BACKGROUND Malabsorptive bariatric surgery,including Roux-en-Y gastric bypass and duodenal switch,are known to be more metabolically effective than restrictive surgery.However,the permanent alteration of gastrointesti...BACKGROUND Malabsorptive bariatric surgery,including Roux-en-Y gastric bypass and duodenal switch,are known to be more metabolically effective than restrictive surgery.However,the permanent alteration of gastrointestinal anatomy from these operations has been shown to alter the kinetics of drug absorption and may make subsequent surgeries more technically challenging.AIM To evaluate perioperative liver transplant outcomes and rates of acute cellular rejection in recipients with prior malabsorptive bariatric surgery.METHODS Patients who underwent liver transplantation at a single institution between 2005-2024 with a history of malabsorptive bariatric surgery were identified.Matched controls were selected based on age,sex,listing model for end-stage liver disease(MELD),and primary liver diagnosis.RESULTS A total of 12 liver transplant patients with prior malabsorptive surgery and 25 controls were included.The mean age in the malabsorptive group was 50.5 years at the time of transplant and 92%were female.The mean MELD at the time of transplant was 27.6 and mean body mass index was 28.There were no significant differences in length of stay,post operative complications,or 1 year survival between the controls and malabsorptive patients.However,the malabsorptive group was significantly more likely to experience biopsy-proven and clinically treated acute cellular rejection than the controls(24%vs 66.7%,P=0.012),more frequent rejection episodes(0.28±0.53 vs 1.0±0.91,P=0.006),and earlier time to first rejection episode(P=0.002).CONCLUSION Previous malabsorptive bariatric surgery in liver transplant recipients did not increase the risk of perioperative complications or mortality but significantly increased the rate and frequency of acute cellular rejection.展开更多
Advancements in machine learning have revolutionized preoperative risk assessment.In this article,we comment on the article by Huang et al,which presents a recent multicenter cohort study demonstrated that machine lea...Advancements in machine learning have revolutionized preoperative risk assessment.In this article,we comment on the article by Huang et al,which presents a recent multicenter cohort study demonstrated that machine learning algorithms effectively stratify recurrence-free survival,providing a robust predictive framework for maximizing surgical outcomes in intrahepatic cholangiocarcinoma.By leveraging interpretable models,the research enhances clinical decision-making,allowing for more precise patient selection and personalized surgical strategies.These findings highlight the growing role of artificial intelligence in optimizing surgical outcomes and improving prognostic accuracy in hepatobiliary oncology.展开更多
This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tu...This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tumors and depre-ssion.The study included 110 patients and compared an experimental group receiving EPI and a mindfulness intervention strategy with a control group treated with mitomycin and standard care.Results showed that the experimental group had significant improvements in immune function,tumor markers,depression severity,quality of life,cancer-related fatigue,and nursing satisfac-tion.Despite acknowledging the study limitations such as a relatively small sample size and a short duration,the study highlights the efficacy of integrating mindfulness interventions into cancer treatment strategies to enhance patient outcomes and address psychological distress.展开更多
Nitrogen(N)is crucial for maize(Zea mays L.)growth,development and yield.Dysfunction of the maize NIN-like protein 5(ZmNLP5)reduces N assimilation,but the precise mechanism by which ZmNLP5 modulates N metabolism and i...Nitrogen(N)is crucial for maize(Zea mays L.)growth,development and yield.Dysfunction of the maize NIN-like protein 5(ZmNLP5)reduces N assimilation,but the precise mechanism by which ZmNLP5 modulates N metabolism and its contribution to agricultural applications are not well understood.In this study,our transcriptomic profiling and chromatin immunoprecipitation followed by sequencing(ChIP-seq)analyses reveal 581 ZmNLP5-modulated target genes.We confirmed that ZmNLP5 physically interacted and transactivated contributors to N assimilation,including ZmNRT1.1D,ZmNIR1.1,ZmNR2.1,ZmGS4,ZmAS1,and ZmLBD6.Overexpression of ZmNLP5 upregulated N metabolism genes,and enhanced the enzymatic activities of nitrate reductase and glutamine synthase.Furthermore,overexpressing ZmNLP5 increased grain yield under both normal-N and low-N conditions.Introgression of the overexpressed ZmNLP5 allele into Zhengdan 958 resulted in comparable yield increases in field trials.Our study unveiled that ZmNLP5 is a potential genetic target for increasing nitrogen use efficiency and grain yield in maize.展开更多
The brood-parasitic brown-headed cowbird(Molothrus ater)has one of the shortest incubation periods of any bird.Brown-headed cowbird eggs,and those of other avian brood parasites,tend to be more spherical due to their ...The brood-parasitic brown-headed cowbird(Molothrus ater)has one of the shortest incubation periods of any bird.Brown-headed cowbird eggs,and those of other avian brood parasites,tend to be more spherical due to their greater relative width.The traditional explanation for this egg shape is that it,combined with the thicker eggshells,resists host puncture-ejection.However,very few North American hosts of the brownheaded cowbird actually engage in puncture-ejection and therefore wider eggs may instead provide greater contact with a host’s brood patch during incubation,especially in large host nests.We tested whether greater egg width increased mean temperature and reduced temperature variation in brown-headed cowbirds by inserting temperature probes into brown-headed cowbird and house sparrow(Passer domesticus)eggs and placing them into red-winged blackbird(Agelaius phoeniceus)nests.House sparrow eggs are similar in appearance and in length to cowbird eggs,but are not as wide.We found no signifcant relationship between brown-headed cowbird egg width and mean incubation temperature.However,brown-headed cowbird eggs experienced less temperature variation than house sparrow eggs,and within brown-headed cowbird eggs,more spherical eggs experienced less temperature variation when accounting for differences in width.These results suggest that brownheaded cowbirds may have short incubation periods in part because their eggs exhibit less temperature variation over the course of incubation.The brown-headed cowbird’s egg shape may contribute to its accelerated embryonic development rate relative to host eggs of similar size,which explains its ability to hatch in a variety of host nests.展开更多
