Safety and efficacy of modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension

BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension(LSPH).The hemorrhage is fatal and requires safe and effective interventions.AIM To evaluate the clinical safety and efficacy of modified endoscopic ultrasound(EUS)-guided selective N-butyl-2-cyanoacrylate(NBC)injections for gastric variceal hemorrhage in LSPH.METHODS A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted.Preoperative EUS evaluations were performed.Enrolled patients were divided into modified and conventional groups according to the NBC injection technique.The final selection of NBC injection technique depended on the patients’preferences and clinical status.The technical and clinical success rates,operation time,NBC doses,perioperative complications,postoperative hospital stay,and recurrent bleeding rates were analyzed,respectively.RESULTS A total of 27 patients were enrolled.No statistically significant differences were observed between the two groups regarding baseline characteristics.In comparison to patients in the conventional group,patients in the modified group demonstrated significantly reduced NBC doses(2.0±0.6 mL vs 3.1±1.0 mL;P=0.004)and increased endoscopic operation time(71.9±11.9 min vs 22.5±6.7 min;P<0.001).Meanwhile,the two groups had no significant difference in the technical and clinical success rates,perioperative complications,postoperative hospital stay,and recurrent bleeding rates.CONCLUSION Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage,with advantages of reduced injection dose and no radiation risk.Drawbacks were time consumption and technical challenge.

A Reference Vector-Assisted Many-Objective Optimization Algorithm with Adaptive Niche Dominance Relation

It is still a huge challenge for traditional Pareto-dominatedmany-objective optimization algorithms to solve manyobjective optimization problems because these algorithms hardly maintain the balance between convergence and diversity and can only find a group of solutions focused on a small area on the Pareto front,resulting in poor performance of those algorithms.For this reason,we propose a reference vector-assisted algorithmwith an adaptive niche dominance relation,for short MaOEA-AR.The new dominance relation forms a niche based on the angle between candidate solutions.By comparing these solutions,the solutionwith the best convergence is found to be the non-dominated solution to improve the selection pressure.In reproduction,a mutation strategy of k-bit crossover and hybrid mutation is used to generate high-quality offspring.On 23 test problems with up to 15-objective,we compared the proposed algorithm with five state-of-the-art algorithms.The experimental results verified that the proposed algorithm is competitive.

Vector Dominance with Threshold Searchable Encryption (VDTSE) for the Internet of Things

The Internet of Medical Things(IoMT)is an application of the Internet of Things(IoT)in the medical field.It is a cutting-edge technique that connects medical sensors and their applications to healthcare systems,which is essential in smart healthcare.However,Personal Health Records(PHRs)are normally kept in public cloud servers controlled by IoMT service providers,so privacy and security incidents may be frequent.Fortunately,Searchable Encryption(SE),which can be used to execute queries on encrypted data,can address the issue above.Nevertheless,most existing SE schemes cannot solve the vector dominance threshold problem.In response to this,we present a SE scheme called Vector Dominance with Threshold Searchable Encryption(VDTSE)in this study.We use a Lagrangian polynomial technique and convert the vector dominance threshold problem into a constraint that the number of two equal-length vectors’corresponding bits excluding wildcards is not less than a threshold t.Then,we solve the problem using the proposed technique modified in Hidden Vector Encryption(HVE).This technique makes the trapdoor size linear to the number of attributes and thus much smaller than that of other similar SE schemes.A rigorous experimental analysis of a specific application for privacy-preserving diabetes demonstrates the feasibility of the proposed VDTSE scheme.

