BACKGROUND Carcinoembryonic antigen(CEA)and cytology in pancreatic cystic fluid are suboptimal for evaluation of pancreatic cystic neoplasms.Genetic testing and microforceps biopsy are promising tools for pre-operativ...BACKGROUND Carcinoembryonic antigen(CEA)and cytology in pancreatic cystic fluid are suboptimal for evaluation of pancreatic cystic neoplasms.Genetic testing and microforceps biopsy are promising tools for pre-operative diagnostic improvement but comparative performance of both methods is unknown.AIM To compare the accuracy of genetic testing and microforceps biopsy in pancreatic cysts referred for surgery.METHODS We performed a literature search in Medline,Scopus,and Web of Science for studies evaluating genetic testing of cystic fluid and microforceps biopsy of pancreatic cysts,with endoscopic ultrasound with fine-needle aspiration(EUSFNA)prior to surgery and surgical pathology as reference standard for diagnosis.We evaluated the diagnostic accuracy for:1-benign cysts;2-mucinous low-risk cysts;3-high-risk cysts,and the diagnostic yield and rate of correctly identified cysts with microforceps biopsy and molecular analysis.We also assessed publication bias,heterogeneity,and study quality.RESULTS Eight studies,including 1206 patients,of which 203(17%)referred for surgery who met the inclusion criteria were analyzed in the systematic review,and seven studies were included in the meta-analysis.Genetic testing and microforceps biopsies were identical for diagnosis of benign cysts.Molecular analysis was superior for diagnosis of both low and high-risk mucinous cysts,with sensitivities of 0.89(95%CI:0.79-0.95)and 0.57(95%CI:0.42-0.71),specificities of 0.88(95%CI:0.75-0.95)and 0.88(95%CI:0.80-0.93)and AUC of 0.9555 and 0.92,respectively.The diagnostic yield was higher in microforceps biopsies than in genetic analysis(0.73 vs 0.54,respectively)but the rates of correctly identified cysts were identical(0.73 with 95%CI:0.62-0.82 vs 0.71 with 95%CI:0.49-0.86,respectively).CONCLUSION Genetic testing and microforceps biopsies are useful second tests,with identical results in benign pancreatic cysts.Genetic analysis performs better for low-and high-risk cysts but has lower diagnostic yield.展开更多
The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promis...The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise.While changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain uncertain.Dietary fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI microbiota.The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical illness.Randomised controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were identified.Studies show dietary fibres have an impact on faecal microbiota in health and disease.The fibre,inulin,has a marked and specific effect on increasing the abundance of faecal Bifidobacteria.Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations.Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness.More research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.展开更多
This paper deals with the problem of recreating horizontal alignments of existing railway lines.The main objective is to propose a simple method for automatically obtaining optimized recreated alignments located as cl...This paper deals with the problem of recreating horizontal alignments of existing railway lines.The main objective is to propose a simple method for automatically obtaining optimized recreated alignments located as close as possible to an existing one.Based on a previously defined geometric model,two different constrained optimization problems are formulated.The first problem uses only the information provided by a set of points representing the track centerline while the second one also considers additional data about the existing alignment.The proposed methodology consists of a two-stage process in which both problems are solved consecutively using numerical techniques.The main results obtained applying this methodology are presented to show its performance and to prove its practical usefulness:an academic example used to compare with other methods,and a case study of a railway section located in Parga(Spain)in which the geometry of its horizontal alignment is successfully recovered.展开更多
We present a wideband polarization analysis of the mode-changing pulsar PSR J1938+2213 using the ultra-wideband low-frequency receiver on Murriyang,the Parkes 64 m radio telescope.Polarization profiles for both the bu...We present a wideband polarization analysis of the mode-changing pulsar PSR J1938+2213 using the ultra-wideband low-frequency receiver on Murriyang,the Parkes 64 m radio telescope.Polarization profiles for both the burst and weak emission modes are obtained.We find that the pulse widths of the two modes exhibit distinct frequency dependencies:the pulse width increases with frequency in the burst mode,but decreases in the weak mode.The linear and circular polarization fractions also show different trends with frequency between the two modes.Our spectral analysis shows that both modes follow power-law spectra,but with differing spectral indices.展开更多