Oats, frequently incorporated into skincare formulations for their anti-inflammatory, moisturizing, and barrier-repairing properties, may present an overlooked risk to individuals with celiac disease, particularly whe...Oats, frequently incorporated into skincare formulations for their anti-inflammatory, moisturizing, and barrier-repairing properties, may present an overlooked risk to individuals with celiac disease, particularly when applied to compromised skin. Although pure oats are inherently gluten-free, the widespread contamination with gluten-containing grains like wheat, barley, or rye during agricultural and processing stages introduces the potential for gluten exposure through topical application. This raises important questions about whether gluten proteins, when applied to damaged skin, might penetrate the epidermal barrier and contribute to immune responses in genetically predisposed celiac patients, given that even minute amounts of gluten can trigger systemic symptoms. Emerging evidence suggests that transdermal absorption of gluten peptides through impaired skin integrity might bypass the gastrointestinal route, yet the precise mechanisms and clinical significance of this pathway remain poorly understood. The role of compromised skin in facilitating gluten absorption and the possible activation of CD4+ T-cells, mimicking gastrointestinal pathways, warrants further investigation. Additionally, the ability of gluten peptides to reach deeper dermal layers and potentially enter the systemic circulation remains speculative, though theoretically possible in severely disrupted skin barriers. Without clinical and molecular studies to determine the risk of topical gluten exposure, particularly in celiac patients with skin injuries, there remains a potential for undetected immune activation and subsequent adverse health outcomes in this sensitive population.展开更多
Due to the high water content in warm frozen soil,the pore water pressure and pore ice pressure generated within the sample during loading significantlyinfluencethe deformation and strength of the soil skeleton.Theref...Due to the high water content in warm frozen soil,the pore water pressure and pore ice pressure generated within the sample during loading significantlyinfluencethe deformation and strength of the soil skeleton.Therefore,it is essential to develop a constitutive model for warm frozen soil that can capture the changes in ice pressure and water pressure.This study introduces a macro-meso constitutive model based on a binary-medium framework to describe the mechanical behavior of warm frozen soil.In this model,warm frozen soil is conceptualized as consisting of bonded and frictional elements from a meso perspective.The bonded elements are modeled using a macro-meso elastic constitutive approach based on poromechanics,while the frictional elements employ a macro-meso elastoplastic approach,also grounded in poromechanics.These two elements are then linked within the binarymedium model framework.By replicating the experimental curves of warm frozen soils,the theoretical results from the proposed model show excellent agreement with experimental data.This consistency indicates that the model effectively simulates the strain softening and volumetric expansion behaviors of warm frozen soil samples under various conditions.Additionally,the constitutive model predicts changes in unfrozen water pressure,frozen temperature,unfrozen water saturation,and porosity during the loading process of warm frozen soil samples.展开更多
The^(6)Li+^(89)Y experiment was performed to explore the reaction mechanism induced by a weakly bound nucleus^(6)Li and its cluster configuration.The particle-γcoincidence method was used to identify the different re...The^(6)Li+^(89)Y experiment was performed to explore the reaction mechanism induced by a weakly bound nucleus^(6)Li and its cluster configuration.The particle-γcoincidence method was used to identify the different reaction channels.Theγ-rays coincident with^(3)He/^(3)H indicate that the^(3)H/^(3)He stripping reaction plays a significant role in the formation of Zr/Nb isotopes.The obtained results support the existence of a^(3)He-^(3)H cluster in^(6)Li.Direct and sequential transfer reactions are adequately discussed,and the FRESCO code is used to perform precise finite-range cyclic redundancy check calculations.In the microscopic calculation,direct cluster transfer is more predominant than sequential transfer in^(3)H transfer.However,the direct cluster transfer is of comparable magnitude to the sequential transfer in the^(3)He transfer.展开更多
Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and geneti...Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and genetic mechanisms and can be derived from an individual's somatic cells(e.g.,blood or skin).This enables patient-specific paradigms for precision neurotrauma research,pa rticula rly relevant to the over 300,000 people in the United States living with chronic effects of spinal cord injury(SCI).展开更多
Protein aggregates,mitochondrial import stress and neurodegenerative disorders:A salient hallmark of several neurodegenerative diseases,including Parkinson’s disease,is the abundance of protein aggregates(Goiran et a...Protein aggregates,mitochondrial import stress and neurodegenerative disorders:A salient hallmark of several neurodegenerative diseases,including Parkinson’s disease,is the abundance of protein aggregates(Goiran et al.,2022).This molecular event is believed to lead to activation of stress pathways ultimately resulting in cellular dysfunction(Eldeeb et al.,2022).Accordingly,many lines of research investigations focused on dampening the formation of protein aggregates or augmenting the clearance of protein aggregates as a potential therapeutic strategy to counteract the progression of neurodegenerative diseases,albeit with little success(Costa-Mattioli and Walter,2020).Cell stress cues such as the accumulation of protein aggregates lead to the activation of stress response pathways that aid cells in responding to the damage.Despite the notion that the transient activation of these pathways helps cells cope with stressors,persistent activation can induce unwanted apoptosis of cells and reduce overall tissue strength as well as lead to an accumulation of aggregation-prone proteins(Hetz and Papa,2018).Mutations in proteins involved in stress signaling termination can cause conditions like ataxia and early-onset dementia(Conroy et al.,2014).Therefore,it is crucial for stress response signaling to be turned off once conditions have improved.Nevertheless,the mechanisms by which cells silence these signals are still elusive.展开更多
As silicon-based transistors face fundamental scaling limits,the search for breakthrough alternatives has led to innovations in 3D architectures,heterogeneous integration,and sub-3 nm semiconductor body thicknesses.Ho...As silicon-based transistors face fundamental scaling limits,the search for breakthrough alternatives has led to innovations in 3D architectures,heterogeneous integration,and sub-3 nm semiconductor body thicknesses.However,the true effectiveness of these advancements lies in the seamless integration of alternative semiconductors tailored for next-generation transistors.In this review,we highlight key advances that enhance both scalability and switching performance by leveraging emerging semiconductor materials.Among the most promising candidates are 2D van der Waals semiconductors,Mott insulators,and amorphous oxide semiconductors,which offer not only unique electrical properties but also low-power operation and high carrier mobility.Additionally,we explore the synergistic interactions between these novel semiconductors and advanced gate dielectrics,including high-K materials,ferroelectrics,and atomically thin hexagonal boron nitride layers.Beyond introducing these novel material configurations,we address critical challenges such as leakage current and long-term device reliability,which become increasingly crucial as transistors scale down to atomic dimensions.Through concrete examples showcasing the potential of these materials in transistors,we provide key insights into overcoming fundamental obstacles—such as device reliability,scaling down limitations,and extended applications in artificial intelligence—ultimately paving the way for the development of future transistor technologies.展开更多
