Multiple sclerosis(MS)is a chronic disorder of the central nervous system characterized by multifocal lesions where inflammation,demyelination,and neurodegeneration occur(Jakimovski et al.,2024).MS diagnosis primarily...Multiple sclerosis(MS)is a chronic disorder of the central nervous system characterized by multifocal lesions where inflammation,demyelination,and neurodegeneration occur(Jakimovski et al.,2024).MS diagnosis primarily relies on the demonstration of dissemination in time and space of the lesions based on clinical,magnetic resonance imaging(MRI),and cerebrospinal fluid assessments(Jakimovski et al.,2024).展开更多
Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in ...Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in their serum, targeting acetylcholine receptor, muscle-specific kinase, or related proteins. Current treatment for myasthenia gravis involves symptomatic therapy, immunosuppressive drugs such as corticosteroids, azathioprine, and mycophenolate mofetil, and thymectomy, which is primarily indicated in patients with thymoma or thymic hyperplasia. However, this condition continues to pose significant challenges including an unpredictable and variable disease progression, differing response to individual therapies, and substantial longterm side effects associated with standard treatments(including an increased risk of infections, osteoporosis, and diabetes), underscoring the necessity for a more personalized approach to treatment. Furthermore, about fifteen percent of patients, called “refractory myasthenia gravis patients”, do not respond adequately to standard therapies. In this context, the introduction of molecular therapies has marked a significant advance in myasthenia gravis management. Advances in understanding myasthenia gravis pathogenesis, especially the role of pathogenic antibodies, have driven the development of these biological drugs, which offer more selective, rapid, and safer alternatives to traditional immunosuppressants. This review aims to provide a comprehensive overview of emerging therapeutic strategies targeting specific immune pathways in myasthenia gravis, with a particular focus on preclinical evidence, therapeutic rationale, and clinical translation of B-cell depletion therapies, neonatal Fc receptor inhibitors, and complement inhibitors.展开更多
The investigation of the Akchour landslide(AKL)demands precise examination on a local scale,which necessitates field surveys that are often hindered by the landslide's steep and extensive nature of the landslide(1...The investigation of the Akchour landslide(AKL)demands precise examination on a local scale,which necessitates field surveys that are often hindered by the landslide's steep and extensive nature of the landslide(1100 m×400 m,ΔZ of 300 m).Digital Elevation Models(DEMs)are among the key datasets used to achieve this objective.A comparative study between freely available DEMs such as Shuttel Radar Topography Mission(SRTM)(30 m×30 m)and Phased Array type L-band Synthetic Aperture Radar(PALSAR)(12.5 m×12.5 m),alongside those generated by unmanned aerial vehicles(UAVs)demonstrates their significant potential for both geomorphological and geomorphometric analysis.Indeed,scaling issues can lead to the oversight of crucial geological elements.Aerial photos at a 1/20000 scale,previously utilized for anaglyph,provide a broad overview but lack detailed information.To address this limitation,we employed the UAV to capture high-resolution aerial views(with a ground resolution of 17 cm).This approach enabled exploration of inaccessible areas,photogrammetry for orthophotos,and the generation of precise DEM supported geomorphological studies.The orthophoto allowed for detailed visual assessment,while the DEM facilitated geomorphological study.The dynamic behaviors within the landslide.Furthermore,the former irrigation network likely exacerbates the situation.Fractures delineating an unstable area are prominent along the main scarp suggesting the possibility of further sliding.This UAV-mapping revealed three distinct zones with varying based approach significantly enhances our understanding of the AKL,surpassing the limitations of traditional methods and providing critical insights into its morphology and potential risks.展开更多
The dynamic characteristics of the track system can directly affect its service performance and failure process.To explore the load characteristics and dynamic response of the track system under the dynamic loads from...The dynamic characteristics of the track system can directly affect its service performance and failure process.To explore the load characteristics and dynamic response of the track system under the dynamic loads from the rack vehicle in traction conditions,a systematic test of the track subsystem was carried out on a large-slope test line.In the test,the bending stress of the rack teeth,the wheel-rail forces,and the acceleration of crucial components in the track system were measured.Subsequently,a detailed analysis was conducted on the tested signals of the rack railway track system in the time domain and the time-frequency domains.The test results indicate that the traction force significantly affects the rack tooth bending stress and the wheel-rail forces.The vibrations of the track system under the traction conditions are mainly caused by the impacts generated from the gear-rack engagement,which are then transferred to the sleepers,the rails,and the ballast beds.Furthermore,both the maximum stress on the racks and the wheel-rail forces measured on the rails remain below their allowable values.This experimental study evaluates the load characteristics and reveals the vibration characteristics of the rack railway track system under the vehicle’s ultimate load,which is very important for the load-strengthening design of the key components such as racks and the vibration and noise reduction of the track system.展开更多
High-altitude glacier-lake systems in the eastern Pamir Plateau,Tajikistan,are highly sensitive elements of Central Asia’s cryosphere and are vital for sustaining regional water resources.The Yashilkul Lake is locate...High-altitude glacier-lake systems in the eastern Pamir Plateau,Tajikistan,are highly sensitive elements of Central Asia’s cryosphere and are vital for sustaining regional water resources.The Yashilkul Lake is located within a tectonic depression dammed by an ancient rockslide,forming a large alpine lake.This lake is currently impacted by intensified warming,glacier retreat,and poorly quantified hydrological shift.The primary objective of this study is to assess multi-decadal changes in the Yashilkul and Bulunkul lakes and their surrounding cryosphere between 1994 and 2024.The changes were analyzed using multitemporal Landsat imagery and unmanned aerial vehicle (UAV) surveys,complemented by in situ meteorological observations from the Bulunkul meteorological station spanning the period from 1990 to 2024.Glacier and lake boundaries were extracted from Landsat data,primarily by applying the normalized difference water index,supplemented by manual delineation.UAV photogrammetry characterized dam morphology and adjacent ponds,and climate trends were evaluated with the modified Mann-Kendall test.A significant warming trend of 0.096℃/a and pronounced interannual precipitation variability have driven persistent glacier retreat and lake surface area fluctuations.The Yashilkul Lake’s surface area decreased from 36.40 (±1.15) km^(2) in 2010 to 31.94 (±0.54) km^(2) in 2020 and partially rebounded to 33.99 (±0.60) km^(2) in 2024,while the Bulunkul Lake’s surface area remained nearly stable owing to limited glacial influence.Additionally,UAV surveys conducted in 2022 and 2024 revealed main features of the Yashilkul Lake:rockslidedammed origin,perched ponds along the dam body,and an artificial canal regulating its outflow.Nearby glaciers,particularly Glacier No.369,exhibited strong frontal retreat and proglacial lake expansion.The proglacial lake expanded nearly fourfold from 0.08 (±0.01)km^(2) in 2000 to 0.33 (±0.02) km^(2) in 2024,raising concerns about potential glacial lake outburst floods that could impact the Yashilkul Lake and compromise the integrity of its natural dam.The findings highlight accelerating hydrological and cryospheric transformations in the Pamir Plateau,emphasizing the need for sustained monitoring of glacier-lake systems owing to their critical implications for water security,ecological stability,and downstream hazard management.