To quantify the seismic effectiveness of the most commonly used fishing line tie up method for securing museum collections and optimize fixed strategies for exhibitions,shaking table tests of the seismic systems used ...To quantify the seismic effectiveness of the most commonly used fishing line tie up method for securing museum collections and optimize fixed strategies for exhibitions,shaking table tests of the seismic systems used for typical museum collection replicas have been carried out.The influence of body shape and fixed measure parameters on the seismic responses of replicas and the interaction behavior between replicas and fixed measures have been explored.Based on the results,seismic effectiveness evaluation indexes of the tie up method are proposed.Reasonable suggestions for fixed strategies are given,which provide a basis for the exhibition of delicate museum collections considering the principle of minimizing seismic responses and intervention.The analysis results show that a larger ratio of height of mass center to bottom diameter led to more intense rocking responses.Increasing the initial pretension of fishing lines was conducive to reducing the seismic responses and stress variation of the lines.Through comprehensive consideration of the interaction forces and effective securement,it is recommended to apply 20%of breaking stress as the initial pretension.For specific museum collections that cannot be effectively protected by the independent tie up method,an optimized strategy of a combination of fishing lines and fasteners is recommended.展开更多
BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinica...BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinical course of AP.It could worsen symptoms and potentially lead to additional complications.However,clinical evidence regarding the specific association between APFC and early readmission in AP remains scarce.Understanding the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare costs.AIM To evaluate the association between APFC and 30-day readmission in patients with AP.METHODS This retrospective cohort study is based on the Nationwide Readmission Database for 2016-2019.Patients with a primary diagnosis of AP were identified.Participants were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was performed.The primary outcome was early readmission rates.Secondary outcomes included the incidence of inpatient complications and healthcare utilization.Unadjusted analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission risks.RESULTS A total of 673059 patients with the principal diagnosis of AP were included.Of these,5.1%had APFC on initial admission.After propensity score matching,each cohort consisted of 33914 patients.Those with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APFC group also had higher readmission charges($28282 vs$22865,P<0.001).The presence of APFC increased the risk of readmission twofold(aHR 2.52,95%confidence interval:2.40-2.65,P<0.001).The independent risk factors for 30-day readmission included female gender,Elixhauser Comorbidity Index≥3,chronic pulmonary diseases,chronic renal disease,protein-calorie malnutrition,substance use disorder,depression,portal and splenic venous thrombosis,and certain endoscopic procedures.CONCLUSION Developing APFC during index hospitalization for AP is linked to higher readmission rates,more inpatient complications,longer LOS,and increased healthcare costs.Knowing predictors of readmission can help target high-risk patients,reducing healthcare burdens.展开更多
The motivation for this study is that the quality of deep fakes is constantly improving,which leads to the need to develop new methods for their detection.The proposed Customized Convolutional Neural Network method in...The motivation for this study is that the quality of deep fakes is constantly improving,which leads to the need to develop new methods for their detection.The proposed Customized Convolutional Neural Network method involves extracting structured data from video frames using facial landmark detection,which is then used as input to the CNN.The customized Convolutional Neural Network method is the date augmented-based CNN model to generate‘fake data’or‘fake images’.This study was carried out using Python and its libraries.We used 242 films from the dataset gathered by the Deep Fake Detection Challenge,of which 199 were made up and the remaining 53 were real.Ten seconds were allotted for each video.There were 318 videos used in all,199 of which were fake and 119 of which were real.Our proposedmethod achieved a testing accuracy of 91.47%,loss of 0.342,and AUC score of 0.92,outperforming two alternative approaches,CNN and MLP-CNN.Furthermore,our method succeeded in greater accuracy than contemporary models such as XceptionNet,Meso-4,EfficientNet-BO,MesoInception-4,VGG-16,and DST-Net.The novelty of this investigation is the development of a new Convolutional Neural Network(CNN)learning model that can accurately detect deep fake face photos.展开更多
