为准确评估监测条件有限的平原河网小流域河水水质演变趋势,预知水质变化情况,利用浙江省台州市南官河2021年6月至2023年6月的水质监测数据,基于贝叶斯优化算法(Bayesian optimization algorithm,BOA)和双向长短期记忆神经网络(bi-direc...为准确评估监测条件有限的平原河网小流域河水水质演变趋势,预知水质变化情况,利用浙江省台州市南官河2021年6月至2023年6月的水质监测数据,基于贝叶斯优化算法(Bayesian optimization algorithm,BOA)和双向长短期记忆神经网络(bi-directional long short-term memory,BiLSTM)建立了地表水水质预测模型。利用箱线图和Spearman秩相关系数挖掘水质的时空分布规律,划定中间河段4个站点为重点研究区域,NH3—N和TP为治理重点。通过BOA和双向信息传递机制优化LSTM超参数和模型结构,结果显示,用BOA-BiLSTM模型预测,未来4 h NH_(3)—N浓度的均方根误差(root mean squared error,RMSE)分别为0.2132,0.3689,0.3327和0.3740;未来4 h TP浓度的RMSE分别为0.0246,0.0321,0.0422和0.0334。二者较基准LSTM模型的预测结果分别提升了15.8%,10.6%,10.6%,17.1%和22.6%,3.6%,14.8%,11.8%。以磨石桥NH_(3)—N浓度为例,对比了时序预测与加入上下游数据后的多变量预测结果,发现时序预测对监测参数较少的平原河网具有更强的适用性和更高的预测精度。同时结合研究区域现场勘查和地块分类情况,指出生活源、污水收集及处理设施不完善、雨污合流应为整治重点。当监测参数有限时,本文模型有助于提升对水质异常的监管水平,为环境执法、水环境治理提供数据支撑。展开更多
The current Tanzanian policy guidelines regarding ecological restoration encourage total protection (enclosure system) against grazing activities, fires and wood extraction to allow regeneration in state-based Miombo ...The current Tanzanian policy guidelines regarding ecological restoration encourage total protection (enclosure system) against grazing activities, fires and wood extraction to allow regeneration in state-based Miombo woodlands. However, there is little evidence on how such treatments would promote restoration. We fetched the pieces of evidence from studies that evaluated the impact of management treatments on the lightly degraded Miombo woodlands at Kitulangalo Forest Reserve in eastern Tanzania. Plot fencing and fire exclusion constrained woody species regeneration due to competition compared to unfenced plots. Adopting quota grazing policies and controlled burning systems can be the shortest and most eco-friendly pathways towards Miombo restoration. The results pointed out that stand disturbances and silvicultural practices can promote regeneration, which is crucial to promoting ecological restoration in Miombo woodlands.展开更多
BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;ho...BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.展开更多
BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid tre...BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.展开更多
AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year ret...AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.展开更多
The acclimation capacity of Betula pendula and Betula pubescens was studied over 4 years in common gardens in central Italy(43°N)and southern(61°N)and northern Finland(67°N),representing drastically dif...The acclimation capacity of Betula pendula and Betula pubescens was studied over 4 years in common gardens in central Italy(43°N)and southern(61°N)and northern Finland(67°N),representing drastically different photoperiod and climate in temperate,boreal and subarctic vegetation zones.Two study sites that differed in soil fertility were established at each location,giving a total of six common gardens.The birch material was micropropagated from naturally regenerated stands of B.pendula and B.pubescens from Susa Valley and Rochemolle Valley in northern Italy,Punkaharju in southern Finland and Kittilä in northern Finland.The plants were measured for height growth,stem diameter,leaf chlorophyll content,leaf herbivory and pathogen damage.The effects of soil fertility on the common garden results were also analyzed.The results showed high acclimation capacity of B.pendula and B.pubescens after a long-range transfer from southern to northern Europe,despite the major shift in climate and photoperiod.First-year growth on average was best in boreal southern Finland for all origins.Betula pendula grew more than B.pubescens in Italy and southern Finland,while B.pubescens grew more in northern Finland and better tolerated the northward transfer.The height growth of origins showed a clear latitude gradient from slowly growing northern to fast growing southern origins in the nursery and laboratory,but not in the field.Soil fertility explained a significant part of variation among locations not only for growth variables,but also for leaf chlorophyll content and leaf herbivory and pathogen damage.Leaf herbivore and pathogen damage was greatest in southern Finland.Our results demonstrate good survival of birch from northern Italy in Finnish conditions and support the possibility of long-range south-to-north transfer of Betula species to provide resistant planting material in boreal forests for the rapidly changing climate.展开更多