展开更多
Wetting deformation in earth-rockfill dams is a critical factor influencingdam safety.Although numerous mathematical models have been developed to describe this phenomenon,most of them rely on empirical formulations a...Wetting deformation in earth-rockfill dams is a critical factor influencingdam safety.Although numerous mathematical models have been developed to describe this phenomenon,most of them rely on empirical formulations and lack prior knowledge of model parameters,which is essential for Bayesian parameter inversion to enhance accuracy and reduce uncertainty.This study introduces a datadriven approach to establishing prior knowledge of earth-rockfill dams.Driving factors are utilized to determine the potential range of model parameters,and settlement changes within this range are calculated.The results are iteratively compared with actual monitoring data until the calculated range encompasses the observed data,thereby providing prior knowledge of the model parameters.The proposed method is applied to the right-bank earth-rockfilldam of Danjiangkou.Employing a Gibbs sample size of 30,000,the proposed method effectively calibrates the prior knowledge of the wetting model parameters,achieving a root mean square error(RMSE)of 5.18 mm for the settlement predictions.By comparison,the use of non-informative priors with sample sizes of 30,000 and 50,000 results in significantly larger RMSE values of 11.97 mm and 16.07 mm,respectively.Furthermore,the computational efficiencyof the proposed method is demonstrated by an inversion computation time of 902 s for 30,000 samples,which is notably shorter than the 1026 s and 1558 s required for noninformative priors with 30,000 and 50,000 samples,respectively.These findingsunderscore the superior performance of the proposed approach in terms of both prediction accuracy and computational efficiency.These results demonstrate that the proposed method not only improves the predictive accuracy but also enhances the computational efficiency,enabling optimal parameter identificationwith reduced computational effort.This approach provides a robust and efficientframework for advancing dam safety assessments.展开更多
Sporosarcina pasteurii was employed as the strain,with an in-situ magnetization construction,to obtain magnetic microorganisms and oriented self-healing mortar specimens based on them.The magnetic field was used to ac...Sporosarcina pasteurii was employed as the strain,with an in-situ magnetization construction,to obtain magnetic microorganisms and oriented self-healing mortar specimens based on them.The magnetic field was used to achieve the directional migration of magnetic microorganisms during the oriented selfhealing of mortar cracks,improving the rate of self-healing of cracks.The experimental results demonstrate that the magnetic microorganisms are composed of Fe_(3)O_(4)nanosheets attached to the surface of Sporosarcina pasteurii,whose mineralization products are comprised of vaterite primarily.Compared with the pure microbial group,the magnetic microbial group exhibits a faster repair rate,shortening the repair time required to achieve an area repair efficiency of over 90%from 28 days to 14 days,thereby doubling the repair rate.Meanwhile,the area repair efficiency of the magnetic microbial group at 7,14,and 28 days are increased by 50.3%,11.2%,and 4.6%,respectively,compared to the pure microbial group,which are due to the magnetic microorganisms'superior directional migration and mineralization ability,exceeding that of the ordinary microorganisms.展开更多
Phosphorus(P)leaching in alkaline soils,exacerbated by excessive fertilizer application,represents a significant pathway for P loss.While soil pore structure and texture critically regulate P transport,mechanisms gove...Phosphorus(P)leaching in alkaline soils,exacerbated by excessive fertilizer application,represents a significant pathway for P loss.While soil pore structure and texture critically regulate P transport,mechanisms governing P loss in texturally diverse alkaline soils remain unclear.This study investigated P leaching dynamics and transport parameters across four alkaline soil textures(silty clay,clay loam,loam,sandy loam)using a one-dimensional convective-diffusion equation(CDE)based on column experiments.Results indicated that phosphorus leaching kinetics were predominantly governed by diffusion transport,evidenced by low Peclet numbers(P_(e))(ranged from 0.02 to 0.31)across varying textures and initial P concentrations(C_(0)).Comparative analysis of transport parameters revealed significant textural effects on dispersion coefficient(D),retardation factor(R),pore water velocity(V),P_(e),and diffusion coefficient(λ)(F>523.42,p<0.001).Among these,only D,P_(e) andλexhibited substantial differences in response to variations in C_(0)(F>89.47,p<0.001).Saturated hydraulic conductivity(K_(s))(R^(2)=62.9%,p<0.01)and total pore area(A)(R^(2)=12.4%,p<0.01)emerged as primary regulators of P leaching.Enhanced clay content increased total pore area while reducing average pore diameter,concurrently decreasing pore water velocity and saturated infiltration rates.These textural modifications amplified diffusive P transport within soil matrices.The findings provide mechanistic insights into texturedependent P mobility in alkaline environments,informing targeted strategies for agricultural phosphorus management.展开更多
This study investigates the potential formation of subglacial lakes beneath the glaciers of the Franz Josef Land archipelago,Russian Arctic,under current and future climatic conditions.Using a one-dimensional heat and...This study investigates the potential formation of subglacial lakes beneath the glaciers of the Franz Josef Land archipelago,Russian Arctic,under current and future climatic conditions.Using a one-dimensional heat and mass transfer model,the research evaluates the influence of geothermal heat flow,ice thickness,and surface temperature on basal melting.The model incorporates enthalpy formulation and boundary conditions derived from field data,including temperature profiles and geothermal measurements.Results indicate that subglacial lakes could form under ice masses exceeding 300 m thickness,driven by geothermal heating,though current basal temperatures remain below the melting point.Simulations under the IPCC SSP1-2.6 scenario suggest a gradual warming trend,highlighting the long-term thermal inertia of Arctic glaciers.The study underscores the need for enhanced observational data to validate models and improve predictions of glacial dynamics in response to climate change.展开更多