BACKGROUND Percutaneous drainage(PCD)and endoscopic approaches have largely replaced surgical drainage as the initial approach for(peri)pancreatic fluid collections(PFC)s,while complications associated with endoscopic...BACKGROUND Percutaneous drainage(PCD)and endoscopic approaches have largely replaced surgical drainage as the initial approach for(peri)pancreatic fluid collections(PFC)s,while complications associated with endoscopic stent implantation are common.AIM To introduce a novel endoscopic therapy named endoscopic transgastric fenestration(ETGF),which involves resection of tissue by endoscopic accessory between gastric and PFCs without stent implantation,and to evaluate its efficacy and safety compared with PCD for the management of PFCs adjacent to the gastric wall.METHODS Patients diagnosed with PFCs adjacent to the gastric wall and who subsequently received ETGF or PCD were restrospectively enrolled.Indications for intervention were consistent with related guidelines.We analyzed patients baseline characteristics,technical and clinical success rate,recurrence and reintervention rate,procedure-related complications and adverse events.RESULTS Seventy-two eligible patients were retrospectively identified(ETGF=34,PCD=38)from October 2017 to May 2021.Patients in the ETGF group had a significantly higher clinical success rate than those in the PCD group(97.1 vs 76.3%,P=0.01).There were no statistically significant differences regarding recurrence,reintervention and incidence of complication between the two groups.While long-term catheter drainage was very common in the PCD group.CONCLUSION Compared with PCD,ETGF has a higher clinical success rate in the management of PFCs adjacent to the gastric wall.ETGF is an alternative effective strategy for the treatment of PFCs adjacent to the gastric wall.展开更多
Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liqui...Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled.展开更多
Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid co...Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid collections include acute fluid collections, acute and chronic pancreatic pseudocysts, pancreatic abscesses and pancreatic necrosis. Before the introduction of linear endoscopic ultrasound (EUS) in the 1990s and the subsequent development of endoscopic ultrasound-guided drainage (EUS-GD) procedures, the available options for drainage in symptomatic PFCs included surgical drainage, percutaneous drainage using radiological guidance and conventional endoscopic transmural drainage. In recent years, it has gradually been recog-nized that, due to its lower morbidity rate compared to the surgical and percutaneous approaches, endoscopic treatment may be the preferred first-line approach for managing symptomatic PFCs. Endoscopic ultrasound-guided drainage has the following advantages, when compared to other alternatives such as surgical, per-cutaneous and non-EUS-guided endoscopic drainage.EUS-GD is less invasive than surgery and therefore does not require general anesthesia. The morbidity rate is lower, recovery is faster and the costs are lower. EUS-GD can avoid local complications related to per-cutaneous drainage. Because the endoscope is placed adjacent to the fluid collection, it can have direct ac-cess to the fluid cavity, unlike percutaneous drainage which traverses the abdominal wall. Complications such as bleeding, inadvertent puncture of adjacent viscera, secondary infection and prolonged periods of drainage with resultant pancreatico-cutaneous fistulae may be avoided. The only difference between EUS and non-EUS drainage is the initial step, namely, gaining access to the pancreatic fluid collection. All the sub-sequent steps are similar, i.e., insertion of guide-wires with fluoroscopic guidance, balloon dilatation of the cystogastrostomy and insertion of transmural stents or nasocystic catheters. With the introduction of the EUS-scope equipped with a large operative channel which permits drainage of the PFCs in 'one step', EUS-GD has been increasingly carried out in many tertiary care centers and has expanded the safety and efficacy of this modality, allowing access to and drainage of overly challenging fluid collections. However, the nature of the PFCs determines the outcome of this procedure. The technique and review of current literature regarding EUS-GD of PFCs will be discussed.展开更多
Endoscopic ultrasound(EUS) guided drainage of pancreatic fluid collections(PFC) has become increasingly popular and become first line management option in many centers. Use of therapeutic echoendoscopes has greatly in...Endoscopic ultrasound(EUS) guided drainage of pancreatic fluid collections(PFC) has become increasingly popular and become first line management option in many centers. Use of therapeutic echoendoscopes has greatly increased the applicability of EUS guided transmural drainage. Drainage is indicated in symptomatic PFCs, PFC related infection, bleed, luminal obstruction, fistulization and biliary obstruction. EUS guided transmural drainage of PFCs is preferred in patients with non bulging lesions, portal hypertension, bleeding tendency and in those whom conventional drainage has failed. In the present decade significant progress has been made in minimally invasive endoscopic techniques. There are newer stent designs, access devices and techniques for more efficient drainage of PFCs. In this review, we discuss the EUS guided drainage of PFCs in acute pancreatitis.展开更多
Background: Endoscopic ultrasound (EUS)-guided drainage is the preferred approach for drainage of pan- creatic uid collections (PFCs) due to the better experience and signi cant progress using newer stents and access ...Background: Endoscopic ultrasound (EUS)-guided drainage is the preferred approach for drainage of pan- creatic uid collections (PFCs) due to the better experience and signi cant progress using newer stents and access devices during last decade. This study aimed to evaluate the role of the evolving experience and possible in uence of new technological devices on the outcome of patients evaluated for PFCs and submitted to EUS-guided drainage during two different periods: the early period at the beginning of experience when a standardized technique was used and the late period when the increased experience of the operator, combined with different stents quality were introduced in the management of PFCs. Methods: We retrospectively analyzed the clinical data of a cohort of 91 consecutive patients, who underwent EUS-guided drainage of symptomatic PFCs from October 2001 to September 2017. Demographic, therapeutic results, complications, and outcomes were compared between early years’ group (2001 2008) and late years’ group (2009 2017). Results: Endoscopic treatment was successfully achieved in 55.6% (20/36) of patients in the early years’ group, and in 96.4% (53/55) in the late years’ group. Eighteen patients (12 in early years’ and 6 in the late year’s group) required additional open surgery. Procedural complications were observed in 5 patients, 4 in early years’ and 1 in late years’ group. Mortality was registered in two patients (2.2%), one for each group. Conclusions: During our long-term survey using EUS-guided endoscopic drainage of PFCs, signi cantly better outcomes in term of improved success rate and decrease complications rate were observed during the late period.展开更多
Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ul...Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ultrasound(EUS)-guided drainage is often considered a standard first-line therapy preferable to surgical or interventional radiology approaches for patients with symptomatic PFC.EUS-guided drainage is effective and successful;it has a technical success rate of90%-100%and a clinical success rate of 85%-98%.Recent studies have shown a 5%-30%adverse events(AEs)rate for the procedure.The most common AEs include infection,hemorrhage,perforation and stent migration.Hemorrhage,a severe and sometimes deadly outcome,requires a well-organized and appropriate treatment strategy.However,few studies have reported the integrated management of hemorrhage during EUS-guided drainage of PFC.Establishing a practical therapeutic strategy is an essential and significant step in standardized management.The aim of this review is to describe the current situation of EUS-guided drainage of PFCs,including the etiology and treatment of procedure-related bleeding as well as current problems and future perspectives.We propose a novel and meaningful algorithm for systematically managing hemorrhage events.To our limited knowledge,a multidisciplinary algorithm for managing EUS-guided drainage for PFC-related bleeding has not been previously reported.展开更多
Moderately severe and severe acute pancreatitis is characterized by local and systemic complications.Systemic complications predominate the early phase of acute pancreatitis while local complications are important in ...Moderately severe and severe acute pancreatitis is characterized by local and systemic complications.Systemic complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the disease.Necrotic fluid collections represent the most important local complication.Drainage of these collections is indicated in the setting of infection,persistent or new onset organ failure,compressive or pressure symptoms,and intraabdominal hypertension.Percutaneous,endoscopic,and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and disadvantages.These methods are often complementary.In this minireview,we discuss the indications,timing,and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter drainage.We also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage.展开更多
In the realities of the modern world, when the natural habitat is rapidly disappearing and the number of imperiled plants is constantly growing, ex situ conservation is gaining importance. To meet this challenge, bota...In the realities of the modern world, when the natural habitat is rapidly disappearing and the number of imperiled plants is constantly growing, ex situ conservation is gaining importance. To meet this challenge, botanic gardens need to revise both their strategic goals and their methodologies to achieve the new goals. This paper proposes a strategy for the management of threatened plants in living collections,which includes setting regional conservation priorities for the species, creation of genetically representative collections for the high priority species, and usage of these collections in in situ actions. In this strategy, the value of existing and future species living collections for conservation is determined by the species' conservation status and how well the accessions represent their natural genetic variation.展开更多
The TECHNOSEUM in Mannheim is one of the biggest museums in continental Europe dealing withthe history of industrialization and its consequences. It shows the "roots of prosperity" which has made巳aden-Wurttemberg t...The TECHNOSEUM in Mannheim is one of the biggest museums in continental Europe dealing withthe history of industrialization and its consequences. It shows the "roots of prosperity" which has made巳aden-Wurttemberg to the most successful economic region in Germany. Synchronous, the collections representrequirements and steps of the development of industry and society in the last three hundred years. Thefocus of collection on exhibits you can call as "technical culture goods" tells about living and working conditionsin past and present. These include inter tools, working places and machines, measure instruments,means of transport and communication, goods of trade and mass production, but also furniture, domestic appliance,clothes, packages or advertising products. They are not only residues of economic and industrial lifebut also evidence of families, societies and organizations as part of scientific work and research.展开更多
Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal...Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal. The frequent lack of a con- scious design for how collections fit together is of equal concern because it means that research libraries are not making the most of the substantial investments they are making in digital initiatives. This paper proposes a framework for a research library’s digital collections that offers integrated discovery and a set of best practices to underpin collection building, federated access, and sus- tainability. The framework’s purpose is to give information seekers a powerful and easy way to search across existing and future collections and to retrieve integrated sets of results. The paper and its recommendations are based upon research undertaken by the author and a team of librarians and technologists at Cornell University Library. The team conducted structured interviews of forty-five library staff members involved in digital collection building at Cornell, studied an inventory of the library’s more than fifty digital collections, and evaluated seven existing Open Archives Initiative (OAI) and federated search production or prototype systems. The author will discuss her team’s research and the rationale for their recommendations to: present a cohesive view of the library’s digital collections for both browsing and searching at the object level; take a programmatic (rather than project-based) approach to digital collection building; require that all new digital collections conform to library-developed and agreed-upon OAI best practices for data providers; and implement organizational structures to sustain the library’s digital collections over the long term.展开更多
A vast quantity of art in existence today is inaccessible to individuals.If people want to know the different types of art that exist,how individual works are connected,and how works of art are interpreted and discuss...A vast quantity of art in existence today is inaccessible to individuals.If people want to know the different types of art that exist,how individual works are connected,and how works of art are interpreted and discussed in the context of other works,they must utilize means other than simply viewing the art.Therefore,this paper proposes a language to analyze,describe,and explore collections of visual art(LadeCA).LadeCA combines human interpretation and automatic analyses of images,allowing users to assess collections of visual art without viewing every image in them.This paper focuses on the lexical base of LadeCA.It also outlines how collections of visual art can be analyzed,described,and explored using a LadeCA vocabulary.Additionally,the relationship between LadeCA and indexing systems,such as ICONCLASS or AAT,is demonstrated,and ways in which LadeCA and indexing systems can complement each other are highlighted.展开更多
BACKGROUND Endoscopic ultrasound(EUS)-guided transluminal drainage is an advanced technique used to treat pancreatic fluid collections(PFCs). However, gastric varices and intervening vessels may be associated with a h...BACKGROUND Endoscopic ultrasound(EUS)-guided transluminal drainage is an advanced technique used to treat pancreatic fluid collections(PFCs). However, gastric varices and intervening vessels may be associated with a high risk of bleeding and are, therefore, listed as relative contraindications. Herein, we report two patients who underwent interventional embolization before EUS-guided drainage.CASE SUMMARY Two 32-year-old males developed symptomatic PFCs after acute pancreatitis and came to our hospital for further treatment. One patient suffered from intermittent abdominal pain and vomiting, and computed tomography(CT) imaging showed an encapsulated cyst 7.93 cm × 6.13 cm in size. The other patient complained of a mass inside the abdomen, which gradually became enlarged. Gastric varices around the ideal puncture site were detected by EUS when we evaluated the possibility of endoscopic drainage in both patients. Interventional embolization was recommended as the first procedure to decrease the risk of bleeding. After that, EUS-guided transluminal drainage was successfully conducted, without vascular rupture. No postoperative complications occurred during hospitalization, and no recurrence was detected at the last follow-up CT scan performed at 1 mo.CONCLUSION Interventional embolization is a safe, preoperative procedure that is performed before EUS-guided drainage in PFC patients with gastric varices or at high risk of bleeding.展开更多
In this paper, we propose an automatic classification for various images collections using two stage clustering method. Here, we have used global and local image features. First, we review about various types of featu...In this paper, we propose an automatic classification for various images collections using two stage clustering method. Here, we have used global and local image features. First, we review about various types of feature vector that is suita-ble to represent local and global properties of images, and similarity measures that can be represented an affinity be-tween these images. Second, we consider a clustering method for image collection. Here, we first build a coarser clus-tering by partitioning various images into several clusters using the flexible Mean shift algorithm and K-mean cluster-ing algorithm. Second, we construct dense clustering of images collection by optimizing a Gaussian Dirichlet process mixture model taking initial clusters as given coarser clustering. Finally, we have conducted the comparative experi-ments between our method and existing methods on various images datasets. Our approach has significant advantage over existing techniques. Besides integrating temporal and image content information, our approach can cluster auto-matically photographs without some assumption about number of clusters or requiring a priori information about initial clusters and it can also generalize better to different image collections.展开更多
According to an FAO report in 1996,49000 cotton genotypes are being maintained in germplasm collections worldwide. Of these accessions,approximately 67% reside in the six largest collections. Identification of mutual ...According to an FAO report in 1996,49000 cotton genotypes are being maintained in germplasm collections worldwide. Of these accessions,approximately 67% reside in the six largest collections. Identification of mutual opportunities and challenges faced by these germplasm banks could result展开更多