The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain....The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.展开更多
The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their recept...The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their receptors,and downstream signal transducers,organize neural wiring to generate the complex architecture of the nervous system.It is now evident that many of these neuroguidance cues and their receptors are active during development and are also expressed in the adult nervous system.This suggests that neuronal guidance pathways are critical not only for neural wiring but also for ongoing function and maintenance of the mature nervous system.Supporting this view,these pathways continue to regulate synaptic connectivity,plasticity,and remodeling,and overall brain homeostasis throughout adulthood.Genetic and transcriptomic analyses have further revealed many neuronal guidance genes to be associated with a wide range of neurodegenerative and neuropsychiatric disorders.Although the precise mechanisms by which aberrant neuronal guidance signaling drives the pathogenesis of these diseases remain to be clarified,emerging evidence points to several common themes,including dysfunction in neurons,microglia,astrocytes,and endothelial cells,along with dysregulation of neuron-microglia-astrocyte,neuroimmune,and neurovascular interactions.In this review,we explore recent advances in understanding the molecular and cellular mechanisms by which aberrant neuronal guidance signaling contributes to disease pathogenesis through altered cell-cell interactions.For instance,recent studies have unveiled two distinct semaphorin-plexin signaling pathways that affect microglial activation and neuroinflammation.We discuss the challenges ahead,along with the therapeutic potentials of targeting neuronal guidance pathways for treating neurodegenerative diseases.Particular focus is placed on how neuronal guidance mechanisms control neuron-glia and neuroimmune interactions and modulate microglial function under physiological and pathological conditions.Specifically,we examine the crosstalk between neuronal guidance signaling and TREM2,a master regulator of microglial function,in the context of pathogenic protein aggregates.It is well-established that age is a major risk factor for neurodegeneration.Future research should address how aging and neuronal guidance signaling interact to influence an individual’s susceptibility to various late-onset neurological diseases and how the progression of these diseases could be therapeutically blocked by targeting neuronal guidance pathways.展开更多
Flexible electronics face critical challenges in achieving monolithic three-dimensional(3D)integration,including material compatibility,structural stability,and scalable fabrication methods.Inspired by the tactile sen...Flexible electronics face critical challenges in achieving monolithic three-dimensional(3D)integration,including material compatibility,structural stability,and scalable fabrication methods.Inspired by the tactile sensing mechanism of the human skin,we have developed a flexible monolithic 3D-integrated tactile sensing system based on a holey MXene paste,where each vertical one-body unit simultaneously functions as a microsupercapacitor and pressure sensor.The in-plane mesopores of MXene significantly improve ion accessibility,mitigate the self-stacking of nanosheets,and allow the holey MXene to multifunctionally act as a sensing material,an active electrode,and a conductive interconnect,thus drastically reducing the interface mismatch and enhancing the mechanical robustness.Furthermore,we fabricate a large-scale device using a blade-coating and stamping method,which demonstrates excellent mechanical flexibility,low-power consumption,rapid response,and stable long-term operation.As a proof-of-concept application,we integrate our sensing array into a smart access control system,leveraging deep learning to accurately identify users based on their unique pressing behaviors.This study provides a promising approach for designing highly integrated,intelligent,and flexible electronic systems for advanced human-computer interactions and personalized electronics.展开更多
Since the first description of the concept of natural orifice translumenal endoscopic surgery (NOTES), a substantial number of clinical NOTES reports have appeared in the literature. This editorial reviews the availab...Since the first description of the concept of natural orifice translumenal endoscopic surgery (NOTES), a substantial number of clinical NOTES reports have appeared in the literature. This editorial reviews the available human data addressing research questions originally proposed by the white paper, including determining the optimal method of access for NOTES, developing safe methods of lumenal closure, suturing and anastomotic devices, advanced multitasking platforms, addressing the risk of infection, managing complications, addressing challenges with visualization, and training for NOTES procedures. An analysis of the literature reveals that so far transvaginal access and closure appear to be the most feasible techniques for NOTES, with a limited, but growing transgastric, transrectal, and transesophageal NOTES experience in humans. The theoretically increased risk of infection as a result of NOTES procedures has not been substantiated in transvaginal and transgastric procedures so far. Development of suturing and anastomotic devices and advanced platforms for NOTES has progressed slowly, with limited clinical data on their use so far. Data onthe optimal management and incidence of intraoperative complications remain sparse, although possible factors contributing to complications are discussed. Finally, this editorial discusses the likely direction of future NOTES development and its possible role in clinical practice.展开更多
Following up the fluid flow simulation in a 60 t tundish, the trajectories of inclusions in the 60 t tundish without flow control are simulated by considering the force balance between the drag force and the inertial ...Following up the fluid flow simulation in a 60 t tundish, the trajectories of inclusions in the 60 t tundish without flow control are simulated by considering the force balance between the drag force and the inertial buoyancy force. The Stochastic model yields more accurate inclusion motion than the non-Stochastic model due to including the effect of the turbulent fluctuation. The average residence time of inclusions decreases with increasing size. The thermal buoyancy favors inclusions removal especially the small inclusions. Using solute transport like the dye injection in water model and copper addition in the real steel tundish cannot accurately study the motion of the inclusions. In the simulation, more than 68% inclusions bigger than 10μm are removed to the top, and less than 32% enters the mold. The thermal buoyancy has little effect on the fraction of inclusions moved to the top of the inlet zone, and it mainly favors the removal of inclusions smaller than 100μm to the top surface of the outlet zone. For inclusions bigger than 100μm, the effect of thermal buoyancy on their motion can be ignored compared to the inertial buoyancy effect.展开更多
