BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outc...BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.展开更多
The second edition of the United Arab Emirates inflammatory bowel disease(IBD)consensus guidance provides updated recommendations for diagnosing,treating,and monitoring IBD.Significant therapeutic advances and evolvin...The second edition of the United Arab Emirates inflammatory bowel disease(IBD)consensus guidance provides updated recommendations for diagnosing,treating,and monitoring IBD.Significant therapeutic advances and evolving treatment paradigms since 2020(including risk stratification and treat-to-target approaches)necessitated this comprehensive update to standardize care across the United Arab Emirates.Developed via Delphi consensus methodology,this guidance incorporates a systematic literature review and key international gui-delines.It presents 188 summary statements covering the full spectrum of IBD care,including complex scenarios like perianal disease and pregnancy.Key updates feature guidance on newer pharmacologic therapies-interleukin-23,Janus kinase,and sphingosine-1-phosphate receptor inhibitors-with refined therapeutic positioning informed by recent head-to-head trials.The consensus emphasizes early,effective treatment to prevent irreversible bowel damage,optimization strategies like therapeutic drug monitoring,and achieving objective treat-to-target goals to improve long-term outcomes.Recognizing local healthcare system challenges,it offers practical recommendations on reducing variability and enhancing equitable access to IBD care.By integrating current clinical evidence with United Arab Emirates-specific considerations,the second edition United Arab Emirates IBD consensus guidance aims to standardize care across sectors,provide a benchmark for payers and policymakers,optimize treatment outcomes,and improve IBD outcomes,aligning national practice with international standards.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common cancers and CRC patients are among the most common intensive care unit(ICU)admitted cancer patients.However,their prognosis and evaluation methods are rarely ...BACKGROUND Colorectal cancer(CRC)is one of the most common cancers and CRC patients are among the most common intensive care unit(ICU)admitted cancer patients.However,their prognosis and evaluation methods are rarely studied.AIM To determine the short-term mortality outcome and identify the potential prognostic factors of CRC cancer patients admitted to the ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at the ICU departments of 37 cancer specialized hospitals in China,and included patients aged≥14 years with ICU duration≥24 hours.Clinical records of patients with a primary CRC diagnosis were reviewed.Patients were separated into groups according to 90-day survival.Characteristics between groups were compared.Univariate and multivariate regression tests were used to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS In total,189 CRC patients were included in the study.The 90-day mortality was 12.2%.Patients who died showed differences compared to patients who survived mostly in terms of disease severity and ICU complications.It appears that patients admitted to the ICU from a clinical ward due to emergencies may have a higher risk of mortality while surgical management was associated with better survival.In multivariate analysis,only chemotherapy,elective surgery and conventional oxygen therapy were identified as independently correlated with 90-day mortality.Sequential organ failure assessment and acute physiology and chronic health evaluation II scores had moderate accuracy in predicting short-term mortality.CONCLUSION ICU admitted CRC patients appear to have low short-term mortality which requires further confirmation in prospective studies.The prognostic tools for these patients need further optimization.展开更多
Knowledge graphs (KGs) offer a structured, machine-readable format for organizing complex information. In heterogeneous catalysis, where data on catalytic materials, reaction conditions, mechanisms, and synthesis rout...Knowledge graphs (KGs) offer a structured, machine-readable format for organizing complex information. In heterogeneous catalysis, where data on catalytic materials, reaction conditions, mechanisms, and synthesis routes are dispersed across diverse sources, KGs provide a semantic framework that supports data integration under the FAIR (Findable, Accessible, Interoperable, and Reusable) principles. This review aims to survey recent developments in catalysis KGs, describe the main techniques for graph construction, and highlight how artificial intelligence, particularly large language models (LLMs), enhances graph generation and query. We conducted a systematic analysis of the literature, focusing on ontology-guided text mining pipelines, graph population methods, and maintenance strategies. Our review identifies key trends: ontology-based approaches enable the automated extraction of domain knowledge, LLM-driven retrieval-augmented generation supports natural-language queries, and scalable graph architectures range from a few thousand to over a million triples. We discuss state-of-the-art applications, such as catalyst recommendation systems and reaction mechanism discovery tools, and examine the major challenges, including data heterogeneity, ontology alignment, and long-term graph curation. We conclude that KGs, when combined with AI methods, hold significant promise for accelerating catalyst discovery and knowledge management, but progress depends on establishing community standards for ontology development and maintenance. This review provides a roadmap for researchers seeking to leverage KGs to advance heterogeneous catalysis research.展开更多
BACKGROUND Atrial fibrillation(AF)represents a common arrhythmia with significant implications and may occur pre-,intra-,or postoperatively(POAF).After cardiac surgery POAF occurs in approximately 30% of patients,whil...BACKGROUND Atrial fibrillation(AF)represents a common arrhythmia with significant implications and may occur pre-,intra-,or postoperatively(POAF).After cardiac surgery POAF occurs in approximately 30% of patients,while non-cardiac/nonthoracic surgery has a reported incidence between 0.4% to 15%,with new onset POAF occurring at a rate of 0.4% to 3%.While AF has been extensively studied,it has not been well described in emergent non-cardiac surgery associated with increased surgical stress in an intensive care unit setting(ICU).AIM To investigate the incidence/predictors of POAF in emergent non-cardiac surgery and its associations with postoperative outcomes in the ICU.METHODS This retrospective study included patients≥18 years who underwent exploratory laparotomy or lower extremity amputation between October 2012 and September 2023 and were admitted in the ICU.Data of interest included occurrence of POAF,demographic characteristics,comorbidities,laboratory values,administered fluids,medications,and postoperative outcomes.Statistical analyses consisted of identifying predic-tors of POAF and associations of POAF with outcomes of interest.RESULTS A total of 347 ICU patients were included,16.4% had a history of AF,13.0% developed POAF,and 7.9%developed new-onset POAF.Patients with new-onset POAF were older(79.6±9.1 vs 68.1±14.8 years,<0.001),of white race(47.8%vs 28.8,P<0.001),hypertensive(87.0%vs 71.2%,P=0.011),had longer ICU length of stay(ICU-LOS)(13.4 vs 6.7 days,P=0.042),higher mortality(43.5%vs 17.6%,P=0.016)and higher rate of cardiac arrest(34.8%vs 14.6%,P=0.005)compared to patients without new-onset POAF.Multivariable analysis revealed increased POAF risk with advanced age(OR=1.06;95%CI:1.02-1.10,P=0.005),white race(OR=2.85;95%CI:1.26-6.76,P=0.014),high intraoperative fluid(OR>1;95%CI:1.00-1.00,P=0.018),and longer ICU-LOS(OR=1.04;95%CI:1.00-1.08,P=0.023).After adjusting for demographics,new onset POAF significantly predicted mortality(OR=3.07;95%CI:1.14-8.01,P=0.022).CONCLUSION POAF was associated with prolonged ICU-LOS,white race,and high intraoperative fluid.New-onset POAF was associated with increased risk of cardiac arrest and death in critically ill patients.展开更多
