BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is su...BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.展开更多
Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomeruloneph...Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomerulonephritis may occur in rare instances.Deposition of IgA in the mesangium seems to be the underlying disease mechanism.Despite current treatment,IgA nephropathy may progress into end-stage renal disease,indicating the necessity for the development of new therapeutic agents.Lifestyle modifications and anti-proteinuric treatment are recommended,and steroids have shown to be beneficial to high risk groups.Nevertheless,other conventional immunosuppressive agents,such as cyclophosphamide and mycophenolate mofetil,may be considered,despite the lack of sufficient evidence to support their efficacy.A considerable proportion of cases remain unresponsive to these treatments,underscoring the need for novel therapeutic approaches.There are several promising immunosuppressive drugs,such as B-cell lineage depleting agents or complement system inhibitors,that are currently undergoing clinical trials.These therapies may be considered for use in selected cases.展开更多
Metabolic dysfunction-associated steatotic liver disease is the most prevalent chronic liver condition,affecting over one-third of the global population,with cirrhosis present in up to 3.3%of cases.Early detection of ...Metabolic dysfunction-associated steatotic liver disease is the most prevalent chronic liver condition,affecting over one-third of the global population,with cirrhosis present in up to 3.3%of cases.Early detection of advanced liver disease in at-risk populations can enable timely intervention,prevent progression,and reduce complications.This review focuses on the current recommendations for early detection of advanced liver disease,evaluates the evidence for the performance of non-invasive tests in the target population for screening,and examines the multifaceted burden of screening,including economic implications and psychological impacts.Additionally,we discuss future directions,such as integrating liver health into a multidisciplinary care framework.Current guidelines recommend case-finding,targeting individuals with type 2 diabetes,metabolically complicated obesity,or persistent elevated liver enzymes.The Fibrosis-4 index is widely endorsed as a first-line non-invasive test,yet the diagnostic performance in primary care settings seems suboptimal,particularly for pre-cirrhotic disease.Sequential strategies incorporating novel non-invasive tests may improve accuracy and cost-effectiveness.Confirmation typically involves vibration-controlled transient elastography.Key challenges include a large eligible population,uncertainties in optimal screening intervals,patient adherence to follow-up,and limited real-world cost-effectiveness data.Integrating liver health assessment into cardiometabolic care pathways,reflex testing,telehealth,and patient education may enhance uptake.While challenges remain,early detection of advanced liver disease is already likely cost-effective.Ongoing advances in screening pathways and treatment options are expected to further strengthen the case for widespread implementation.展开更多
Peristaltic transport of non-Newtonian nanofluids with double diffusion is essential to biological engineering,microfluidics,and manufacturing processes.The authors tackle the key problem of Sisko nanofluids under dou...Peristaltic transport of non-Newtonian nanofluids with double diffusion is essential to biological engineering,microfluidics,and manufacturing processes.The authors tackle the key problem of Sisko nanofluids under double diffusion convection with thermal radiations and electroosmotic effects.Thestudy proposes a solution approach by using Morlet-Wavelet Neural Networks that can effectively solve this complex problem by their superior ability in the capture of nonlinear dynamics.These convergence analyses were calculated across fifty independent runs.Theil’s Inequality Coefficient and theMean Squared Error values range from 10^(-7) to 10^(-5) and 10^(-7) to 10^(-10),respectively.These values showed the proposed method is scientifically reliable and fast converging.Studies reveal that the intensity of the magnetic field causes a reduction in the flow velocity profile in the center of the channel.It is also evaluated that thermal radiations enhance the energy of the system,which promotes thermally induced diffusion and particle flow.The physical applications of this work pertain to improving fluid flow and heat transfer in engineering structures like converters or cooling devices or magnetic fluids in electronics,energy,and biomedical applications,where optimal control of fluid behavior is of paramount importance.展开更多
