From text to image:challenges in integrating vision into ChatGPT for medical image interpretation

Large language models(LLMs),such as ChatGPT developed by OpenAI,represent a significant advancement in artificial intelligence(AI),designed to understand,generate,and interpret human language by analyzing extensive text data.Their potential integration into clinical settings offers a promising avenue that could transform clinical diagnosis and decision-making processes in the future(Thirunavukarasu et al.,2023).This article aims to provide an in-depth analysis of LLMs’current and potential impact on clinical practices.Their ability to generate differential diagnosis lists underscores their potential as invaluable tools in medical practice and education(Hirosawa et al.,2023;Koga et al.,2023).

Research on the Implementation Strategies of Teaching-Assessment Integration in Mathematics Classrooms under the Context of New Quality Productivity

With the introduction of the concept of new quality productivity,the field of education is facing unprecedented opportunities and challenges.New quality productivity emphasizes the leading role of innovation and advocates for a development model focused on high technology,efficiency,and quality.This perspective provides new insights and momentum for reform in mathematics classroom teaching.Through a literature review,this study identifies gaps in existing research and underscores the necessity of further exploration.To improve the effectiveness of mathematics teaching and enhance students’learning outcomes,the paper explores strategies for the implementation of teaching-assessment integration in mathematics classrooms under the background of new quality productivity.A series of specific implementation strategies are proposed,focusing on teaching design,learning assessment,teaching feedback and adjustments,technological integration and innovation,as well as teacher professional development.This study is of significant theoretical and practical value for guiding mathematics classroom reforms and fostering the overall development of students.The study also highlights potential challenges in the implementation process and offers suggestions for future research.

Research on Mechanisms for University Connotation Construction and High-Quality Employment in the Context of New Quality Productivity

The introduction of the concept of new quality productivity has attracted a great deal of attention in the educational community.However,there is an urgent need to align it with policy orientation and advancements in science and technology moving forward.Colleges and universities themselves should be the leaders of advanced thinking and scientific and technological development,and play their due roles in line with the development of the times to provide quality and urgent talents and intellectual support.For this reason,this paper proposes that universities should consciously establish a set of regular operation mechanisms,namely,the linkage mechanism between“social demand”and“connotation construction,”and operate regularly under the guarantee of the system.This enables universities to lead or grasp the pulse of scientific and technological development,constantly improve the level of connotation construction,promote high-quality employment,and provide high-quality services for modernization and the great rejuvenation of the Chinese nation.

Based on non-targeted metabolomics for differential components screening of Rosae Chinensis Flos and Rosae Rugosae Flos and their quality evaluation

Background:Rosa chinensis Jacq.and Rosa rugosa Thunb.are not only of ornamental value,but also edible flowers and the flower buds have been listed in the Chinese Pharmacopoeia as traditional medicines.The two plants have some differences in efficacy,but the flower buds are easily confused for similar traits.In addition,large-scale cultivation of ornamental rose flowers may lead to a decrease in the effective components of medicinal roses.Therefore,it is necessary to study the chemical composition and make quality evaluation of Rosae Chinensis Flos(Yueji)and Rosae Rugosae Flos(Meigui).Methods:In this study,40 batches of samples including Meigui and Yueji from different regions in China were collected to establish high-performance liquid chromatography fingerprints.Then,the fingerprints data was analyzed using principal component analysis,hierarchical cluster analysis,and partial least squares discriminant analysis analysis chemometrics to obtain information on intergroup differences,and non-targeted metabolomic techniques were applied to identify and compare chemical compositions of samples which were chosen from groups with large differences.Differential compounds were screened by orthogonal partial least-squares discriminant analysis and S-plot,and finally multi-component quantification was performed to comprehensively evaluate the quality of Yueji and Meigui.Results:The similarity between the fingerprints of 40 batches roses and the reference print R was 0.73 to 0.93,indicating that there were similarities and differences between the samples.Through principal component analysis and hierarchical cluster analysis of fingerprints data,the samples from different origins and varieties were intuitively divided into four groups.Partial least-squares discriminant analysis analysis showed that Meigui and Yueji cluster into two categories and the model was reliable.A total of 89 compounds were identified by high resolution mass spectrometry,mainly were flavonoids and flavonoid glycosides,as well as phenolic acids.Eight differential components were screened out by orthogonal partial least-squares discriminant analysis and S-plot analysis.Quantitative analyses of the eight compounds,including gallic acid,ellagic acid,hyperoside,isoquercitrin,etc.,showed that Yueji was generally richer in phenolic acids and flavonoids than Meigui,and the quality of Yueji from Shandong and Hebei was better.It is worth noting that Xinjiang rose is rich in various components,which is worth focusing on more in-depth research.Conclusion:In this study,the fingerprints of Meigui and Yueji were established.The chemical components information of roses was further improved based on non-targeted metabolomics and mass spectrometry technology.At the same time,eight differential components of Meigui and Yueji were screened out and quantitatively analyzed.The research results provided a scientific basis for the quality control and rational development and utilization of Rosae Chinensis Flos and Rosae Rugosae Flos,and also laid a foundation for the study of their pharmacodynamic material basis.