Polymer-modified bentonite(PMB)is much more effective at containing chemically aggressive liquids than conventional bentonite.The PMB manufacturing process typically utilizes natural,high-quality sodium bentonite(NaB)...Polymer-modified bentonite(PMB)is much more effective at containing chemically aggressive liquids than conventional bentonite.The PMB manufacturing process typically utilizes natural,high-quality sodium bentonite(NaB)owing to its excellent hydrophilicity and swelling capacity.However,calcium bentonite(CaB),which is much more abundant worldwide,is rarely used for containment applications owing to its poor hydrophilicity.This study proposed a polymerization method that transforms sodium-activated calcium bentonite(NCB)into PMB to achieve low hydraulic conductivity(k)to aggressive liquids.The mechanism for its low k was revealed through characterization techniques and analyses(e.g.X-ray diffraction(XRD),Fourier transform infrared spectroscopy(FTIR),scanning electron microscopy(SEM),and Brunauer-Emmett-Teller(BET)).The results showed that the PMB had a small amount of polymer elution(indicating better interface stability)and thus exhibited excellent barrier properties under chemically aggressive conditions,with the k of<10^(-11) m/s for 0.6 mol/L NaCl solution,which is four orders of magnitude lower than that of the NCB(k=3×10^(-7) m/s).Various microscopic analyses indicated that the selected monomers were successfully polymerized,and intercalated into and grafted onto the montmorillonite layers of bentonite.The formed polymer network increased the swelling capability of PMB granules,decreased the pore size,and created narrow and tortuous flow pathways leading to a very low k to aggressive liquids.展开更多
Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central ne...Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central nervous system.Central copper dysregulations have been evidenced in two genetic disorders characterized by mutations in the copper-ATPases ATP7A and ATP7B,Menkes disease and Wilson’s disease,respectively,and also in multifactorial neurological disorders such as Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,and multiple sclerosis.This review summarizes current knowledge about the role of copper in central nervous system physiology and pathology,reports about unbalances in copper levels and/or distribution under disease,describes relevant animal models for human disorders where copper metabolism genes are dysregulated,and discusses relevant therapeutic approaches modulating copper availability.Overall,alterations in copper metabolism may contribute to the etiology of central nervous system disorders and represent relevant therapeutic targets to restore tissue homeostasis.展开更多
Iced transmission line galloping poses a significant threat to the safety and reliability of power systems,leading directly to line tripping,disconnections,and power outages.Existing early warning methods of iced tran...Iced transmission line galloping poses a significant threat to the safety and reliability of power systems,leading directly to line tripping,disconnections,and power outages.Existing early warning methods of iced transmission line galloping suffer from issues such as reliance on a single data source,neglect of irregular time series,and lack of attention-based closed-loop feedback,resulting in high rates of missed and false alarms.To address these challenges,we propose an Internet of Things(IoT)empowered early warning method of transmission line galloping that integrates time series data from optical fiber sensing and weather forecast.Initially,the method applies a primary adaptive weighted fusion to the IoT empowered optical fiber real-time sensing data and weather forecast data,followed by a secondary fusion based on a Back Propagation(BP)neural network,and uses the K-medoids algorithm for clustering the fused data.Furthermore,an adaptive irregular time series perception adjustment module is introduced into the traditional Gated Recurrent Unit(GRU)network,and closed-loop feedback based on attentionmechanism is employed to update network parameters through gradient feedback of the loss function,enabling closed-loop training and time series data prediction of the GRU network model.Subsequently,considering various types of prediction data and the duration of icing,an iced transmission line galloping risk coefficient is established,and warnings are categorized based on this coefficient.Finally,using an IoT-driven realistic dataset of iced transmission line galloping,the effectiveness of the proposed method is validated through multi-dimensional simulation scenarios.展开更多
Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is importan...Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced EUS.Clinical studies have reported varying diagnostic and adverse event rates with these modalities.In addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different recommendations.In this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.展开更多
Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco ...Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.展开更多
In recent years,mudflows have emerged as a significant threat to infrastructure and lives,exhibiting increased frequency and severity.This study collectively addresses the rising threat of natural hazards,specifically...In recent years,mudflows have emerged as a significant threat to infrastructure and lives,exhibiting increased frequency and severity.This study collectively addresses the rising threat of natural hazards,specifically mudflows in mountain-foothill zones in Tajikistan,utilizing UAV and remote sensing technologies to monitor their impact.From 2020 to 2023,we employed a QC-2 Micro UAV and a DJI Phantom 4 quadcopter to capture high-resolution aerial imagery across multiple affected districts,supplemented by pre-and post-event Sentinel-2 images analyzed using the Normalized Difference Water Index(NDWI)and Normalized Difference Vegetation Index(NDVI).Our analysis revealed that 49 districts and cities experienced significant mudflow events,resulting in estimated damages and economic losses of 30.2 million USD,with particularly severe impacts noted in the Khuroson,Tojikobod,Vakhsh,Panjakent,Lakhsh,and Varzob.The composition of mudflows in the six studied areas predominantly consisted of clay,with some regions featuring mudstone and a few exhibiting a mixture of both materials.Our findings indicate the predominance of rain-induced mudflows in foothill areas,contrasting with rain-snow,glacial,and lake-outburst-induced mudflows in mountainous regions.This underscores the urgent need for effective disaster risk management strategies in vulnerable locations.Integrating UAV and remote sensing technologies provides crucial information for analyzing damages,identifying vulnerable areas,and advising emergency response efforts,thereby enhancing disaster risk management in Tajikistan.展开更多