Inflammatory bowel disease(IBD),including Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic inflammatory disease of the digestive tract with increasing prevalence globally.Although venous thromboembolism(VTE...Inflammatory bowel disease(IBD),including Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic inflammatory disease of the digestive tract with increasing prevalence globally.Although venous thromboembolism(VTE)is a major complication in IBD patients,it is often underappreciated with limited tools for risk stratification.AIM To estimate the proportion of VTE among IBD patients and assess genetic risk factors(monogenic and polygenic)for VTE.METHODS Incident VTE was followed for 8465 IBD patients in the UK Biobank(UKB).The associations of VTE with F5 factor V leiden(FVL)mutation,F2 G20210A prothrombin gene mutation(PGM),and polygenic score(PGS003332)were tested using Cox hazards regression analysis,adjusting for age at IBD diagnosis,gender,and genetic background(top 10 principal components).The performance of genetic risk factors for discriminating VTE diagnosis was estimated using the area under the receiver operating characteristic curve(AUC).RESULTS The overall proportion of incident VTE was 4.70%in IBD patients and was similar for CD(4.46%),UC(4.49%),and unclassified(6.42%),and comparable to that of cancer patients(4.66%)who are well-known at increased risk for VTE.Mutation carriers of F5/F2 had a significantly increased risk for VTE compared to non-mutation carriers,hazard ratio(HR)was 1.94,95%confidence interval(CI):1.42-2.65.In contrast,patients with the top PGS decile had a considerably higher risk for VTE compared to those with intermediate scores(middle 8 deciles),HR was 2.06(95%CI:1.57-2.71).The AUC for differentiating VTE diagnosis was 0.64(95%CI:0.61-0.67),0.68(95%CI:0.66-0.71),and 0.69(95%CI:0.66-0.71),respectively,for F5/F2 mutation carriers,PGS,and combined.CONCLUSION Similar to cancer patients,VTE complications are common in IBD patients.PGS provides more informative risk information than F5/F2 mutations(FVL and PGM)for personalized thromboprophylaxis.展开更多
AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient status.METHODS： We identified 355 consecutive patients who completed C...AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient status.METHODS： We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient （OP）, 70 in-patient （IP）], CE indications, findings, location of the patients [IP vs OP and intensive care unit （ICU） vs general medical floor （GMF）] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 （Chicago, IL）. Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS： The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs （P = 0.07）. The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding （OGB） was significantly more com- mon for the IP CE （P = 0.0001）, while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams （P = 0.002 and P = 0.01, respec- tively）. Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel （SB） in 6/70 IPs and 8/264 OPs （P = 0.04）. The capsule never reached the cecum in 31.4% （22/70） of IP vs 9.5% （25/ 264） of OP ex- aminations （P 〈 0.001）. The mean gastric transit time （GTT） was delayed in IPs compared to OPs, 98.5 ± 139.5 min vs 60.4 ± 92.6 min （P = 0.008）. Minimal SB transit time was significantly prolonged in the IP com- pared to the OP setting [IP = 275.1±111.6 min vs OP = 244.0 ± 104.3 min （P = 0.037）]. CECR was also sig- nificantly higher in the subgroup of patients with OGB who had OP vs IP exams （95% vs 80% respectively, P = 0.001）. The proportion of patients with incomplete exams was higher in the ICU （n = 7/13, 54%） as com- pared to the GMF （n = 15/57, 26%） （P = 0.05）. There was only a single permanent SB retention case which was secondary to a previously unknown SB stricture, and the remaining incomplete SB exams were due to slow transit. Medications which affect gastrointesti- nal system motility were tested both individually and also in aggregate in univariate analysis in hospitalized patients （ICU and GMF） and were not predictive of incomplete capsule passage （P 〉 0.05）. Patient loca- tion （IP vs OP） and GTT were independent predictors of incomplete CE exams （P 〈 0.001 and P = 0.008, respectively）. CONCLUSION： Incomplete CE is a multifactorial prob- lem. Patient location and related factors such as sever- ity of illness and sedentary status may contribute to incomplete exams.展开更多
The phase selection of ternary intermetallic compound τphase (Mg32(Al, Zn)49 ) and φ phase (Al2Mg5Zn2) in high zinc magnesium alloys was studied by using scanning electron microscope, X-ray diffractometer and differ...The phase selection of ternary intermetallic compound τphase (Mg32(Al, Zn)49 ) and φ phase (Al2Mg5Zn2) in high zinc magnesium alloys was studied by using scanning electron microscope, X-ray diffractometer and differential scanning calorimeter, etc. The results indicate that, when adding element Si in Mg-8Zn-4Al-0.3Mn (ZA84) alloy, φ phase is promoted, whereas τ phase is inhibited. The Chinese script-type Mg2Si and matrix microstructure are greatly refined, the formation of τ phase is facilitated and φ phase is restrained when modifier Al-AlP master alloy is added in ZA84 alloy containing Si. The kinetics study of phase selection indicates that there is a critical degree of undercooling of the melt. If the undercooling exceeds the critical value, τ phase preferentially forms while φ phase is restrained; otherwise, φ phase preferentially forms while τ phase is restrained.展开更多
Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at p...Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.展开更多
文摘BACKGROUND Malabsorptive bariatric surgery,including Roux-en-Y gastric bypass and duodenal switch,are known to be more metabolically effective than restrictive surgery.However,the permanent alteration of gastrointestinal anatomy from these operations has been shown to alter the kinetics of drug absorption and may make subsequent surgeries more technically challenging.AIM To evaluate perioperative liver transplant outcomes and rates of acute cellular rejection in recipients with prior malabsorptive bariatric surgery.METHODS Patients who underwent liver transplantation at a single institution between 2005-2024 with a history of malabsorptive bariatric surgery were identified.Matched controls were selected based on age,sex,listing model for end-stage liver disease(MELD),and primary liver diagnosis.RESULTS A total of 12 liver transplant patients with prior malabsorptive surgery and 25 controls were included.The mean age in the malabsorptive group was 50.5 years at the time of transplant and 92%were female.The mean MELD at the time of transplant was 27.6 and mean body mass index was 28.There were no significant differences in length of stay,post operative complications,or 1 year survival between the controls and malabsorptive patients.However,the malabsorptive group was significantly more likely to experience biopsy-proven and clinically treated acute cellular rejection than the controls(24%vs 66.7%,P=0.012),more frequent rejection episodes(0.28±0.53 vs 1.0±0.91,P=0.006),and earlier time to first rejection episode(P=0.002).CONCLUSION Previous malabsorptive bariatric surgery in liver transplant recipients did not increase the risk of perioperative complications or mortality but significantly increased the rate and frequency of acute cellular rejection.