Single-and dual-atom catalysts(SACs and DACs)on single-layer graphene are widely investigated for a wide range of electrochemical reactions.However,the effect of van der Waals interactions on the activity of these cat...Single-and dual-atom catalysts(SACs and DACs)on single-layer graphene are widely investigated for a wide range of electrochemical reactions.However,the effect of van der Waals interactions on the activity of these catalysts has not been investigated through systematic high-throughput screening.Here we introduce the concept of van der Waals interactions through a double-layer DAC structure which has axial d orbital modification towards enhanced CO_(2) reduction reaction(CO_(2)RR),hydrogen evolution reaction(HER),oxygen reduction reaction(ORR),and oxygen evolution reaction(OER).We applied density functional theory(DFT)to screen 3d,4d,and 5d transition metals supported by double-layer nitrogen-doped graphene,denoted as M2N8.We sought catalysts with high thermodynamic and electrochemical stabilities along with low overpotentials for CO_(2)RR,ORR,OER,or HER.We find that HER can take place inside the van der Waals gap of V2N8 and Co2N8 leading to overpotentials of 0.10 and 0.16 V.Moreover,ORR and OER can take place on the surface of Fe2N8 and Ir2N8,respectively,leading to overpotentials of 0.39 and 0.37 V.DFT predicts a CO_(2)RR overpotential of 0.85 V towards CO on the surface of Co2N8 along with the HER overpotential of 0.16 V inside the van der Waals gap of Co2N8 towards the production of syngas(CO+H_(2)).This paper provides fundamental insights into the design of advanced multi-layer catalysts by applying the concept of van der Waals interactions for electrochemistry at room temperature.展开更多
The global pursuit of clean and sustainable renewable energy emphasizes the necessity for advanced energy storage systems.Researchers in this field aim to develop devices that integrate the high-energy density of batt...The global pursuit of clean and sustainable renewable energy emphasizes the necessity for advanced energy storage systems.Researchers in this field aim to develop devices that integrate the high-energy density of batteries with the rapid charge and discharge rates characteristic of capacitors.Protons,due to their small size and efficient diffusion via Grotthuss conduction mechanism,serve as particularly advantageous charge carriers for ultrafast intercalation and deintercalation in aqueous batteries.This property has led to the development of a novel energy storage device defined as the aqueous proton battery(APB),which holds the potential to establish a distinct position within the energy storage landscape.This article offers a comprehensive review of recent advancements in electrode materials and battery configurations specifically designed for APBs.The fundamental principles of electrochemical proton storage and detailed insights into Faradaic APB electrodes are highlighted,while the associated challenges regarding their electrochemical performance and operational mechanisms are emphasized.Additionally,the strategic design approaches for full-battery systems aimed at achieving high-performance aqueous proton energy storage are summarized.Finally,the challenges and potential opportunities for further enhancing the applications of APBs are proposed.展开更多
BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the im...BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.METHODS Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed.Patient medical records were assessed.Predictors for overall survival(OS)were determined using multivariable Cox regression.RESULTS Of the 346 included patients with iGBC,138(39.9%)had bile spillage,which was associated with higher American Society of Anesthesiologists classification(P=0.020),cholecystitis(P<0.001),higher tumor stage(P=0.005),and non-radical resection(P<0.001).Bile spillage was associated with poor OS[hazard ratio=1.97,95%confidence interval(CI):1.48-2.63,P<0.001]with a median OS of 12 months(95%CI:7-18 months)vs 34 months(95%CI:14-55 months,P<0.001).In multivariable analysis,spillage was not an independent prognostic factor for survival(hazard ratio=1.21,95%CI:0.84-1.74,P=0.313).CONCLUSION Although bile spillage correlates with prognostic factors,it lacks independent prognostic significance for survival.Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center,irrespective of whether bile spillage has occurred.展开更多
Slow-moving landslides are widespread in the Mediterranean area,causing damage to the exposed facilities and economic losses in many countries.The recognition of slow-moving landslides in urban areas is always a diffi...Slow-moving landslides are widespread in the Mediterranean area,causing damage to the exposed facilities and economic losses in many countries.The recognition of slow-moving landslides in urban areas is always a difficult task to deal with because the presence of buildings,infrastructures,and human activities usually conceals the morphological signs of these landslide activities.So,in the last decades,numerous researchers have shown new methodologies to deepen the studies of similar instability phenomena.The present research is based on an integrated approach to investigate the landslide boundaries,type of movement,failure surface depth,and vulnerability state of buildings in Rota Greca Village(Calabria region,southern Italy) affected by a slowmoving landslide.For this purpose,multi-source data were acquired through geological and geomorphological surveys,recognition of landslide-induced damage on the built environment,subsurface investigations(e.g.,continuous drill boreholes,Standard Penetration Test,Rock Quality Designation index and inclinometer monitoring),laboratory tests(direct shear tests on undisturbed samples),geophysical survey,and InSAR-derived map of deformation rates.The complete integration of multi-source data allowed for the construction of reliable landslide modelling with relative geotechnical properties.In addition,the cross-comparison between surface deformation data by SAR images and severity damage level collected on the exposed buildings enabled to obtain the vulnerability map of the built area.In particular,the achieved goals highlighted two failure surfaces at about-13 and-25 m depth,causing a high vulnerability value for the buildings allocated in the central portion of the Rota Greca Village.The knowledge acquired by the multi-approach can be used to manage and implement appropriate landslide risk mitigation strategies,providing helpful advice and best practices to state-run organisations and stakeholders for landslide management in urban sites.展开更多