All-solid-state Li batteries(ASSLBs)using solid electrolytes(SEs)have gained significant attention in recent years considering the safety issue and their high energy density.Despite these advantages,the commercializat...All-solid-state Li batteries(ASSLBs)using solid electrolytes(SEs)have gained significant attention in recent years considering the safety issue and their high energy density.Despite these advantages,the commercialization of ASSLBs still faces challenges regarding the electrolyte/electrodes interfaces and growth of Li dendrites.Elemental doping is an effective and direct method to enhance the performance of SEs.Here,we report an Al-F co-doping strategy to improve the overall properties including ion conductivity,high voltage stability,and cathode and anode compatibility.Particularly,the Al-F co-doping enables the formation of a thin Li-Al alloy layer and fluoride interphases,thereby constructing a relatively stable interface and promoting uniform Li deposition.The similar merits of Al-F co-doping are also revealed in the Li-argyrodite series.ASSLBs assembled with these optimized electrolytes gain good electrochemical performance,demonstrating the universality of Al-F co-doping towards advanced SEs.展开更多
A 64-year-old woman who presented with progressive exertional dyspnea(NYHA class IIb)over the previous month,unresponsive to adjustments in diuretic therapy.She denied chest pain or palpitations.On physical examinatio...A 64-year-old woman who presented with progressive exertional dyspnea(NYHA class IIb)over the previous month,unresponsive to adjustments in diuretic therapy.She denied chest pain or palpitations.On physical examination,bilateral lower extremity edema and a right parasternal systolic murmur were noted.Electrocardiography showed sinus rhythm with first-degree atrioventricular block and complete right bundle branch block.展开更多
Coastal zones are dynamic interfaces responding to complex natural processes and anthropogenic pressures.Monitoring shoreline evolution is essential for sustainable coastal management,particularly given climate change...Coastal zones are dynamic interfaces responding to complex natural processes and anthropogenic pressures.Monitoring shoreline evolution is essential for sustainable coastal management,particularly given climate change,urban expansion,and sediment flux disruption.This study investigates shoreline changes along Morocco’s northern Atlantic coast from 1990 to 2023,an area of strategic economic importance and environmental vulnerability.Landsat satellite imagery and geospatial techniques,including the Digital Shoreline Analysis System(DSAS v5.1)and the Normalized Difference Water Index(NDWI),provided a high-resolution,diachronic assessment.Shoreline extraction and image enhancement were conducted with ENVI software,and change detection utilized Linear Regression Rate(LRR)and End Point Rate(EPR)indicators.Results revealed significant spatial variability:sectors like northern Moulay Bousselham and Chlihat showed pronounced accretion(+3.2 to+4.7 m/year),while areas such as Tahaddart and southern Mehdia experienced severe erosion(up to−3.4 m/year).The total net eroded area exceeds 58,000 m².Trends correlate strongly with hydrodynamic forces,upstream damming,sediment extraction,and extreme weather events,notably storms in 2014 and 2017.Findings align with studies highlighting compounded effects of sediment starvation and sea-level rise.By integrating remote sensing,time-series analysis,and uncertainty quantification,this research provides insights into the primary drivers of shoreline dynamics,emphasizing the urgent need for adaptive,evidence-based coastal management strategies,including regulation of sand mining,sediment buffer restoration,and soft-engineering solutions.展开更多
The genus Lilium comprises 119 taxa,primarily native to temperate and alpine regions of the Northern Hemisphere,extending to the northern Philippines.In this study,we report the first occurrence of Lilium candidum L.i...The genus Lilium comprises 119 taxa,primarily native to temperate and alpine regions of the Northern Hemisphere,extending to the northern Philippines.In this study,we report the first occurrence of Lilium candidum L.in Morocco,specifically in the jbel Sidi Ali El Jawzi area,within the territorial commune of Asjen,Ouezzane Province(Pre-Rif region).During a botanical survey conducted in May 2022,a population of L.candidum was identified,marking its first recorded presence in the country.Morphological characteristics were analyzed and compared with existing descriptions in the literature to confirm species identification.The species was found in a humid microclimate with calcareous soils,suggesting specific ecological requirements that facilitated its establishment.This unexpected discovery raises several questions regarding its biogeographical history,potential introduction pathways,and adaptation mechanisms in the Moroccan environment.Given its limited distribution and ecological specificity,its conservation status should be carefully evaluated,as human activities,habitat disturbance,and climate change may pose significant threats.Further studies,including genetic analyses and ecological monitoring,are needed to determine its origin,assess population stability,and establish conservation strategies.The presence of L.candidum in the Pre-Rif region expands the known distribution of the species and highlights the importance of continuous botanical exploration in North Africa,particularly in understudied mountainous ecosystems.展开更多
BACKGROUND The optimal management of gallstones and common bile duct stones remains a subject of ongoing debate.The conventional two-stage treatment involves initial endoscopic retrograde cholangiopancreatography(ERCP...BACKGROUND The optimal management of gallstones and common bile duct stones remains a subject of ongoing debate.The conventional two-stage treatment involves initial endoscopic retrograde cholangiopancreatography(ERCP)to clear the bile duct,followed by laparoscopic cholecystectomy.Alternatively,the single-stage laparoendoscopic rendezvous(LERV)procedure combines ERCP and laparoscopic cholecystectomy in the same surgical session.AIM To evaluate the efficacy,safety,and logistical considerations of these two approaches,emphasizing their implications for different healthcare settings.METHODS A literature search was conducted through a PubMed search(2010-2024)using the terms“laparoendoscopic rendezvous”,“endoscopic retrograde cholangiopancreatography”,and“cholecystocholedocholithiasis”.Only English-language studies were included.RESULTS In our analysis,LERV significantly reduced the incidence of post-ERCP pancreatitis by 67%(2.4%vs 8.8%)and shortened hospital stay by a mean of up to 6 days.Stone clearance rates were comparable between LERV(97%)and the two-stage approach(96%).Although LERV was associated with a longer operative time(139.8 minutes vs 107.7 minutes),it demonstrated lower overall costs,largely due to reduced hospitalization.Rates of postoperative bleeding,cholangitis,and bile leak were low and did not differ significantly between groups.CONCLUSION The single-stage LERV approach is safe,effective,and associated with lower pancreatitis rates,shorter hospital stays,and reduced costs compared to the two-stage strategy.Its implementation,however,requires coordinated surgical-endoscopic expertise,making it most suitable for well-equipped centers and carefully selected patients.展开更多
基金supported by Italian Ministry for Health(RF-2011-02349698,RF-2018-12367731)(to CF).