文摘Advancements in machine learning have revolutionized preoperative risk assessment.In this article,we comment on the article by Huang et al,which presents a recent multicenter cohort study demonstrated that machine learning algorithms effectively stratify recurrence-free survival,providing a robust predictive framework for maximizing surgical outcomes in intrahepatic cholangiocarcinoma.By leveraging interpretable models,the research enhances clinical decision-making,allowing for more precise patient selection and personalized surgical strategies.These findings highlight the growing role of artificial intelligence in optimizing surgical outcomes and improving prognostic accuracy in hepatobiliary oncology.
文摘This letter discusses the study by Liu et al recently published in World Journal of Psychiatry,which examines the benefits of combining epirubicin(EPI)with mindfulness interventions for patients with urinary system tumors and depre-ssion.The study included 110 patients and compared an experimental group receiving EPI and a mindfulness intervention strategy with a control group treated with mitomycin and standard care.Results showed that the experimental group had significant improvements in immune function,tumor markers,depression severity,quality of life,cancer-related fatigue,and nursing satisfac-tion.Despite acknowledging the study limitations such as a relatively small sample size and a short duration,the study highlights the efficacy of integrating mindfulness interventions into cancer treatment strategies to enhance patient outcomes and address psychological distress.
基金supported by grants from the National Natural Science Foundation of China(32001564,32372031,32272133,and 32372101)the“JBGS”Project of Seed Industry Revitalization in Jiangsu Province(JBGS[2021]012).
文摘Nitrogen(N)is crucial for maize(Zea mays L.)growth,development and yield.Dysfunction of the maize NIN-like protein 5(ZmNLP5)reduces N assimilation,but the precise mechanism by which ZmNLP5 modulates N metabolism and its contribution to agricultural applications are not well understood.In this study,our transcriptomic profiling and chromatin immunoprecipitation followed by sequencing(ChIP-seq)analyses reveal 581 ZmNLP5-modulated target genes.We confirmed that ZmNLP5 physically interacted and transactivated contributors to N assimilation,including ZmNRT1.1D,ZmNIR1.1,ZmNR2.1,ZmGS4,ZmAS1,and ZmLBD6.Overexpression of ZmNLP5 upregulated N metabolism genes,and enhanced the enzymatic activities of nitrate reductase and glutamine synthase.Furthermore,overexpressing ZmNLP5 increased grain yield under both normal-N and low-N conditions.Introgression of the overexpressed ZmNLP5 allele into Zhengdan 958 resulted in comparable yield increases in field trials.Our study unveiled that ZmNLP5 is a potential genetic target for increasing nitrogen use efficiency and grain yield in maize.
文摘The brood-parasitic brown-headed cowbird(Molothrus ater)has one of the shortest incubation periods of any bird.Brown-headed cowbird eggs,and those of other avian brood parasites,tend to be more spherical due to their greater relative width.The traditional explanation for this egg shape is that it,combined with the thicker eggshells,resists host puncture-ejection.However,very few North American hosts of the brownheaded cowbird actually engage in puncture-ejection and therefore wider eggs may instead provide greater contact with a host’s brood patch during incubation,especially in large host nests.We tested whether greater egg width increased mean temperature and reduced temperature variation in brown-headed cowbirds by inserting temperature probes into brown-headed cowbird and house sparrow(Passer domesticus)eggs and placing them into red-winged blackbird(Agelaius phoeniceus)nests.House sparrow eggs are similar in appearance and in length to cowbird eggs,but are not as wide.We found no signifcant relationship between brown-headed cowbird egg width and mean incubation temperature.However,brown-headed cowbird eggs experienced less temperature variation than house sparrow eggs,and within brown-headed cowbird eggs,more spherical eggs experienced less temperature variation when accounting for differences in width.These results suggest that brownheaded cowbirds may have short incubation periods in part because their eggs exhibit less temperature variation over the course of incubation.The brown-headed cowbird’s egg shape may contribute to its accelerated embryonic development rate relative to host eggs of similar size,which explains its ability to hatch in a variety of host nests.