Cyber threat detection is a crucial aspect of contemporary cybersecurity due to the depth and complexity of cyberattacks.It is the identification of malicious activity,unauthorized access,and possible intrusions in ne...Cyber threat detection is a crucial aspect of contemporary cybersecurity due to the depth and complexity of cyberattacks.It is the identification of malicious activity,unauthorized access,and possible intrusions in networks and systems.Modern detection methods employ artificial intelligence and machine learning to study vast amounts of data,learn patterns,and anticipate potential threats.Real-time monitoring and anomaly detection improve the capacity to react to changing threats more rapidly.Cyber threat detection systems aim to reduce false positives and provide complete coverage against the broadest possible attacks.This research advocates for proactive measures and adaptive technologies in defending digital environments.Improvements in detection ability by organizations will assist in safeguarding assets and integrity in operations in this increasingly digital world.This paper draws on the categorization of cyber threat detection methods using hesitant bipolar fuzzy Frank operators.Categorization is a step that is necessary for systematic comparison and assessment of detection methods so that the most suitable method for particular cybersecurity requirements is chosen.Furthermore,this research manages uncertainty and vagueness that exists in decision-making by applying hesitant bipolar fuzzy logic.The importance of the work lies in how it fortifies cybersecurity architectures with a formal method of discovering optimal detection measures and improving responsiveness,resulting in holistic protection against dynamic threats.展开更多
Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula...Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.展开更多
We present the first search for pulsed CH maser emission potentially stimulated by PSR J1644-4559,conducted using the ultra-wide-bandwidth low-frequency receiver on Murriyang,CSIRO's Parkes Radio Telescope.Observa...We present the first search for pulsed CH maser emission potentially stimulated by PSR J1644-4559,conducted using the ultra-wide-bandwidth low-frequency receiver on Murriyang,CSIRO's Parkes Radio Telescope.Observations targeted three CHΛ-doublet transitions at 3264,3335,and 3349 MHz,with a variability timescale of78 ms.We detected ten CH emission features at 3335 and 3349 MHz,and seven features at 3264 MHz,during both pulsar-ON and pulsar-OFF phases.The observed velocities align with the OH emission and absorption reported by a previous study,suggesting a close spatial association between CH and OH molecules.The derived column densities for CH clouds within the Parkes beam range from 0.05 to 9.8×10^(13)cm^(-2),indicating that these clouds are likely in diffuse and translucent states.Upper limits for CH column densities within the pulsar beam ranged from 0.3 to 9.8×10^(13)cm^(-2).Comparison of these column densities suggests that CH clouds may exhibit clumpiness and substructure.No significant stimulated emission feature was detected in the optical depth spectra.Additionally,as part of our search for pulsed stimulated emission,we investigated the potential CH absorption of the pulsar signal and found none,in agreement with astrophysical expectations.The upper limits for the potential maser amplification factors towards PSR J1644-4559 at 3264,3335,and 3349 MHz are 1.014,1.009,and 1.009,respectively.This study demonstrates the feasibility of detecting pulsed CH maser emission in the interstellar medium stimulated by pulsar photons.展开更多
文摘BACKGROUND Carcinoembryonic antigen(CEA)and cytology in pancreatic cystic fluid are suboptimal for evaluation of pancreatic cystic neoplasms.Genetic testing and microforceps biopsy are promising tools for pre-operative diagnostic improvement but comparative performance of both methods is unknown.AIM To compare the accuracy of genetic testing and microforceps biopsy in pancreatic cysts referred for surgery.METHODS We performed a literature search in Medline,Scopus,and Web of Science for studies evaluating genetic testing of cystic fluid and microforceps biopsy of pancreatic cysts,with endoscopic ultrasound with fine-needle aspiration(EUSFNA)prior to surgery and surgical pathology as reference standard for diagnosis.We evaluated the diagnostic accuracy for:1-benign cysts;2-mucinous low-risk cysts;3-high-risk cysts,and the diagnostic yield and rate of correctly identified cysts with microforceps biopsy and molecular analysis.We also assessed publication bias,heterogeneity,and study quality.RESULTS Eight studies,including 1206 patients,of which 203(17%)referred for surgery who met the inclusion criteria were analyzed in the systematic review,and seven studies were included in the meta-analysis.Genetic testing and microforceps biopsies were identical for diagnosis of benign cysts.Molecular analysis was superior for diagnosis of both low and high-risk mucinous cysts,with sensitivities of 0.89(95%CI:0.79-0.95)and 0.57(95%CI:0.42-0.71),specificities of 0.88(95%CI:0.75-0.95)and 0.88(95%CI:0.80-0.93)and AUC of 0.9555 and 0.92,respectively.The diagnostic yield was higher in microforceps biopsies than in genetic analysis(0.73 vs 0.54,respectively)but the rates of correctly identified cysts were identical(0.73 with 95%CI:0.62-0.82 vs 0.71 with 95%CI:0.49-0.86,respectively).CONCLUSION Genetic testing and microforceps biopsies are useful second tests,with identical results in benign pancreatic cysts.Genetic analysis performs better for low-and high-risk cysts but has lower diagnostic yield.