In this study,we used an extensive sampling network established in central Romania to develop tree height and crown length models.Our analysis included more than 18,000 tree measurements from five different species.In...In this study,we used an extensive sampling network established in central Romania to develop tree height and crown length models.Our analysis included more than 18,000 tree measurements from five different species.Instead of building univariate models for each response variable,we employed a multivariate approach using seemingly unrelated mixed-effects models.These models incorporated variables related to species mixture,tree and stand size,competition,and stand structure.With the inclusion of additional variables in the multivariate seemingly unrelated mixed-effects models,the accuracy of the height prediction models improved by over 10% for all species,whereas the improvement in the crown length models was considerably smaller.Our findings indicate that trees in mixed stands tend to have shorter heights but longer crowns than those in pure stands.We also observed that trees in homogeneous stand structures have shorter crown lengths than those in heterogeneous stands.By employing a multivariate mixed-effects modelling framework,we were able to perform cross-model random-effect predictions,leading to a significant increase in accuracy when both responses were used to calibrate the model.In contrast,the improvement in accuracy was marginal when only height was used for calibration.We demonstrate how multivariate mixed-effects models can be effectively used to develop multi-response allometric models that can be easily calibrated with a limited number of observations while simultaneously achieving better-aligned projections.展开更多
Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systemat...Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.展开更多
We demonstrate a multi-method approach towards discovering and structuring sustainability transition knowl edge in marginalized mountain regions.By employing reflective thinking,artificial intelligence(AI)-powered tex...We demonstrate a multi-method approach towards discovering and structuring sustainability transition knowl edge in marginalized mountain regions.By employing reflective thinking,artificial intelligence(AI)-powered text summarization and text mining,we synthesize experts’narratives on sustainable development challenges and solutions in Kardüz Upland,Türkiye.We then analyze their alignment with the UN Sustainable Development Goals(SDGs)using document embedding.Investment in infrastructure,education,and resilient socio-ecological systems emerged as priority sectors to combat poor infrastructure,geographic isolation,climate change,poverty,depopulation,unemployment,low education levels,and inadequate social services.The narratives were closest in substance to SDG 1,3,and 11.Social dimensions of sustainability were more pronounced than environmental dimensions.The presented approach supports policymakers in organizing loosely structured sustainability tran sition knowledge and fragmented data corpora,while also advancing AI applications for designing and planning sustainable development policies at the regional level.展开更多
BACKGROUND Regulatory agencies are increasingly recognizing that minority trial repres-entation is inadequate,contributing to healthcare disparities.The scope of min-ority population disparities in clinical trial part...BACKGROUND Regulatory agencies are increasingly recognizing that minority trial repres-entation is inadequate,contributing to healthcare disparities.The scope of min-ority population disparities in clinical trial participation remains unclear,as previous studies have compiled enrollment data from published trials,which AIM To evaluate sex,racial and ethnic inequities in liver transplantation(LT)trials participation in the United States.METHODS We used data from completed United States liver transplant clinical trials registered and reported on the National Institute of Health(NIH)website(clincaltrials.gov).Demographic data,including race,ethnicity,sex,and age were collected.To make inferences to a larger population,95%CIs were computed for estimates in each demographic group using the Wilson method for binomial proportions.We also computed the simultaneous 95%CIs by applying a Bonferroni correction to reflect the multinomial distribution of race proportions.The numbers and percentages of racial/ethnic minority and female individuals compared with United States census data from 2010 and 2018.Secondary outcome measures were inclusion by trial funding source and year of completion.RESULTS A total of 69 United States based clinical trials involving 6990 participants were included in the analysis.Of these,35 trials(51%)were randomized,and 26(38%)were conducted across multiple United States regions.All trials reported sex,while 42(61%)reported race and 27(39%)reported ethnicity.Compared to United States census data,Asian individuals were overrepresented(9.3%;95%CI:8.1%-10.5%),whereas African American(7.8%;95%CI:6.7%-8.9%)and American Indian or Alaska Native individuals(0.4%;95%CI:0.1%-0.6%)were