Oncologic impact of colonic stents for obstructive left-sided colon cancer

Colonic stenting has had a significant positive impact on the management of obstructive left-sided colon cancer(OLCC) in terms of both palliative treatment and bridge-to-surgery(BTS). Notably, many studies have convincingly demonstrated the effectiveness of stenting as a BTS, resulting in improvements in shortterm outcomes and quality of life, safety, and efficacy in subsequent curative surgery, and increased cost-effectiveness, whereas the safety of chemotherapy after stenting and the long-term outcomes of stenting as a BTS are controversial. Several studies have suggested an increased risk of perforation in patients receiving bevacizumab chemotherapy after colonic stenting. In addition, several pathological analyses have suggested a negative oncological impact of colonic stenting. In contrast, many recent studies have demonstrated that colonic stenting for OLCC does not negatively impact the safety of chemotherapy or long-term oncological outcomes. The updated version of the European Society of Gastrointestinal Endoscopy guidelines released in 2020 included colonic stenting as a BTS for OLCC as a recommended treatment. It should be noted that the experience of endoscopists is involved in determining technical and clinical success rates and possibly oncological outcomes. This review discusses the positive and negative impacts of colonic stenting on OLCC treatment, particularly in terms of oncology.

Ponseti Treatment of Bilateral Idiopathic Clubfoot: Does the Hand Dominance of the Provider Make a Difference?

Introduction: Congenital talipes equinovarus (CTEV) is the commonest musculoskeletal deformity worldwide. The Ponseti technique is the goal standard for clubfoot treatment. During the correction phase, the provider’s right hand manipulates the right foot and the left hand, left foot. Often, one foot is ready for Achilles tenotomy before the other in bilateral clubfoot. Objective: To determine the effect of the provider’s hand dominance would have on bilateral clubfoot treated with the Ponseti technique. Method: This was a prospective cross-sectional study that analyzed idiopathic bilateral clubfoot patients aged 0 - 5 years and treated using the Ponseti technique at FMC Umuahia from October 2019 to September 2020. Informed consent and ethical clearance were obtained. The Pirani scores were obtained and compared at presentation and at each clinic visit. All trained manipulators were right-handed. Two-tailed t-test was used and a p-value less than 0.05 was deemed significant. Results: Forty-seven patients participated in the study with an M:F of 2.6:1 and mean age of 13.79 ± 13.39 months. Thirty-six patients (76.6%) had the same Pirani score on both feet at presentation, while the right and left feet were more severely affected in 8 and 3 cases respectively. The mean number of casts before readiness for tenotomy was 4.95 on the right and 5.28 on the left with p-value of 0.042. Conclusion: Though the right foot had a worse mean Pirani score on presentation, however, it required fewer casts before readiness for tenotomy than the left.

Transseptal approach for catheter ablation of left-sided accessory pathways in children with Marfan syndrome:A case report

BACKGROUND Left-sided accessory pathways(APs)can be accessed with either a transaortic(TA)or transseptal approach(TS).For children with Marfan syndrome(MFS)who have aortic disease,the use of TA can aggravate the disease,making TS the best choice for these patients.CASE SUMMARY A 10-year-old girl was hospitalized because of intermittent heart palpitations and chest tightness.She was diagnosed with MFS,supraventricular tachycardia,Wolff-Parkinson-White syndrome,and left-sided AP was detected by cardiac electrophysiological.Catheter ablation was successfully performed via TS under the guidance of the Ensite system.During the follow-up,no recurrence or complications occurred.CONCLUSION The TS for catheter ablation of left-sided APs can be considered in children with MFS.Adequate evaluation and selection of the appropriate puncture site are particularly important.

Aviary measurements of dominance and affiliation between members of mixed-species birds flocks in southern China

In mutualistic interactions,all parties are usually considered to benefit;yet there may be asymmetries in mutualisms where some partners/individuals benefit more than others.Such is thought to be the case in mixedspecies flocks of birds,where following species are thought to benefit more than leading species,and leading species may not be able to escape the association if they are subordinate to other species.We measured dominance and affiliation patterns of a mixed-species flock system of southern China in an aviary where these variables could be measured in a standardized way.In eight wild-caught flocks,the leading species,David’s Fulvetta(Alcippe davidi),was usually among the more subordinate flock members(ranking 9 of 13 species,with the the most dominant species ranked number one,and dominance measured by normalized David’s scores).Dominance was strongly influenced by body mass,and not by bill length or the number of individuals.Female fulvettas in particular tended to be among the most subordinate individuals in the flock.There was evidence of a negative relationship between a species pair’s affiliation,measured as the percentage of all observations in which these two species were found perching together,and their difference in ranking in the dominance hierarchy,particularly when some ground species,which are not likely to remain in flocks long term,were removed from the analysis.Species pairs that had more pronounced differences in their dominance rankings were less likely to be affiliated,which is consistent with the idea that subordinate species may avoid dominants.David’s Fulvetta is a strong information provider,so other species are likely benefitted in this relationship.Our data suggest one reason that fulvettas stay in flocks is that they may be subordinate and therefore have little control over who associates with them.

