development of resistance.Additionally,some strains of HSV exist that are ACV resistant,and they can cause severe complications that may be impossible to treat with current therapies.We report the first case of ACV-resistant herpes encephalitis(ARHE)recurring in an immunocompromised adult patient without neurosurgical intervention.CASE SUMMARY A 58-year-old man with a fever of 38°C had tremors.Evaluation revealed 14 points on the Glasgow Coma Scale with 39°C fever but unremarkable physical examination.Diagnosis was infection of unknown origin;fever continued,and the Glasgow Coma Scale worsened to 8.Imaging showing a high-intensity area between the left temporal lobe and insular cortex suggested herpes encephalitis.ACV was started.Cerebrospinal fluid(CSF)was positive for HSV DNA,confirming the diagnosis.However,unresolved symptoms suggested ARHE;therefore,we initiated vidarabine treatment.Later testing confirmed ARHE.Foscarnet was started based on a hospital day 25 blood test revealing pancytopenia,possibly from vidarabine.Consciousness improved,and the patient moved to rehabilitation.However,symptoms worsened,suggesting recurrence.Diffusion-weighted magnetic resonance imaging revealed a high high-intensity area around the right temporal lobe;CSF was positive for HSV DNA,confirming recurrent herpes encephalitis.ACV and foscarnet were initiated.Fever decreased,consciousness improved,and HSV DNA on hospital days 78 and 93 was CSF negative.Treatment was terminated on hospital day 86.CONCLUSION ARHE recurred in the patient following remission;therefore,it is necessary to discuss the length of the treatment period.展开更多
Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans ...Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.展开更多
Due to its superior nanoscale properties,cobalt(Co)is highly desirable for ultrahigh-density 3D integration into materials through metal/dielectric hybrid bonding.However,this process is very challenging through Co/Si...Due to its superior nanoscale properties,cobalt(Co)is highly desirable for ultrahigh-density 3D integration into materials through metal/dielectric hybrid bonding.However,this process is very challenging through Co/SiO_(2)hybrid bonding,as very hydrophilic SiO_(2)surfaces are needed for bonding during dehydration reactions and oxidation of the Co surfaces must be avoided.Additionally,the substantial coefficient of thermal expansion mismatch between the robust capping layers(Co and SiO_(2)layers)necessitates hybrid bonding with minimal thermal input and compression.In this study,we introduce a ternary plasma activation strategy employing an Ar/NH_(3)/H_(2)O gas mixture to facilitate Co/SiO_(2)hybrid bonding at temperatures as low as~200℃,which is markedly lower than the melting point of Co(~1500℃).Intriguingly,non-oxide metallization at the Co-Co interface can be realized without the hindrance of a bonding barrier,thereby reducing the electrical resistance by over 40%and compression force requirements.Moreover,the enhancement in the SiO_(2)surface energy through active group terminations fosters extensive interfacial hydration and strengthens the mechanical properties.This research paves the way for fine-tuning bonding surfaces using a material-selective strategy which should advance metal/dielectric hybrid bonding for future integration applications.展开更多
Heat dissipation and thermal switches are vital for adaptive cooling and extending the lifespan of electronic devices and batteries. In this work, we conducted high-throughput investigations on the thermal transport o...Heat dissipation and thermal switches are vital for adaptive cooling and extending the lifespan of electronic devices and batteries. In this work, we conducted high-throughput investigations on the thermal transport of 24 experimentally realized two-dimensional(2D) materials and their potential as thermal switches, leveraging machine-learning-assisted strain engineering and phonon transport simulations. We identified several highperformance thermal switches with ratios exceeding 2, with germanene(Ge) achieving an ultrahigh ratio of up to9.64 within the reversible deformation range. The underlying mechanism is strain-induced bond softening, which sensitively affects anharmonicity represented by three-and four-phonon scattering. The widespread occurrence of four-phonon scattering was confirmed in the thermal transport of 2D materials. Opposite switching trends were discovered, with 2D transition metal dichalcogenide materials showing negative responses to tensile strain while buckled 2D elemental materials showed positive responses. We further proposed a screening descriptor based on strain-induced changes in the Gr¨uneisen parameter for efficiently identifying new high-performance thermal switch materials. This work establishes a paradigm for thermal energy control in 2D materials through strain engineering, which may be experimentally realized in the future via bending, substrate mismatch, and related approaches, thereby laying a robust foundation for further developments and applications.展开更多
Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),...Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),comprising an initialization followed by subsequent learning,selects a small subset of informative data points for labeling.Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks.However,their potential in cold-start AL remains unexplored.Methods:To validate the efficacy of domain-specific pretraining,we compared two foundation models:supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet.Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks:psychiatric pneumonia and COVID-19.For initialization,we assessed their integration with three strategies:diversity,uncertainty,and hybrid sampling.For subsequent learning,we focused on uncertainty sampling powered by different pretrained models.We also conducted statistical tests to compare the foundation models with ImageNet counterparts,investigate the relationship between initialization and subsequent learning,examine the performance of one-shot initialization against the full AL process,and investigate the influence of class balance in initialization samples on initialization and subsequent learning.Results:First,domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection.Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios.However,pretrained model-based initialization surpassed random sampling,the default approach in cold-start AL.Second,initialization performance was positively correlated with subsequent learning performance,highlighting the importance of initialization strategies.Third,one-shot initialization performed comparably to the full AL process,demonstrating the potential of reducing experts'repeated waiting during AL iterations.Last,a U-shaped correlation was observed between the class balance of initialization samples and model performance,suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.Conclusions:In this study,we highlighted the limitations of medical pretraining compared to general pretraining in the context of cold-start AL.We also identified promising outcomes related to cold-start AL,including initialization based on pretrained models,the positive influence of initialization on subsequent learning,the potential for one-shot initialization,and the influence of class balance on middle-budget AL.Researchers are encouraged to improve medical pretraining for versatile DL foundations and explore novel AL methods.展开更多
In this study,a machine learning-based predictive model was developed for the Musa petti Wind Farm in Sri Lanka to address the need for localized forecasting solutions.Using data on wind speed,air temperature,nacelle ...In this study,a machine learning-based predictive model was developed for the Musa petti Wind Farm in Sri Lanka to address the need for localized forecasting solutions.Using data on wind speed,air temperature,nacelle position,and actual power,lagged features were generated to capture temporal dependencies.Among 24 evaluated models,the ensemble bagging approach achieved the best performance,with R^(2) values of 0.89 at 0 min and 0.75 at 60 min.Shapley Additive exPlanations(SHAP)analysis revealed that while wind speed is the primary driver for short-term predictions,air temperature and nacelle position become more influential at longer forecasting horizons.These findings underscore the reliability of short-term predictions and the potential benefits of integrating hybrid AI and probabilistic models for extended forecasts.Our work contributes a robust and explainable framework to support Sri Lanka’s renewable energy transition,and future research will focus on real-time deployment and uncertainty quantification.展开更多
As a representative of wide-bandgap semiconductors,wurtzite gallium nitride(GaN)has been widely utilized in highpower devices due to its high breakdown voltage and low specific on-resistance.Accurate prediction of wur...As a representative of wide-bandgap semiconductors,wurtzite gallium nitride(GaN)has been widely utilized in highpower devices due to its high breakdown voltage and low specific on-resistance.Accurate prediction of wurtzite GaN’s thermal conductivity is a prerequisite for designing effective thermal management systems for electronic applications.Machine learning-driven molecular dynamics simulation offers a promising approach to predicting the thermal conductivity of large-scale systems without requiring predefined parameters.However,these methods often underestimate the thermal conductivity of materials with inherently high thermal conductivity due to the large predicted force error compared with first-principles calculations,posing a critical challenge for their broader application.In this study,we successfully developed a neuroevolution potential for wurtzite GaN and accurately predicted its thermal conductivity,259±6 W/(m·K)at room temperature,achieving excellent agreement with reported experimental measurements.The hyperparameters of the neuroevolution potential(NEP)were optimized based on a systematic analysis of reproduced energy and force,structural features,and computational efficiency.Furthermore,a force error correction method was implemented,effectively reducing the error caused by the additional force noise in the Langevin thermostat by extrapolating to the zero-force error limit.This study provides valuable insights and holds significant implications for advancing efficient thermal management technologies in wide-bandgap semiconductor devices.展开更多
Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiv...Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiveness in resecting lesions regardless of their size and severity of fibrosis.Based on excellent outcomes for esophageal neoplasms with a small likelihood of lymph node metastasis,the number of ESD candidates has increased.On the other hand,ESD still requires highly skilled endoscopists due to technical difficulties.To avoid unnecessary complications including perforation and postoperative stricture,the indications for ESD require careful consideration and a full understanding of this modality.This article,in the highlight topic series,provides detailed information on the indication,procedure,outcome,complications and their prevention in ESD of superficial esophageal neoplasms.展开更多
Viral hepatitis represents a major danger to public health,and is a globally leading cause of death.The five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis...Viral hepatitis represents a major danger to public health,and is a globally leading cause of death.The five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral therapies.There remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver disease.Furthermore,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’complications.In 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral hepatitis.Today,treatment is sufficiently able to prevent the disease from reaching advanced phases.However,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral hepatitis.This review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.展开更多
文摘BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.
基金financial support from the Nuclear Energy Science&Technology and Human Resource Development Project of the Japan Atomic Energy Agency/Collaborative Laboratories for Advanced Decommissioning Science(No.R04I034)The author Ruicong Xu appreciates the scholarship(financial support)from the China Scholarship Council(CSC,No.202106380073).
文摘Laser-induced aerosols,predominantly submicron in size,pose significant environmental and health risks during the decommissioning of nuclear reactors.This study experimentally investigated the removal of laser-generated aerosol particles using a water spray system integrated with an innovative system for pre-injecting electrically charged mist in our facility.To simulate aerosol generation in reactor decommissioning,a high-power laser was used to irradiate various materials(including stainless steel,carbon steel,and concrete),generating aerosol particles that were agglomerated with injected water mist and subsequently scavenged by water spray.Experimental results demonstrate enhanced aerosol removal via aerosol-mist agglomeration,with charged mist significantly improving particle capture by increasing wettability and size.The average improvements for the stainless steel,carbon steel,and concrete were 40%,44%,and 21%,respectively.The results of experiments using charged mist with different polarities(both positive and negative)and different surface coatings reveal that the dominant polarity of aerosols varies with the irradiated materials,influenced by their crystal structure and electron emission properties.Notably,surface coatings such as ZrO_(2)and CeO_(2)were found to possibly alter aerosol charging characteristics,thereby affecting aerosol removal efficiency with charged mist configurations.The innovative aerosol-mist agglomeration approach shows promise in mitigating radiation exposure,ensuring environmental safety,and reducing contaminated water during reactor dismantling.This study contributes critical knowledge for the development of advanced aerosol management strategies for nuclear reactor decommissioning.The understanding obtained in this work is also expected to be useful for various environmental and chemical engineering applications such as gas decontamination,air purification,and pollution control.
文摘胃癌腹膜转移(GCPM)是进展期胃癌常见且致死性高的并发症,中位生存期仅5~11个月。本共识由亚洲30位专家(中国、日本、韩国、新加坡)采用德尔菲法和GRADE证据分级制定,共29条声明,涵盖GCPM诊断评估、腹腔镜探查与NIPS(normothermic intraperitoneal and systemic treatment)适应证、治疗方案、并发症预防管理、转化手术指征及术后腹腔治疗等。共识旨在规范临床实践,提高GCPM预后。
基金supports by the Grant-in-Aid of Scientific Research of Challenging Research(Exploratory)(JP23K17738)to TS from MEXT of Japanthe 41st grant of research from Nippon Sheet Glass Foundation for Materials Science and Engineering to TS.