BACKGROUND Normothermic liver machine perfusion(NMP)is a novel technology used to preserve and evaluate the function of liver allografts.AIM To assess NMP utilization in liver transplant(LT)practices.METHODS All adult...BACKGROUND Normothermic liver machine perfusion(NMP)is a novel technology used to preserve and evaluate the function of liver allografts.AIM To assess NMP utilization in liver transplant(LT)practices.METHODS All adult deceased-donor LT recipients between January 2021 and September 2023 in the United States were analyzed.Outcomes including discard rates,survival,preservation time and timing of surgery were compared between two groups:NMP vs non-NMP.RESULTS Between 2021 and 2023,NMP was utilized in 1493(6.3%)of all LTs in the United States.Compared to non-NMP group,NMP group had lower allograft discard rate(6.5%vs 10%,P<0.001),older recipients’age(median:47 vs 42 years,P<0.001),and higher utilization of donors from donation after circulatory death(DCD)(55%vs 11%,P<0.001).NMP group also had longer distances between recipient and donor hospitals(median:156 vs 138 miles,P<0.001),longer preser-vation time(median:12.2 vs 5.8 hours,P<0.001),and more daytime reperfusion(74%vs 55%,P<0.001).Post-transplant survival outcomes were comparable between the two groups.In a subgroup analysis of NMP,recipients in the long preservation time(≥8 hours)group had higher daytime reperfusion(78%vs 55%,P<0.001)and similar post-transplant survival when compared to the short preservation time(<8 hours)group.CONCLUSION The utilization of NMP is associated with lower discard rates and increased DCD organs for LT.NMP allows for prolonging the preservation time and increased occurrence of daytime LT,without any impact on the survival outcomes.展开更多
Interventional pulmonology(IP)represents a rapidly growing and developing subspecialty within pulmonary medicine.To the intensivist,given the elaborate undertakings with respect to airway,lung and pleural disease mana...Interventional pulmonology(IP)represents a rapidly growing and developing subspecialty within pulmonary medicine.To the intensivist,given the elaborate undertakings with respect to airway,lung and pleural disease management-IP has shown an increasing presence and remain a major ally in the care of these pa-tients.Thus,an understanding of the different roles that IP could offer to the intensivist is of prime importance in the multi-disciplinary care of the complex patients within the intensive care units,particularly in relation to lung,airway and pleural diseases.This review article will explore the different intersections of IP in critical care and discuss the applications of this discipline within the highly complex critical care environment.展开更多
Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge w...Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].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
Continuous cropping leads to high incidence of soilborne diseases such as bacterial wilt caused by Ralstonia solanacearum,which poses a risk to agricultural production.Anaerobic soil disinfestation(ASD)and plant growt...Continuous cropping leads to high incidence of soilborne diseases such as bacterial wilt caused by Ralstonia solanacearum,which poses a risk to agricultural production.Anaerobic soil disinfestation(ASD)and plant growthpromoting rhizobacteria(PGPR)are considered environmentally friendly methods to control bacterial wilt.However,the underlying mechanism of the improvement of soil health and the inhibition of bacterial wilt after ASD treatment and PGPR inoculation needs further exploration.This study evaluated the effect of ASD treatment on soil improvement at pre-planting of tomato,and the effect of ASD treatment combined with the application of Bacillus velezensis Y6(BV)on soil quality,R.solanacearum abundance,and bacterial communities at 90 days before harvesting of tomato.The results showed that ASD treatment reduced R.solanacearum abundance in soil by17.6%at pre-planting and 18.7%at 90 days before harvesting,but BV inoculation did not influence R.solanacearum abundance.ASD and ASD+BV treatments effectively reduced the occurrence of bacterial wilt,improved soil nutrient status and increased soil microbial activity at 90 days before harvesting.Principal co-ordinate analysis showed that the soil bacterial community was significantly influenced by ASD treatment both at pre-planting and at 90 days before harvesting.Further investigation found that ASD contributed to the enrichment of beneficial flora(Bacillus and Streptomyces).Moreover,pH was an important environmental factor affecting the abundance of R.solanacearum in soil.Co-occurrence network analysis showed that ASD treatment significantly increased network connection of bacterial communities and the proportion of beneficial microorganisms(Proteobacteria and Firmicutes),leading to complex soil bacterial co-occurrence networks both at pre-planting and at 90 days before harvesting.Collectively,these results indicate that ASD treatment,but not microbial inoculation can enhance tomato plant resistance to bacterial wilt by improving soil quality and modulating the soil bacterial community.展开更多
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
Fibrolamellar hepatocellular carcinoma is a rare and unique subtype of primary liver cancer that predominantly affects adolescents and young adults who do not have underlying liver disease or cirrhosis.Representing le...Fibrolamellar hepatocellular carcinoma is a rare and unique subtype of primary liver cancer that predominantly affects adolescents and young adults who do not have underlying liver disease or cirrhosis.Representing less than five percent of all liver tumors,it poses significant diagnostic and therapeutic challenges due to its uncommon occurrence,vague clinical symptoms,and absence of standardized treatment protocols.This review summarizes the current understanding of the disease,covering its epidemiology,clinical presentation,imaging characteristics,histopathologic features,molecular biology,and treatment approaches.Patients often present with nonspecific abdominal symptoms,and typical tumor markers,such as alpha-fetoprotein,are usually absent.Imaging may show a central scar and calcifications,while histology reveals large eosinophilic tumor cells separated by fibrous bands.A defining molecular hallmark is the DNAJB1-PRKACA fusion gene,found in the majority of cases.Surgical resection remains the primary curative treatment for localized disease,although recurrence rates are high.Liver transplantation may be an option for selected patients with non-resectable,liverconfined tumors.Treatment options for advanced disease are limited,with some benefit observed from chemotherapy and targeted agents.Recent developments in molecular therapies and immunotherapy offer promise,but further research and clinical trial participation are essential to improve outcomes in this challenging malignancy.展开更多
Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic ...Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic targets. Apolipoprotein E(APOE) genotypes and their corresponding protein(Apo E) isoforms may influence the biophysical properties of the cell membrane lipid bilayer. However, the role of APOE in central nervous system pathophysiology extended beyond its lipid transport function. In the present review article, we analyzed the links existing between APOE genotypes and the neurobiology of neuropsychiatric symptoms in neurodegenerative and vascular diseases. APOE genotypes(APOE ε2, APOE ε3, and APOE ε4) were implicated in common mechanisms underlying a wide spectrum of neurodegenerative diseases, including sporadic Alzheimer's disease, synucleinopathies such as Parkinson's disease and Lewy body disease, stroke, and traumatic brain injury. These shared pathways often involved neuroinflammation, abnormal protein accumulation, or responses to acute detrimental events. Across these conditions, APOE variants are believed to contribute to the modulation of inflammatory responses, the regulation of amyloid and tau pathology, as well as the clearance of proteins such as α-synuclein. The bidirectional interactions among Apo E, amyloid and mitochondrial metabolism, immunomodulatory effects, neuronal repair, and remodeling underscored the complexity of Apo E's role in neuropsychiatric symptoms associated with these conditions since from early phases of cognitive impairment such as mild cognitive impairment and mild behavioral impairment. Besides Apo E-specific isoforms' link to increased neuropsychiatric symptoms in Alzheimer's disease(depression, psychosis, aberrant motor behaviors, and anxiety, not apathy), the APOE ε4 genotype was also considered a significant genetic risk factor for Lewy body disease and its worse cognitive outcomes. Conversely, the APOE ε2 variant has been observed not to exert a protective effect equally in all neurodegenerative diseases. Specifically, in Lewy body disease, this variant may delay disease onset, paralleling its protective role in Alzheimer's disease, although its role in frontotemporal dementia is uncertain. The APOE ε4 genotype has been associated with adverse cognitive outcomes across other various neurodegenerative conditions. In Parkinson's disease, the APOE ε4 allele significantly impacted cognitive performance, increasing the risk of developing dementia, even in cases of pure synucleinopathies with minimal co-pathology from Alzheimer's disease. Similarly, in traumatic brain injury, recovery rates varied, with APOE ε4 carriers demonstrating a greater risk of poor long-term cognitive outcomes and elevated levels of neuropsychiatric symptoms. Furthermore, APOE ε4 influenced the age of onset and severity of stroke, as well as the likelihood of developing stroke-associated dementia, potentially due to its role in compromising endothelial integrity and promoting blood–brain barrier dysfunction.展开更多
Background The diagnostic delay of cardiac amyloidosis(CA)is known to be substantially long.A prolonged time from symptoms onset to diagnosis negatively impacts quality of life and life expectancy of the affected pati...Background The diagnostic delay of cardiac amyloidosis(CA)is known to be substantially long.A prolonged time from symptoms onset to diagnosis negatively impacts quality of life and life expectancy of the affected patients.We aim to describe the role of the incidental finding of amyloid deposits in prostatic tissue as an early marker of CA.Methods A systematic cardiological evaluation,comprising ECG,echocardiogram and 99mTc-DPD scintigraphy,was offered to a cohort of 19 patients with incidental prostatic amyloidosis(PA)findings,propectively detected between 2014-2023,to assess cardiac involvement.Results The median age of the patients was 80.2 years(IQR:74.9-82.6 years).Histopathological study revealed amyloid deposits within the walls of small vessels(predominantly small arteries)in 18 patients and mainly in the stroma in the remaining case.All of them were immunohistochemically positive for transthyretin(ATTR)except one patient,with known myeloma,which was unconclusive fo ATTR.Clonal dyscrasia was excluded in the rest of the patients.Thirteen patients(68.4%)underwent all cardiological tests,4 patients(21.1%)underwent only ECG and echocardiographic evaluation and two patients(10.5%)refused to undergo any cardiological study.Among 13 individuals undergoing the complete evaluation,six patients were eventually diagnosed with CA(46.15%).All of them were asymptomatic from a cardiovascular point of view at the time of the prostate biopsy.Conclusion The finding of PA should prompt a complete cardiovascular examination,given the significant percentage of patients eventually diagnosed with early-stage CA.Multidisciplinary collaboration among different medical specialists must be encouraged,given the potential clinical impact of CA early diagnosis.展开更多
The use of water resources for energy generation has become increasingly prevalent,encompassing the conversion of kinetic energy from streams,tides,and waves into renewable electrical power.Water energy sources offer ...The use of water resources for energy generation has become increasingly prevalent,encompassing the conversion of kinetic energy from streams,tides,and waves into renewable electrical power.Water energy sources offer numerous benefits,including widespread availability,stability,and the absence of carbon dioxide and other greenhouse gas emissions,making them a clean and environmentally friendly form of energy.In this work,we develop a droplet-based liquid-solid triboelectric nanogenerator(LS-TENG)using sophisticatedly designed inflatable columnar structures with inner and outer dual-electrodes.This device can be utilized to harvest both the internal droplet-rolling mechanical energy and the external droplet-falling mechanical energy,capable of being assembled into various structures for versatile applications.The design incorporates a combined structure of both internal and external TENG to optimize output performance via multiple energy harvesting strategies.The internal structure features a dual-electrode columnar-shaped LS-TENG,designed to harvest fluid kinetic energy from water droplets.By leveraging the back-and-forth motion of a small amount of water within the air column,mechanical energy can be readily collected,achieving a maximum mass power density of 9.02 W·Kg^(−1)and an energy conversion efficiency of 10.358%.The external component is a droplet-based LS-TENG,which utilizes a double-layer capacitor switch effect elucidated with an equivalent circuit model.Remarkably,without the need for pre-charging,a single droplet can generate over 140 V of high voltage,achieving a maximum power density of 7.35 W·m^(−2)and an energy conversion efficiency of 22.058%.The combined LS-TENG with a sophisticated inflatable columnar structure can simultaneously collect multiple types of energy with high efficacy,exhibiting great significance in potential applications such as TENG aeration rollers,inflatable lifejacket,wind energy harvesting,TENG tents,and green houses.展开更多