文摘Multiple sclerosis(MS)is a chronic disorder of the central nervous system characterized by multifocal lesions where inflammation,demyelination,and neurodegeneration occur(Jakimovski et al.,2024).MS diagnosis primarily relies on the demonstration of dissemination in time and space of the lesions based on clinical,magnetic resonance imaging(MRI),and cerebrospinal fluid assessments(Jakimovski et al.,2024).
文摘Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in their serum, targeting acetylcholine receptor, muscle-specific kinase, or related proteins. Current treatment for myasthenia gravis involves symptomatic therapy, immunosuppressive drugs such as corticosteroids, azathioprine, and mycophenolate mofetil, and thymectomy, which is primarily indicated in patients with thymoma or thymic hyperplasia. However, this condition continues to pose significant challenges including an unpredictable and variable disease progression, differing response to individual therapies, and substantial longterm side effects associated with standard treatments(including an increased risk of infections, osteoporosis, and diabetes), underscoring the necessity for a more personalized approach to treatment. Furthermore, about fifteen percent of patients, called “refractory myasthenia gravis patients”, do not respond adequately to standard therapies. In this context, the introduction of molecular therapies has marked a significant advance in myasthenia gravis management. Advances in understanding myasthenia gravis pathogenesis, especially the role of pathogenic antibodies, have driven the development of these biological drugs, which offer more selective, rapid, and safer alternatives to traditional immunosuppressants. This review aims to provide a comprehensive overview of emerging therapeutic strategies targeting specific immune pathways in myasthenia gravis, with a particular focus on preclinical evidence, therapeutic rationale, and clinical translation of B-cell depletion therapies, neonatal Fc receptor inhibitors, and complement inhibitors.
文摘The investigation of the Akchour landslide(AKL)demands precise examination on a local scale,which necessitates field surveys that are often hindered by the landslide's steep and extensive nature of the landslide(1100 m×400 m,ΔZ of 300 m).Digital Elevation Models(DEMs)are among the key datasets used to achieve this objective.A comparative study between freely available DEMs such as Shuttel Radar Topography Mission(SRTM)(30 m×30 m)and Phased Array type L-band Synthetic Aperture Radar(PALSAR)(12.5 m×12.5 m),alongside those generated by unmanned aerial vehicles(UAVs)demonstrates their significant potential for both geomorphological and geomorphometric analysis.Indeed,scaling issues can lead to the oversight of crucial geological elements.Aerial photos at a 1/20000 scale,previously utilized for anaglyph,provide a broad overview but lack detailed information.To address this limitation,we employed the UAV to capture high-resolution aerial views(with a ground resolution of 17 cm).This approach enabled exploration of inaccessible areas,photogrammetry for orthophotos,and the generation of precise DEM supported geomorphological studies.The orthophoto allowed for detailed visual assessment,while the DEM facilitated geomorphological study.The dynamic behaviors within the landslide.Furthermore,the former irrigation network likely exacerbates the situation.Fractures delineating an unstable area are prominent along the main scarp suggesting the possibility of further sliding.This UAV-mapping revealed three distinct zones with varying based approach significantly enhances our understanding of the AKL,surpassing the limitations of traditional methods and providing critical insights into its morphology and potential risks.
基金supported by the National Natural Science Foundation of China(No.52388102)the Sichuan Science and Technology Program(No.2024NSFTD0011)the Fundamental Research Funds for the State Key Laboratory of Rail Transit Vehicle System of Southwest Jiaotong University(No.2023TPL-T11).
文摘The dynamic characteristics of the track system can directly affect its service performance and failure process.To explore the load characteristics and dynamic response of the track system under the dynamic loads from the rack vehicle in traction conditions,a systematic test of the track subsystem was carried out on a large-slope test line.In the test,the bending stress of the rack teeth,the wheel-rail forces,and the acceleration of crucial components in the track system were measured.Subsequently,a detailed analysis was conducted on the tested signals of the rack railway track system in the time domain and the time-frequency domains.The test results indicate that the traction force significantly affects the rack tooth bending stress and the wheel-rail forces.The vibrations of the track system under the traction conditions are mainly caused by the impacts generated from the gear-rack engagement,which are then transferred to the sleepers,the rails,and the ballast beds.Furthermore,both the maximum stress on the racks and the wheel-rail forces measured on the rails remain below their allowable values.This experimental study evaluates the load characteristics and reveals the vibration characteristics of the rack railway track system under the vehicle’s ultimate load,which is very important for the load-strengthening design of the key components such as racks and the vibration and noise reduction of the track system.