文摘A redox-active monolayer on an optically transparent electrode constitutes a typical platform for spectroelectrochemical sensing.The necessity for its sophistication arises from the availability of multi-dimensional sensing signals.Simultaneous monitoring of the redox current and color change synchronized with the oxidation state change significantly enhances sen-sitivity and selectivity.This study aimed to elucidate the modification of an indium tin oxide(ITO)electrode with a viologen monolayer with an ordered orientation.Novel methods were developed to immobilize a viologen molecule bearing a car-boxyl group to form assembled monolayers through a condensation reaction using 1-ethyl-3-(3-dimethylaminopropyl)-car-bodiimide with N-hydroxy-succinimide(EDC/NHS).In the two methods of immobilization,one utilizes a two-step process to firstly form an aromatic siloxane base layer and subsequently attach the viologen derivative through an amide linkage by post-amidation.The other employs a direct ester linkage between the hydroxyl groups of the ITO surface and the car-boxyl group of the viologen derivative.The latter method was also applied to immobilize a ferrocenyl group at a very short distance from the ITO surface.Potential-modulated UV-visible transmission absorption spectral measurement techniques with oblique incidence of plane-polarized light were employed to determine the orientation of the longitudinal axis of the reduced form of the viologen.The frequency dependence data of the potential-modulated transmission absorption signals were utilized to analyze the electron transfer kinetics.The performance of the two viologen-modified electrodes was com-pared to that of an ITO modified by post-amidation to the most commonly used base layer prepared with 3-aminopropyl triethoxysilane.
基金partially supported by U.S.National Science Foundation grants EAR1925965 and RISE-2425889support from the European Research Council under the European Union Horizon 2020 research and innovation program(grant agreement no.742335,FIMAGE)。
文摘Several physical mechanisms of earthquake nucleation,such as pre-slip,cascade triggering,aseismic slip,and fluid-driven models,have been proposed.However,it is still not clear which model plays the most important role in driving foreshocks and mainshock nucleation for given cases.In this study,we focus on the relationship between an intensive earthquake swarm that started beneath the Noto Peninsula in Central Japan since November 2020 and the nucleation of the 2024 M 7.6 Noto Hanto earthquake.We relocate earthquakes listed in the standard Japan Meteorological Agency(JMA)catalog since 2018 with the double-different relocation method.Relocated seismicity revealed that the 2024 M 7.6 mainshock likely ruptured a thrust fault above a parallel fault where the M 6.5 Suzu earthquake occurred in May 2023.We find possible along-strike and along-dip expansion of seismicity in the first few months at the beginning of the swarm sequence,while no obvious migration pattern in the last few days before the M 7.6 mainshock was observed.Several smaller events occurred in between the M 5.5 and M 4.6 foreshocks that occurred about 4min and 2 min before the M 7.6 mainshock.The Coulomb stress changes from the M 5.5 foreshock were negative at the hypocenter of the M 7.6 mainshock,which is inconsistent with a simple cascade triggering model.Moreover,an M 5.9 foreshock was identified in the JMA catalog 14 s before the mainshock.Results from backprojection of high-frequency teleseismic P waves show a prolonged initial rupture process near the mainshock hypocenter lasting for~25 s,before propagating bilaterally outward.Our results suggest a complex evolution process linking the earthquake swarm to the nucleation of the M 7.6 mainshock at a region of complex structures associated with the bend of a mapped large-scale reverse fault.A combination of fluid migration,aseismic slip and elastic stress triggering likely work in concert to drive both the prolonged earthquake swarm and the nucleation of the M 7.6 mainshock.
基金funding support from the National Natural Science Foundation of China(Grant No.52374119)the opening fund of State Key Laboratory of Coal Mine Disaster Dynamics and Control(Grant No.2011DA105827-FW202209)the opening fund of State Key Laboratory of Performance Monitoring and Protecting of Rail Transit Infrastructure,East China Jiaotong University(Grant No.HJGZ2023103).
