Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary...Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary lymph node dissection. Advances in SLN detection have been very important in refining surgical techniques and improving patient outcomes. The purpose of the present study is to compare the effectiveness of radiocolloids, blue dyes, and fluorescent tracers in detecting the sentinel lymph node in breast cancer. Materials and Methods: Specifically, we analyzed the detection rate, accuracy, and safety profile of the techniques to outline the most reliable and clinically available. A comprehensive review was conducted, searching key databases, including PubMed, Scopus, and Web of Science, for studies published between 2010 and 2024. The review focused on studies that compared the performance of radiocolloids, blue dyes, and fluorescent tracers in the detection of sentinel lymph nodes in breast cancer patients. A total of 54 studies were included based on specific inclusion criteria. Results: Radiocolloids showed high detection rates in studies. Blue dyes have comparable results, but a small percentage of allergic reactions has been observed. Fluorescent tracers such as indocyanine green have improved visualization and accuracy, but their use requires specialized equipment and expertise. Combining radiocolloids with blue dyes or fluorescent tracers has improved detection rates in several studies. Cost and accessibility challenges have also been pointed out, particularly in low-resource settings. Conclusions: Radiocolloids have attained the status of gold standard in the detection of SLNs in breast cancer for their reliability and accuracy. While combined use with other tracers, like blue dyes or fluorescent agents, enhances overall detection performance, making it more holistic. As expected, further innovation and effort are required to improve accessibility and optimize the technique of sentinel lymph node biopsy worldwide.展开更多
The increasing fluency of advanced language models,such as GPT-3.5,GPT-4,and the recently introduced DeepSeek,challenges the ability to distinguish between human-authored and AI-generated academic writing.This situati...The increasing fluency of advanced language models,such as GPT-3.5,GPT-4,and the recently introduced DeepSeek,challenges the ability to distinguish between human-authored and AI-generated academic writing.This situation is raising significant concerns regarding the integrity and authenticity of academic work.In light of the above,the current research evaluates the effectiveness of Bidirectional Long Short-TermMemory(BiLSTM)networks enhanced with pre-trained GloVe(Global Vectors for Word Representation)embeddings to detect AIgenerated scientific Abstracts drawn from the AI-GA(Artificial Intelligence Generated Abstracts)dataset.Two core BiLSTM variants were assessed:a single-layer approach and a dual-layer design,each tested under static or adaptive embeddings.The single-layer model achieved nearly 97%accuracy with trainable GloVe,occasionally surpassing the deeper model.Despite these gains,neither configuration fully matched the 98.7%benchmark set by an earlier LSTMWord2Vec pipeline.Some runs were over-fitted when embeddings were fine-tuned,whereas static embeddings offered a slightly lower yet stable accuracy of around 96%.This lingering gap reinforces a key ethical and procedural concern:relying solely on automated tools,such as Turnitin’s AI-detection features,to penalize individuals’risks and unjust outcomes.Misclassifications,whether legitimate work is misread as AI-generated or engineered text,evade detection,demonstrating that these classifiers should not stand as the sole arbiters of authenticity.Amore comprehensive approach is warranted,one which weaves model outputs into a systematic process supported by expert judgment and institutional guidelines designed to protect originality.展开更多
In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential ...In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential of noninvasive biomarkers for Crohn’s disease(CD)management.This article highlights the significance of the findings,particularly the identification of albumin and fibrinogen amplitude changes as effective,noninvasive biomarkers for predicting endoscopic improvement in CD.The authors introduce a reliable nomogram model,constructed through careful logistic regression analyses,that demonstrates high predictive accuracy across training,internal validation,and external validation cohorts.With further validation through calibration and decision curve analyses,this model shows its clinical relevance and applicability.By incorporating albumin and fibrinogen fluctuations into clinical decision-making,this model addresses a critical gap in noninvasive monitoring tools for CD,offering a practical,patient-centered alternative to guide therapeutic strategies.These findings not only validate the utility of the model but also pave the way for broader integration of biomarker-driven decision-making in the management of CD.This article discusses the broader implications of these advancements,emphasizing their potential to refine patient care and improve outcomes in CD management.展开更多
In this article,we comment on the article by Blüthner et al.The article provides a comprehensive analysis of the factors contributing to the late detection of Crohn’s disease and ulcerative colitis within a Germ...In this article,we comment on the article by Blüthner et al.The article provides a comprehensive analysis of the factors contributing to the late detection of Crohn’s disease and ulcerative colitis within a German cohort.It highlights the conse-quences on patient outcomes,particularly disease progression and the increased risk of developing complications.The study identifies specific predictors asso-ciated with both patient-related and physician-related delays,offering a detailed exploration of the initial approach.Additionally,the article delves into the distinct patterns observed in the German population,stressing the unique aspects of diagnostic delays that may differ from those reported in other regions.This detailed examination offers valuable insights into the specific challenges faced within the German healthcare system and underscores the necessity of targeted interventions to facilitate early diagnosis.The importance of improved screening tools,patient education,and better healthcare infrastructure is emphasized as crucial steps toward improving patient care in inflammatory bowel disease.展开更多
The NSC-34 cell line is a widely recognized motor neuron model and various neuronal differentiation protocols have been exploited. Under previously reported experimental conditions, only part of the cells resemble dif...The NSC-34 cell line is a widely recognized motor neuron model and various neuronal differentiation protocols have been exploited. Under previously reported experimental conditions, only part of the cells resemble differentiated neurons;however, they do not exhibit extensive and time-prolonged neuritogenesis, and maintain their duplication capacity in culture. The aim of the present work was to facilitate long-term and more homogeneous neuronal differentiation in motor neuron–like NSC-34 cells. We found that the antimitotic drug cytosine arabinoside promoted robust and persistent neuronal differentiation in the entire cell population. Long and interconnecting neuronal processes with abundant growth cones were homogeneously induced and were durable for up to at least 6 weeks in culture. Moreover, cytosine arabinoside was permissive, dispensable, and mostly irreversible in priming NSC-34 cells for neurite initiation and regeneration after mechanical dislodgement. Finally, the expression of the cell proliferation antigen Ki67 was inhibited by cytosine arabinoside, whereas the expression levels of neuronal growth associated protein 43, vimentin, and motor neuron–specific p75, Islet2, homeobox 9 markers were upregulated, as confirmed by western blot and/or confocal immunofluorescence analysis. Overall, these findings support the use of NSC-34 cells as a motor neuron model for properly investigating neurodegenerative mechanisms and prospectively identifying neuroprotective strategies.展开更多
Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and...Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and performance of different types of protective textiles.Three distinct structures of 3D woven textiles and 2D plain weave fabric made with similar high-performance fiber and areal density were designed and manufactured to be tested.Two samples,one composed of a single and the other of 4-panel layers,from each fabric type structure,were prepared,and tested against stabbing at[0○],[22.5○],and[45○]angle of incidence.A new stabbing experimental setup that entertained testing of the specimens at various angles of incidence was engineered and utilized.The stabbing bench is also equipped with magnetic sensors and a UK Home Office Scientific Development Branch(HOSDB)/P1/B sharpness engineered knives to measure the impact velocity and exerted impact energy respectively.A silicon compound was utilized to imprint the Back Face Signature(BFS)on the backing material after every specimen test.Each silicon print was then scanned,digitized,and precisely measured to evaluate the stab response and performance of the specimen based on different performance variables,including Depth of Trauma(DOT),Depth of Penetration(DOP),and Length of Penetration(LOP).Besides,the post-impact surface failure modes of the fabrics were also measured using Image software and analyzed at the microscale level.The results show stab angle of incidence greatly influences the stab response and performance of protective textiles.The outcome of the study could provide not only valuable insights into understanding the stab response and capabilities of protective textiles under different angle of incidence,but also provide valuable information for protective textile manufacturer,armor developer and stab testing and standardizing organizations to consider the angle of incidence while developing,testing,optimizing,and using protective textiles in various applications.展开更多
Stab-resistant textiles play a critical role in personal protection,necessitating a deeper understanding of how structural and layering factors influence their performance.The current study experimentally examines the...Stab-resistant textiles play a critical role in personal protection,necessitating a deeper understanding of how structural and layering factors influence their performance.The current study experimentally examines the effects of textile structure,layering,and ply orientation on the stab resistance of multi-layer textiles.Three 3D warp interlock(3DWI)structures({f1},{f2},{f3})and a 2D woven fabric({f4}),all made of high-performance p-aramid yarns,were engineered and manufactured.Multi-layer specimens were prepared and subjected to drop-weight stabbing tests following HOSBD standards.Stabbing performance metrics,including Depth of Trauma(DoT),Depth of Penetration(DoP),and trauma deformation(Ymax,Xmax),were investigated and analyzed.Statistical analyses(Two-and One-Way ANOVA)indicated that fabric type and layer number significantly impacted DoP(P<0.05),while ply orientation significantly affected DoP(P<0.05)but not DoT(P>0.05).Further detailed analysis revealed that 2D woven fabrics exhibited greater trauma deformation than 3D WIF structures.Increasing the number of layers reduced both DoP and DoT across all fabric structures,with f3 demonstrating the best performance in multi-layer configurations.Aligned ply orientations also enhanced stab resistance,underscoring the importance of alignment in dissipating impact energy.展开更多
Pelargonium zonale is an important ornamental and medicinal plant.The purpose of this investigation was to evaluate the effects of conventional and unconventional fertilization on variations in the physicochemical par...Pelargonium zonale is an important ornamental and medicinal plant.The purpose of this investigation was to evaluate the effects of conventional and unconventional fertilization on variations in the physicochemical parameters of the culture substrate(temperature,pH,and electrical conductivity)in two cultivars of Pelargonium zonale(L.)L’Hér.,grown in pots.This study was conducted under greenhouse conditions,using Pindstrup peat as the culture substrate.The analysis focused on how these physicochemical indicators of peat influenced plant height and development under fertilization conditions.Results revealed that in the‘Tango Salmon’cultivar,both fertilization regimes significantly modified substrate temperature and electrical conductivity(conventional fertilization leading to the highest electric conductivity values of 0.77 mS/cm)while in control,was observed the highest substrate temperature(21.24℃).In contrast,pH remained relatively stable across treatments.In the‘Tango Dark Red’cultivar,no significant differences were observed between substrate physicochemical parameters regardless of treatment.The multiple correlations coefficients values showed that substrate parameters influenced plant height with varying degrees of intensity depending on cultivar and fertilization scheme,reaching up the highest predictability of 60.6%in the‘Tango Dark Red’control variant.The study highlighted that physicochemical properties of the substrate(particularly electric conductivity and temperature)are for were the main contributors to optimal plant development and should be carefully managed within fertilization strategies.展开更多
In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the Wo...In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):5668-5682.Inflammatory bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of life.While many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD.Chronic pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity.Physical activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders.The“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically inactive.This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease.The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles.Moreover,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment status.Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental health.The“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and IBD.Regular exercise can influence the course of IBD,potentially reducing symptom severity and prolonging remission periods.As such,it is mandatory that healthcare providers actively educate patients,dispel misconceptions,and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.展开更多