文摘Oats, frequently incorporated into skincare formulations for their anti-inflammatory, moisturizing, and barrier-repairing properties, may present an overlooked risk to individuals with celiac disease, particularly when applied to compromised skin. Although pure oats are inherently gluten-free, the widespread contamination with gluten-containing grains like wheat, barley, or rye during agricultural and processing stages introduces the potential for gluten exposure through topical application. This raises important questions about whether gluten proteins, when applied to damaged skin, might penetrate the epidermal barrier and contribute to immune responses in genetically predisposed celiac patients, given that even minute amounts of gluten can trigger systemic symptoms. Emerging evidence suggests that transdermal absorption of gluten peptides through impaired skin integrity might bypass the gastrointestinal route, yet the precise mechanisms and clinical significance of this pathway remain poorly understood. The role of compromised skin in facilitating gluten absorption and the possible activation of CD4+ T-cells, mimicking gastrointestinal pathways, warrants further investigation. Additionally, the ability of gluten peptides to reach deeper dermal layers and potentially enter the systemic circulation remains speculative, though theoretically possible in severely disrupted skin barriers. Without clinical and molecular studies to determine the risk of topical gluten exposure, particularly in celiac patients with skin injuries, there remains a potential for undetected immune activation and subsequent adverse health outcomes in this sensitive population.
基金the financial support from the funding of the National Natural Science Foundation of China(NSFC)(Grant Nos.42401160 and U22A20596)the Science and Technology Plan Project of Linzhi(Grant No.SYQ2024-13).
文摘Due to the high water content in warm frozen soil,the pore water pressure and pore ice pressure generated within the sample during loading significantlyinfluencethe deformation and strength of the soil skeleton.Therefore,it is essential to develop a constitutive model for warm frozen soil that can capture the changes in ice pressure and water pressure.This study introduces a macro-meso constitutive model based on a binary-medium framework to describe the mechanical behavior of warm frozen soil.In this model,warm frozen soil is conceptualized as consisting of bonded and frictional elements from a meso perspective.The bonded elements are modeled using a macro-meso elastic constitutive approach based on poromechanics,while the frictional elements employ a macro-meso elastoplastic approach,also grounded in poromechanics.These two elements are then linked within the binarymedium model framework.By replicating the experimental curves of warm frozen soils,the theoretical results from the proposed model show excellent agreement with experimental data.This consistency indicates that the model effectively simulates the strain softening and volumetric expansion behaviors of warm frozen soil samples under various conditions.Additionally,the constitutive model predicts changes in unfrozen water pressure,frozen temperature,unfrozen water saturation,and porosity during the loading process of warm frozen soil samples.
基金supported by the National Natural Science Foundation of China under Grant Nos.U2167204,11975040,111 Center(B20065)Brazilian authors were supported in part by local funding agencies CNPq+10 种基金FAPERJCAPESand INCT-FNA(Instituto Nacional de Ciência e Tecnologia,Física Nuclear e Aplicacoes)Research Project No.464898/2014-5Marco Siciliano's work was partially supported by the US Department of EnergyOffice of Scienceand Office of Nuclear Physics(DE-AC02-06CH11357)supported by Nuclear Energy Development and Research Project No.HNKF202224(28)Ling Chuang Research Project of the China National Nuclear Corporation No.CNNCLCKY-2023 and No.20221024000072F6-0002-7Guangdong Key Research and Development Program No.2020B040420005Guangdong Basic and Applied Basic Research Foundation No.2021B1515120027。
文摘The^(6)Li+^(89)Y experiment was performed to explore the reaction mechanism induced by a weakly bound nucleus^(6)Li and its cluster configuration.The particle-γcoincidence method was used to identify the different reaction channels.Theγ-rays coincident with^(3)He/^(3)H indicate that the^(3)H/^(3)He stripping reaction plays a significant role in the formation of Zr/Nb isotopes.The obtained results support the existence of a^(3)He-^(3)H cluster in^(6)Li.Direct and sequential transfer reactions are adequately discussed,and the FRESCO code is used to perform precise finite-range cyclic redundancy check calculations.In the microscopic calculation,direct cluster transfer is more predominant than sequential transfer in^(3)H transfer.However,the direct cluster transfer is of comparable magnitude to the sequential transfer in the^(3)He transfer.
基金supported by the Belle Carnell Regenerative Neurorehabilitation Fundthe National Institutes of Health(R01NS113935 to CKF)。
文摘Human spinal cord organoids(hSCOs)offer a promising platform to study neurotrauma by addressing many limitations of traditional research models.These organoids provide access to human-specific physiological and genetic mechanisms and can be derived from an individual's somatic cells(e.g.,blood or skin).This enables patient-specific paradigms for precision neurotrauma research,pa rticula rly relevant to the over 300,000 people in the United States living with chronic effects of spinal cord injury(SCI).
文摘Protein aggregates,mitochondrial import stress and neurodegenerative disorders:A salient hallmark of several neurodegenerative diseases,including Parkinson’s disease,is the abundance of protein aggregates(Goiran et al.,2022).This molecular event is believed to lead to activation of stress pathways ultimately resulting in cellular dysfunction(Eldeeb et al.,2022).Accordingly,many lines of research investigations focused on dampening the formation of protein aggregates or augmenting the clearance of protein aggregates as a potential therapeutic strategy to counteract the progression of neurodegenerative diseases,albeit with little success(Costa-Mattioli and Walter,2020).Cell stress cues such as the accumulation of protein aggregates lead to the activation of stress response pathways that aid cells in responding to the damage.Despite the notion that the transient activation of these pathways helps cells cope with stressors,persistent activation can induce unwanted apoptosis of cells and reduce overall tissue strength as well as lead to an accumulation of aggregation-prone proteins(Hetz and Papa,2018).Mutations in proteins involved in stress signaling termination can cause conditions like ataxia and early-onset dementia(Conroy et al.,2014).Therefore,it is crucial for stress response signaling to be turned off once conditions have improved.Nevertheless,the mechanisms by which cells silence these signals are still elusive.