文摘Understanding the dynamic responses of hard rocks is crucial during deep mining and tunneling activities and when constructing nuclear waste repositories. However, the response of deep massive rocks with openings of different shapes and orientations to dynamic loading is not well understood. Therefore, this study investigates the dynamic responses of hard rocks of deep underground excavation activities. Split Hopkins Pressure Bar (SHPB) tests on granite with holes of different shapes (rectangle, circle, vertical ellipse (elliptical short (ES) axis parallel to the impact load direction), and horizontal ellipse (elliptical long (EL) axis parallel to the impact load direction)) were carried out. The influence of hole shape and location on the dynamic responses was analyzed to reveal the rocks' dynamic strengths and cracking characteristics. We used the ResNet18 (convolutional neural network-based) network to recognize crack types using high-speed photographs. Moreover, a prediction model for the stress-strain response of rocks with different openings was established using Deep Neural Network (DNN). The results show that the dynamic strengths of the granite with EL and ES holes are the highest and lowest, respectively. The strength-weakening coefficient decreases first and then increases with an increase of thickness-span ratio (h/L). The weakening of the granite with ES holes is the most obvious. The ResNet18 network can improve the analyzing efficiency of the cracking mechanism, and the trained model's recognition accuracy reaches 99%. Finally, the dynamic stress-strain prediction model can predict the complete stress-strain curve well, with an accuracy above 85%.
基金Supported by the Japan Society for the Promotion of Science KAKENHI Grant,No.JP24K15491.
文摘BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lead to the development of resistance.Additionally,some strains of HSV exist that are ACV resistant,and they can cause severe complications that may be impossible to treat with current therapies.We report the first case of ACV-resistant herpes encephalitis(ARHE)recurring in an immunocompromised adult patient without neurosurgical intervention.CASE SUMMARY A 58-year-old man with a fever of 38°C had tremors.Evaluation revealed 14 points on the Glasgow Coma Scale with 39°C fever but unremarkable physical examination.Diagnosis was infection of unknown origin;fever continued,and the Glasgow Coma Scale worsened to 8.Imaging showing a high-intensity area between the left temporal lobe and insular cortex suggested herpes encephalitis.ACV was started.Cerebrospinal fluid(CSF)was positive for HSV DNA,confirming the diagnosis.However,unresolved symptoms suggested ARHE;therefore,we initiated vidarabine treatment.Later testing confirmed ARHE.Foscarnet was started based on a hospital day 25 blood test revealing pancytopenia,possibly from vidarabine.Consciousness improved,and the patient moved to rehabilitation.However,symptoms worsened,suggesting recurrence.Diffusion-weighted magnetic resonance imaging revealed a high high-intensity area around the right temporal lobe;CSF was positive for HSV DNA,confirming recurrent herpes encephalitis.ACV and foscarnet were initiated.Fever decreased,consciousness improved,and HSV DNA on hospital days 78 and 93 was CSF negative.Treatment was terminated on hospital day 86.CONCLUSION ARHE recurred in the patient following remission;therefore,it is necessary to discuss the length of the treatment period.
基金Supported by The Japan Society for the Promotion of Science KAKENHI Grant,No.24K15491.
文摘Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.
基金supported by the National Natural Science Foundation of China(Grant Nos.92164105 and 51975151)the Heilongjiang Provincial Natural Science Foundation of China under grant LH2019E041+1 种基金the Heilongjiang Touyan Innovation Team Program(HITTY-20190013)State Key Laboratory of Precision Welding&Joining of Materials and Structures(No.24-T-04)。
文摘Due to its superior nanoscale properties,cobalt(Co)is highly desirable for ultrahigh-density 3D integration into materials through metal/dielectric hybrid bonding.However,this process is very challenging through Co/SiO_(2)hybrid bonding,as very hydrophilic SiO_(2)surfaces are needed for bonding during dehydration reactions and oxidation of the Co surfaces must be avoided.Additionally,the substantial coefficient of thermal expansion mismatch between the robust capping layers(Co and SiO_(2)layers)necessitates hybrid bonding with minimal thermal input and compression.In this study,we introduce a ternary plasma activation strategy employing an Ar/NH_(3)/H_(2)O gas mixture to facilitate Co/SiO_(2)hybrid bonding at temperatures as low as~200℃,which is markedly lower than the melting point of Co(~1500℃).Intriguingly,non-oxide metallization at the Co-Co interface can be realized without the hindrance of a bonding barrier,thereby reducing the electrical resistance by over 40%and compression force requirements.Moreover,the enhancement in the SiO_(2)surface energy through active group terminations fosters extensive interfacial hydration and strengthens the mechanical properties.This research paves the way for fine-tuning bonding surfaces using a material-selective strategy which should advance metal/dielectric hybrid bonding for future integration applications.