Predicting portal venous anomalies by left-sided gallbladder or rightsided ligamentum teres hepatis: A large scale, propensity scorematched study

BACKGROUND Right-sided ligamentum teres(RSLT)is often associated with portal venous anomalies(PVA)and is regarded as a concerning feature for hepatobiliary intervention.Most studies consider RSLT to be one of the causes of left-sided gallbladder(LGB),leading to the hypothesis that LGB must always be present with RSLT.However,some cases have shown that right-sided gallbladder(RGB)can also be present in livers with RSLT.AIM To highlight the rare variation that RSLT may not come with LGB and to determine whether ligamentum teres(LT)or gallbladder location is reliable to predict PVA.METHODS This study retrospectively assessed 8552 contrast-enhanced abdominal computed tomography examinations from 2018 to 2021[4483 men,4069 women;mean age,59.5±16.2(SD)years].We defined the surrogate outcome as major PVAs.The cases were divided into 4 subgroups according to gallbladder and LT locations.On one hand,we analyzed PVA prevalence by LT locations using gallbladder location as a controlled variable(n=36).On the other hand,we controlled LT location and computed PVA prevalence by gallbladder locations(n=34).Finally,we investigated LT location as an independent factor of PVA by using propensity score matching(PSM)and inverse probability of treatment weighting(IPTW).RESULTS We found 9 cases of RSLT present with RGB.Among the LGB cases,RSLT is associated with significantly higher PVA prevalence than typical LT[80.0%vs 18.2%,P=0.001;OR=18,95%confidence interval(CI):2.92-110.96].When RSLT is present,we found no statistically significant difference in PVA prevalence for RGB and LGB cases(88.9%vs 80.0%,P>0.99).Both PSM and IPTW yielded balanced cohorts in demographics and gallbladder locations.The RSLT group had a significantly higher PVA prevalence after adjusted by PSM(77.3%vs 4.5%,P<0.001;OR=16.27,95%CI:2.25-117.53)and IPTW(82.5%vs 4.7%,P<0.001).CONCLUSION RSLT doesn't consistently coexist with LGB.RSLT can predict PVA independently while the gallbladder location does not serve as a sufficient predictor.

Strategy dominance mechanism of autonomous collaboration in unmanned swarm within the framework of public goods game

The key advantage of unmanned swarm operation is its autonomous cooperation. How to improve the proportion of cooperators is one of the key issues of autonomous collaboration in unmanned swarm operations. This work proposes a strategy dominance mechanism of autonomous collaboration in unmanned swarm within the framework of public goods game. It starts with the requirement analysis of autonomous collaboration in unmanned swarm;and an aspiration-driven multiplayer evolutionary game model is established based on the requirement. Then the average abundance function and strategy dominance condition of the model are constructed by theoretical derivation. Furthermore, the evolutionary mechanism of parameter adjustment in swarm cooperation is revealed via simulation,and the influences of the multiplication factor r, aspiration levelα, threshold m and other parameters on the strategy dominance conditions were simulated for both linear and threshold public goods games(PGGs) to determine the strategy dominance characteristics;Finally, deliberate proposals are suggested to provide a meaningful exploration in the actual control of unmanned swarm cooperation.