Type 1 diabetes(T1D)is a chronic organ-specific autoimmune disorder characterized by a progressive loss of the insulin-secreting pancreatic beta cells,which ultimately results in insulinopenia,hyperglycemia and lifelo...Type 1 diabetes(T1D)is a chronic organ-specific autoimmune disorder characterized by a progressive loss of the insulin-secreting pancreatic beta cells,which ultimately results in insulinopenia,hyperglycemia and lifelong need for exogenous insulin therapy.In the pathophysiological landscape of T1D,T helper 17 cells(Th17 cells)and their hallmark cytokine,interleukin(IL)-17,play pivotal roles from disease onset to disease progression.In this narrative mini-review,we discuss the dynamic interplay between Th17 cells and IL-17 in the context of T1D,providing insights into the underlying immunologic mechanisms contributing to the IL-17-immunity-mediated pancreatic beta-cell destruction.Furthermore,we summarized the main animal and clinical studies that investigated Th17-and IL-17-targeted interventions as promising immunotherapies able to alter the natural history of T1D.展开更多
Nonalcoholic fatty liver disease(NAFLD)is becoming rapidly one of the most common indications for orthotopic liver transplantation in the world.Development of graft steatosis is a significant problem during the posttr...Nonalcoholic fatty liver disease(NAFLD)is becoming rapidly one of the most common indications for orthotopic liver transplantation in the world.Development of graft steatosis is a significant problem during the posttransplant course,which may happen as a recurrence of pre-existing disease or de novo NAFLD.There are different risk factors that might play a role in development of graft steatosis including post-transplant metabolic syndrome,immune-suppressive medications,genetics and others.There are few studies that assessed the effects of NAFLD on graft and patient survival;most of them were limited by the duration of follow up or by the number of patients.With this review article we will try to shed light on post-liver transplantation NAFLD,significance of the disease,how it develops,risk factors,clinical course and treatment options.展开更多
AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES...AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES) 1988-1994, NAFLD participants aged 20 or greater without any other liver diseases were included in this study. Excessive alcohol intake is defined as > 2 drinks per day for males and > 1 drink per day for females. C-peptide and 27 other factors known to be associated with NAFLD(e.g., age, gender, body mass index, waist circumference, race/ethnicity, liver chemistries, and other diabetes tests) were tested in both univariate and multivariate level using logistic regression with a P-value 0.05.RESULTS Of 18825 participants aged ≥ 20, 3235 participants(n = 3235) met inclusion criteria. There were 23 factors associated with NAFLD by univariate analysis. 9 factors, ranked by the highest change in pseudo R2, were found to be significant predictors of NAFLD in multivariate model: waist circumference, fasting C-peptide, natural log of alanine aminotransferase(ALT), total protein, beingMexican American, natural log of glycated hemoglobin, triglyceride level, being non-Hispanic white, and ferritin level. CONCLUSION Together with waist circumference and ALT, fasting C-peptide is among three most important predictors of NAFLD in United States population in the NHANES data set. Further study is needed to validate the clinical utility of fasting C-peptide in diagnosis or monitoring insulin resistance in NAFLD patients.展开更多
Hepatocellular carcinoma(HCC)is the most common form of liver cancer worldwide.It is caused by a variety of risk factors,most common ones being infection with hepatitis viruses,alcohol,and obesity.HCC often develops i...Hepatocellular carcinoma(HCC)is the most common form of liver cancer worldwide.It is caused by a variety of risk factors,most common ones being infection with hepatitis viruses,alcohol,and obesity.HCC often develops in the background of underlying cirrhosis,and even though a number of interventional treatment methods are currently in use,recurrence is fairly common among patients who have had a resection.Therefore,whole liver transplantation remains the most practical treatment option for HCC.Due to the growing incidence of HCC,intense research efforts are being made to understand cellular and molecular mechanisms of the disease so that novel therapeutic strategies can be developed to combat liver cancer.In recent years,it has become clear that innate immunity plays a critical role in the development of a number of liver diseases,including HCC.In particular,the activation of Toll-like receptor signaling results in the generation of immune responses that often results in the production of proinflammatory cytokines and chemokines,and could cause acute inflammation in the liver.In this review,the current knowledge on the role of innate immune responses in the development and progression of HCC is examined,and emerging therapeutic strategies based on molecular mechanisms of HCC are discussed.展开更多
Ulcerative colitis and Crohn’s disease are the main entities of inflammatory bowel disease characterized by chronic remittent inflammation of the gastrointestinal tract.The incidence and prevalence are on the rise wo...Ulcerative colitis and Crohn’s disease are the main entities of inflammatory bowel disease characterized by chronic remittent inflammation of the gastrointestinal tract.The incidence and prevalence are on the rise worldwide,and the heterogeneity between patients and within individuals over time is striking.The progressive advance in our understanding of the etiopathogenesis coupled with an unprecedented increase in therapeutic options have changed the management towards evidence-based interventions by clinicians with patients.This guideline was stimulated and supported by the Emirates Gastroenterology and Hepatology Society following a systematic review and a Delphi consensus process that provided evidence-and expert opinion-based recommendations.Comprehensive up-to-date guidance is provided regarding diagnosis,evaluation of disease severity,appropriate and timely use of different investigations,choice of appropriate therapy for induction and remission phase according to disease severity,and management of main complications.展开更多
文摘BACKGROUND Esophageal cancer patients had the highest intensive care unit(ICU)admitted rate in cancer patients.But their prognosis and evaluation methods were rarely studied.AIM To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at ICU departments of 37 cancer specialized hospitals in China.Patients aged≥14 years with ICU duration≥24 hours were included.Clinical records of patients with primary esophageal cancer diagnosis were reviewed.Patients were separated into groups according to the 90 days survival.Characteristics between groups were compared.Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS Total 180 esophageal cancer patients were included.The 90 days mortality was 22.2%.Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward.The current evaluation tools,including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death.ICU admitted esophageal cancer patients have poor prognosis,especially those with acute illness.CONCLUSION The prognostic tools for these patients need to be further optimized.