Effects of increased seeding density on seedling characteristics,mechanical transplantation quality,and yields of rice with crop straw boards for seedling cultivation

The high labor demand during rice seedling cultivation and transplantation poses a significant challenge in advancing machine-transplanted rice cultivation.This problem may be solved by increasing the seeding rate during seedling production while reducing the number of seedling trays.This study conducted field experiments from 2021 to 2022,using transplanting seedling ages of 10 and 15 days to explore the effects of 250,300,and 350 g/tray on the seedling quality,mechanical transplantation quality,yields,and economic benefits of rice.The commonly used combination of 150 g/tray with a 20-day seedling age in rice production was used as CK.The cultivation of seedlings under a high seeding rate and short seedling age significantly affected seedling characteristics,but there was no significant difference in seedling vitality compared to CK.The minimum number of rice trays used in the experiment was observed in the treatment of 350-10(300 g/tray and 10-day seedling age),only 152-155 trays ha^(-1),resulting in a 62%reduction in the number of trays needed.By increasing the seeding rate of rice,missed holes during mechanical transplantation decreased by 2.8 to 4%.The treatment of 300-15(300 g/tray and 15-day seedling age)achieved the highest yields and economic gains.These results indicated that using crop straw boards can reduce the application of seedling trays.On that basis,rice yields can be increased by raising the seeding rate and shortening the seedling age of rice without compromising seedling quality.

Application of Fructo-oligosaccharides Quality Control Chart in Milk Powder

The quality control chart of fructo-oligosaccharides in milk powder was established to determine whether the detection process and results are in control state.The content of fructo-oligosaccharides in milk powder control samples was determined by ion chromatography,and the quality control chart of fructo-oligosaccharides was established to analyze the controlled state.The results indicate that the median of the quality control chart is 1613.14 mg/100 g,and the standard deviation is 85.57 mg/100 g.The new quality control points were evaluated and analyzed,and the precision changed,but the mean value did not change.Further F test was conducted to determine that the precision did not change significantly,indicating that the test was in a statistical control state,and the detection process,method and results were controlled.

China’s High-Quality Technology Innovation:Scenario Narrative and Measurement System

The world today is undergoing disruptive,transformative shifts driven by a new wave of technological revolutions and industrial changes.In this context,a central question for China’s innovation-driven development strategy is how to effectively identify and measure high-quality technological innovations.Drawing on the stylized facts and scenario narrative of China’s technological landscape,this paper proposes a framework and measurement system for evaluating high-quality technological innovations.While China’s top-level design for technological innovation is guided by policy documents,the increasing number of enterprises applying for“high-tech enterprise”status has coincided with a decline in the quality of patent filings.In response,this paper first underscores the challenges and necessity of measuring the quality of technological innovations.Second,we introduce the high-quality technological innovation indicators and employ them to assess the quality of tech innovations at the firm level,utilizing an approach that combines analogical narrative,gene coding,text analysis,semantic logic,and a database of granted invention patents in China.Third,we examine the systematic and individual biases inherent in citation counts,a commonly used indicator,under specific contexts,and employ a granular instrumental variable approach to validate the effectiveness of the indicators.Finally,we develop a“family tree”of the indicators and explore their application scenarios through a combination of established and extended indicators.Our findings provide a theoretical foundation for evaluating China’s technological innovation quality,inform policy incentives,and offer insights for academia to apply high-quality technological innovation indicators in different contexts.

The chemical composition, quality control and pharmacological effects of Gualou-Xiebai-Banxia Decoction: a review

Gualou-Xiebai-Banxia Decoction(GXBD)is a traditional Chinese herbal formula including four traditional Chinese medicines:Gualou(Trichosanthis Fructus,TF),Xiebai(Allii Macrostemonis Bulbus,AMB),Banxia(Pinelliae Rhizoma,PR)and yellow wine.It is a classical therapy for chest stuffiness and pain syndrome and is widely used in the clinical treatment of coronary heart disease.It also shows significant therapeutic effects on pulmonary heart disease,hyperlipidemia,and arrhythmia.This study conducted a literature review and collected information on GXBD from databases such as PubMed,Web of Science,China National Knowledge Infrastructure,and ScienceDirect.The result indicated that the main active ingredients of GXBD are steroids,flavonoids,terpenoids,alkaloids,amino acids,and organic acids.Trigonelline,macrostemonoside and cucurbitacin B can provide reference for its quality control.GXBD may exert therapeutic effects on coronary heart disease through AMPK,PI3K-AKT,oxLDL,VEGF,and NF-κB signal pathways.This review provides a comprehensive analysis and summary of the chemical composition and in vivo metabolism of three traditional Chinese medicines(TF,AMB,and PR),along with an evaluation of the chemical composition,quality control,pharmacological effects,and clinical application of GXBD.Based on these,areas requiring further research on GXBD have been proposed to provide a reference for its further development and new drug research.