基金supported by the National Research Foundation of Korea(NRF)funded by the Ministry of Science and ICT(MSIT),South Korea(RS-2024-00421181)financially supported in part by National R&D Program(2021M3H4A3A02086430)through NRF(National Research Foundation of Korea)funded by Ministry of Science and ICT+2 种基金the National Research Council of Science&Technology(NST)grant by the Korea government(MSIT)(No.GTL25021-210)The Inter-University Semiconductor Research Center,Institute of Engineering Research,and Soft Foundry Institute at Seoul National University provided research facilities for this workhe grant by the National Research Foundation of Korea(NSF)supported by the Korea government(MIST)(RS-2025-16903034)。
文摘As silicon-based transistors face fundamental scaling limits,the search for breakthrough alternatives has led to innovations in 3D architectures,heterogeneous integration,and sub-3 nm semiconductor body thicknesses.However,the true effectiveness of these advancements lies in the seamless integration of alternative semiconductors tailored for next-generation transistors.In this review,we highlight key advances that enhance both scalability and switching performance by leveraging emerging semiconductor materials.Among the most promising candidates are 2D van der Waals semiconductors,Mott insulators,and amorphous oxide semiconductors,which offer not only unique electrical properties but also low-power operation and high carrier mobility.Additionally,we explore the synergistic interactions between these novel semiconductors and advanced gate dielectrics,including high-K materials,ferroelectrics,and atomically thin hexagonal boron nitride layers.Beyond introducing these novel material configurations,we address critical challenges such as leakage current and long-term device reliability,which become increasingly crucial as transistors scale down to atomic dimensions.Through concrete examples showcasing the potential of these materials in transistors,we provide key insights into overcoming fundamental obstacles—such as device reliability,scaling down limitations,and extended applications in artificial intelligence—ultimately paving the way for the development of future transistor technologies.
基金supported by the Australian Research Council(Grant No.CE230100012)。
文摘The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.
基金supported by JSPS(KAKENHI:21K06205,23K06937,24K23419)AMED(to JYK,SaY,TM,SiY,YT,and NH)JYW had long been supported by the NIH.
文摘The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their receptors,and downstream signal transducers,organize neural wiring to generate the complex architecture of the nervous system.It is now evident that many of these neuroguidance cues and their receptors are active during development and are also expressed in the adult nervous system.This suggests that neuronal guidance pathways are critical not only for neural wiring but also for ongoing function and maintenance of the mature nervous system.Supporting this view,these pathways continue to regulate synaptic connectivity,plasticity,and remodeling,and overall brain homeostasis throughout adulthood.Genetic and transcriptomic analyses have further revealed many neuronal guidance genes to be associated with a wide range of neurodegenerative and neuropsychiatric disorders.Although the precise mechanisms by which aberrant neuronal guidance signaling drives the pathogenesis of these diseases remain to be clarified,emerging evidence points to several common themes,including dysfunction in neurons,microglia,astrocytes,and endothelial cells,along with dysregulation of neuron-microglia-astrocyte,neuroimmune,and neurovascular interactions.In this review,we explore recent advances in understanding the molecular and cellular mechanisms by which aberrant neuronal guidance signaling contributes to disease pathogenesis through altered cell-cell interactions.For instance,recent studies have unveiled two distinct semaphorin-plexin signaling pathways that affect microglial activation and neuroinflammation.We discuss the challenges ahead,along with the therapeutic potentials of targeting neuronal guidance pathways for treating neurodegenerative diseases.Particular focus is placed on how neuronal guidance mechanisms control neuron-glia and neuroimmune interactions and modulate microglial function under physiological and pathological conditions.Specifically,we examine the crosstalk between neuronal guidance signaling and TREM2,a master regulator of microglial function,in the context of pathogenic protein aggregates.It is well-established that age is a major risk factor for neurodegeneration.Future research should address how aging and neuronal guidance signaling interact to influence an individual’s susceptibility to various late-onset neurological diseases and how the progression of these diseases could be therapeutically blocked by targeting neuronal guidance pathways.
基金supported by the National Natural Science Foundation of China(52272177,12204010)the Foundation for the Introduction of High-Level Talents of Anhui University(S020118002/097)+1 种基金the University Synergy Innovation Program of Anhui Province(GXXT-2023-066)the Scientific Research Project of Anhui Provincial Higher Education Institution(2023AH040008)。
文摘Flexible electronics face critical challenges in achieving monolithic three-dimensional(3D)integration,including material compatibility,structural stability,and scalable fabrication methods.Inspired by the tactile sensing mechanism of the human skin,we have developed a flexible monolithic 3D-integrated tactile sensing system based on a holey MXene paste,where each vertical one-body unit simultaneously functions as a microsupercapacitor and pressure sensor.The in-plane mesopores of MXene significantly improve ion accessibility,mitigate the self-stacking of nanosheets,and allow the holey MXene to multifunctionally act as a sensing material,an active electrode,and a conductive interconnect,thus drastically reducing the interface mismatch and enhancing the mechanical robustness.Furthermore,we fabricate a large-scale device using a blade-coating and stamping method,which demonstrates excellent mechanical flexibility,low-power consumption,rapid response,and stable long-term operation.As a proof-of-concept application,we integrate our sensing array into a smart access control system,leveraging deep learning to accurately identify users based on their unique pressing behaviors.This study provides a promising approach for designing highly integrated,intelligent,and flexible electronic systems for advanced human-computer interactions and personalized electronics.
文摘Since the first description of the concept of natural orifice translumenal endoscopic surgery (NOTES), a substantial number of clinical NOTES reports have appeared in the literature. This editorial reviews the available human data addressing research questions originally proposed by the white paper, including determining the optimal method of access for NOTES, developing safe methods of lumenal closure, suturing and anastomotic devices, advanced multitasking platforms, addressing the risk of infection, managing complications, addressing challenges with visualization, and training for NOTES procedures. An analysis of the literature reveals that so far transvaginal access and closure appear to be the most feasible techniques for NOTES, with a limited, but growing transgastric, transrectal, and transesophageal NOTES experience in humans. The theoretically increased risk of infection as a result of NOTES procedures has not been substantiated in transvaginal and transgastric procedures so far. Development of suturing and anastomotic devices and advanced platforms for NOTES has progressed slowly, with limited clinical data on their use so far. Data onthe optimal management and incidence of intraoperative complications remain sparse, although possible factors contributing to complications are discussed. Finally, this editorial discusses the likely direction of future NOTES development and its possible role in clinical practice.