基金supported bythe Science and Technology Commission of Shanghai Municipality (Grant No.24CL2901702)The numerical calculations were performed at the Supercomputer Center (Project No.2024-Cb-0042)Institute for Solid State Physics,the University of Tokyo。
文摘Heat dissipation and thermal switches are vital for adaptive cooling and extending the lifespan of electronic devices and batteries. In this work, we conducted high-throughput investigations on the thermal transport of 24 experimentally realized two-dimensional(2D) materials and their potential as thermal switches, leveraging machine-learning-assisted strain engineering and phonon transport simulations. We identified several highperformance thermal switches with ratios exceeding 2, with germanene(Ge) achieving an ultrahigh ratio of up to9.64 within the reversible deformation range. The underlying mechanism is strain-induced bond softening, which sensitively affects anharmonicity represented by three-and four-phonon scattering. The widespread occurrence of four-phonon scattering was confirmed in the thermal transport of 2D materials. Opposite switching trends were discovered, with 2D transition metal dichalcogenide materials showing negative responses to tensile strain while buckled 2D elemental materials showed positive responses. We further proposed a screening descriptor based on strain-induced changes in the Gr¨uneisen parameter for efficiently identifying new high-performance thermal switch materials. This work establishes a paradigm for thermal energy control in 2D materials through strain engineering, which may be experimentally realized in the future via bending, substrate mismatch, and related approaches, thereby laying a robust foundation for further developments and applications.
文摘Objective:Deep learning(DL)has become the prevailing method in chest radiograph analysis,yet its performance heavily depends on large quantities of annotated images.To mitigate the cost,cold-start active learning(AL),comprising an initialization followed by subsequent learning,selects a small subset of informative data points for labeling.Recent advancements in pretrained models by supervised or self-supervised learning tailored to chest radiograph have shown broad applicability to diverse downstream tasks.However,their potential in cold-start AL remains unexplored.Methods:To validate the efficacy of domain-specific pretraining,we compared two foundation models:supervised TXRV and self-supervised REMEDIS with their general domain counterparts pretrained on ImageNet.Model performance was evaluated at both initialization and subsequent learning stages on two diagnostic tasks:psychiatric pneumonia and COVID-19.For initialization,we assessed their integration with three strategies:diversity,uncertainty,and hybrid sampling.For subsequent learning,we focused on uncertainty sampling powered by different pretrained models.We also conducted statistical tests to compare the foundation models with ImageNet counterparts,investigate the relationship between initialization and subsequent learning,examine the performance of one-shot initialization against the full AL process,and investigate the influence of class balance in initialization samples on initialization and subsequent learning.Results:First,domain-specific foundation models failed to outperform ImageNet counterparts in six out of eight experiments on informative sample selection.Both domain-specific and general pretrained models were unable to generate representations that could substitute for the original images as model inputs in seven of the eight scenarios.However,pretrained model-based initialization surpassed random sampling,the default approach in cold-start AL.Second,initialization performance was positively correlated with subsequent learning performance,highlighting the importance of initialization strategies.Third,one-shot initialization performed comparably to the full AL process,demonstrating the potential of reducing experts'repeated waiting during AL iterations.Last,a U-shaped correlation was observed between the class balance of initialization samples and model performance,suggesting that the class balance is more strongly associated with performance at middle budget levels than at low or high budgets.Conclusions:In this study,we highlighted the limitations of medical pretraining compared to general pretraining in the context of cold-start AL.We also identified promising outcomes related to cold-start AL,including initialization based on pretrained models,the positive influence of initialization on subsequent learning,the potential for one-shot initialization,and the influence of class balance on middle-budget AL.Researchers are encouraged to improve medical pretraining for versatile DL foundations and explore novel AL methods.