In early 2009, I had the chance to visit six Japanese university libraries or museums, which house 15 cuneiform tablets, seven royal inscriptions and one cylinder seal. Most of them seem to have been acquired from some
基金Beijing Nova Program under Grant No.2022036National Key Research and Development Program under Grant No.2019YFC1521000。
文摘To quantify the seismic effectiveness of the most commonly used fishing line tie up method for securing museum collections and optimize fixed strategies for exhibitions,shaking table tests of the seismic systems used for typical museum collection replicas have been carried out.The influence of body shape and fixed measure parameters on the seismic responses of replicas and the interaction behavior between replicas and fixed measures have been explored.Based on the results,seismic effectiveness evaluation indexes of the tie up method are proposed.Reasonable suggestions for fixed strategies are given,which provide a basis for the exhibition of delicate museum collections considering the principle of minimizing seismic responses and intervention.The analysis results show that a larger ratio of height of mass center to bottom diameter led to more intense rocking responses.Increasing the initial pretension of fishing lines was conducive to reducing the seismic responses and stress variation of the lines.Through comprehensive consideration of the interaction forces and effective securement,it is recommended to apply 20%of breaking stress as the initial pretension.For specific museum collections that cannot be effectively protected by the independent tie up method,an optimized strategy of a combination of fishing lines and fasteners is recommended.
文摘BACKGROUND Patients with acute pancreatitis(AP)frequently experience hospital readmissions,posing a significant burden to healthcare systems.Acute peripancreatic fluid collection(APFC)may negatively impact the clinical course of AP.It could worsen symptoms and potentially lead to additional complications.However,clinical evidence regarding the specific association between APFC and early readmission in AP remains scarce.Understanding the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare costs.AIM To evaluate the association between APFC and 30-day readmission in patients with AP.METHODS This retrospective cohort study is based on the Nationwide Readmission Database for 2016-2019.Patients with a primary diagnosis of AP were identified.Participants were categorized into those with and without APFC.A 1:1 propensity score matching for age,gender,and Elixhauser comorbidities was performed.The primary outcome was early readmission rates.Secondary outcomes included the incidence of inpatient complications and healthcare utilization.Unadjusted analyses used Mann-Whitney U andχ2 tests,while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios(aHR).Kaplan-Meier curves and log-rank tests verified readmission risks.RESULTS A total of 673059 patients with the principal diagnosis of AP were included.Of these,5.1%had APFC on initial admission.After propensity score matching,each cohort consisted of 33914 patients.Those with APFC showed a higher incidence of inpatient complications,including septic shock(3.1%vs 1.3%,P<0.001),portal venous thrombosis(4.4%vs 0.8%,P<0.001),and mechanical ventilation(1.8%vs 0.9%,P<0.001).The length of stay(LOS)was longer for APFC patients[4(3-7)vs 3(2-5)days,P<0.001],as were hospital charges($29451 vs$24418,P<0.001).For 30-day readmissions,APFC patients had a higher rate(15.7%vs 6.5%,P<0.001)and a longer median readmission LOS(4 vs 3 days,P<0.001).The APFC group also had higher readmission charges($28282 vs$22865,P<0.001).The presence of APFC increased the risk of readmission twofold(aHR 2.52,95%confidence interval:2.40-2.65,P<0.001).The independent risk factors for 30-day readmission included female gender,Elixhauser Comorbidity Index≥3,chronic pulmonary diseases,chronic renal disease,protein-calorie malnutrition,substance use disorder,depression,portal and splenic venous thrombosis,and certain endoscopic procedures.CONCLUSION Developing APFC during index hospitalization for AP is linked to higher readmission rates,more inpatient complications,longer LOS,and increased healthcare costs.Knowing predictors of readmission can help target high-risk patients,reducing healthcare burdens.
基金Science and Technology Funds from the Liaoning Education Department(Serial Number:LJKZ0104).
文摘The motivation for this study is that the quality of deep fakes is constantly improving,which leads to the need to develop new methods for their detection.The proposed Customized Convolutional Neural Network method involves extracting structured data from video frames using facial landmark detection,which is then used as input to the CNN.The customized Convolutional Neural Network method is the date augmented-based CNN model to generate‘fake data’or‘fake images’.This study was carried out using Python and its libraries.We used 242 films from the dataset gathered by the Deep Fake Detection Challenge,of which 199 were made up and the remaining 53 were real.Ten seconds were allotted for each video.There were 318 videos used in all,199 of which were fake and 119 of which were real.Our proposedmethod achieved a testing accuracy of 91.47%,loss of 0.342,and AUC score of 0.92,outperforming two alternative approaches,CNN and MLP-CNN.Furthermore,our method succeeded in greater accuracy than contemporary models such as XceptionNet,Meso-4,EfficientNet-BO,MesoInception-4,VGG-16,and DST-Net.The novelty of this investigation is the development of a new Convolutional Neural Network(CNN)learning model that can accurately detect deep fake face photos.