This study investigates the role of Interleukin 17(IL-17)in exacerbating periapical lesions caused by Porphyromonas gingivalis(Pg)lipopolysaccharides(LPS)in the context of metabolic disease and its potential impact on...This study investigates the role of Interleukin 17(IL-17)in exacerbating periapical lesions caused by Porphyromonas gingivalis(Pg)lipopolysaccharides(LPS)in the context of metabolic disease and its potential impact on glucose tolerance.Researchers developed a unique mouse model where mice were monocolonized with Pg to induce periapical lesions.After 1 month,they were fed a highfat diet(HFD)for 2 months to simulate metabolic disease and oral microbiota dysbiosis.To explore the role of LPS from Pg,wildtype(WT)mice were challenged with purified LPS from Porphyromonas gingivalis,as well as with LPS-depleted and non-depleted Pg bacteria;IL-17 knockout(KO)mice were also included to assess the role of IL-17 signaling.The impact on bone lysis,periapical injury,glucose intolerance,and immune response was assessed.Results showed that in WT mice,the presence of LPS significantly worsened bone lysis,Th17 cell recruitment,and periapical injury.IL-17 KO mice exhibited reduced bone loss,glucose intolerance,and immune cell infiltration.Additionally,inflammatory markers in adipose tissue were lower in IL-17 KO mice,despite increased dysbiosis.The findings suggest that IL-17 plays a critical role in amplifying Pg-induced periapical lesions and systemic metabolic disturbances.Targeting IL-17 recruitment could offer a novel approach to improving glycemic control and reducing type 2 diabetes(T2D)risk in individuals with periapical disease.展开更多
This research investigates dynamic earth processes within the South Setifian allochthonous ensemble,providing insights into landscape evolution and seismotectonic activity within the Tellian mountain chain.Focusing on...This research investigates dynamic earth processes within the South Setifian allochthonous ensemble,providing insights into landscape evolution and seismotectonic activity within the Tellian mountain chain.Focusing on the Jebel Gustar and Kef Lahmar area,which includes 14 sub-basins,this research uses a DEM-based technique to assess Holocene activities,lineament characteristics,and stream systems.Five geomorphic indices are used to assess relative active tectonics:the stream lengthgradient index(SL),drainage basin asymmetry(AF),valley-floor width to valley height ratio(VF),drainage basin shape(BS),and mountain front sinuosity(SMF).A weighted overlay of these five indices produces the Index of Relative Active Tectonics(IRAT)map.The findings reveal significant neotectonic activity in the study area,supported by profound basement faulting.This research highlights the morpho-structural processes and neotectonics activity in the Jebel Gustar,providing a framework for investigating the evolution of this structure.Additionally,it enhances comprehension of the interactions between the alpine range's internal zones in Eastern Algeria and the Atlasic domain.This study proposes a systematic approach to evaluate the tectonic and geomorphological dynamics of the South Setif region.展开更多
Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of a...Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.展开更多
Facial morphology,a complex trait influenced by genetics,holds great significance in evolutionary research.However,due to limited fossil evidence,the facial characteristics of Neanderthals and Denisovans have remained...Facial morphology,a complex trait influenced by genetics,holds great significance in evolutionary research.However,due to limited fossil evidence,the facial characteristics of Neanderthals and Denisovans have remained largely unknown.In this study,we conduct a large-scale multi-ethnic meta-analysis of the genome-wide association study(GWAS),including 9674 East Asians and 10,115 Europeans,quantitatively assessing 78 facial traits using 3D facial images.We identify 71 genomic loci associated with facial features,including 21 novel loci.We develop a facial polygenic score(FPS)that enables the prediction of facial features based on genetic information.Interestingly,the distribution of FPSs among populations from diverse continental groups exhibits relevant correlations with observed facial features.Furthermore,we apply the FPS to predict the facial traits of seven Neanderthals and one Denisovan using ancient DNA and align predictions with the fossil records.Our results suggest that Neanderthals and Denisovans likely share similar facial features,such as a wider but shorter nose and a wider endocanthion distance.The decreased mouth width is characterized specifically in Denisovans.The integration of genomic data and facial trait analysis provides valuable insights into the evolutionary history and adaptive changes in human facial morphology.展开更多
文摘BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.