文摘In this study,a machine learning-based predictive model was developed for the Musa petti Wind Farm in Sri Lanka to address the need for localized forecasting solutions.Using data on wind speed,air temperature,nacelle position,and actual power,lagged features were generated to capture temporal dependencies.Among 24 evaluated models,the ensemble bagging approach achieved the best performance,with R^(2) values of 0.89 at 0 min and 0.75 at 60 min.Shapley Additive exPlanations(SHAP)analysis revealed that while wind speed is the primary driver for short-term predictions,air temperature and nacelle position become more influential at longer forecasting horizons.These findings underscore the reliability of short-term predictions and the potential benefits of integrating hybrid AI and probabilistic models for extended forecasts.Our work contributes a robust and explainable framework to support Sri Lanka’s renewable energy transition,and future research will focus on real-time deployment and uncertainty quantification.
基金supported by the National Natural Science Foundation of China(Grant Nos.52376063 and 52306116)the Hebei Key Laboratory of Low Carbon and High Efficiency Power Generation Technology Prevention Fund(Grant No.2022-K03)the China Postdoctoral Science Foundation(Grant No.2023MD744223).
文摘As a representative of wide-bandgap semiconductors,wurtzite gallium nitride(GaN)has been widely utilized in highpower devices due to its high breakdown voltage and low specific on-resistance.Accurate prediction of wurtzite GaN’s thermal conductivity is a prerequisite for designing effective thermal management systems for electronic applications.Machine learning-driven molecular dynamics simulation offers a promising approach to predicting the thermal conductivity of large-scale systems without requiring predefined parameters.However,these methods often underestimate the thermal conductivity of materials with inherently high thermal conductivity due to the large predicted force error compared with first-principles calculations,posing a critical challenge for their broader application.In this study,we successfully developed a neuroevolution potential for wurtzite GaN and accurately predicted its thermal conductivity,259±6 W/(m·K)at room temperature,achieving excellent agreement with reported experimental measurements.The hyperparameters of the neuroevolution potential(NEP)were optimized based on a systematic analysis of reproduced energy and force,structural features,and computational efficiency.Furthermore,a force error correction method was implemented,effectively reducing the error caused by the additional force noise in the Langevin thermostat by extrapolating to the zero-force error limit.This study provides valuable insights and holds significant implications for advancing efficient thermal management technologies in wide-bandgap semiconductor devices.
文摘Endoscopic submucosal dissection(ESD) is currently accepted as the major treatment modality for superficial neoplasms in the gastrointestinal tract including the esophagus.An important advantage of ESD is its effectiveness in resecting lesions regardless of their size and severity of fibrosis.Based on excellent outcomes for esophageal neoplasms with a small likelihood of lymph node metastasis,the number of ESD candidates has increased.On the other hand,ESD still requires highly skilled endoscopists due to technical difficulties.To avoid unnecessary complications including perforation and postoperative stricture,the indications for ESD require careful consideration and a full understanding of this modality.This article,in the highlight topic series,provides detailed information on the indication,procedure,outcome,complications and their prevention in ESD of superficial esophageal neoplasms.
基金Supported by the JSPS Kakenhi Grant,No.JP24K15491.
文摘Viral hepatitis represents a major danger to public health,and is a globally leading cause of death.The five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral therapies.There remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver disease.Furthermore,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’complications.In 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral hepatitis.Today,treatment is sufficiently able to prevent the disease from reaching advanced phases.However,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral hepatitis.This review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.