文摘The second edition of the United Arab Emirates inflammatory bowel disease(IBD)consensus guidance provides updated recommendations for diagnosing,treating,and monitoring IBD.Significant therapeutic advances and evolving treatment paradigms since 2020(including risk stratification and treat-to-target approaches)necessitated this comprehensive update to standardize care across the United Arab Emirates.Developed via Delphi consensus methodology,this guidance incorporates a systematic literature review and key international gui-delines.It presents 188 summary statements covering the full spectrum of IBD care,including complex scenarios like perianal disease and pregnancy.Key updates feature guidance on newer pharmacologic therapies-interleukin-23,Janus kinase,and sphingosine-1-phosphate receptor inhibitors-with refined therapeutic positioning informed by recent head-to-head trials.The consensus emphasizes early,effective treatment to prevent irreversible bowel damage,optimization strategies like therapeutic drug monitoring,and achieving objective treat-to-target goals to improve long-term outcomes.Recognizing local healthcare system challenges,it offers practical recommendations on reducing variability and enhancing equitable access to IBD care.By integrating current clinical evidence with United Arab Emirates-specific considerations,the second edition United Arab Emirates IBD consensus guidance aims to standardize care across sectors,provide a benchmark for payers and policymakers,optimize treatment outcomes,and improve IBD outcomes,aligning national practice with international standards.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common cancers and CRC patients are among the most common intensive care unit(ICU)admitted cancer patients.However,their prognosis and evaluation methods are rarely studied.AIM To determine the short-term mortality outcome and identify the potential prognostic factors of CRC cancer patients admitted to the ICU.METHODS A multicenter cross-sectional study was performed from May 10,2021 to July 10,2021 at the ICU departments of 37 cancer specialized hospitals in China,and included patients aged≥14 years with ICU duration≥24 hours.Clinical records of patients with a primary CRC diagnosis were reviewed.Patients were separated into groups according to 90-day survival.Characteristics between groups were compared.Univariate and multivariate regression tests were used to analyze the correlated factors of ICU outcomes.Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.RESULTS In total,189 CRC patients were included in the study.The 90-day mortality was 12.2%.Patients who died showed differences compared to patients who survived mostly in terms of disease severity and ICU complications.It appears that patients admitted to the ICU from a clinical ward due to emergencies may have a higher risk of mortality while surgical management was associated with better survival.In multivariate analysis,only chemotherapy,elective surgery and conventional oxygen therapy were identified as independently correlated with 90-day mortality.Sequential organ failure assessment and acute physiology and chronic health evaluation II scores had moderate accuracy in predicting short-term mortality.CONCLUSION ICU admitted CRC patients appear to have low short-term mortality which requires further confirmation in prospective studies.The prognostic tools for these patients need further optimization.
基金support from the Full Bridge Fellowship for enabling the research stay at Virginia Tech.H.Xin acknowledge the financial support from the US Department of Energy,Office of Basic Energy Sciences under contract no.DE-SC0023323from the National Science Foundation through the grant 2245402 from CBET Catalysis and CDS&E programs.
文摘Knowledge graphs (KGs) offer a structured, machine-readable format for organizing complex information. In heterogeneous catalysis, where data on catalytic materials, reaction conditions, mechanisms, and synthesis routes are dispersed across diverse sources, KGs provide a semantic framework that supports data integration under the FAIR (Findable, Accessible, Interoperable, and Reusable) principles. This review aims to survey recent developments in catalysis KGs, describe the main techniques for graph construction, and highlight how artificial intelligence, particularly large language models (LLMs), enhances graph generation and query. We conducted a systematic analysis of the literature, focusing on ontology-guided text mining pipelines, graph population methods, and maintenance strategies. Our review identifies key trends: ontology-based approaches enable the automated extraction of domain knowledge, LLM-driven retrieval-augmented generation supports natural-language queries, and scalable graph architectures range from a few thousand to over a million triples. We discuss state-of-the-art applications, such as catalyst recommendation systems and reaction mechanism discovery tools, and examine the major challenges, including data heterogeneity, ontology alignment, and long-term graph curation. We conclude that KGs, when combined with AI methods, hold significant promise for accelerating catalyst discovery and knowledge management, but progress depends on establishing community standards for ontology development and maintenance. This review provides a roadmap for researchers seeking to leverage KGs to advance heterogeneous catalysis research.