基金funded by the Key Program of National Natural Science Foundation of China (42230708,42361144887)the Tianshan Talent Project of Xinjiang Uygur Autonomous Region,China (2022TSYCLJ0056)。
文摘High-altitude glacier-lake systems in the eastern Pamir Plateau,Tajikistan,are highly sensitive elements of Central Asia’s cryosphere and are vital for sustaining regional water resources.The Yashilkul Lake is located within a tectonic depression dammed by an ancient rockslide,forming a large alpine lake.This lake is currently impacted by intensified warming,glacier retreat,and poorly quantified hydrological shift.The primary objective of this study is to assess multi-decadal changes in the Yashilkul and Bulunkul lakes and their surrounding cryosphere between 1994 and 2024.The changes were analyzed using multitemporal Landsat imagery and unmanned aerial vehicle (UAV) surveys,complemented by in situ meteorological observations from the Bulunkul meteorological station spanning the period from 1990 to 2024.Glacier and lake boundaries were extracted from Landsat data,primarily by applying the normalized difference water index,supplemented by manual delineation.UAV photogrammetry characterized dam morphology and adjacent ponds,and climate trends were evaluated with the modified Mann-Kendall test.A significant warming trend of 0.096℃/a and pronounced interannual precipitation variability have driven persistent glacier retreat and lake surface area fluctuations.The Yashilkul Lake’s surface area decreased from 36.40 (±1.15) km^(2) in 2010 to 31.94 (±0.54) km^(2) in 2020 and partially rebounded to 33.99 (±0.60) km^(2) in 2024,while the Bulunkul Lake’s surface area remained nearly stable owing to limited glacial influence.Additionally,UAV surveys conducted in 2022 and 2024 revealed main features of the Yashilkul Lake:rockslidedammed origin,perched ponds along the dam body,and an artificial canal regulating its outflow.Nearby glaciers,particularly Glacier No.369,exhibited strong frontal retreat and proglacial lake expansion.The proglacial lake expanded nearly fourfold from 0.08 (±0.01)km^(2) in 2000 to 0.33 (±0.02) km^(2) in 2024,raising concerns about potential glacial lake outburst floods that could impact the Yashilkul Lake and compromise the integrity of its natural dam.The findings highlight accelerating hydrological and cryospheric transformations in the Pamir Plateau,emphasizing the need for sustained monitoring of glacier-lake systems owing to their critical implications for water security,ecological stability,and downstream hazard management.
基金supported by the National Key R&D Program of China(Grant No.2023YFC3209504)Natural Science Foundation of Wuhan(Grant No.2024040801020271)the Fundamental Research Funds for Central Public Welfare Research Institutes(Grant No.CKSF2025718/YT).
文摘Wetting deformation in earth-rockfill dams is a critical factor influencingdam safety.Although numerous mathematical models have been developed to describe this phenomenon,most of them rely on empirical formulations and lack prior knowledge of model parameters,which is essential for Bayesian parameter inversion to enhance accuracy and reduce uncertainty.This study introduces a datadriven approach to establishing prior knowledge of earth-rockfill dams.Driving factors are utilized to determine the potential range of model parameters,and settlement changes within this range are calculated.The results are iteratively compared with actual monitoring data until the calculated range encompasses the observed data,thereby providing prior knowledge of the model parameters.The proposed method is applied to the right-bank earth-rockfilldam of Danjiangkou.Employing a Gibbs sample size of 30,000,the proposed method effectively calibrates the prior knowledge of the wetting model parameters,achieving a root mean square error(RMSE)of 5.18 mm for the settlement predictions.By comparison,the use of non-informative priors with sample sizes of 30,000 and 50,000 results in significantly larger RMSE values of 11.97 mm and 16.07 mm,respectively.Furthermore,the computational efficiencyof the proposed method is demonstrated by an inversion computation time of 902 s for 30,000 samples,which is notably shorter than the 1026 s and 1558 s required for noninformative priors with 30,000 and 50,000 samples,respectively.These findingsunderscore the superior performance of the proposed approach in terms of both prediction accuracy and computational efficiency.These results demonstrate that the proposed method not only improves the predictive accuracy but also enhances the computational efficiency,enabling optimal parameter identificationwith reduced computational effort.This approach provides a robust and efficientframework for advancing dam safety assessments.
基金Funded by the National Key R&D Program of China(No.2023YFC3806100)the National Nature Science Foundation of China(Nos.52278269,52278268,52178264,and 52108238)+2 种基金the Tianjin Outstanding Young Scholars Science Fund Project(No.22JCJQJC00020)the Key Project of Tianjin Natural Science Foundation(No.23JCZDJC00430)the Joint Research Center of China and Foreign Countries Special Fund of Tianjin Innovation Platform(No.24PTLYHZ00240)。
文摘Sporosarcina pasteurii was employed as the strain,with an in-situ magnetization construction,to obtain magnetic microorganisms and oriented self-healing mortar specimens based on them.The magnetic field was used to achieve the directional migration of magnetic microorganisms during the oriented selfhealing of mortar cracks,improving the rate of self-healing of cracks.The experimental results demonstrate that the magnetic microorganisms are composed of Fe_(3)O_(4)nanosheets attached to the surface of Sporosarcina pasteurii,whose mineralization products are comprised of vaterite primarily.Compared with the pure microbial group,the magnetic microbial group exhibits a faster repair rate,shortening the repair time required to achieve an area repair efficiency of over 90%from 28 days to 14 days,thereby doubling the repair rate.Meanwhile,the area repair efficiency of the magnetic microbial group at 7,14,and 28 days are increased by 50.3%,11.2%,and 4.6%,respectively,compared to the pure microbial group,which are due to the magnetic microorganisms'superior directional migration and mineralization ability,exceeding that of the ordinary microorganisms.
基金supported by the National Natural Science Foundation of China(Nos.42077067,42277329)the Projects of Talents Recruitment of GDUPT(No.XJ2005000301)。
文摘Phosphorus(P)leaching in alkaline soils,exacerbated by excessive fertilizer application,represents a significant pathway for P loss.While soil pore structure and texture critically regulate P transport,mechanisms governing P loss in texturally diverse alkaline soils remain unclear.This study investigated P leaching dynamics and transport parameters across four alkaline soil textures(silty clay,clay loam,loam,sandy loam)using a one-dimensional convective-diffusion equation(CDE)based on column experiments.Results indicated that phosphorus leaching kinetics were predominantly governed by diffusion transport,evidenced by low Peclet numbers(P_(e))(ranged from 0.02 to 0.31)across varying textures and initial P concentrations(C_(0)).Comparative analysis of transport parameters revealed significant textural effects on dispersion coefficient(D),retardation factor(R),pore water velocity(V),P_(e),and diffusion coefficient(λ)(F>523.42,p<0.001).Among these,only D,P_(e) andλexhibited substantial differences in response to variations in C_(0)(F>89.47,p<0.001).Saturated hydraulic conductivity(K_(s))(R^(2)=62.9%,p<0.01)and total pore area(A)(R^(2)=12.4%,p<0.01)emerged as primary regulators of P leaching.Enhanced clay content increased total pore area while reducing average pore diameter,concurrently decreasing pore water velocity and saturated infiltration rates.These textural modifications amplified diffusive P transport within soil matrices.The findings provide mechanistic insights into texturedependent P mobility in alkaline environments,informing targeted strategies for agricultural phosphorus management.