Selection,effective dominance,and completeness of Cry1A.105/Cry2Ab2 dual-protein resistance in Helicoverpa zea(Boddie)(Lepidoptera:Noctuidae)

In the U.S.,Helicoverpa zea(Boddie)is a major pest targeted by both transgenic maize and cotton expressing Bacillus thuringiensis(Bt)proteins.Resistance of insect to Bt maize and cotton containing cry1A and cry2A genes has widely occurred in the U.S.In this study,two trials were performed to investigate larval survival and development of a Cry1A.105/Cry2Ab2 dual-protein resistant(VT2P-RR),a susceptible,and an F1 heterozygous(VT2P-RS)populations of H.zea on ears of nine Bt and three non-Bt maize hybrids.The Bt maize hybrids evaluated represent five common pyramided traits expressing two or three of the Cry1A.105,Cry1Ab,Cry1F,Cry2Ab2,and Vip3Aa20 proteins.In the laboratory,neonates of the three H.zea populations were inoculated on silks of ears collected from maize at R1-R2 plant stages;and larval survivorship was checked 10 d after neonate release.All three insect populations survived normally on non-Bt maize ears.Varied numbers of VT2P-RR and VT2P-RS survived on ears of Cry1A.105/Cry2Ab2 maize,while all larvae of the three populations died or could not develop on ears of Vip3Aa20-expressing maize.The results demonstrated that the dual-protein resistant H.zea was not cross-resistant to Vip3Aa20-expressing maize,and thus traits with vip3Aa20 gene should be effective to manage Cry1A.105/Cry2Ab2-resistant H.zea.The resistance in VT2P-RR was determined to be incomplete on Cry1A.105/Cry2Ab2 maize.The effective dominance levels varied greatly,from recessive to incompletely dominant,depending on maize hybrids and trials,suggesting that proper selection of maize hybrids could be important for mitigating the Cry1A.105/Cry2Ab2 resistance.The data generated should aid in modeling multiple-protein Bt resistance in H.zea.

Distribution and dynamics of niche and interspecific association of dominant phytoplankton species in the Feiyun River basin,Zhejiang,China

To investigate the dominant species and interspecific association in the phytoplankton community of the Feiyun River basin in Zhejiang Province,East China,the main stream and the Shanxi Zhaoshandu Reservoir in the downstream were chosen as the study area,for which 22 sampling sites were designated.Sampling was conducted in September 2021,January,May,and July 2022.Phytoplankton species were identified from both quantitative samples and in-vivo observations.Phytoplankton was quantified by direct counting.Results show that there were 98 species belonging to 6 phyla and 78 genera.In addition,to clarify the niches of the dominant phytoplankton species and their interspecific association,the dominance index was calculated,and a comprehensive analysis was conducted including niche width,niche overlap value,ecological response rate,overall association,chi-square test,and the stability.The phytoplankton community exhibited characteristics of a Cyanobacteria-Chlorophyta-Diatom type community,showing higher diversity in spring and lower diversity in summer.Among 11 dominants phytoplankton species from 3 phyla,both frequency and dominance degree varied seasonally,of which Microcystis sp.was the dominant species in Spring,Autumn,and Winter.The niche widths of the dominant species ranged from 0.234 to 0.933,and were categorized into three groups.The niche overlap values of the 11 dominant species ranged from 0.359 to 0.959,exhibiting significant seasonal differences-highest in winter followed by autumn,spring,and summer in turn.The overall correlation among dominant species in all four seasons revealed a non-significant negative association,resulting in an unstable community structure.A significant portion(84.2%)of species pairs displayed positive associations,suggesting a successional pattern where Diatoms dominated while other dominant species shared resources and space.Despite this pattern,stability measurements indicated that the dominant species community remained unstable.Therefore,careful monitoring is recommended for potential water environment issues arising from abnormal proliferation of dominant species in the watershed during winter.This research built a theoretical foundation with a data support to the early warning of eutrophication and provided a reference for water resources management in similar watersheds along the eastern coast of China.

Italian Domination of Strong Product of Two Paths

The domination problem of graphs is an important issue in the field of graph theory.This paper mainly considers the Italian domination number of the strong product between two paths.By constructing recursive Italian dominating functions,the upper bound of its Italian domination number is obtained,and then a partition method is proposed to prove its lower bound.Finally,this paper yields a sharp bound for the Italian domination number of the strong product of paths.