基金Zhongyuan Talent Program,No.ZYYCYU202012113The Key R and D Program of Henan Province,No.222102310038.
文摘BACKGROUND Percutaneous drainage(PCD)and endoscopic approaches have largely replaced surgical drainage as the initial approach for(peri)pancreatic fluid collections(PFC)s,while complications associated with endoscopic stent implantation are common.AIM To introduce a novel endoscopic therapy named endoscopic transgastric fenestration(ETGF),which involves resection of tissue by endoscopic accessory between gastric and PFCs without stent implantation,and to evaluate its efficacy and safety compared with PCD for the management of PFCs adjacent to the gastric wall.METHODS Patients diagnosed with PFCs adjacent to the gastric wall and who subsequently received ETGF or PCD were restrospectively enrolled.Indications for intervention were consistent with related guidelines.We analyzed patients baseline characteristics,technical and clinical success rate,recurrence and reintervention rate,procedure-related complications and adverse events.RESULTS Seventy-two eligible patients were retrospectively identified(ETGF=34,PCD=38)from October 2017 to May 2021.Patients in the ETGF group had a significantly higher clinical success rate than those in the PCD group(97.1 vs 76.3%,P=0.01).There were no statistically significant differences regarding recurrence,reintervention and incidence of complication between the two groups.While long-term catheter drainage was very common in the PCD group.CONCLUSION Compared with PCD,ETGF has a higher clinical success rate in the management of PFCs adjacent to the gastric wall.ETGF is an alternative effective strategy for the treatment of PFCs adjacent to the gastric wall.
文摘Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled.
文摘Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid collections include acute fluid collections, acute and chronic pancreatic pseudocysts, pancreatic abscesses and pancreatic necrosis. Before the introduction of linear endoscopic ultrasound (EUS) in the 1990s and the subsequent development of endoscopic ultrasound-guided drainage (EUS-GD) procedures, the available options for drainage in symptomatic PFCs included surgical drainage, percutaneous drainage using radiological guidance and conventional endoscopic transmural drainage. In recent years, it has gradually been recog-nized that, due to its lower morbidity rate compared to the surgical and percutaneous approaches, endoscopic treatment may be the preferred first-line approach for managing symptomatic PFCs. Endoscopic ultrasound-guided drainage has the following advantages, when compared to other alternatives such as surgical, per-cutaneous and non-EUS-guided endoscopic drainage.EUS-GD is less invasive than surgery and therefore does not require general anesthesia. The morbidity rate is lower, recovery is faster and the costs are lower. EUS-GD can avoid local complications related to per-cutaneous drainage. Because the endoscope is placed adjacent to the fluid collection, it can have direct ac-cess to the fluid cavity, unlike percutaneous drainage which traverses the abdominal wall. Complications such as bleeding, inadvertent puncture of adjacent viscera, secondary infection and prolonged periods of drainage with resultant pancreatico-cutaneous fistulae may be avoided. The only difference between EUS and non-EUS drainage is the initial step, namely, gaining access to the pancreatic fluid collection. All the sub-sequent steps are similar, i.e., insertion of guide-wires with fluoroscopic guidance, balloon dilatation of the cystogastrostomy and insertion of transmural stents or nasocystic catheters. With the introduction of the EUS-scope equipped with a large operative channel which permits drainage of the PFCs in 'one step', EUS-GD has been increasingly carried out in many tertiary care centers and has expanded the safety and efficacy of this modality, allowing access to and drainage of overly challenging fluid collections. However, the nature of the PFCs determines the outcome of this procedure. The technique and review of current literature regarding EUS-GD of PFCs will be discussed.
文摘Endoscopic ultrasound(EUS) guided drainage of pancreatic fluid collections(PFC) has become increasingly popular and become first line management option in many centers. Use of therapeutic echoendoscopes has greatly increased the applicability of EUS guided transmural drainage. Drainage is indicated in symptomatic PFCs, PFC related infection, bleed, luminal obstruction, fistulization and biliary obstruction. EUS guided transmural drainage of PFCs is preferred in patients with non bulging lesions, portal hypertension, bleeding tendency and in those whom conventional drainage has failed. In the present decade significant progress has been made in minimally invasive endoscopic techniques. There are newer stent designs, access devices and techniques for more efficient drainage of PFCs. In this review, we discuss the EUS guided drainage of PFCs in acute pancreatitis.