文摘BACKGROUND Atrial fibrillation(AF)represents a common arrhythmia with significant implications and may occur pre-,intra-,or postoperatively(POAF).After cardiac surgery POAF occurs in approximately 30% of patients,while non-cardiac/nonthoracic surgery has a reported incidence between 0.4% to 15%,with new onset POAF occurring at a rate of 0.4% to 3%.While AF has been extensively studied,it has not been well described in emergent non-cardiac surgery associated with increased surgical stress in an intensive care unit setting(ICU).AIM To investigate the incidence/predictors of POAF in emergent non-cardiac surgery and its associations with postoperative outcomes in the ICU.METHODS This retrospective study included patients≥18 years who underwent exploratory laparotomy or lower extremity amputation between October 2012 and September 2023 and were admitted in the ICU.Data of interest included occurrence of POAF,demographic characteristics,comorbidities,laboratory values,administered fluids,medications,and postoperative outcomes.Statistical analyses consisted of identifying predic-tors of POAF and associations of POAF with outcomes of interest.RESULTS A total of 347 ICU patients were included,16.4% had a history of AF,13.0% developed POAF,and 7.9%developed new-onset POAF.Patients with new-onset POAF were older(79.6±9.1 vs 68.1±14.8 years,<0.001),of white race(47.8%vs 28.8,P<0.001),hypertensive(87.0%vs 71.2%,P=0.011),had longer ICU length of stay(ICU-LOS)(13.4 vs 6.7 days,P=0.042),higher mortality(43.5%vs 17.6%,P=0.016)and higher rate of cardiac arrest(34.8%vs 14.6%,P=0.005)compared to patients without new-onset POAF.Multivariable analysis revealed increased POAF risk with advanced age(OR=1.06;95%CI:1.02-1.10,P=0.005),white race(OR=2.85;95%CI:1.26-6.76,P=0.014),high intraoperative fluid(OR>1;95%CI:1.00-1.00,P=0.018),and longer ICU-LOS(OR=1.04;95%CI:1.00-1.08,P=0.023).After adjusting for demographics,new onset POAF significantly predicted mortality(OR=3.07;95%CI:1.14-8.01,P=0.022).CONCLUSION POAF was associated with prolonged ICU-LOS,white race,and high intraoperative fluid.New-onset POAF was associated with increased risk of cardiac arrest and death in critically ill patients.
文摘BACKGROUND Normothermic liver machine perfusion(NMP)is a novel technology used to preserve and evaluate the function of liver allografts.AIM To assess NMP utilization in liver transplant(LT)practices.METHODS All adult deceased-donor LT recipients between January 2021 and September 2023 in the United States were analyzed.Outcomes including discard rates,survival,preservation time and timing of surgery were compared between two groups:NMP vs non-NMP.RESULTS Between 2021 and 2023,NMP was utilized in 1493(6.3%)of all LTs in the United States.Compared to non-NMP group,NMP group had lower allograft discard rate(6.5%vs 10%,P<0.001),older recipients’age(median:47 vs 42 years,P<0.001),and higher utilization of donors from donation after circulatory death(DCD)(55%vs 11%,P<0.001).NMP group also had longer distances between recipient and donor hospitals(median:156 vs 138 miles,P<0.001),longer preser-vation time(median:12.2 vs 5.8 hours,P<0.001),and more daytime reperfusion(74%vs 55%,P<0.001).Post-transplant survival outcomes were comparable between the two groups.In a subgroup analysis of NMP,recipients in the long preservation time(≥8 hours)group had higher daytime reperfusion(78%vs 55%,P<0.001)and similar post-transplant survival when compared to the short preservation time(<8 hours)group.CONCLUSION The utilization of NMP is associated with lower discard rates and increased DCD organs for LT.NMP allows for prolonging the preservation time and increased occurrence of daytime LT,without any impact on the survival outcomes.
文摘Interventional pulmonology(IP)represents a rapidly growing and developing subspecialty within pulmonary medicine.To the intensivist,given the elaborate undertakings with respect to airway,lung and pleural disease management-IP has shown an increasing presence and remain a major ally in the care of these pa-tients.Thus,an understanding of the different roles that IP could offer to the intensivist is of prime importance in the multi-disciplinary care of the complex patients within the intensive care units,particularly in relation to lung,airway and pleural diseases.This review article will explore the different intersections of IP in critical care and discuss the applications of this discipline within the highly complex critical care environment.
文摘Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].
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.
基金the National Natural Science Foundation of China(31870420)the Science and Technology Program of Guangdong Province,China(2121A0505030057)。
文摘Continuous cropping leads to high incidence of soilborne diseases such as bacterial wilt caused by Ralstonia solanacearum,which poses a risk to agricultural production.Anaerobic soil disinfestation(ASD)and plant growthpromoting rhizobacteria(PGPR)are considered environmentally friendly methods to control bacterial wilt.However,the underlying mechanism of the improvement of soil health and the inhibition of bacterial wilt after ASD treatment and PGPR inoculation needs further exploration.This study evaluated the effect of ASD treatment on soil improvement at pre-planting of tomato,and the effect of ASD treatment combined with the application of Bacillus velezensis Y6(BV)on soil quality,R.solanacearum abundance,and bacterial communities at 90 days before harvesting of tomato.The results showed that ASD treatment reduced R.solanacearum abundance in soil by17.6%at pre-planting and 18.7%at 90 days before harvesting,but BV inoculation did not influence R.solanacearum abundance.ASD and ASD+BV treatments effectively reduced the occurrence of bacterial wilt,improved soil nutrient status and increased soil microbial activity at 90 days before harvesting.Principal co-ordinate analysis showed that the soil bacterial community was significantly influenced by ASD treatment both at pre-planting and at 90 days before harvesting.Further investigation found that ASD contributed to the enrichment of beneficial flora(Bacillus and Streptomyces).Moreover,pH was an important environmental factor affecting the abundance of R.solanacearum in soil.Co-occurrence network analysis showed that ASD treatment significantly increased network connection of bacterial communities and the proportion of beneficial microorganisms(Proteobacteria and Firmicutes),leading to complex soil bacterial co-occurrence networks both at pre-planting and at 90 days before harvesting.Collectively,these results indicate that ASD treatment,but not microbial inoculation can enhance tomato plant resistance to bacterial wilt by improving soil quality and modulating the soil bacterial community.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
文摘Fibrolamellar hepatocellular carcinoma is a rare and unique subtype of primary liver cancer that predominantly affects adolescents and young adults who do not have underlying liver disease or cirrhosis.Representing less than five percent of all liver tumors,it poses significant diagnostic and therapeutic challenges due to its uncommon occurrence,vague clinical symptoms,and absence of standardized treatment protocols.This review summarizes the current understanding of the disease,covering its epidemiology,clinical presentation,imaging characteristics,histopathologic features,molecular biology,and treatment approaches.Patients often present with nonspecific abdominal symptoms,and typical tumor markers,such as alpha-fetoprotein,are usually absent.Imaging may show a central scar and calcifications,while histology reveals large eosinophilic tumor cells separated by fibrous bands.A defining molecular hallmark is the DNAJB1-PRKACA fusion gene,found in the majority of cases.Surgical resection remains the primary curative treatment for localized disease,although recurrence rates are high.Liver transplantation may be an option for selected patients with non-resectable,liverconfined tumors.Treatment options for advanced disease are limited,with some benefit observed from chemotherapy and targeted agents.Recent developments in molecular therapies and immunotherapy offer promise,but further research and clinical trial participation are essential to improve outcomes in this challenging malignancy.