underrepresented.The proportion of White participants(75.9%;95%CI:74.1%-77.7%)was consistent with census estimates.Hispanic participants were underrepresented(13.3%;95%CI:12.2%-14.5%)regardless of the census year referenced.In industry-sponsored trials,Asian representation was three times higher than in the general population(15%).NIH funded trials showed overrepresentation of White participants(83.8%)and underrepresentation of Black participants(4.1%)relative to census data.Women comprised 31.1%of all participants(95%CI:30.0%-32.2%),in-dicating underrepresentation.Among trials that reported racial data,62(90%)did not include participants of American Indian or Alaska Native,Native Hawaiian,or Pacific Islander descent.CONCLUSION Our analysis indicates that women,African Americans,and Hispanic individuals are underrepresented in LT clinical trials compared to the general United States population.These results highlight the need for regulatory initiatives aimed at enhancing the inclusion of historically marginalized racial and ethnic groups in clinical re-search.展开更多
Objectives:As the Duchenne Muscular Dystrophy(DMD)is a progressive neuromuscular disorder frequently associated with cardiac dysfunction,this study aimed to evaluate the influence of beta-blocker therapy on cardiac au...Objectives:As the Duchenne Muscular Dystrophy(DMD)is a progressive neuromuscular disorder frequently associated with cardiac dysfunction,this study aimed to evaluate the influence of beta-blocker therapy on cardiac autonomic modulation in adolescents withDMDby analyzing heart rate variability(HRV)indices in patients with and without betablockers.Methods:A cross-sectional study was conducted with 90 participants divided into three groups:(1)participants with DMD receiving beta-blocker therapy(DMDB,n=30),(2)participants with DMD without beta-blocker therapy(GMDM,n=30),and(3)age-and sex-matched typically developing participants(GDT,n=30).HRV was assessed using validated beat-to-beat heart rate monitoring(RS800CX,Polar)under controlled conditions.Linear and non-linear HRV indices(including Detrended Fluctuation Analysis and Symbolic Dynamics)were analysed using Kubios HRV software.Results:DMD patients exhibited autonomic impairment,characterized by decreased HRV,increased sympathetic dominance,and reduced parasympathetic modulation.Betablocker therapy was associated with significantly higher Mean Beat-to-beat interval(RR)and lower Mean Heart Rate(HR)compared to the non-beta-blocker DMD group,with values approaching those observed in typically developing participants.Non-linear indices suggested thatDMDpatients receiving beta-blockers demonstrated increased HRV complexity and fractal properties compared to those not receiving beta-blockers,although differences remained between the DMD and control groups.Conclusions:Autonomic dysfunction in DMD is characterized by reduced HRV and altered sympathovagal balance.In our results,beta-blocker therapy was associated with improved HRV and enhanced autonomic control.These findings highlight the potential cardioprotective role of betablockers in DMD management and emphasize the need for further research into optimizing autonomic function in DMD.展开更多
文摘为准确评估监测条件有限的平原河网小流域河水水质演变趋势,预知水质变化情况,利用浙江省台州市南官河2021年6月至2023年6月的水质监测数据,基于贝叶斯优化算法(Bayesian optimization algorithm,BOA)和双向长短期记忆神经网络(bi-directional long short-term memory,BiLSTM)建立了地表水水质预测模型。利用箱线图和Spearman秩相关系数挖掘水质的时空分布规律,划定中间河段4个站点为重点研究区域,NH3—N和TP为治理重点。通过BOA和双向信息传递机制优化LSTM超参数和模型结构,结果显示,用BOA-BiLSTM模型预测,未来4 h NH_(3)—N浓度的均方根误差(root mean squared error,RMSE)分别为0.2132,0.3689,0.3327和0.3740;未来4 h TP浓度的RMSE分别为0.0246,0.0321,0.0422和0.0334。二者较基准LSTM模型的预测结果分别提升了15.8%,10.6%,10.6%,17.1%和22.6%,3.6%,14.8%,11.8%。以磨石桥NH_(3)—N浓度为例,对比了时序预测与加入上下游数据后的多变量预测结果,发现时序预测对监测参数较少的平原河网具有更强的适用性和更高的预测精度。同时结合研究区域现场勘查和地块分类情况,指出生活源、污水收集及处理设施不完善、雨污合流应为整治重点。当监测参数有限时,本文模型有助于提升对水质异常的监管水平,为环境执法、水环境治理提供数据支撑。
文摘The current Tanzanian policy guidelines regarding ecological restoration encourage total protection (enclosure system) against grazing activities, fires and wood extraction to allow regeneration in state-based Miombo woodlands. However, there is little evidence on how such treatments would promote restoration. We fetched the pieces of evidence from studies that evaluated the impact of management treatments on the lightly degraded Miombo woodlands at Kitulangalo Forest Reserve in eastern Tanzania. Plot fencing and fire exclusion constrained woody species regeneration due to competition compared to unfenced plots. Adopting quota grazing policies and controlled burning systems can be the shortest and most eco-friendly pathways towards Miombo restoration. The results pointed out that stand disturbances and silvicultural practices can promote regeneration, which is crucial to promoting ecological restoration in Miombo woodlands.