Plasma treatment is necessary to optimize the performance of biomaterial surfaces.It enhances and regulates the performance of biomaterial su rfaces,creating an effective interface with the human body.Plasma treatment...Plasma treatment is necessary to optimize the performance of biomaterial surfaces.It enhances and regulates the performance of biomaterial su rfaces,creating an effective interface with the human body.Plasma treatments have the ability to modify the chemical com position and physical structu re of a surface while leaving its properties unaffected.They possess the ability to modify material su rfaces,eliminate contaminants,conduct investigations on cancer therapy,and facilitate wound healing.The subject of study in question involves the integration of plasma science and technology with biology and medicine.Using a helium plasma jet source,applying up to 18 kV,with an average power of 10 W,polymer foils were treated for 60 s.Plasma treatment has the ability to alter the chemical composition and physical structure of a su rface while maintaining its quality.This investigation involved the application of helium plasma at atmospheric pressure to polyamide 6 and polyethylene terephthalate sheets.The inquiry involves monitoring and assessing the plasma source and polymer materials,as well as analyzing the impacts of plasma therapy.Calculating the mean power of the discharge aids in assessing the economic efficacy of the plasma source.Electric discharge in helium at atmospheric pressure has beneficial effects in technology,where it increases the surface free energy of polymer materials.In biomedicine,it is used to investigate cytotoxicity and cell survival,particularly in direct blood exposure situations that can expedite coagulation.Comprehending the specific parameters that influence the plasma source in the desired manner for the intended application is of utmost im portance.展开更多
The current investigation offers an innovative synthetic solution regarding electrochromic(EC)and energy storage applications by exploring phenoxazine(POZ)moiety.Subsequently,three POZ-based polymers(polyimide,polyazo...The current investigation offers an innovative synthetic solution regarding electrochromic(EC)and energy storage applications by exploring phenoxazine(POZ)moiety.Subsequently,three POZ-based polymers(polyimide,polyazomethine,and polyamide)were synthesized to ascertain the superior performer.The polyamide exhibited remarkable attributes,including high redox stability during 500 repetitive CVs,optical contrast of 61.98%,rapid response times of 1.02 and 1.38 s for coloring and bleaching,EC efficiency of 280 cm^(2)C^(-1).and decays of the optical density and EC efficiency of only 12.18%and 6.23%after 1000 cycles.Then,the energy storage performance of polyamide PA was tested,for which the following parameters were obtained:74.7 F g^(-1)(CV,scan rate of 10 mV s^(-1))and 118 F g^(-1)(GCD,charging current of 0.1 A g^(-1)).Then,the polyamide was tested in EES devices,which yielded the following EC parameters:an optical contrast of 62.15%,response times of 9.24 and 5.01 s for coloring and bleaching,EC efficiency of 178 cm^(2)C^(-1),and moderate decays of 20.25%and 23.24%for the optical density and EC efficiency after 500 cycles.The energy storage performance included a capacitance of 106 F g^(-1)(CV,scan rate of 0.1 mV s^(-1))and 9.23 F g^(-1)(GCD,charging current of 0.1 A g^(-1)),capacitance decay of 11.9%after500 cycles,and 1.7 V retention after 2 h.Also,two EES devices connected in series powered a 3 V LED for almost 30 s.展开更多
The functional properties of BaTiO_(3)ceramics,produced by using the same pressing/sintering strategy from nanopowders with two distinct morphologies(cuboidal/equiaxed nanoparticles)and similar particle sizes,are comp...The functional properties of BaTiO_(3)ceramics,produced by using the same pressing/sintering strategy from nanopowders with two distinct morphologies(cuboidal/equiaxed nanoparticles)and similar particle sizes,are comparatively investigated.The sintered ceramics exhibit similar nanoscale structures,with faceted crystalline grains and crystalline inclusions,clean grain boundaries and well-defined 90°lamellar domains extending in some entire grains or finer nanodomains inside grain regions.The differences in the functional behavior originating from the different nanopowder morphology are described in terms of the nanoparticle assembly during the pressing step.The numerically simulated green body densification indicated a more efficient assembly resulting in higher density for the cubic particles(0.90 vs.0.84 relative density)and a more homogeneous pore distribution in the spherical-derived ones.As a result of the higher density after sintering,the functional properties are enhanced in cuboid-originated ceramics.For comparison,the ceramic produced from cubic nanoparticles sintered at T_(1)/T_(2)=1250/800℃shows higher permittivity(room temperature value of∼2100-cubic vs.∼1700-rounded),enhanced ferroelectric characteristics(cubic:P_(s)=8.57μC cm^(-2),P_(r)=0.95μC cm^(-2),and E_(c)=2.3 kV cm^(-1),with respect to P_(s)=6.06μC cm^(-2),P_(r)=0.4μC cm^(-2),and E_(c)=1.4 kV cm^(-1),for spherical-derived ones,measured at E_(max)=29.3 kV cm^(-1))and a stronger dc-field dependence of their permittivity of∼12%(cubic)vs.only∼2%(spherical),for a dc-applied field in the range of-15 kV cm^(-1)<Edc<15 kV cm^(-1).In contrast,the spherical particles-derived ceramics contain fewer defects and have a more homogeneous and finer porosity distribution in the ceramic volume and consequently,they are more stable and sustain larger field applications in comparison with the cubic-derived counterparts.展开更多
Mesenchymal stromal cells(MSCs)hold great promise for tissue regeneration in debilitating disorders.Despite reported improvements,the short-term outcomes of MSC transplantation,which is possibly linked to poor cell su...Mesenchymal stromal cells(MSCs)hold great promise for tissue regeneration in debilitating disorders.Despite reported improvements,the short-term outcomes of MSC transplantation,which is possibly linked to poor cell survival,demand extensive investigation.Disease-associated stress microenvironments further complicate outcomes.This debate underscores the need for a deeper understanding of the phenotypes of transplanted MSCs and their environment-induced fluctuations.Additionally,questions arise about how to predict,track,and comprehend cell fate post-transplantation.In vivo cellular imaging has emerged as a critical requirement for both short-and long-term safety and efficacy studies.However,translating preclinical imaging methods to clinical settings remains challenging.The fate and function of transplanted cells within the host environment present intricate challenges,including MSC engraftment,variability,and inconsistencies between preclinical and clinical data.The study explored the impact of high glucose concentrations on MSC survival in diabetic environments,emphasizing mitochondrial factors.Preserving these factors may enhance MSC survival,suggesting potential strategies involving genetic modification,biomaterials,and nanoparticles.Understanding stressors in diabetic patients is crucial for predicting the effects of MSC-based therapies.These multifaceted challenges call for a holistic approach involving the incorporation of large-scale data,computational disease modeling,and possibly artificial intelligence to enable deterministic insights.展开更多