基金supported by the Shanghai Science and Technology Innovation Action Plan(Grant no.23230712200).
文摘This study investigates the potential formation of subglacial lakes beneath the glaciers of the Franz Josef Land archipelago,Russian Arctic,under current and future climatic conditions.Using a one-dimensional heat and mass transfer model,the research evaluates the influence of geothermal heat flow,ice thickness,and surface temperature on basal melting.The model incorporates enthalpy formulation and boundary conditions derived from field data,including temperature profiles and geothermal measurements.Results indicate that subglacial lakes could form under ice masses exceeding 300 m thickness,driven by geothermal heating,though current basal temperatures remain below the melting point.Simulations under the IPCC SSP1-2.6 scenario suggest a gradual warming trend,highlighting the long-term thermal inertia of Arctic glaciers.The study underscores the need for enhanced observational data to validate models and improve predictions of glacial dynamics in response to climate change.
基金supported by the National Natural Science Foundation of China(Grant Nos.52478351,52208329)the Shenzhen Science and Technology Innovation Commission(Grant No.JCYJ20240813143306009)support is gratefully acknowledged.
文摘Polymer-modified bentonite(PMB)is much more effective at containing chemically aggressive liquids than conventional bentonite.The PMB manufacturing process typically utilizes natural,high-quality sodium bentonite(NaB)owing to its excellent hydrophilicity and swelling capacity.However,calcium bentonite(CaB),which is much more abundant worldwide,is rarely used for containment applications owing to its poor hydrophilicity.This study proposed a polymerization method that transforms sodium-activated calcium bentonite(NCB)into PMB to achieve low hydraulic conductivity(k)to aggressive liquids.The mechanism for its low k was revealed through characterization techniques and analyses(e.g.X-ray diffraction(XRD),Fourier transform infrared spectroscopy(FTIR),scanning electron microscopy(SEM),and Brunauer-Emmett-Teller(BET)).The results showed that the PMB had a small amount of polymer elution(indicating better interface stability)and thus exhibited excellent barrier properties under chemically aggressive conditions,with the k of<10^(-11) m/s for 0.6 mol/L NaCl solution,which is four orders of magnitude lower than that of the NCB(k=3×10^(-7) m/s).Various microscopic analyses indicated that the selected monomers were successfully polymerized,and intercalated into and grafted onto the montmorillonite layers of bentonite.The formed polymer network increased the swelling capability of PMB granules,decreased the pore size,and created narrow and tortuous flow pathways leading to a very low k to aggressive liquids.
文摘Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central nervous system.Central copper dysregulations have been evidenced in two genetic disorders characterized by mutations in the copper-ATPases ATP7A and ATP7B,Menkes disease and Wilson’s disease,respectively,and also in multifactorial neurological disorders such as Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,and multiple sclerosis.This review summarizes current knowledge about the role of copper in central nervous system physiology and pathology,reports about unbalances in copper levels and/or distribution under disease,describes relevant animal models for human disorders where copper metabolism genes are dysregulated,and discusses relevant therapeutic approaches modulating copper availability.Overall,alterations in copper metabolism may contribute to the etiology of central nervous system disorders and represent relevant therapeutic targets to restore tissue homeostasis.
基金research was funded by Science and Technology Project of State Grid Corporation of China under grant number 5200-202319382A-2-3-XG.
文摘Iced transmission line galloping poses a significant threat to the safety and reliability of power systems,leading directly to line tripping,disconnections,and power outages.Existing early warning methods of iced transmission line galloping suffer from issues such as reliance on a single data source,neglect of irregular time series,and lack of attention-based closed-loop feedback,resulting in high rates of missed and false alarms.To address these challenges,we propose an Internet of Things(IoT)empowered early warning method of transmission line galloping that integrates time series data from optical fiber sensing and weather forecast.Initially,the method applies a primary adaptive weighted fusion to the IoT empowered optical fiber real-time sensing data and weather forecast data,followed by a secondary fusion based on a Back Propagation(BP)neural network,and uses the K-medoids algorithm for clustering the fused data.Furthermore,an adaptive irregular time series perception adjustment module is introduced into the traditional Gated Recurrent Unit(GRU)network,and closed-loop feedback based on attentionmechanism is employed to update network parameters through gradient feedback of the loss function,enabling closed-loop training and time series data prediction of the GRU network model.Subsequently,considering various types of prediction data and the duration of icing,an iced transmission line galloping risk coefficient is established,and warnings are categorized based on this coefficient.Finally,using an IoT-driven realistic dataset of iced transmission line galloping,the effectiveness of the proposed method is validated through multi-dimensional simulation scenarios.
文摘Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced EUS.Clinical studies have reported varying diagnostic and adverse event rates with these modalities.In addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different recommendations.In this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.
文摘Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.
基金funded by the Gansu Provincial Science and Technology Program(22ZD6FA005)Gansu Postdoctoral Science Foundation(Grant number E339880204)。
文摘In recent years,mudflows have emerged as a significant threat to infrastructure and lives,exhibiting increased frequency and severity.This study collectively addresses the rising threat of natural hazards,specifically mudflows in mountain-foothill zones in Tajikistan,utilizing UAV and remote sensing technologies to monitor their impact.From 2020 to 2023,we employed a QC-2 Micro UAV and a DJI Phantom 4 quadcopter to capture high-resolution aerial imagery across multiple affected districts,supplemented by pre-and post-event Sentinel-2 images analyzed using the Normalized Difference Water Index(NDWI)and Normalized Difference Vegetation Index(NDVI).Our analysis revealed that 49 districts and cities experienced significant mudflow events,resulting in estimated damages and economic losses of 30.2 million USD,with particularly severe impacts noted in the Khuroson,Tojikobod,Vakhsh,Panjakent,Lakhsh,and Varzob.The composition of mudflows in the six studied areas predominantly consisted of clay,with some regions featuring mudstone and a few exhibiting a mixture of both materials.Our findings indicate the predominance of rain-induced mudflows in foothill areas,contrasting with rain-snow,glacial,and lake-outburst-induced mudflows in mountainous regions.This underscores the urgent need for effective disaster risk management strategies in vulnerable locations.Integrating UAV and remote sensing technologies provides crucial information for analyzing damages,identifying vulnerable areas,and advising emergency response efforts,thereby enhancing disaster risk management in Tajikistan.