文摘Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomerulonephritis may occur in rare instances.Deposition of IgA in the mesangium seems to be the underlying disease mechanism.Despite current treatment,IgA nephropathy may progress into end-stage renal disease,indicating the necessity for the development of new therapeutic agents.Lifestyle modifications and anti-proteinuric treatment are recommended,and steroids have shown to be beneficial to high risk groups.Nevertheless,other conventional immunosuppressive agents,such as cyclophosphamide and mycophenolate mofetil,may be considered,despite the lack of sufficient evidence to support their efficacy.A considerable proportion of cases remain unresponsive to these treatments,underscoring the need for novel therapeutic approaches.There are several promising immunosuppressive drugs,such as B-cell lineage depleting agents or complement system inhibitors,that are currently undergoing clinical trials.These therapies may be considered for use in selected cases.
文摘Metabolic dysfunction-associated steatotic liver disease is the most prevalent chronic liver condition,affecting over one-third of the global population,with cirrhosis present in up to 3.3%of cases.Early detection of advanced liver disease in at-risk populations can enable timely intervention,prevent progression,and reduce complications.This review focuses on the current recommendations for early detection of advanced liver disease,evaluates the evidence for the performance of non-invasive tests in the target population for screening,and examines the multifaceted burden of screening,including economic implications and psychological impacts.Additionally,we discuss future directions,such as integrating liver health into a multidisciplinary care framework.Current guidelines recommend case-finding,targeting individuals with type 2 diabetes,metabolically complicated obesity,or persistent elevated liver enzymes.The Fibrosis-4 index is widely endorsed as a first-line non-invasive test,yet the diagnostic performance in primary care settings seems suboptimal,particularly for pre-cirrhotic disease.Sequential strategies incorporating novel non-invasive tests may improve accuracy and cost-effectiveness.Confirmation typically involves vibration-controlled transient elastography.Key challenges include a large eligible population,uncertainties in optimal screening intervals,patient adherence to follow-up,and limited real-world cost-effectiveness data.Integrating liver health assessment into cardiometabolic care pathways,reflex testing,telehealth,and patient education may enhance uptake.While challenges remain,early detection of advanced liver disease is already likely cost-effective.Ongoing advances in screening pathways and treatment options are expected to further strengthen the case for widespread implementation.
文摘Peristaltic transport of non-Newtonian nanofluids with double diffusion is essential to biological engineering,microfluidics,and manufacturing processes.The authors tackle the key problem of Sisko nanofluids under double diffusion convection with thermal radiations and electroosmotic effects.Thestudy proposes a solution approach by using Morlet-Wavelet Neural Networks that can effectively solve this complex problem by their superior ability in the capture of nonlinear dynamics.These convergence analyses were calculated across fifty independent runs.Theil’s Inequality Coefficient and theMean Squared Error values range from 10^(-7) to 10^(-5) and 10^(-7) to 10^(-10),respectively.These values showed the proposed method is scientifically reliable and fast converging.Studies reveal that the intensity of the magnetic field causes a reduction in the flow velocity profile in the center of the channel.It is also evaluated that thermal radiations enhance the energy of the system,which promotes thermally induced diffusion and particle flow.The physical applications of this work pertain to improving fluid flow and heat transfer in engineering structures like converters or cooling devices or magnetic fluids in electronics,energy,and biomedical applications,where optimal control of fluid behavior is of paramount importance.
基金William A.Goddard III thanks the US National Science Foundation(No.CBET-2311117)for supportGuanHua Chen acknowledges financial support from the General Research Fund(Grant No.17309620)Research Grants Council(RGC:T23-713/22-R).
文摘Single-and dual-atom catalysts(SACs and DACs)on single-layer graphene are widely investigated for a wide range of electrochemical reactions.However,the effect of van der Waals interactions on the activity of these catalysts has not been investigated through systematic high-throughput screening.Here we introduce the concept of van der Waals interactions through a double-layer DAC structure which has axial d orbital modification towards enhanced CO_(2) reduction reaction(CO_(2)RR),hydrogen evolution reaction(HER),oxygen reduction reaction(ORR),and oxygen evolution reaction(OER).We applied density functional theory(DFT)to screen 3d,4d,and 5d transition metals supported by double-layer nitrogen-doped graphene,denoted as M2N8.We sought catalysts with high thermodynamic and electrochemical stabilities along with low overpotentials for CO_(2)RR,ORR,OER,or HER.We find that HER can take place inside the van der Waals gap of V2N8 and Co2N8 leading to overpotentials of 0.10 and 0.16 V.Moreover,ORR and OER can take place on the surface of Fe2N8 and Ir2N8,respectively,leading to overpotentials of 0.39 and 0.37 V.DFT predicts a CO_(2)RR overpotential of 0.85 V towards CO on the surface of Co2N8 along with the HER overpotential of 0.16 V inside the van der Waals gap of Co2N8 towards the production of syngas(CO+H_(2)).This paper provides fundamental insights into the design of advanced multi-layer catalysts by applying the concept of van der Waals interactions for electrochemistry at room temperature.