Genomic selection for meat quality traits based on VIS/NIR spectral information

The principle of genomic selection(GS) entails estimating breeding values(BVs) by summing all the SNP polygenic effects. The visible/near-infrared spectroscopy(VIS/NIRS) wavelength and abundance values can directly reflect the concentrations of chemical substances, and the measurement of meat traits by VIS/NIRS is similar to the processing of genomic selection data by summing all ‘polygenic effects' associated with spectral feature peaks. Therefore, it is meaningful to investigate the incorporation of VIS/NIRS information into GS models to establish an efficient and low-cost breeding model. In this study, we measured 6 meat quality traits in 359Duroc×Landrace×Yorkshire pigs from Guangxi Zhuang Autonomous Region, China, and genotyped them with high-density SNP chips. According to the completeness of the information for the target population, we proposed 4breeding strategies applied to different scenarios: Ⅰ, only spectral and genotypic data exist for the target population;Ⅱ, only spectral data exist for the target population;Ⅲ, only spectral and genotypic data but with different prediction processes exist for the target population;and Ⅳ, only spectral and phenotypic data exist for the target population.The 4 scenarios were used to evaluate the genomic estimated breeding value(GEBV) accuracy by increasing the VIS/NIR spectral information. In the results of the 5-fold cross-validation, the genetic algorithm showed remarkable potential for preselection of feature wavelengths. The breeding efficiency of Strategies Ⅱ, Ⅲ, and Ⅳ was superior to that of traditional GS for most traits, and the GEBV prediction accuracy was improved by 32.2, 40.8 and 15.5%, respectively on average. Among them, the prediction accuracy of Strategy Ⅱ for fat(%) even improved by 50.7% compared to traditional GS. The GEBV prediction accuracy of Strategy Ⅰ was nearly identical to that of traditional GS, and the fluctuation range was less than 7%. Moreover, the breeding cost of the 4 strategies was lower than that of traditional GS methods, with Strategy Ⅳ being the lowest as it did not require genotyping.Our findings demonstrate that GS methods based on VIS/NIRS data have significant predictive potential and are worthy of further research to provide a valuable reference for the development of effective and affordable breeding strategies.

Predicting the Construction Quality of Projects by Using Hybrid Soft Computing Techniques

The construction phase of a project is a critical factor that significantly impacts its overall success.The construction environment is characterized by uncertainty and dynamism,involving nonlinear relationships among various factors that affect construction quality.This study utilized 987 construction inspection records from 1993 to 2022,obtained from the Taiwan residents Public Construction Management Information System(PCMIS),to determine the relationships between construction factors and quality.First,fuzzy logic was applied to calculate the weights of 499 defects,and 25 critical construction factors were selected based on these weight values.Next,a deep neural network was used to identify the relationship between the critical construction factors(input variables)and construction quality(output variable).Finally,the prediction model’s performance was evaluated to confirm the impact of these critical construction factors on project outcomes.This study employed an innovative hybrid soft computing technique,com-bining fuzzy logic and an artificial neural network,to effectively predict the relationship between critical construction factors and construction quality,achieving a model accuracy of 96.08%.Project managers can utilize the findings of this study to enhance project management practices and establish effective construction management strategies,thereby improving project construction quality.

SlPGR5/SlPGRL1 pathway-dependent cyclic electron transport regulates photoprotection and chloroplast quality in tomato plants