基金supported by the National Natural Science Foundation of China(Nos.52172243,52371215)。
文摘All-solid-state Li batteries(ASSLBs)using solid electrolytes(SEs)have gained significant attention in recent years considering the safety issue and their high energy density.Despite these advantages,the commercialization of ASSLBs still faces challenges regarding the electrolyte/electrodes interfaces and growth of Li dendrites.Elemental doping is an effective and direct method to enhance the performance of SEs.Here,we report an Al-F co-doping strategy to improve the overall properties including ion conductivity,high voltage stability,and cathode and anode compatibility.Particularly,the Al-F co-doping enables the formation of a thin Li-Al alloy layer and fluoride interphases,thereby constructing a relatively stable interface and promoting uniform Li deposition.The similar merits of Al-F co-doping are also revealed in the Li-argyrodite series.ASSLBs assembled with these optimized electrolytes gain good electrochemical performance,demonstrating the universality of Al-F co-doping towards advanced SEs.
文摘A 64-year-old woman who presented with progressive exertional dyspnea(NYHA class IIb)over the previous month,unresponsive to adjustments in diuretic therapy.She denied chest pain or palpitations.On physical examination,bilateral lower extremity edema and a right parasternal systolic murmur were noted.Electrocardiography showed sinus rhythm with first-degree atrioventricular block and complete right bundle branch block.
文摘Coastal zones are dynamic interfaces responding to complex natural processes and anthropogenic pressures.Monitoring shoreline evolution is essential for sustainable coastal management,particularly given climate change,urban expansion,and sediment flux disruption.This study investigates shoreline changes along Morocco’s northern Atlantic coast from 1990 to 2023,an area of strategic economic importance and environmental vulnerability.Landsat satellite imagery and geospatial techniques,including the Digital Shoreline Analysis System(DSAS v5.1)and the Normalized Difference Water Index(NDWI),provided a high-resolution,diachronic assessment.Shoreline extraction and image enhancement were conducted with ENVI software,and change detection utilized Linear Regression Rate(LRR)and End Point Rate(EPR)indicators.Results revealed significant spatial variability:sectors like northern Moulay Bousselham and Chlihat showed pronounced accretion(+3.2 to+4.7 m/year),while areas such as Tahaddart and southern Mehdia experienced severe erosion(up to−3.4 m/year).The total net eroded area exceeds 58,000 m².Trends correlate strongly with hydrodynamic forces,upstream damming,sediment extraction,and extreme weather events,notably storms in 2014 and 2017.Findings align with studies highlighting compounded effects of sediment starvation and sea-level rise.By integrating remote sensing,time-series analysis,and uncertainty quantification,this research provides insights into the primary drivers of shoreline dynamics,emphasizing the urgent need for adaptive,evidence-based coastal management strategies,including regulation of sand mining,sediment buffer restoration,and soft-engineering solutions.
文摘The genus Lilium comprises 119 taxa,primarily native to temperate and alpine regions of the Northern Hemisphere,extending to the northern Philippines.In this study,we report the first occurrence of Lilium candidum L.in Morocco,specifically in the jbel Sidi Ali El Jawzi area,within the territorial commune of Asjen,Ouezzane Province(Pre-Rif region).During a botanical survey conducted in May 2022,a population of L.candidum was identified,marking its first recorded presence in the country.Morphological characteristics were analyzed and compared with existing descriptions in the literature to confirm species identification.The species was found in a humid microclimate with calcareous soils,suggesting specific ecological requirements that facilitated its establishment.This unexpected discovery raises several questions regarding its biogeographical history,potential introduction pathways,and adaptation mechanisms in the Moroccan environment.Given its limited distribution and ecological specificity,its conservation status should be carefully evaluated,as human activities,habitat disturbance,and climate change may pose significant threats.Further studies,including genetic analyses and ecological monitoring,are needed to determine its origin,assess population stability,and establish conservation strategies.The presence of L.candidum in the Pre-Rif region expands the known distribution of the species and highlights the importance of continuous botanical exploration in North Africa,particularly in understudied mountainous ecosystems.
文摘BACKGROUND The optimal management of gallstones and common bile duct stones remains a subject of ongoing debate.The conventional two-stage treatment involves initial endoscopic retrograde cholangiopancreatography(ERCP)to clear the bile duct,followed by laparoscopic cholecystectomy.Alternatively,the single-stage laparoendoscopic rendezvous(LERV)procedure combines ERCP and laparoscopic cholecystectomy in the same surgical session.AIM To evaluate the efficacy,safety,and logistical considerations of these two approaches,emphasizing their implications for different healthcare settings.METHODS A literature search was conducted through a PubMed search(2010-2024)using the terms“laparoendoscopic rendezvous”,“endoscopic retrograde cholangiopancreatography”,and“cholecystocholedocholithiasis”.Only English-language studies were included.RESULTS In our analysis,LERV significantly reduced the incidence of post-ERCP pancreatitis by 67%(2.4%vs 8.8%)and shortened hospital stay by a mean of up to 6 days.Stone clearance rates were comparable between LERV(97%)and the two-stage approach(96%).Although LERV was associated with a longer operative time(139.8 minutes vs 107.7 minutes),it demonstrated lower overall costs,largely due to reduced hospitalization.Rates of postoperative bleeding,cholangitis,and bile leak were low and did not differ significantly between groups.CONCLUSION The single-stage LERV approach is safe,effective,and associated with lower pancreatitis rates,shorter hospital stays,and reduced costs compared to the two-stage strategy.Its implementation,however,requires coordinated surgical-endoscopic expertise,making it most suitable for well-equipped centers and carefully selected patients.