基金financially supported by the National Natural Science Foundation of China (No.52101269)the Natural Science Foundation of Hubei Province (No. 2024AFD039)
文摘The global pursuit of clean and sustainable renewable energy emphasizes the necessity for advanced energy storage systems.Researchers in this field aim to develop devices that integrate the high-energy density of batteries with the rapid charge and discharge rates characteristic of capacitors.Protons,due to their small size and efficient diffusion via Grotthuss conduction mechanism,serve as particularly advantageous charge carriers for ultrafast intercalation and deintercalation in aqueous batteries.This property has led to the development of a novel energy storage device defined as the aqueous proton battery(APB),which holds the potential to establish a distinct position within the energy storage landscape.This article offers a comprehensive review of recent advancements in electrode materials and battery configurations specifically designed for APBs.The fundamental principles of electrochemical proton storage and detailed insights into Faradaic APB electrodes are highlighted,while the associated challenges regarding their electrochemical performance and operational mechanisms are emphasized.Additionally,the strategic design approaches for full-battery systems aimed at achieving high-performance aqueous proton energy storage are summarized.Finally,the challenges and potential opportunities for further enhancing the applications of APBs are proposed.
文摘BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.METHODS Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed.Patient medical records were assessed.Predictors for overall survival(OS)were determined using multivariable Cox regression.RESULTS Of the 346 included patients with iGBC,138(39.9%)had bile spillage,which was associated with higher American Society of Anesthesiologists classification(P=0.020),cholecystitis(P<0.001),higher tumor stage(P=0.005),and non-radical resection(P<0.001).Bile spillage was associated with poor OS[hazard ratio=1.97,95%confidence interval(CI):1.48-2.63,P<0.001]with a median OS of 12 months(95%CI:7-18 months)vs 34 months(95%CI:14-55 months,P<0.001).In multivariable analysis,spillage was not an independent prognostic factor for survival(hazard ratio=1.21,95%CI:0.84-1.74,P=0.313).CONCLUSION Although bile spillage correlates with prognostic factors,it lacks independent prognostic significance for survival.Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center,irrespective of whether bile spillage has occurred.
基金supported by the MIUR-ex 60% Project(responsibility of Fabio Ietto)。
文摘Slow-moving landslides are widespread in the Mediterranean area,causing damage to the exposed facilities and economic losses in many countries.The recognition of slow-moving landslides in urban areas is always a difficult task to deal with because the presence of buildings,infrastructures,and human activities usually conceals the morphological signs of these landslide activities.So,in the last decades,numerous researchers have shown new methodologies to deepen the studies of similar instability phenomena.The present research is based on an integrated approach to investigate the landslide boundaries,type of movement,failure surface depth,and vulnerability state of buildings in Rota Greca Village(Calabria region,southern Italy) affected by a slowmoving landslide.For this purpose,multi-source data were acquired through geological and geomorphological surveys,recognition of landslide-induced damage on the built environment,subsurface investigations(e.g.,continuous drill boreholes,Standard Penetration Test,Rock Quality Designation index and inclinometer monitoring),laboratory tests(direct shear tests on undisturbed samples),geophysical survey,and InSAR-derived map of deformation rates.The complete integration of multi-source data allowed for the construction of reliable landslide modelling with relative geotechnical properties.In addition,the cross-comparison between surface deformation data by SAR images and severity damage level collected on the exposed buildings enabled to obtain the vulnerability map of the built area.In particular,the achieved goals highlighted two failure surfaces at about-13 and-25 m depth,causing a high vulnerability value for the buildings allocated in the central portion of the Rota Greca Village.The knowledge acquired by the multi-approach can be used to manage and implement appropriate landslide risk mitigation strategies,providing helpful advice and best practices to state-run organisations and stakeholders for landslide management in urban sites.