文摘BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.
文摘BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.
文摘AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.
基金supported by Academy of Finland(project 284931)the Finnish Cultural Foundation/Eva Barbara WilhelminaFoundation(Decision 27.2.2021).
文摘The acclimation capacity of Betula pendula and Betula pubescens was studied over 4 years in common gardens in central Italy(43°N)and southern(61°N)and northern Finland(67°N),representing drastically different photoperiod and climate in temperate,boreal and subarctic vegetation zones.Two study sites that differed in soil fertility were established at each location,giving a total of six common gardens.The birch material was micropropagated from naturally regenerated stands of B.pendula and B.pubescens from Susa Valley and Rochemolle Valley in northern Italy,Punkaharju in southern Finland and Kittilä in northern Finland.The plants were measured for height growth,stem diameter,leaf chlorophyll content,leaf herbivory and pathogen damage.The effects of soil fertility on the common garden results were also analyzed.The results showed high acclimation capacity of B.pendula and B.pubescens after a long-range transfer from southern to northern Europe,despite the major shift in climate and photoperiod.First-year growth on average was best in boreal southern Finland for all origins.Betula pendula grew more than B.pubescens in Italy and southern Finland,while B.pubescens grew more in northern Finland and better tolerated the northward transfer.The height growth of origins showed a clear latitude gradient from slowly growing northern to fast growing southern origins in the nursery and laboratory,but not in the field.Soil fertility explained a significant part of variation among locations not only for growth variables,but also for leaf chlorophyll content and leaf herbivory and pathogen damage.Leaf herbivore and pathogen damage was greatest in southern Finland.Our results demonstrate good survival of birch from northern Italy in Finnish conditions and support the possibility of long-range south-to-north transfer of Betula species to provide resistant planting material in boreal forests for the rapidly changing climate.
基金supported by the European Union and the Romanian Government through the Competitiveness Operational Programme 2014–2020, under the project“Increasing the economic competitiveness of the forestry sector and the quality of life through knowledge transfer,technology and CDI skills”(CRESFORLIFE),ID P 40 380/105506, subsidiary contract no. 17/2020partially by the FORCLIMSOC Nucleu Programme (Contract 12N/2023)+2 种基金project PN 23090101CresPerfInst project (Contract 34PFE/December 30, 2021)“Increasing the institutional capacity and performance of INCDS ‘Marin Drǎcea’in RDI activities-CresPer”LM was financially supported by the Research Council of Finland's flagship ecosystem for Forest-Human-Machine Interplay–Building Resilience, Redefining Value Networks and Enabling Meaningful Experiences (UNITE)(decision number 357909)
文摘In this study,we used an extensive sampling network established in central Romania to develop tree height and crown length models.Our analysis included more than 18,000 tree measurements from five different species.Instead of building univariate models for each response variable,we employed a multivariate approach using seemingly unrelated mixed-effects models.These models incorporated variables related to species mixture,tree and stand size,competition,and stand structure.With the inclusion of additional variables in the multivariate seemingly unrelated mixed-effects models,the accuracy of the height prediction models improved by over 10% for all species,whereas the improvement in the crown length models was considerably smaller.Our findings indicate that trees in mixed stands tend to have shorter heights but longer crowns than those in pure stands.We also observed that trees in homogeneous stand structures have shorter crown lengths than those in heterogeneous stands.By employing a multivariate mixed-effects modelling framework,we were able to perform cross-model random-effect predictions,leading to a significant increase in accuracy when both responses were used to calibrate the model.In contrast,the improvement in accuracy was marginal when only height was used for calibration.We demonstrate how multivariate mixed-effects models can be effectively used to develop multi-response allometric models that can be easily calibrated with a limited number of observations while simultaneously achieving better-aligned projections.
文摘Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.
基金work conducted under COST Action CA21125-a European forum for revitalisation of marginalised moun-tain areas(MARGISTAR)supported by COST(European Cooperation in Science and Technology)gratefully acknowledges the support received for the research from the University of Ljubljana’s research program Forest,forestry and renewable forest resources(P4-0059).
文摘We demonstrate a multi-method approach towards discovering and structuring sustainability transition knowl edge in marginalized mountain regions.By employing reflective thinking,artificial intelligence(AI)-powered text summarization and text mining,we synthesize experts’narratives on sustainable development challenges and solutions in Kardüz Upland,Türkiye.We then analyze their alignment with the UN Sustainable Development Goals(SDGs)using document embedding.Investment in infrastructure,education,and resilient socio-ecological systems emerged as priority sectors to combat poor infrastructure,geographic isolation,climate change,poverty,depopulation,unemployment,low education levels,and inadequate social services.The narratives were closest in substance to SDG 1,3,and 11.Social dimensions of sustainability were more pronounced than environmental dimensions.The presented approach supports policymakers in organizing loosely structured sustainability tran sition knowledge and fragmented data corpora,while also advancing AI applications for designing and planning sustainable development policies at the regional level.