文摘The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise.While changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain uncertain.Dietary fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI microbiota.The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical illness.Randomised controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were identified.Studies show dietary fibres have an impact on faecal microbiota in health and disease.The fibre,inulin,has a marked and specific effect on increasing the abundance of faecal Bifidobacteria.Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations.Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness.More research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.
基金founded by project TED2021129324B-I00 of the Ministerio de Ciencia e Innovación(Spain)and NextGenerationEU(European Union)the Collaboration Agreement between Consellería de Educación,Formación Profesional e Universidades(Xunta de Galicia,Spain)and Universidade de Santiago de Compostela(Spain)which regulates the Specialization Campus Campus Terra under Grant number 2022-PU014support given by Xunta de Galicia(Spain)by means of the research projects 2023 GPC GI-2084 ED431B2023/17 and GRC GI-1563-ED431C 2021/15,respectively.
文摘This paper deals with the problem of recreating horizontal alignments of existing railway lines.The main objective is to propose a simple method for automatically obtaining optimized recreated alignments located as close as possible to an existing one.Based on a previously defined geometric model,two different constrained optimization problems are formulated.The first problem uses only the information provided by a set of points representing the track centerline while the second one also considers additional data about the existing alignment.The proposed methodology consists of a two-stage process in which both problems are solved consecutively using numerical techniques.The main results obtained applying this methodology are presented to show its performance and to prove its practical usefulness:an academic example used to compare with other methods,and a case study of a railway section located in Parga(Spain)in which the geometry of its horizontal alignment is successfully recovered.
基金supported by the National Natural Science Foundation of China(Nos.12288102,12203092,12041304,12403060,12203045,12203093,12163001 and 12463007)the Major Science and Technology Program of Xinjiang Uygur Autonomous Region(Nos.2022A03013-3,and 2022A03013-2)+7 种基金the National SKA Program of China(No.2020SKA0120100)the National Key Research and Development Program of China(Nos.2022YFC2205202 and 2021YFC2203502)the Natural Science Foundation of Xinjiang Uygur Autonomous Region(Nos.2022D01B71 and 2022D01B218)the Tianshan Talent Training Program for Young Elite Scientists(No.2023TSYCQNTJ0024)the 2022 Project Xinjiang Uygur Autonomous Region of China for Tianchi Talents,the open research project funded by the Key Laboratory of Xinjiang Uyghur Autonomous Region(No.2021000059)the National Key Research and Development Program(No.2022YFA1603104)The research is partly supported by the Operation,Maintenance and Upgrading Fund for Astronomical Telescopes and Facility Instruments,budgeted from the Ministry of Finance of China(MOF)and administrated by the Chinese Academy of Sciences(CAS)Murriyang,CSIRO’s Parkes radio telescope,is part of the Australia Telescope National Facility(https://ror.org/05qajvd42)which is funded by the Australian Government for operation as a National Facility managed by CSIRO.
文摘We present a wideband polarization analysis of the mode-changing pulsar PSR J1938+2213 using the ultra-wideband low-frequency receiver on Murriyang,the Parkes 64 m radio telescope.Polarization profiles for both the burst and weak emission modes are obtained.We find that the pulse widths of the two modes exhibit distinct frequency dependencies:the pulse width increases with frequency in the burst mode,but decreases in the weak mode.The linear and circular polarization fractions also show different trends with frequency between the two modes.Our spectral analysis shows that both modes follow power-law spectra,but with differing spectral indices.
基金funded by Ongoing Research Funding program(ORF-2025-749),King Saud University,Riyadh,Saudi Arabia.
文摘Cyber threat detection is a crucial aspect of contemporary cybersecurity due to the depth and complexity of cyberattacks.It is the identification of malicious activity,unauthorized access,and possible intrusions in networks and systems.Modern detection methods employ artificial intelligence and machine learning to study vast amounts of data,learn patterns,and anticipate potential threats.Real-time monitoring and anomaly detection improve the capacity to react to changing threats more rapidly.Cyber threat detection systems aim to reduce false positives and provide complete coverage against the broadest possible attacks.This research advocates for proactive measures and adaptive technologies in defending digital environments.Improvements in detection ability by organizations will assist in safeguarding assets and integrity in operations in this increasingly digital world.This paper draws on the categorization of cyber threat detection methods using hesitant bipolar fuzzy Frank operators.Categorization is a step that is necessary for systematic comparison and assessment of detection methods so that the most suitable method for particular cybersecurity requirements is chosen.Furthermore,this research manages uncertainty and vagueness that exists in decision-making by applying hesitant bipolar fuzzy logic.The importance of the work lies in how it fortifies cybersecurity architectures with a formal method of discovering optimal detection measures and improving responsiveness,resulting in holistic protection against dynamic threats.