基金supported by the Paul Calas Award from the French Society of Endodontics(SFE)。
文摘This study investigates the role of Interleukin 17(IL-17)in exacerbating periapical lesions caused by Porphyromonas gingivalis(Pg)lipopolysaccharides(LPS)in the context of metabolic disease and its potential impact on glucose tolerance.Researchers developed a unique mouse model where mice were monocolonized with Pg to induce periapical lesions.After 1 month,they were fed a highfat diet(HFD)for 2 months to simulate metabolic disease and oral microbiota dysbiosis.To explore the role of LPS from Pg,wildtype(WT)mice were challenged with purified LPS from Porphyromonas gingivalis,as well as with LPS-depleted and non-depleted Pg bacteria;IL-17 knockout(KO)mice were also included to assess the role of IL-17 signaling.The impact on bone lysis,periapical injury,glucose intolerance,and immune response was assessed.Results showed that in WT mice,the presence of LPS significantly worsened bone lysis,Th17 cell recruitment,and periapical injury.IL-17 KO mice exhibited reduced bone loss,glucose intolerance,and immune cell infiltration.Additionally,inflammatory markers in adipose tissue were lower in IL-17 KO mice,despite increased dysbiosis.The findings suggest that IL-17 plays a critical role in amplifying Pg-induced periapical lesions and systemic metabolic disturbances.Targeting IL-17 recruitment could offer a novel approach to improving glycemic control and reducing type 2 diabetes(T2D)risk in individuals with periapical disease.
文摘This research investigates dynamic earth processes within the South Setifian allochthonous ensemble,providing insights into landscape evolution and seismotectonic activity within the Tellian mountain chain.Focusing on the Jebel Gustar and Kef Lahmar area,which includes 14 sub-basins,this research uses a DEM-based technique to assess Holocene activities,lineament characteristics,and stream systems.Five geomorphic indices are used to assess relative active tectonics:the stream lengthgradient index(SL),drainage basin asymmetry(AF),valley-floor width to valley height ratio(VF),drainage basin shape(BS),and mountain front sinuosity(SMF).A weighted overlay of these five indices produces the Index of Relative Active Tectonics(IRAT)map.The findings reveal significant neotectonic activity in the study area,supported by profound basement faulting.This research highlights the morpho-structural processes and neotectonics activity in the Jebel Gustar,providing a framework for investigating the evolution of this structure.Additionally,it enhances comprehension of the interactions between the alpine range's internal zones in Eastern Algeria and the Atlasic domain.This study proposes a systematic approach to evaluate the tectonic and geomorphological dynamics of the South Setif region.
基金supported in part by the Higher Education Sprout Project,Ministry of Education,to the Headquarters of University Advancement at National Cheng Kung University(NCKU).
文摘Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.
基金funded by the following grants and contracts:Strategic Priority Research Program of the Chinese Academy of Sciences(XDB38020400 to S.W.)the National Natural Science Foundation of China(32325013 to S.W.,32271186 to J.T.,31900408 to M.Z.)+5 种基金the CAS Project for Young Scientists in Basic Research(YSBR-077 to S.W.)Shanghai Science and Technology Commission Excellent Academic Leaders Program(22XD1424700 to S.W.)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-066 to L.J.and J.W.)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01 to L.J.and S.W.)the National Science and Technology Basic Research Project(2015FY111700 to L.J.)the 111 Project(B13016 to L.J.).
文摘Facial morphology,a complex trait influenced by genetics,holds great significance in evolutionary research.However,due to limited fossil evidence,the facial characteristics of Neanderthals and Denisovans have remained largely unknown.In this study,we conduct a large-scale multi-ethnic meta-analysis of the genome-wide association study(GWAS),including 9674 East Asians and 10,115 Europeans,quantitatively assessing 78 facial traits using 3D facial images.We identify 71 genomic loci associated with facial features,including 21 novel loci.We develop a facial polygenic score(FPS)that enables the prediction of facial features based on genetic information.Interestingly,the distribution of FPSs among populations from diverse continental groups exhibits relevant correlations with observed facial features.Furthermore,we apply the FPS to predict the facial traits of seven Neanderthals and one Denisovan using ancient DNA and align predictions with the fossil records.Our results suggest that Neanderthals and Denisovans likely share similar facial features,such as a wider but shorter nose and a wider endocanthion distance.The decreased mouth width is characterized specifically in Denisovans.The integration of genomic data and facial trait analysis provides valuable insights into the evolutionary history and adaptive changes in human facial morphology.
