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
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
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
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
Perennial forage plants are efficient utilizers of solar radiation and nutrients so that there is a lot of scope to increase the production of green biomass in many areas.Currently,grasses are mainly used as feeds for...Perennial forage plants are efficient utilizers of solar radiation and nutrients so that there is a lot of scope to increase the production of green biomass in many areas.Currently,grasses are mainly used as feeds for ruminants and equines,but there could be higher added value use for several components of the green biomass.Interest in green biorefin-ing has risen recently motivated by the increased sustainability pressures and need to break the reliance on fossil fuels.Novel products derived from grass,such as paper and packaging,nanofibers,animal bedding,novel protein feeds,extracted proteins,biochemicals,nutraceuticals,bioactive compounds,biogas and biochar could create new sustainable business opportunities in rural areas.Most green biorefinery concepts focus on using fresh green biomass as the feedstock,but preservation of it by ensiling would provide several benefits such as all-year-around avail-ability of the feedstock and increased stability of the press juice and press cake.The major difference between fresh and ensiled grass is the conversion of water soluble carbohydrates into fermentation end products,mainly lactic and acetic acids,that lower the pH of the silage so that it becomes stable in anaerobic conditions.This has some important consequences on the processability and quality of products,which are partly positive and partly negative,e.g.,degradation of protein into peptides,amino acids and ammonia.These aspects are discussed in this review.展开更多
Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether perf...Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.展开更多
Osteoarthritis(OA)of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability.Cartilage damage is frequently linked to elevated osteoarthritis incidence.Supe...Osteoarthritis(OA)of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability.Cartilage damage is frequently linked to elevated osteoarthritis incidence.Supercritical carbon dioxide(scCO_(2))decellularized cartilage graft produced from the porcine cartilage is an ideal candidate for cartilage tissue engineering.In the present study,we derived collagen type II(Col II)solution from the scCO_(2) decellularized porcine cartilage graft(dPCG)and compared its efficacy with hyaluronic acid(HA)in the surgical medial meniscectomy(MNX)induced post-traumatic osteoarthritis(PTOA)model.Dose-dependent attenuation of the OA(12.3±0.8)progression was observed in the intra-articular administration of Col II solution(7.3±1.2)which significantly decreased the MNX-induced OA symptoms similar to HA.The pain of the OA group(37.4±2.7)was attenuated dose-dependently by Col II solution(45.9±4.1)similar to HA(43.1±3.5)as evaluated by a capacitance meter.Micro-CT depicted a dose-dependent attenuation of articular cartilage damage by the Col II solution similar to HA treatment.A significant(p<0.001)dose-dependent elevation in the bone volume was also observed in Col II solution-treated OA animals.The protective competence of Col II solution on articular cartilage damage is due to its significant(p<0.001)increase in the expression of type II collagen,aggrecan and SOX-9 similar to HA.To conclude,intra-articular adminis-tration of type II collagen solution and HA reestablished the injured cartilage and decreased osteoarthritis progression in the experimental PTOA model.展开更多
We comment on the article by Jia et al,in the World Journal of Gastrointestinal Surgery.We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopi...We comment on the article by Jia et al,in the World Journal of Gastrointestinal Surgery.We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopic retrograde cholan-giopancreatography(ERCP).ERCP is a complex endoscopic therapeutic proce-dure,which demands great skill from the endoscopist but also has recognized complications.Gastric retention impairs the endoscopist’s visibility but also increases the risk of complications,such as aspiration pneumonia.Therefore,identifying the factors that predispose to gastric retention alerts the endoscopists of the possible risks and enables them to take evasive action.The authors in the current study by Jia et al developed and validated a predictive model,which in-corporates five different factors,i.e.,gender,primary disease,jaundice,opioid use,and gastrointestinal obstruction,which were found to influence gastric retention.This model was shown to have a high predictive value to accurately identify pa-tients at risk for gastric retention before a therapeutic ERCP.展开更多
BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal fu...BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.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.
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.
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the funding from project GrassProtein received from the Ministry of Agriculture and Forestry of Finland/Makera (VN/7679/2021)
文摘Perennial forage plants are efficient utilizers of solar radiation and nutrients so that there is a lot of scope to increase the production of green biomass in many areas.Currently,grasses are mainly used as feeds for ruminants and equines,but there could be higher added value use for several components of the green biomass.Interest in green biorefin-ing has risen recently motivated by the increased sustainability pressures and need to break the reliance on fossil fuels.Novel products derived from grass,such as paper and packaging,nanofibers,animal bedding,novel protein feeds,extracted proteins,biochemicals,nutraceuticals,bioactive compounds,biogas and biochar could create new sustainable business opportunities in rural areas.Most green biorefinery concepts focus on using fresh green biomass as the feedstock,but preservation of it by ensiling would provide several benefits such as all-year-around avail-ability of the feedstock and increased stability of the press juice and press cake.The major difference between fresh and ensiled grass is the conversion of water soluble carbohydrates into fermentation end products,mainly lactic and acetic acids,that lower the pH of the silage so that it becomes stable in anaerobic conditions.This has some important consequences on the processability and quality of products,which are partly positive and partly negative,e.g.,degradation of protein into peptides,amino acids and ammonia.These aspects are discussed in this review.
文摘Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.
文摘Osteoarthritis(OA)of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability.Cartilage damage is frequently linked to elevated osteoarthritis incidence.Supercritical carbon dioxide(scCO_(2))decellularized cartilage graft produced from the porcine cartilage is an ideal candidate for cartilage tissue engineering.In the present study,we derived collagen type II(Col II)solution from the scCO_(2) decellularized porcine cartilage graft(dPCG)and compared its efficacy with hyaluronic acid(HA)in the surgical medial meniscectomy(MNX)induced post-traumatic osteoarthritis(PTOA)model.Dose-dependent attenuation of the OA(12.3±0.8)progression was observed in the intra-articular administration of Col II solution(7.3±1.2)which significantly decreased the MNX-induced OA symptoms similar to HA.The pain of the OA group(37.4±2.7)was attenuated dose-dependently by Col II solution(45.9±4.1)similar to HA(43.1±3.5)as evaluated by a capacitance meter.Micro-CT depicted a dose-dependent attenuation of articular cartilage damage by the Col II solution similar to HA treatment.A significant(p<0.001)dose-dependent elevation in the bone volume was also observed in Col II solution-treated OA animals.The protective competence of Col II solution on articular cartilage damage is due to its significant(p<0.001)increase in the expression of type II collagen,aggrecan and SOX-9 similar to HA.To conclude,intra-articular adminis-tration of type II collagen solution and HA reestablished the injured cartilage and decreased osteoarthritis progression in the experimental PTOA model.
文摘We comment on the article by Jia et al,in the World Journal of Gastrointestinal Surgery.We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopic retrograde cholan-giopancreatography(ERCP).ERCP is a complex endoscopic therapeutic proce-dure,which demands great skill from the endoscopist but also has recognized complications.Gastric retention impairs the endoscopist’s visibility but also increases the risk of complications,such as aspiration pneumonia.Therefore,identifying the factors that predispose to gastric retention alerts the endoscopists of the possible risks and enables them to take evasive action.The authors in the current study by Jia et al developed and validated a predictive model,which in-corporates five different factors,i.e.,gender,primary disease,jaundice,opioid use,and gastrointestinal obstruction,which were found to influence gastric retention.This model was shown to have a high predictive value to accurately identify pa-tients at risk for gastric retention before a therapeutic ERCP.
文摘BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.