文摘Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic targets. Apolipoprotein E(APOE) genotypes and their corresponding protein(Apo E) isoforms may influence the biophysical properties of the cell membrane lipid bilayer. However, the role of APOE in central nervous system pathophysiology extended beyond its lipid transport function. In the present review article, we analyzed the links existing between APOE genotypes and the neurobiology of neuropsychiatric symptoms in neurodegenerative and vascular diseases. APOE genotypes(APOE ε2, APOE ε3, and APOE ε4) were implicated in common mechanisms underlying a wide spectrum of neurodegenerative diseases, including sporadic Alzheimer's disease, synucleinopathies such as Parkinson's disease and Lewy body disease, stroke, and traumatic brain injury. These shared pathways often involved neuroinflammation, abnormal protein accumulation, or responses to acute detrimental events. Across these conditions, APOE variants are believed to contribute to the modulation of inflammatory responses, the regulation of amyloid and tau pathology, as well as the clearance of proteins such as α-synuclein. The bidirectional interactions among Apo E, amyloid and mitochondrial metabolism, immunomodulatory effects, neuronal repair, and remodeling underscored the complexity of Apo E's role in neuropsychiatric symptoms associated with these conditions since from early phases of cognitive impairment such as mild cognitive impairment and mild behavioral impairment. Besides Apo E-specific isoforms' link to increased neuropsychiatric symptoms in Alzheimer's disease(depression, psychosis, aberrant motor behaviors, and anxiety, not apathy), the APOE ε4 genotype was also considered a significant genetic risk factor for Lewy body disease and its worse cognitive outcomes. Conversely, the APOE ε2 variant has been observed not to exert a protective effect equally in all neurodegenerative diseases. Specifically, in Lewy body disease, this variant may delay disease onset, paralleling its protective role in Alzheimer's disease, although its role in frontotemporal dementia is uncertain. The APOE ε4 genotype has been associated with adverse cognitive outcomes across other various neurodegenerative conditions. In Parkinson's disease, the APOE ε4 allele significantly impacted cognitive performance, increasing the risk of developing dementia, even in cases of pure synucleinopathies with minimal co-pathology from Alzheimer's disease. Similarly, in traumatic brain injury, recovery rates varied, with APOE ε4 carriers demonstrating a greater risk of poor long-term cognitive outcomes and elevated levels of neuropsychiatric symptoms. Furthermore, APOE ε4 influenced the age of onset and severity of stroke, as well as the likelihood of developing stroke-associated dementia, potentially due to its role in compromising endothelial integrity and promoting blood–brain barrier dysfunction.
文摘Background The diagnostic delay of cardiac amyloidosis(CA)is known to be substantially long.A prolonged time from symptoms onset to diagnosis negatively impacts quality of life and life expectancy of the affected patients.We aim to describe the role of the incidental finding of amyloid deposits in prostatic tissue as an early marker of CA.Methods A systematic cardiological evaluation,comprising ECG,echocardiogram and 99mTc-DPD scintigraphy,was offered to a cohort of 19 patients with incidental prostatic amyloidosis(PA)findings,propectively detected between 2014-2023,to assess cardiac involvement.Results The median age of the patients was 80.2 years(IQR:74.9-82.6 years).Histopathological study revealed amyloid deposits within the walls of small vessels(predominantly small arteries)in 18 patients and mainly in the stroma in the remaining case.All of them were immunohistochemically positive for transthyretin(ATTR)except one patient,with known myeloma,which was unconclusive fo ATTR.Clonal dyscrasia was excluded in the rest of the patients.Thirteen patients(68.4%)underwent all cardiological tests,4 patients(21.1%)underwent only ECG and echocardiographic evaluation and two patients(10.5%)refused to undergo any cardiological study.Among 13 individuals undergoing the complete evaluation,six patients were eventually diagnosed with CA(46.15%).All of them were asymptomatic from a cardiovascular point of view at the time of the prostate biopsy.Conclusion The finding of PA should prompt a complete cardiovascular examination,given the significant percentage of patients eventually diagnosed with early-stage CA.Multidisciplinary collaboration among different medical specialists must be encouraged,given the potential clinical impact of CA early diagnosis.
基金supported by the National Key Research and Development Program of China(2023YFB3208102,2021YFB3200304)the National Natural Science Foundation of China(52073031)+2 种基金Beijing Nova Program(Z211100002121148)Fundamental Research Funds for the Central Universities(E0EG6801X2)the‘Hundred Talents Program’of the Chinese Academy of Sciences.