文摘Background:Health professions education(HPE)in underserved and resource-constrained regions faces persistent challenges,including limited faculty development opportunities and the absence of context-specific curricula.The growing need to increase access to cataract surgery and reduce avoidable blindness underscores the urgency of training more competent cataract surgeons.Developing a standardized,nationally endorsed,outcome-based curriculum for simulation-based training in cataract surgery represents a strategic solution.This study explores integrating online active and constructivist social learning strategies within team projects to address these educational gaps,emphasizing equitable international partnerships between experienced global ophthalmological societies(GOS)in HPE,and national ophthalmological societies(NOS)especially in underserved regions.Methods:We conducted an non-experimental investigation involving the Mozambican College of Ophthalmology(NOS),comprising ten senior ophthalmologist educators,including the President(A.B.),each with over ten years of postgraduate teaching leadership experience.To promote inclusivity and foster future leadership,six early-career ophthalmologists with under five years of experience were invited to join.The GOS was represented by two ophthalmologist educators(K.G.and H.P.F.)affiliated with the Ophthalmology Foundation and experienced in international HPE.Together,both organizations formed an equitable and culturally adapted partnership,led by the NOS,to co-design an outcome-based curriculum for cataract surgery simulation training.The collaborative process used a group mentor-facilitated model integrating design thinking,and social constructivist strategies.A virtual community of practice(vCoP),sustained through WhatsApp,enabled continuous peer support and knowledge exchange.The project spanned eight monthly 90-minute videoconferences via Zoom,incorporating online group mentoring and a virtual jigsaw exercise.Results:The collaboration resulted in the development of a competency-based,simulation-enhanced small incision cataract surgery curriculum structured around the Ophthalmic Simulated Surgical Competency Assessment Rubric(Sim-OSSCAR).The curriculum followed Kern’s six-step framework and was organized into four modular components covering the full range of surgical steps.The vCoP emerged as a key platform for sustained faculty development,collaborative problem-solving,and shared expertise,enhancing institutional capacity within the NOS.Participants anecdotally reported increased confidence in curriculum design,strengthened mentoring relationships,and greater engagement through active learning methodologies.The model demonstrated scalability and adaptability,indicating potential for broader application across other medical specialties and contexts.Conclusions:This study highlights the transformative potential of combining design thinking,active and social learning strategies,and digital tools in HPE.By fostering equitable,structured international collaborations,this approach supports sustainable faculty development and contextually relevant educational innovation.The creation of a dynamic vCoP was instrumental in promoting shared ownership and collaboration,ultimately advancing competency-based,simulation-enhanced training in ophthalmology.These findings suggest similar team-based,technology-enabled strategies could strengthen training and patient care in other underserved settings and with other disciplines.
基金supported by the National Natural Science Foundation of China(NSFC,Grant Nos.11988101,12203044,and 12473023)by the Leading Innovation and Entrepreneurship Team of Zhejiang Province of China grant No.2023R01008+2 种基金by Key R&D Program of Zhejiang grant No.2024SSYS0012by the University Annual Scientific Research Plan of Anhui Province(No.2023AH030052,No.2022AH010013)Cultivation Project for FAST Scientific Payoff and Research Achievement of CAMS-CAS。
文摘We present the first search for pulsed CH maser emission potentially stimulated by PSR J1644-4559,conducted using the ultra-wide-bandwidth low-frequency receiver on Murriyang,CSIRO's Parkes Radio Telescope.Observations targeted three CHΛ-doublet transitions at 3264,3335,and 3349 MHz,with a variability timescale of78 ms.We detected ten CH emission features at 3335 and 3349 MHz,and seven features at 3264 MHz,during both pulsar-ON and pulsar-OFF phases.The observed velocities align with the OH emission and absorption reported by a previous study,suggesting a close spatial association between CH and OH molecules.The derived column densities for CH clouds within the Parkes beam range from 0.05 to 9.8×10^(13)cm^(-2),indicating that these clouds are likely in diffuse and translucent states.Upper limits for CH column densities within the pulsar beam ranged from 0.3 to 9.8×10^(13)cm^(-2).Comparison of these column densities suggests that CH clouds may exhibit clumpiness and substructure.No significant stimulated emission feature was detected in the optical depth spectra.Additionally,as part of our search for pulsed stimulated emission,we investigated the potential CH absorption of the pulsar signal and found none,in agreement with astrophysical expectations.The upper limits for the potential maser amplification factors towards PSR J1644-4559 at 3264,3335,and 3349 MHz are 1.014,1.009,and 1.009,respectively.This study demonstrates the feasibility of detecting pulsed CH maser emission in the interstellar medium stimulated by pulsar photons.