文摘Following up the fluid flow simulation in a 60 t tundish, the trajectories of inclusions in the 60 t tundish without flow control are simulated by considering the force balance between the drag force and the inertial buoyancy force. The Stochastic model yields more accurate inclusion motion than the non-Stochastic model due to including the effect of the turbulent fluctuation. The average residence time of inclusions decreases with increasing size. The thermal buoyancy favors inclusions removal especially the small inclusions. Using solute transport like the dye injection in water model and copper addition in the real steel tundish cannot accurately study the motion of the inclusions. In the simulation, more than 68% inclusions bigger than 10μm are removed to the top, and less than 32% enters the mold. The thermal buoyancy has little effect on the fraction of inclusions moved to the top of the inlet zone, and it mainly favors the removal of inclusions smaller than 100μm to the top surface of the outlet zone. For inclusions bigger than 100μm, the effect of thermal buoyancy on their motion can be ignored compared to the inertial buoyancy effect.
基金The UK Biobank was approved by North West-Haydock Research Ethics Committee(REC reference:16/NW/0274,IRAS project ID:200778).
文摘Inflammatory bowel disease(IBD),including Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic inflammatory disease of the digestive tract with increasing prevalence globally.Although venous thromboembolism(VTE)is a major complication in IBD patients,it is often underappreciated with limited tools for risk stratification.AIM To estimate the proportion of VTE among IBD patients and assess genetic risk factors(monogenic and polygenic)for VTE.METHODS Incident VTE was followed for 8465 IBD patients in the UK Biobank(UKB).The associations of VTE with F5 factor V leiden(FVL)mutation,F2 G20210A prothrombin gene mutation(PGM),and polygenic score(PGS003332)were tested using Cox hazards regression analysis,adjusting for age at IBD diagnosis,gender,and genetic background(top 10 principal components).The performance of genetic risk factors for discriminating VTE diagnosis was estimated using the area under the receiver operating characteristic curve(AUC).RESULTS The overall proportion of incident VTE was 4.70%in IBD patients and was similar for CD(4.46%),UC(4.49%),and unclassified(6.42%),and comparable to that of cancer patients(4.66%)who are well-known at increased risk for VTE.Mutation carriers of F5/F2 had a significantly increased risk for VTE compared to non-mutation carriers,hazard ratio(HR)was 1.94,95%confidence interval(CI):1.42-2.65.In contrast,patients with the top PGS decile had a considerably higher risk for VTE compared to those with intermediate scores(middle 8 deciles),HR was 2.06(95%CI:1.57-2.71).The AUC for differentiating VTE diagnosis was 0.64(95%CI:0.61-0.67),0.68(95%CI:0.66-0.71),and 0.69(95%CI:0.66-0.71),respectively,for F5/F2 mutation carriers,PGS,and combined.CONCLUSION Similar to cancer patients,VTE complications are common in IBD patients.PGS provides more informative risk information than F5/F2 mutations(FVL and PGM)for personalized thromboprophylaxis.
文摘AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient status.METHODS： We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient （OP）, 70 in-patient （IP）], CE indications, findings, location of the patients [IP vs OP and intensive care unit （ICU） vs general medical floor （GMF）] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 （Chicago, IL）. Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS： The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs （P = 0.07）. The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding （OGB） was significantly more com- mon for the IP CE （P = 0.0001）, while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams （P = 0.002 and P = 0.01, respec- tively）. Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel （SB） in 6/70 IPs and 8/264 OPs （P = 0.04）. The capsule never reached the cecum in 31.4% （22/70） of IP vs 9.5% （25/ 264） of OP ex- aminations （P 〈 0.001）. The mean gastric transit time （GTT） was delayed in IPs compared to OPs, 98.5 ± 139.5 min vs 60.4 ± 92.6 min （P = 0.008）. Minimal SB transit time was significantly prolonged in the IP com- pared to the OP setting [IP = 275.1±111.6 min vs OP = 244.0 ± 104.3 min （P = 0.037）]. CECR was also sig- nificantly higher in the subgroup of patients with OGB who had OP vs IP exams （95% vs 80% respectively, P = 0.001）. The proportion of patients with incomplete exams was higher in the ICU （n = 7/13, 54%） as com- pared to the GMF （n = 15/57, 26%） （P = 0.05）. There was only a single permanent SB retention case which was secondary to a previously unknown SB stricture, and the remaining incomplete SB exams were due to slow transit. Medications which affect gastrointesti- nal system motility were tested both individually and also in aggregate in univariate analysis in hospitalized patients （ICU and GMF） and were not predictive of incomplete capsule passage （P 〉 0.05）. Patient loca- tion （IP vs OP） and GTT were independent predictors of incomplete CE exams （P 〈 0.001 and P = 0.008, respectively）. CONCLUSION： Incomplete CE is a multifactorial prob- lem. Patient location and related factors such as sever- ity of illness and sedentary status may contribute to incomplete exams.
基金Project(50571092) supported by the National Natural Science Foundation of ChinaProject(0523020500) supported by the Excellent Young Scholars Foundation of Henan Province, China
文摘The phase selection of ternary intermetallic compound τphase (Mg32(Al, Zn)49 ) and φ phase (Al2Mg5Zn2) in high zinc magnesium alloys was studied by using scanning electron microscope, X-ray diffractometer and differential scanning calorimeter, etc. The results indicate that, when adding element Si in Mg-8Zn-4Al-0.3Mn (ZA84) alloy, φ phase is promoted, whereas τ phase is inhibited. The Chinese script-type Mg2Si and matrix microstructure are greatly refined, the formation of τ phase is facilitated and φ phase is restrained when modifier Al-AlP master alloy is added in ZA84 alloy containing Si. The kinetics study of phase selection indicates that there is a critical degree of undercooling of the melt. If the undercooling exceeds the critical value, τ phase preferentially forms while φ phase is restrained; otherwise, φ phase preferentially forms while τ phase is restrained.
文摘Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.