Quantum algorithm for minimum dominating set problem with circuit design

Using quantum algorithms to solve various problems has attracted widespread attention with the development of quantum computing.Researchers are particularly interested in using the acceleration properties of quantum algorithms to solve NP-complete problems.This paper focuses on the well-known NP-complete problem of finding the minimum dominating set in undirected graphs.To expedite the search process,a quantum algorithm employing Grover’s search is proposed.However,a challenge arises from the unknown number of solutions for the minimum dominating set,rendering direct usage of original Grover’s search impossible.Thus,a swap test method is introduced to ascertain the number of iterations required.The oracle,diffusion operators,and swap test are designed with achievable quantum gates.The query complexity is O(1.414^(n))and the space complexity is O(n).To validate the proposed approach,qiskit software package is employed to simulate the quantum circuit,yielding the anticipated results.

Species’ geographical range, environmental range and traits lead to specimen collection preference of dominant plant species of grasslands in Northern China

Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection in China is preferred by species traits(i.e.,plant height,flowering and fruiting period),environmental range(i.e.,the temperature and precipitation range)and geographical range(i.e.,distribution range and altitudinal range).Ordinary least squares models and phylogenetic generalized linear mixed models were used to analyze the relationships between specimen number and the explanatory variables.Random Forest models were then used to find the most parsimonious multivariate model.The results showed that interannual variation in specimen number between 1900 and 2020 was considerable.Specimen number of these species in southeast China was notably lower than that in northwest China.Environmental range and geographical range of species had significant positive correlations with specimen number.In addition,there were relatively weak but significant associations between specimen number and species trait(i.e.,plant height and flowering and fruiting period).Random Forest models indicated that distribution range was the most important variable,followed by flowering and fruiting period,and altitudinal range.These findings suggest that future floristic surveys should pay more attention to species with small geographical range,narrow environmental range,short plant height,and short flowering and fruiting period.The correction of specimen collection preference will also make the results of species distribution model,species evolution and other works based on specimen data more accurate.

Complex adaptive system theory,agent-based modeling,and simulation in dominant technology formation

Dominant technology formation is the key for the hightech industry to“cross the chasm”and gain an established foothold in the market(and hence disrupt the regime).Therefore,a stimulus-response model is proposed to investigate the dominant technology by exploring its formation process and mechanism.Specifically,based on complex adaptive system theory and the basic stimulus-response model,we use a combination of agent-based modeling and system dynamics modeling to capture the interactions between dominant technology and the socio-technical landscape.The results indicate the following:(i)The dynamic interaction is“stimulus-reaction-selection”,which promotes the dominant technology’s formation.(ii)The dominant technology’s formation can be described as a dynamic process in which the adaptation intensity of technology standards increases continuously until it becomes the leading technology under the dual action of internal and external mechanisms.(iii)The dominant technology’s formation in the high-tech industry is influenced by learning ability,the number of adopting users and adaptability.Therein,a“critical scale”of learning ability exists to promote the formation of leading technology:a large number of adopting users can promote the dominant technology’s formation by influencing the adaptive response of technology standards to the socio-technical landscape and the choice of technology standards by the socio-technical landscape.There is a minimum threshold and a maximum threshold for the role of adaptability in the dominant technology’s formation.(iv)The socio-technical landscape can promote the leading technology’s shaping in the high-tech industry,and different elements have different effects.This study promotes research on the formation mechanism of dominant technology in the high-tech industry,presents new perspectives and methods for researchers,and provides essential enlightenment for managers to formulate technology strategies.

Dominant woody plant species recognition with a hierarchical model based on multimodal geospatial data for subtropical forests

Since the launch of the Google Earth Engine(GEE)cloud platform in 2010,it has been widely used,leading to a wealth of valuable information.However,the potential of GEE for forest resource management has not been fully exploited.To extract dominant woody plant species,GEE combined Sen-tinel-1(S1)and Sentinel-2(S2)data with the addition of the National Forest Resources Inventory(NFRI)and topographic data,resulting in a 10 m resolution multimodal geospatial dataset for subtropical forests in southeast China.Spectral and texture features,red-edge bands,and vegetation indices of S1 and S2 data were computed.A hierarchical model obtained information on forest distribution and area and the dominant woody plant species.The results suggest that combining data sources from the S1 winter and S2 yearly ranges enhances accuracy in forest distribution and area extraction compared to using either data source independently.Similarly,for dominant woody species recognition,using S1 winter and S2 data across all four seasons was accurate.Including terrain factors and removing spatial correlation from NFRI sample points further improved the recognition accuracy.The optimal forest extraction achieved an overall accuracy(OA)of 97.4%and a maplevel image classification efficacy(MICE)of 96.7%.OA and MICE were 83.6%and 80.7%for dominant species extraction,respectively.The high accuracy and efficacy values indicate that the hierarchical recognition model based on multimodal remote sensing data performed extremely well for extracting information about dominant woody plant species.Visualizing the results using the GEE application allows for an intuitive display of forest and species distribution,offering significant convenience for forest resource monitoring.