文摘The use of water resources for energy generation has become increasingly prevalent,encompassing the conversion of kinetic energy from streams,tides,and waves into renewable electrical power.Water energy sources offer numerous benefits,including widespread availability,stability,and the absence of carbon dioxide and other greenhouse gas emissions,making them a clean and environmentally friendly form of energy.In this work,we develop a droplet-based liquid-solid triboelectric nanogenerator(LS-TENG)using sophisticatedly designed inflatable columnar structures with inner and outer dual-electrodes.This device can be utilized to harvest both the internal droplet-rolling mechanical energy and the external droplet-falling mechanical energy,capable of being assembled into various structures for versatile applications.The design incorporates a combined structure of both internal and external TENG to optimize output performance via multiple energy harvesting strategies.The internal structure features a dual-electrode columnar-shaped LS-TENG,designed to harvest fluid kinetic energy from water droplets.By leveraging the back-and-forth motion of a small amount of water within the air column,mechanical energy can be readily collected,achieving a maximum mass power density of 9.02 W·Kg^(−1)and an energy conversion efficiency of 10.358%.The external component is a droplet-based LS-TENG,which utilizes a double-layer capacitor switch effect elucidated with an equivalent circuit model.Remarkably,without the need for pre-charging,a single droplet can generate over 140 V of high voltage,achieving a maximum power density of 7.35 W·m^(−2)and an energy conversion efficiency of 22.058%.The combined LS-TENG with a sophisticated inflatable columnar structure can simultaneously collect multiple types of energy with high efficacy,exhibiting great significance in potential applications such as TENG aeration rollers,inflatable lifejacket,wind energy harvesting,TENG tents,and green houses.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘Type 1 diabetes(T1D)is a chronic organ-specific autoimmune disorder characterized by a progressive loss of the insulin-secreting pancreatic beta cells,which ultimately results in insulinopenia,hyperglycemia and lifelong need for exogenous insulin therapy.In the pathophysiological landscape of T1D,T helper 17 cells(Th17 cells)and their hallmark cytokine,interleukin(IL)-17,play pivotal roles from disease onset to disease progression.In this narrative mini-review,we discuss the dynamic interplay between Th17 cells and IL-17 in the context of T1D,providing insights into the underlying immunologic mechanisms contributing to the IL-17-immunity-mediated pancreatic beta-cell destruction.Furthermore,we summarized the main animal and clinical studies that investigated Th17-and IL-17-targeted interventions as promising immunotherapies able to alter the natural history of T1D.
文摘Nonalcoholic fatty liver disease(NAFLD)is becoming rapidly one of the most common indications for orthotopic liver transplantation in the world.Development of graft steatosis is a significant problem during the posttransplant course,which may happen as a recurrence of pre-existing disease or de novo NAFLD.There are different risk factors that might play a role in development of graft steatosis including post-transplant metabolic syndrome,immune-suppressive medications,genetics and others.There are few studies that assessed the effects of NAFLD on graft and patient survival;most of them were limited by the duration of follow up or by the number of patients.With this review article we will try to shed light on post-liver transplantation NAFLD,significance of the disease,how it develops,risk factors,clinical course and treatment options.
文摘AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES) 1988-1994, NAFLD participants aged 20 or greater without any other liver diseases were included in this study. Excessive alcohol intake is defined as > 2 drinks per day for males and > 1 drink per day for females. C-peptide and 27 other factors known to be associated with NAFLD(e.g., age, gender, body mass index, waist circumference, race/ethnicity, liver chemistries, and other diabetes tests) were tested in both univariate and multivariate level using logistic regression with a P-value 0.05.RESULTS Of 18825 participants aged ≥ 20, 3235 participants(n = 3235) met inclusion criteria. There were 23 factors associated with NAFLD by univariate analysis. 9 factors, ranked by the highest change in pseudo R2, were found to be significant predictors of NAFLD in multivariate model: waist circumference, fasting C-peptide, natural log of alanine aminotransferase(ALT), total protein, beingMexican American, natural log of glycated hemoglobin, triglyceride level, being non-Hispanic white, and ferritin level. CONCLUSION Together with waist circumference and ALT, fasting C-peptide is among three most important predictors of NAFLD in United States population in the NHANES data set. Further study is needed to validate the clinical utility of fasting C-peptide in diagnosis or monitoring insulin resistance in NAFLD patients.
文摘Hepatocellular carcinoma(HCC)is the most common form of liver cancer worldwide.It is caused by a variety of risk factors,most common ones being infection with hepatitis viruses,alcohol,and obesity.HCC often develops in the background of underlying cirrhosis,and even though a number of interventional treatment methods are currently in use,recurrence is fairly common among patients who have had a resection.Therefore,whole liver transplantation remains the most practical treatment option for HCC.Due to the growing incidence of HCC,intense research efforts are being made to understand cellular and molecular mechanisms of the disease so that novel therapeutic strategies can be developed to combat liver cancer.In recent years,it has become clear that innate immunity plays a critical role in the development of a number of liver diseases,including HCC.In particular,the activation of Toll-like receptor signaling results in the generation of immune responses that often results in the production of proinflammatory cytokines and chemokines,and could cause acute inflammation in the liver.In this review,the current knowledge on the role of innate immune responses in the development and progression of HCC is examined,and emerging therapeutic strategies based on molecular mechanisms of HCC are discussed.
基金Supported by Emirates Gastroenterology and Hepatology Society,No.001802.
文摘Ulcerative colitis and Crohn’s disease are the main entities of inflammatory bowel disease characterized by chronic remittent inflammation of the gastrointestinal tract.The incidence and prevalence are on the rise worldwide,and the heterogeneity between patients and within individuals over time is striking.The progressive advance in our understanding of the etiopathogenesis coupled with an unprecedented increase in therapeutic options have changed the management towards evidence-based interventions by clinicians with patients.This guideline was stimulated and supported by the Emirates Gastroenterology and Hepatology Society following a systematic review and a Delphi consensus process that provided evidence-and expert opinion-based recommendations.Comprehensive up-to-date guidance is provided regarding diagnosis,evaluation of disease severity,appropriate and timely use of different investigations,choice of appropriate therapy for induction and remission phase according to disease severity,and management of main complications.