Quality assurance in surgery has been one of the most important topics of debate among colorectal surgeons in the past decade.It has produced new surgical standards that led in part to the impressive oncological outco...Quality assurance in surgery has been one of the most important topics of debate among colorectal surgeons in the past decade.It has produced new surgical standards that led in part to the impressive oncological outcomes we see in many units today.Total mesorectal excision,complete mesocolic excision(CME),and the Japanese D3 lymphadenectomy are now benchmark techniques embraced by many surgeons and widely recommended by surgical societies.However,there are still ongoing discrepancies in outcomes largely based on surgeon performance.This is one of the main reasons why many countries have shifted colorectal cancer surgery only to high volume centers.Defining markers of surgical quality is thus a perquisite to ensure that standards and oncological outcomes are met at an institutional level.With the evolution of CME surgery,various quality markers have been described,mostly based on measurements on the surgical specimen and lymph node yield,while others have proposed radiological markers(i.e.arterial stumps)measured on postoperative scans as part of the routine cancer follow-up.There is no ideal marker;however,taken together and assembled into a new score or set of criteria may become a future point of reference for reporting outcomes of colorectal cancer surgery in research studies and defining subspecialization requirements both at an individual and hospital level.展开更多
Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary s...Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary site for metastatic spread,with the peritoneum,lungs,and bones also being common targets.With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions,the options to treat metastatic gastric cancer have expanded.This diversified therapeutic approach is designed to enhance patient quality of life and prolong survival,showcasing the progress in treatment modalities for individuals with gastric cancer and liver metastases.展开更多
Introduction: The impact of sleep on student life is crucial, particularly for those in demanding fields such as medicine. This study examines the relationships between sleep patterns, academic performance, and social...Introduction: The impact of sleep on student life is crucial, particularly for those in demanding fields such as medicine. This study examines the relationships between sleep patterns, academic performance, and social integration among medical students, who often face irregular sleep cycles and sleep deprivation due to rigorous academic demands. Aim: This study aims to assess how sleep issues affect academic achievement and social relationships among medical students. Method: Data were collected from 215 medical students through surveys and academic records. Quantitative data provided insights into sleep quality and academic performance, while qualitative interviews explored the effects of sleep on social interactions. Results: The findings revealed a significant correlation between sleep quality and academic performance, with students reporting better sleep hygiene achieving higher grades. Qualitative data indicated that poor sleep negatively impacts social interactions, leading to feelings of isolation and reduced social participation. Conclusions: The study highlights the importance of promoting good sleep practices in medical schools to enhance academic success and social well-being. Interventions aimed at improving sleep quality may help reduce burnout and improve overall well-being among medical students. Future research should focus on longitudinal studies to better understand the long-term effects of sleep on academic and social outcomes in this population.展开更多
The subscription economy has become a dominant influence in the current business environment,fundamentally transforming the manner in which organizations interact with customers and create income.This article examines...The subscription economy has become a dominant influence in the current business environment,fundamentally transforming the manner in which organizations interact with customers and create income.This article examines the substantial influence of the subscription economy on the worldwide economy,evaluating its effects on different industries and marketplaces.The research examines relevant literature and case studies to identify the main factors,difficulties,and possibilities related to the subscription economy.Moreover,its objective is to examine the consequences for firms,customers,and economic expansion,elucidating the possibility of continuous value generation and innovation.展开更多
BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis worldwide.However,there is a lack of accurate data on the epidemiology and risk factors f...BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis worldwide.However,there is a lack of accurate data on the epidemiology and risk factors for HDV.Hepatitis B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and death.AIM To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian patients.METHODS This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in Romania.All consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were enrolled.Patients with acute hepatitis or incomplete data were excluded.Of the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion criteria.Testing for anti-HDV antibodies and HDV RNA was performed for all participants.Demographic and risk factor data were collected by investigators using medical charts and patient questionnaires.All data were stored in an anonymized online database during the study.RESULTS The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years old.Patients with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(P<0.0001),older age at diagnosis(P=0.01)and sexual contact with persons with known viral hepatitis(P=0.0003)as significant risk factors for HDV.CONCLUSION This study shows that HDV infection among those with HBV remains endemic in Romania and updates our understanding of HDV epidemiology and associated risk factors.It emphasizes the need for systematic screening for HDV infection and collaborative initiatives for controlling and preventing HBV and HDV infection.展开更多
Abstract： Romania is famous of the potential of his vineyard, winemaking is a traditional occupation, in fact it can be said that there are many areas that can provide a vineyard product. Moreover, typicity and authe...Abstract： Romania is famous of the potential of his vineyard, winemaking is a traditional occupation, in fact it can be said that there are many areas that can provide a vineyard product. Moreover, typicity and authenticity of a wine are defining conditions under conditions of fierce intemational competition to guarantee success of wine. There were concerns for determining areas with designation of origin from a vineyard that will produce quality wines, but the purpose of this study is to delimit the level of a vineyard small area that can ensure the achievement of a certain type of wine, a quality required by consumers. The research was made during 2006-2008 and revealed that the production of quality grapes and are influenced by different factors such as genetic, environmental and technological acting in complex. This is a first attempt to study characterize the concept of ＂terroir＂, as applied in the Copou vineyard from lasi county and provides information on the behavior of two varieties of grapes for wine： Feteasca Regala and Muscat Ottonel. Depending on the purpose, observations and calculations have found the influence of soil characteristics on several biochemical parameters and productive at varieties of Feteasca Regala and Muscat Ottonel （soluble carbohydrate content, total acidity, the average yield of grapes） for the purpose of knowledge than a more detailed wine center in northeast of Romania. The results of this study can be used to determine with precision small areas crop at the parcel that will produce quality wines.展开更多
AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven ...AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and CDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of CDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q statistic.Potential publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, P < 0.001) as compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P < 0.0001), and cohort(OR = 1.98, CI: 1.51-2.59, P < 0.0001); adjusted(OR = 1.95, CI: 1.67-2.27, P < 0.0001) and unadjusted(OR = 2.02, CI: 1.41-2.91, P < 0.0001); unicenter(OR = 2.18, CI: 1.72-2.75, P < 0.0001) and multicenter(OR = 1.82, CI: 1.51-2.19, P < 0.0001); age ≥ 65 years(OR = 1.93, CI: 1.40-2.68, P < 0.0001) and < 65 years(OR = 2.06, CI: 1.11-3.81, P < 0.01). No significant differences were found in subgroup analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and < 65 years. There was significant heterogeneity across studies(I^2 = 85.4%, P < 0.001) as well as evidence of publication bias(funnel plot asymmetry test, P = 0.002). CONCLUSION This meta-analysis provides further evidence that PPI use is associated with an increased risk for development of CDI. Further high-quality, prospective studies are needed to assess whether this association is causal.展开更多
文摘Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary lymph node dissection. Advances in SLN detection have been very important in refining surgical techniques and improving patient outcomes. The purpose of the present study is to compare the effectiveness of radiocolloids, blue dyes, and fluorescent tracers in detecting the sentinel lymph node in breast cancer. Materials and Methods: Specifically, we analyzed the detection rate, accuracy, and safety profile of the techniques to outline the most reliable and clinically available. A comprehensive review was conducted, searching key databases, including PubMed, Scopus, and Web of Science, for studies published between 2010 and 2024. The review focused on studies that compared the performance of radiocolloids, blue dyes, and fluorescent tracers in the detection of sentinel lymph nodes in breast cancer patients. A total of 54 studies were included based on specific inclusion criteria. Results: Radiocolloids showed high detection rates in studies. Blue dyes have comparable results, but a small percentage of allergic reactions has been observed. Fluorescent tracers such as indocyanine green have improved visualization and accuracy, but their use requires specialized equipment and expertise. Combining radiocolloids with blue dyes or fluorescent tracers has improved detection rates in several studies. Cost and accessibility challenges have also been pointed out, particularly in low-resource settings. Conclusions: Radiocolloids have attained the status of gold standard in the detection of SLNs in breast cancer for their reliability and accuracy. While combined use with other tracers, like blue dyes or fluorescent agents, enhances overall detection performance, making it more holistic. As expected, further innovation and effort are required to improve accessibility and optimize the technique of sentinel lymph node biopsy worldwide.
文摘The increasing fluency of advanced language models,such as GPT-3.5,GPT-4,and the recently introduced DeepSeek,challenges the ability to distinguish between human-authored and AI-generated academic writing.This situation is raising significant concerns regarding the integrity and authenticity of academic work.In light of the above,the current research evaluates the effectiveness of Bidirectional Long Short-TermMemory(BiLSTM)networks enhanced with pre-trained GloVe(Global Vectors for Word Representation)embeddings to detect AIgenerated scientific Abstracts drawn from the AI-GA(Artificial Intelligence Generated Abstracts)dataset.Two core BiLSTM variants were assessed:a single-layer approach and a dual-layer design,each tested under static or adaptive embeddings.The single-layer model achieved nearly 97%accuracy with trainable GloVe,occasionally surpassing the deeper model.Despite these gains,neither configuration fully matched the 98.7%benchmark set by an earlier LSTMWord2Vec pipeline.Some runs were over-fitted when embeddings were fine-tuned,whereas static embeddings offered a slightly lower yet stable accuracy of around 96%.This lingering gap reinforces a key ethical and procedural concern:relying solely on automated tools,such as Turnitin’s AI-detection features,to penalize individuals’risks and unjust outcomes.Misclassifications,whether legitimate work is misread as AI-generated or engineered text,evade detection,demonstrating that these classifiers should not stand as the sole arbiters of authenticity.Amore comprehensive approach is warranted,one which weaves model outputs into a systematic process supported by expert judgment and institutional guidelines designed to protect originality.
文摘In this article,we comment paper by Wang et al published recently.The study represents a notable step in the pursuit of precision medicine for inflammatory bowel diseases,offering valuable insights into the potential of noninvasive biomarkers for Crohn’s disease(CD)management.This article highlights the significance of the findings,particularly the identification of albumin and fibrinogen amplitude changes as effective,noninvasive biomarkers for predicting endoscopic improvement in CD.The authors introduce a reliable nomogram model,constructed through careful logistic regression analyses,that demonstrates high predictive accuracy across training,internal validation,and external validation cohorts.With further validation through calibration and decision curve analyses,this model shows its clinical relevance and applicability.By incorporating albumin and fibrinogen fluctuations into clinical decision-making,this model addresses a critical gap in noninvasive monitoring tools for CD,offering a practical,patient-centered alternative to guide therapeutic strategies.These findings not only validate the utility of the model but also pave the way for broader integration of biomarker-driven decision-making in the management of CD.This article discusses the broader implications of these advancements,emphasizing their potential to refine patient care and improve outcomes in CD management.
文摘In this article,we comment on the article by Blüthner et al.The article provides a comprehensive analysis of the factors contributing to the late detection of Crohn’s disease and ulcerative colitis within a German cohort.It highlights the conse-quences on patient outcomes,particularly disease progression and the increased risk of developing complications.The study identifies specific predictors asso-ciated with both patient-related and physician-related delays,offering a detailed exploration of the initial approach.Additionally,the article delves into the distinct patterns observed in the German population,stressing the unique aspects of diagnostic delays that may differ from those reported in other regions.This detailed examination offers valuable insights into the specific challenges faced within the German healthcare system and underscores the necessity of targeted interventions to facilitate early diagnosis.The importance of improved screening tools,patient education,and better healthcare infrastructure is emphasized as crucial steps toward improving patient care in inflammatory bowel disease.