Safety and efficacy of transcatheter arterial embolization in autosomal dominant polycystic kidney patients with gross hematuria: Six case reports

BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease(ADPKD)patients with gross hematuria.CASE SUMMARY The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria.Materials and methods:During the period from January 2018 to December 2019,renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria.Renal arteriography was performed first,and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring.Improvements in routine blood test results,routine urine test results,urine color and postoperative reactions were observed and analyzed.Results:Renal transcatheter arterial embolization was successfully conducted in 6 patients.The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery.No severe complication reactions occurred.CONCLUSION For autosomal dominant polycystic kidney syndrome patients with gross hematuria,transcatheter arterial embolization was safe and effective.

Incidental renal cell carcinoma post bilateral nephrectomy in autosomal dominant polycystic kidney disease

BACKGROUND Renal cell carcinoma(RCC)is more common in patients with autosomal dominant polycystic kidney disease(ADPKD)than in the general population.Diagnosing RCC in ADPKD is challenging due to the presence of multiple renal cysts,often leading to delays and difficulties in distinguishing RCC from cyst infection or hemorrhage.A total of 38 kidneys were excised from 19 patients,with a mean age of 56.8 years and an average hemodialysis duration of 84.2 months.Eight patients underwent open nephrectomies,and 11 underwent hand-assisted laparoscopic nephrec-tomies.RCC was detected in 15.8%of kidneys,affecting 21.1%of patients.Two patients had multifocal RCC in both kidneys.All RCC cases were pT1 stage,with the largest lesion averaging 16.5 mm in diameter.The average operative duration was 120 minutes,with intraoperative blood loss averaging 184.2 mL.Five patients required blood transfusions.Postoperative complications occurred in five patients,with a mean hospital stay of 17.1 days.The mean follow-up period was 28.1 months.CONCLUSION The prevalence of RCC is higher in patients with ADPKD with ESRD than in those with ESRD alone.Thus,clinicians should be cautious and implement surveillance programs to monitor the development of RCC in patients with ADPKD,particularly those on dialysis.

The Distribution of Eigenvance of Product Diagonal Dominance Matrix

Let DD_0(R)={A∈C^(n×#)||Rea_(ii)Rea_(jj)|≥A_iA_j,i≠j,i,j∈N}.PD_0(R)={A∈C^(n×#)||Rea_(ii)Rea_(kk)|≥A_iA_jA_k,i≠j≠k,i,j,k∈N}. In this paper,we show DD_0(R)PD_0(R),and the conditions under which the numbers of eigen vance of A∈PD_0(R)\DD_0(R)are equal to the numbers of a_(ii),i∈N in positive and negative real part respectively.Some couter examples are given which present the condnions can not be omitted.

Analysis of the Species Dominance & Dominant on the Karst Mountain Grassland Plant Community

[Objective] The aim was to study the species,quantity and community traits of dominant plant in karst mountain grassland plant community so as to provide support for the vegetation restoration in karst mountain grassland.[Method] Standard plot sites investigation method was used study the quantity traits of different plant communities of different altitudes and slopes.[Result] The IV SDR4 were the highest in the all plot sites of plant community on the kasrt mountain grassland,but the IV SDR4 were showed a trend of decreasing with the increasing of the altitude.The dominant quantity was increasing with the altitude upward,so the altitude was the mostly factor for plant community construction.[Conclusion] Altitude was the main factor to influence the community structure of plant.