文摘BACKGROUND Regulatory agencies are increasingly recognizing that minority trial repres-entation is inadequate,contributing to healthcare disparities.The scope of min-ority population disparities in clinical trial participation remains unclear,as previous studies have compiled enrollment data from published trials,which AIM To evaluate sex,racial and ethnic inequities in liver transplantation(LT)trials participation in the United States.METHODS We used data from completed United States liver transplant clinical trials registered and reported on the National Institute of Health(NIH)website(clincaltrials.gov).Demographic data,including race,ethnicity,sex,and age were collected.To make inferences to a larger population,95%CIs were computed for estimates in each demographic group using the Wilson method for binomial proportions.We also computed the simultaneous 95%CIs by applying a Bonferroni correction to reflect the multinomial distribution of race proportions.The numbers and percentages of racial/ethnic minority and female individuals compared with United States census data from 2010 and 2018.Secondary outcome measures were inclusion by trial funding source and year of completion.RESULTS A total of 69 United States based clinical trials involving 6990 participants were included in the analysis.Of these,35 trials(51%)were randomized,and 26(38%)were conducted across multiple United States regions.All trials reported sex,while 42(61%)reported race and 27(39%)reported ethnicity.Compared to United States census data,Asian individuals were overrepresented(9.3%;95%CI:8.1%-10.5%),whereas African American(7.8%;95%CI:6.7%-8.9%)and American Indian or Alaska Native individuals(0.4%;95%CI:0.1%-0.6%)were underrepresented.The proportion of White participants(75.9%;95%CI:74.1%-77.7%)was consistent with census estimates.Hispanic participants were underrepresented(13.3%;95%CI:12.2%-14.5%)regardless of the census year referenced.In industry-sponsored trials,Asian representation was three times higher than in the general population(15%).NIH funded trials showed overrepresentation of White participants(83.8%)and underrepresentation of Black participants(4.1%)relative to census data.Women comprised 31.1%of all participants(95%CI:30.0%-32.2%),in-dicating underrepresentation.Among trials that reported racial data,62(90%)did not include participants of American Indian or Alaska Native,Native Hawaiian,or Pacific Islander descent.CONCLUSION Our analysis indicates that women,African Americans,and Hispanic individuals are underrepresented in LT clinical trials compared to the general United States population.These results highlight the need for regulatory initiatives aimed at enhancing the inclusion of historically marginalized racial and ethnic groups in clinical re-search.
文摘Objectives:As the Duchenne Muscular Dystrophy(DMD)is a progressive neuromuscular disorder frequently associated with cardiac dysfunction,this study aimed to evaluate the influence of beta-blocker therapy on cardiac autonomic modulation in adolescents withDMDby analyzing heart rate variability(HRV)indices in patients with and without betablockers.Methods:A cross-sectional study was conducted with 90 participants divided into three groups:(1)participants with DMD receiving beta-blocker therapy(DMDB,n=30),(2)participants with DMD without beta-blocker therapy(GMDM,n=30),and(3)age-and sex-matched typically developing participants(GDT,n=30).HRV was assessed using validated beat-to-beat heart rate monitoring(RS800CX,Polar)under controlled conditions.Linear and non-linear HRV indices(including Detrended Fluctuation Analysis and Symbolic Dynamics)were analysed using Kubios HRV software.Results:DMD patients exhibited autonomic impairment,characterized by decreased HRV,increased sympathetic dominance,and reduced parasympathetic modulation.Betablocker therapy was associated with significantly higher Mean Beat-to-beat interval(RR)and lower Mean Heart Rate(HR)compared to the non-beta-blocker DMD group,with values approaching those observed in typically developing participants.Non-linear indices suggested thatDMDpatients receiving beta-blockers demonstrated increased HRV complexity and fractal properties compared to those not receiving beta-blockers,although differences remained between the DMD and control groups.Conclusions:Autonomic dysfunction in DMD is characterized by reduced HRV and altered sympathovagal balance.In our results,beta-blocker therapy was associated with improved HRV and enhanced autonomic control.These findings highlight the potential cardioprotective role of betablockers in DMD management and emphasize the need for further research into optimizing autonomic function in DMD.