基金supported by FATALSDrug Project [Progetti di Ricerca@CNR SAC.AD002.173.058] from National Research Council,Italy (to CV)。
文摘The NSC-34 cell line is a widely recognized motor neuron model and various neuronal differentiation protocols have been exploited. Under previously reported experimental conditions, only part of the cells resemble differentiated neurons;however, they do not exhibit extensive and time-prolonged neuritogenesis, and maintain their duplication capacity in culture. The aim of the present work was to facilitate long-term and more homogeneous neuronal differentiation in motor neuron–like NSC-34 cells. We found that the antimitotic drug cytosine arabinoside promoted robust and persistent neuronal differentiation in the entire cell population. Long and interconnecting neuronal processes with abundant growth cones were homogeneously induced and were durable for up to at least 6 weeks in culture. Moreover, cytosine arabinoside was permissive, dispensable, and mostly irreversible in priming NSC-34 cells for neurite initiation and regeneration after mechanical dislodgement. Finally, the expression of the cell proliferation antigen Ki67 was inhibited by cytosine arabinoside, whereas the expression levels of neuronal growth associated protein 43, vimentin, and motor neuron–specific p75, Islet2, homeobox 9 markers were upregulated, as confirmed by western blot and/or confocal immunofluorescence analysis. Overall, these findings support the use of NSC-34 cells as a motor neuron model for properly investigating neurodegenerative mechanisms and prospectively identifying neuroprotective strategies.
文摘Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and performance of different types of protective textiles.Three distinct structures of 3D woven textiles and 2D plain weave fabric made with similar high-performance fiber and areal density were designed and manufactured to be tested.Two samples,one composed of a single and the other of 4-panel layers,from each fabric type structure,were prepared,and tested against stabbing at[0○],[22.5○],and[45○]angle of incidence.A new stabbing experimental setup that entertained testing of the specimens at various angles of incidence was engineered and utilized.The stabbing bench is also equipped with magnetic sensors and a UK Home Office Scientific Development Branch(HOSDB)/P1/B sharpness engineered knives to measure the impact velocity and exerted impact energy respectively.A silicon compound was utilized to imprint the Back Face Signature(BFS)on the backing material after every specimen test.Each silicon print was then scanned,digitized,and precisely measured to evaluate the stab response and performance of the specimen based on different performance variables,including Depth of Trauma(DOT),Depth of Penetration(DOP),and Length of Penetration(LOP).Besides,the post-impact surface failure modes of the fabrics were also measured using Image software and analyzed at the microscale level.The results show stab angle of incidence greatly influences the stab response and performance of protective textiles.The outcome of the study could provide not only valuable insights into understanding the stab response and capabilities of protective textiles under different angle of incidence,but also provide valuable information for protective textile manufacturer,armor developer and stab testing and standardizing organizations to consider the angle of incidence while developing,testing,optimizing,and using protective textiles in various applications.
文摘Stab-resistant textiles play a critical role in personal protection,necessitating a deeper understanding of how structural and layering factors influence their performance.The current study experimentally examines the effects of textile structure,layering,and ply orientation on the stab resistance of multi-layer textiles.Three 3D warp interlock(3DWI)structures({f1},{f2},{f3})and a 2D woven fabric({f4}),all made of high-performance p-aramid yarns,were engineered and manufactured.Multi-layer specimens were prepared and subjected to drop-weight stabbing tests following HOSBD standards.Stabbing performance metrics,including Depth of Trauma(DoT),Depth of Penetration(DoP),and trauma deformation(Ymax,Xmax),were investigated and analyzed.Statistical analyses(Two-and One-Way ANOVA)indicated that fabric type and layer number significantly impacted DoP(P<0.05),while ply orientation significantly affected DoP(P<0.05)but not DoT(P>0.05).Further detailed analysis revealed that 2D woven fabrics exhibited greater trauma deformation than 3D WIF structures.Increasing the number of layers reduced both DoP and DoT across all fabric structures,with f3 demonstrating the best performance in multi-layer configurations.Aligned ply orientations also enhanced stab resistance,underscoring the importance of alignment in dissipating impact energy.
文摘Pelargonium zonale is an important ornamental and medicinal plant.The purpose of this investigation was to evaluate the effects of conventional and unconventional fertilization on variations in the physicochemical parameters of the culture substrate(temperature,pH,and electrical conductivity)in two cultivars of Pelargonium zonale(L.)L’Hér.,grown in pots.This study was conducted under greenhouse conditions,using Pindstrup peat as the culture substrate.The analysis focused on how these physicochemical indicators of peat influenced plant height and development under fertilization conditions.Results revealed that in the‘Tango Salmon’cultivar,both fertilization regimes significantly modified substrate temperature and electrical conductivity(conventional fertilization leading to the highest electric conductivity values of 0.77 mS/cm)while in control,was observed the highest substrate temperature(21.24℃).In contrast,pH remained relatively stable across treatments.In the‘Tango Dark Red’cultivar,no significant differences were observed between substrate physicochemical parameters regardless of treatment.The multiple correlations coefficients values showed that substrate parameters influenced plant height with varying degrees of intensity depending on cultivar and fertilization scheme,reaching up the highest predictability of 60.6%in the‘Tango Dark Red’control variant.The study highlighted that physicochemical properties of the substrate(particularly electric conductivity and temperature)are for were the main contributors to optimal plant development and should be carefully managed within fertilization strategies.
文摘In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):5668-5682.Inflammatory bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of life.While many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD.Chronic pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity.Physical activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders.The“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically inactive.This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease.The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles.Moreover,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment status.Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental health.The“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and IBD.Regular exercise can influence the course of IBD,potentially reducing symptom severity and prolonging remission periods.As such,it is mandatory that healthcare providers actively educate patients,dispel misconceptions,and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.
基金financially supported by UEFISCDI,PNCDI III,project PN-III-P1-1.1-TE-2021(No.150/09.06.2022)supported by COST(European Cooperation in Science and Technology,available online:https://www.cost.eu,accessed on 20 November 2023)。
文摘Plasma treatment is necessary to optimize the performance of biomaterial surfaces.It enhances and regulates the performance of biomaterial su rfaces,creating an effective interface with the human body.Plasma treatments have the ability to modify the chemical com position and physical structu re of a surface while leaving its properties unaffected.They possess the ability to modify material su rfaces,eliminate contaminants,conduct investigations on cancer therapy,and facilitate wound healing.The subject of study in question involves the integration of plasma science and technology with biology and medicine.Using a helium plasma jet source,applying up to 18 kV,with an average power of 10 W,polymer foils were treated for 60 s.Plasma treatment has the ability to alter the chemical composition and physical structure of a su rface while maintaining its quality.This investigation involved the application of helium plasma at atmospheric pressure to polyamide 6 and polyethylene terephthalate sheets.The inquiry involves monitoring and assessing the plasma source and polymer materials,as well as analyzing the impacts of plasma therapy.Calculating the mean power of the discharge aids in assessing the economic efficacy of the plasma source.Electric discharge in helium at atmospheric pressure has beneficial effects in technology,where it increases the surface free energy of polymer materials.In biomedicine,it is used to investigate cytotoxicity and cell survival,particularly in direct blood exposure situations that can expedite coagulation.Comprehending the specific parameters that influence the plasma source in the desired manner for the intended application is of utmost im portance.