文摘Background: Endoscopic ultrasound (EUS)-guided drainage is the preferred approach for drainage of pan- creatic uid collections (PFCs) due to the better experience and signi cant progress using newer stents and access devices during last decade. This study aimed to evaluate the role of the evolving experience and possible in uence of new technological devices on the outcome of patients evaluated for PFCs and submitted to EUS-guided drainage during two different periods: the early period at the beginning of experience when a standardized technique was used and the late period when the increased experience of the operator, combined with different stents quality were introduced in the management of PFCs. Methods: We retrospectively analyzed the clinical data of a cohort of 91 consecutive patients, who underwent EUS-guided drainage of symptomatic PFCs from October 2001 to September 2017. Demographic, therapeutic results, complications, and outcomes were compared between early years’ group (2001 2008) and late years’ group (2009 2017). Results: Endoscopic treatment was successfully achieved in 55.6% (20/36) of patients in the early years’ group, and in 96.4% (53/55) in the late years’ group. Eighteen patients (12 in early years’ and 6 in the late year’s group) required additional open surgery. Procedural complications were observed in 5 patients, 4 in early years’ and 1 in late years’ group. Mortality was registered in two patients (2.2%), one for each group. Conclusions: During our long-term survey using EUS-guided endoscopic drainage of PFCs, signi cantly better outcomes in term of improved success rate and decrease complications rate were observed during the late period.
文摘Pancreatic fluid collections(PFCs),common sequelae of acute or chronic pancreatitis,are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification.Endoscopic ultrasound(EUS)-guided drainage is often considered a standard first-line therapy preferable to surgical or interventional radiology approaches for patients with symptomatic PFC.EUS-guided drainage is effective and successful;it has a technical success rate of90%-100%and a clinical success rate of 85%-98%.Recent studies have shown a 5%-30%adverse events(AEs)rate for the procedure.The most common AEs include infection,hemorrhage,perforation and stent migration.Hemorrhage,a severe and sometimes deadly outcome,requires a well-organized and appropriate treatment strategy.However,few studies have reported the integrated management of hemorrhage during EUS-guided drainage of PFC.Establishing a practical therapeutic strategy is an essential and significant step in standardized management.The aim of this review is to describe the current situation of EUS-guided drainage of PFCs,including the etiology and treatment of procedure-related bleeding as well as current problems and future perspectives.We propose a novel and meaningful algorithm for systematically managing hemorrhage events.To our limited knowledge,a multidisciplinary algorithm for managing EUS-guided drainage for PFC-related bleeding has not been previously reported.
文摘Moderately severe and severe acute pancreatitis is characterized by local and systemic complications.Systemic complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the disease.Necrotic fluid collections represent the most important local complication.Drainage of these collections is indicated in the setting of infection,persistent or new onset organ failure,compressive or pressure symptoms,and intraabdominal hypertension.Percutaneous,endoscopic,and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and disadvantages.These methods are often complementary.In this minireview,we discuss the indications,timing,and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter drainage.We also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage.
文摘In the realities of the modern world, when the natural habitat is rapidly disappearing and the number of imperiled plants is constantly growing, ex situ conservation is gaining importance. To meet this challenge, botanic gardens need to revise both their strategic goals and their methodologies to achieve the new goals. This paper proposes a strategy for the management of threatened plants in living collections,which includes setting regional conservation priorities for the species, creation of genetically representative collections for the high priority species, and usage of these collections in in situ actions. In this strategy, the value of existing and future species living collections for conservation is determined by the species' conservation status and how well the accessions represent their natural genetic variation.
文摘The TECHNOSEUM in Mannheim is one of the biggest museums in continental Europe dealing withthe history of industrialization and its consequences. It shows the "roots of prosperity" which has made巳aden-Wurttemberg to the most successful economic region in Germany. Synchronous, the collections representrequirements and steps of the development of industry and society in the last three hundred years. Thefocus of collection on exhibits you can call as "technical culture goods" tells about living and working conditionsin past and present. These include inter tools, working places and machines, measure instruments,means of transport and communication, goods of trade and mass production, but also furniture, domestic appliance,clothes, packages or advertising products. They are not only residues of economic and industrial lifebut also evidence of families, societies and organizations as part of scientific work and research.