基金supported by a grant of the Ministry of Research,Innovation and Digitization,CNCS–UEFISCDI,project number PNIII-P1-1.1-TE-2021-1110PNCDI III,contract number TE 83/2022,and project number PN-III-P2-2.1-PED-2019-3520PNCDI III,contract number 438PED/2020。
文摘The current investigation offers an innovative synthetic solution regarding electrochromic(EC)and energy storage applications by exploring phenoxazine(POZ)moiety.Subsequently,three POZ-based polymers(polyimide,polyazomethine,and polyamide)were synthesized to ascertain the superior performer.The polyamide exhibited remarkable attributes,including high redox stability during 500 repetitive CVs,optical contrast of 61.98%,rapid response times of 1.02 and 1.38 s for coloring and bleaching,EC efficiency of 280 cm^(2)C^(-1).and decays of the optical density and EC efficiency of only 12.18%and 6.23%after 1000 cycles.Then,the energy storage performance of polyamide PA was tested,for which the following parameters were obtained:74.7 F g^(-1)(CV,scan rate of 10 mV s^(-1))and 118 F g^(-1)(GCD,charging current of 0.1 A g^(-1)).Then,the polyamide was tested in EES devices,which yielded the following EC parameters:an optical contrast of 62.15%,response times of 9.24 and 5.01 s for coloring and bleaching,EC efficiency of 178 cm^(2)C^(-1),and moderate decays of 20.25%and 23.24%for the optical density and EC efficiency after 500 cycles.The energy storage performance included a capacitance of 106 F g^(-1)(CV,scan rate of 0.1 mV s^(-1))and 9.23 F g^(-1)(GCD,charging current of 0.1 A g^(-1)),capacitance decay of 11.9%after500 cycles,and 1.7 V retention after 2 h.Also,two EES devices connected in series powered a 3 V LED for almost 30 s.
基金supported by the Romanian Ministry of Education and Research,CNCS-UEFISCDI Research Grant No.PN-Ⅲ-P1-1.1-PD-2021-0531.
文摘The functional properties of BaTiO_(3)ceramics,produced by using the same pressing/sintering strategy from nanopowders with two distinct morphologies(cuboidal/equiaxed nanoparticles)and similar particle sizes,are comparatively investigated.The sintered ceramics exhibit similar nanoscale structures,with faceted crystalline grains and crystalline inclusions,clean grain boundaries and well-defined 90°lamellar domains extending in some entire grains or finer nanodomains inside grain regions.The differences in the functional behavior originating from the different nanopowder morphology are described in terms of the nanoparticle assembly during the pressing step.The numerically simulated green body densification indicated a more efficient assembly resulting in higher density for the cubic particles(0.90 vs.0.84 relative density)and a more homogeneous pore distribution in the spherical-derived ones.As a result of the higher density after sintering,the functional properties are enhanced in cuboid-originated ceramics.For comparison,the ceramic produced from cubic nanoparticles sintered at T_(1)/T_(2)=1250/800℃shows higher permittivity(room temperature value of∼2100-cubic vs.∼1700-rounded),enhanced ferroelectric characteristics(cubic:P_(s)=8.57μC cm^(-2),P_(r)=0.95μC cm^(-2),and E_(c)=2.3 kV cm^(-1),with respect to P_(s)=6.06μC cm^(-2),P_(r)=0.4μC cm^(-2),and E_(c)=1.4 kV cm^(-1),for spherical-derived ones,measured at E_(max)=29.3 kV cm^(-1))and a stronger dc-field dependence of their permittivity of∼12%(cubic)vs.only∼2%(spherical),for a dc-applied field in the range of-15 kV cm^(-1)<Edc<15 kV cm^(-1).In contrast,the spherical particles-derived ceramics contain fewer defects and have a more homogeneous and finer porosity distribution in the ceramic volume and consequently,they are more stable and sustain larger field applications in comparison with the cubic-derived counterparts.
基金Supported by the Romanian Ministry of Research,Innovation and Digitization,CNCS/CCCDI-UEFISCDI,project number ERANETEURONANOMED-3-OASIs,within PNCDI III(contract number 273/2022).
文摘Mesenchymal stromal cells(MSCs)hold great promise for tissue regeneration in debilitating disorders.Despite reported improvements,the short-term outcomes of MSC transplantation,which is possibly linked to poor cell survival,demand extensive investigation.Disease-associated stress microenvironments further complicate outcomes.This debate underscores the need for a deeper understanding of the phenotypes of transplanted MSCs and their environment-induced fluctuations.Additionally,questions arise about how to predict,track,and comprehend cell fate post-transplantation.In vivo cellular imaging has emerged as a critical requirement for both short-and long-term safety and efficacy studies.However,translating preclinical imaging methods to clinical settings remains challenging.The fate and function of transplanted cells within the host environment present intricate challenges,including MSC engraftment,variability,and inconsistencies between preclinical and clinical data.The study explored the impact of high glucose concentrations on MSC survival in diabetic environments,emphasizing mitochondrial factors.Preserving these factors may enhance MSC survival,suggesting potential strategies involving genetic modification,biomaterials,and nanoparticles.Understanding stressors in diabetic patients is crucial for predicting the effects of MSC-based therapies.These multifaceted challenges call for a holistic approach involving the incorporation of large-scale data,computational disease modeling,and possibly artificial intelligence to enable deterministic insights.
文摘Quality assurance in surgery has been one of the most important topics of debate among colorectal surgeons in the past decade.It has produced new surgical standards that led in part to the impressive oncological outcomes we see in many units today.Total mesorectal excision,complete mesocolic excision(CME),and the Japanese D3 lymphadenectomy are now benchmark techniques embraced by many surgeons and widely recommended by surgical societies.However,there are still ongoing discrepancies in outcomes largely based on surgeon performance.This is one of the main reasons why many countries have shifted colorectal cancer surgery only to high volume centers.Defining markers of surgical quality is thus a perquisite to ensure that standards and oncological outcomes are met at an institutional level.With the evolution of CME surgery,various quality markers have been described,mostly based on measurements on the surgical specimen and lymph node yield,while others have proposed radiological markers(i.e.arterial stumps)measured on postoperative scans as part of the routine cancer follow-up.There is no ideal marker;however,taken together and assembled into a new score or set of criteria may become a future point of reference for reporting outcomes of colorectal cancer surgery in research studies and defining subspecialization requirements both at an individual and hospital level.
文摘Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary site for metastatic spread,with the peritoneum,lungs,and bones also being common targets.With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions,the options to treat metastatic gastric cancer have expanded.This diversified therapeutic approach is designed to enhance patient quality of life and prolong survival,showcasing the progress in treatment modalities for individuals with gastric cancer and liver metastases.
文摘Introduction: The impact of sleep on student life is crucial, particularly for those in demanding fields such as medicine. This study examines the relationships between sleep patterns, academic performance, and social integration among medical students, who often face irregular sleep cycles and sleep deprivation due to rigorous academic demands. Aim: This study aims to assess how sleep issues affect academic achievement and social relationships among medical students. Method: Data were collected from 215 medical students through surveys and academic records. Quantitative data provided insights into sleep quality and academic performance, while qualitative interviews explored the effects of sleep on social interactions. Results: The findings revealed a significant correlation between sleep quality and academic performance, with students reporting better sleep hygiene achieving higher grades. Qualitative data indicated that poor sleep negatively impacts social interactions, leading to feelings of isolation and reduced social participation. Conclusions: The study highlights the importance of promoting good sleep practices in medical schools to enhance academic success and social well-being. Interventions aimed at improving sleep quality may help reduce burnout and improve overall well-being among medical students. Future research should focus on longitudinal studies to better understand the long-term effects of sleep on academic and social outcomes in this population.
文摘The subscription economy has become a dominant influence in the current business environment,fundamentally transforming the manner in which organizations interact with customers and create income.This article examines the substantial influence of the subscription economy on the worldwide economy,evaluating its effects on different industries and marketplaces.The research examines relevant literature and case studies to identify the main factors,difficulties,and possibilities related to the subscription economy.Moreover,its objective is to examine the consequences for firms,customers,and economic expansion,elucidating the possibility of continuous value generation and innovation.
文摘BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis worldwide.However,there is a lack of accurate data on the epidemiology and risk factors for HDV.Hepatitis B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and death.AIM To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian patients.METHODS This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in Romania.All consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were enrolled.Patients with acute hepatitis or incomplete data were excluded.Of the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion criteria.Testing for anti-HDV antibodies and HDV RNA was performed for all participants.Demographic and risk factor data were collected by investigators using medical charts and patient questionnaires.All data were stored in an anonymized online database during the study.RESULTS The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years old.Patients with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(P<0.0001),older age at diagnosis(P=0.01)and sexual contact with persons with known viral hepatitis(P=0.0003)as significant risk factors for HDV.CONCLUSION This study shows that HDV infection among those with HBV remains endemic in Romania and updates our understanding of HDV epidemiology and associated risk factors.It emphasizes the need for systematic screening for HDV infection and collaborative initiatives for controlling and preventing HBV and HDV infection.
文摘Abstract： Romania is famous of the potential of his vineyard, winemaking is a traditional occupation, in fact it can be said that there are many areas that can provide a vineyard product. Moreover, typicity and authenticity of a wine are defining conditions under conditions of fierce intemational competition to guarantee success of wine. There were concerns for determining areas with designation of origin from a vineyard that will produce quality wines, but the purpose of this study is to delimit the level of a vineyard small area that can ensure the achievement of a certain type of wine, a quality required by consumers. The research was made during 2006-2008 and revealed that the production of quality grapes and are influenced by different factors such as genetic, environmental and technological acting in complex. This is a first attempt to study characterize the concept of ＂terroir＂, as applied in the Copou vineyard from lasi county and provides information on the behavior of two varieties of grapes for wine： Feteasca Regala and Muscat Ottonel. Depending on the purpose, observations and calculations have found the influence of soil characteristics on several biochemical parameters and productive at varieties of Feteasca Regala and Muscat Ottonel （soluble carbohydrate content, total acidity, the average yield of grapes） for the purpose of knowledge than a more detailed wine center in northeast of Romania. The results of this study can be used to determine with precision small areas crop at the parcel that will produce quality wines.
文摘AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and CDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of CDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q statistic.Potential publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, P < 0.001) as compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P < 0.0001), and cohort(OR = 1.98, CI: 1.51-2.59, P < 0.0001); adjusted(OR = 1.95, CI: 1.67-2.27, P < 0.0001) and unadjusted(OR = 2.02, CI: 1.41-2.91, P < 0.0001); unicenter(OR = 2.18, CI: 1.72-2.75, P < 0.0001) and multicenter(OR = 1.82, CI: 1.51-2.19, P < 0.0001); age ≥ 65 years(OR = 1.93, CI: 1.40-2.68, P < 0.0001) and < 65 years(OR = 2.06, CI: 1.11-3.81, P < 0.01). No significant differences were found in subgroup analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and < 65 years. There was significant heterogeneity across studies(I^2 = 85.4%, P < 0.001) as well as evidence of publication bias(funnel plot asymmetry test, P = 0.002). CONCLUSION This meta-analysis provides further evidence that PPI use is associated with an increased risk for development of CDI. Further high-quality, prospective studies are needed to assess whether this association is causal.