文摘Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal. The frequent lack of a con- scious design for how collections fit together is of equal concern because it means that research libraries are not making the most of the substantial investments they are making in digital initiatives. This paper proposes a framework for a research library’s digital collections that offers integrated discovery and a set of best practices to underpin collection building, federated access, and sus- tainability. The framework’s purpose is to give information seekers a powerful and easy way to search across existing and future collections and to retrieve integrated sets of results. The paper and its recommendations are based upon research undertaken by the author and a team of librarians and technologists at Cornell University Library. The team conducted structured interviews of forty-five library staff members involved in digital collection building at Cornell, studied an inventory of the library’s more than fifty digital collections, and evaluated seven existing Open Archives Initiative (OAI) and federated search production or prototype systems. The author will discuss her team’s research and the rationale for their recommendations to: present a cohesive view of the library’s digital collections for both browsing and searching at the object level; take a programmatic (rather than project-based) approach to digital collection building; require that all new digital collections conform to library-developed and agreed-upon OAI best practices for data providers; and implement organizational structures to sustain the library’s digital collections over the long term.
文摘A vast quantity of art in existence today is inaccessible to individuals.If people want to know the different types of art that exist,how individual works are connected,and how works of art are interpreted and discussed in the context of other works,they must utilize means other than simply viewing the art.Therefore,this paper proposes a language to analyze,describe,and explore collections of visual art(LadeCA).LadeCA combines human interpretation and automatic analyses of images,allowing users to assess collections of visual art without viewing every image in them.This paper focuses on the lexical base of LadeCA.It also outlines how collections of visual art can be analyzed,described,and explored using a LadeCA vocabulary.Additionally,the relationship between LadeCA and indexing systems,such as ICONCLASS or AAT,is demonstrated,and ways in which LadeCA and indexing systems can complement each other are highlighted.
基金Supported by National Natural Science Foundation of China,No. 82070682Beijing Municipal Science and Technology Commission,China,No. Z181100001718177。
文摘BACKGROUND Endoscopic ultrasound(EUS)-guided transluminal drainage is an advanced technique used to treat pancreatic fluid collections(PFCs). However, gastric varices and intervening vessels may be associated with a high risk of bleeding and are, therefore, listed as relative contraindications. Herein, we report two patients who underwent interventional embolization before EUS-guided drainage.CASE SUMMARY Two 32-year-old males developed symptomatic PFCs after acute pancreatitis and came to our hospital for further treatment. One patient suffered from intermittent abdominal pain and vomiting, and computed tomography(CT) imaging showed an encapsulated cyst 7.93 cm × 6.13 cm in size. The other patient complained of a mass inside the abdomen, which gradually became enlarged. Gastric varices around the ideal puncture site were detected by EUS when we evaluated the possibility of endoscopic drainage in both patients. Interventional embolization was recommended as the first procedure to decrease the risk of bleeding. After that, EUS-guided transluminal drainage was successfully conducted, without vascular rupture. No postoperative complications occurred during hospitalization, and no recurrence was detected at the last follow-up CT scan performed at 1 mo.CONCLUSION Interventional embolization is a safe, preoperative procedure that is performed before EUS-guided drainage in PFC patients with gastric varices or at high risk of bleeding.
文摘In this paper, we propose an automatic classification for various images collections using two stage clustering method. Here, we have used global and local image features. First, we review about various types of feature vector that is suita-ble to represent local and global properties of images, and similarity measures that can be represented an affinity be-tween these images. Second, we consider a clustering method for image collection. Here, we first build a coarser clus-tering by partitioning various images into several clusters using the flexible Mean shift algorithm and K-mean cluster-ing algorithm. Second, we construct dense clustering of images collection by optimizing a Gaussian Dirichlet process mixture model taking initial clusters as given coarser clustering. Finally, we have conducted the comparative experi-ments between our method and existing methods on various images datasets. Our approach has significant advantage over existing techniques. Besides integrating temporal and image content information, our approach can cluster auto-matically photographs without some assumption about number of clusters or requiring a priori information about initial clusters and it can also generalize better to different image collections.
文摘According to an FAO report in 1996,49000 cotton genotypes are being maintained in germplasm collections worldwide. Of these accessions,approximately 67% reside in the six largest collections. Identification of mutual opportunities and challenges faced by these germplasm banks could result
文摘In early 2009, I had the chance to visit six Japanese university libraries or museums, which house 15 cuneiform tablets, seven royal inscriptions and one cylinder seal. Most of them seem to have been acquired from some