The essential photoprotective role of proton gradient regulation 5(PGR5)-dependent cyclic electron flow(CEF)has been reported in Arabidopsis,rice,and algae.However,its functional assessment has not been performed in tomato yet.In this study,we focused on elucidate the function of SlPGR5 and SlPGR5-like photosynthetic phenotype 1(PGRL1)in tomato.We performed RNA interference and found that SlPGR5/SlPGRL1-suppressed transformants exhibited extremely low CO_(2)assimilation capacity,their photosystem I(PSI)and PSII were severely photoinhibited and chloroplasts were obviously damaged.The SlPGR5/SlPGRL1-suppressed plants almost completely inhibited CEF and Y(ND),and PSII photoinhibition may be directly related to the inability to produce sufficient proton motive force to induce NPQ.The transgenic plants overexpressing SlPGR5 and SlPGRL1 driven by 35S promoter capable alleviate photoinhibition of plants under low night temperature.The transcriptomic and proteomic analyses suggested that the nuclear gene transcription and turnover of chloroplast proteins,including the plastoglobule-related proteins,were closely related to SlPGR5/SlPGRL1 pathway dependent CEF.The bridge relationship between CEF and chloroplast quality maintenance was a novel report to our knowledge.In conclusion,these results revealed the regulatory mechanism of the SlPGR5/SlPGRL1 pathway in photoprotection and maintenance of chloroplast function in tomato,which is crucial for reduce yield loss,especially under adverse environmental conditions.

Water Quality,Influential Factors,and Management Strategies from 2016 to 2020 in the Yangtze River Economic Belt,China

The Yangtze River economic belt(YREB),China is important to the Chinese economy and for supporting sustainable development.Clarifying the relationship between water quality indices and socioeconomic indicators could help improve aquatic environment management in the YREB and our understanding of the causes and effects of water quality variations in other large river basins.In this study,river water quality,factors affecting water quality,and management strategies,and correlations between water quality indices and socioeconomic indicators in the YREB during the 13th Five-Year Plan period(2016-2020)were assessed.The single-factor evaluation method,constant price for GDP,and correlation analyses were adopted.The results showed that:1)water quality in the YREB improved during the 13th Five-Year Plan period.The number of aquatic environment sections meeting GradeⅠ-Ⅲwater quality standards increased by 13.1%and the number below Grade V decreased by 2.9%.2)The values of 12 indicators in the YREB exceeded relevant standards.The indicators with highest concentreation were the total phosphorus,chemical oxygen demand,ammonia nitrogen,and permanganate index,which were relatively high in downstream regions in Anhui Province,Jiangsu Province,and Shanghai Municipality.3)Ammonia nitrogen,chemical oxygen demand,and total phosphorus emissions per unit area and water extraction per unit area are relatively high in the three downstream regions mentioned above.4)Increased domestic sewage discharges have increased total wastewater discharges in the YREB.5)River water quality in the YREB strongly correlated with population,economic,and water resource indices and less strongly correlated with government investment,agriculture,meteorology,energy,and forestry indices.This confirmed the need to decrease wastewater discharges and non-point-source pollutant emissions.The aquatic environment could be improved by taking reasonable measures to control population growth,adjusting the industrial structure to accelerate industrial transformation and increase the proportion of tertiary industries,and investing in technological innovations to protect the environment.

Ecological security pattern construction using landscape ecological quality:A case study of Yanchi County,northern China

Ecological security patterns are paramount to the advancement of an ecological civilization in China,aiming to enhance the stability and service functions of ecosystems to achieve sustainable regional development.However,current regional ecological protection efforts have not been effectively integrated into the regional development planning of ecological security pattern.This study systematically assessed the effectiveness of ecological protection projects in Yanchi County,Ningxia Hui Autonomous Region,China,through the evaluation of landscape ecological quality.Based on the evaluation results of landscape ecological quality,this study used morphological pattern analysis(MSPA),minimum cumulative resistance(MCR)model,and gravity model together to construct the ecological security pattern of Yanchi County.The findings revealed that from 1990 to 2020,with the implementation of ecological protection projects started from 2000,the landscape stability of Yanchi County first decreased and then increased,and the intensity of landscape disturbance first intensified but then decreased,indicating an improvement in the landscape ecological quality and a significant enhancement of the ecological environment in Yanchi County.The ecological security pattern of Yanchi County consisted of 10 ecological sources,10 ecological source points,23 ecological corridors,and 27 ecological nodes.The ecological security pattern of Yanchi County exhibited distinct spatial variations,with stronger ecological security observed in the southern part than in northern part of the county.The ecological sources were denser in the southern part than in the northern part of the county,and accordingly,the length of ecological corridors was shorter and denser in the southern than that in the northern part of the county.Based on the spatial distribution of landscape ecological quality and the characteristics of ecological security pattern of Yanchi County in 2020,we suggested Yanchi County to build four zones to optimize the ecological security pattern construction:the Haba Lake ecological conservation zone,the urban ecological planning zone,the ecological environment restoration zone,and the ecological security improvement zone.This study can provide essential guidance for the construction of ecological security pattern in farming-pastoral areas both in China and worldwide.

Correlation between psychological,family social support,and home nursing quality for an implanted venous access port

BACKGROUND Cancer patients with an implanted venous access port(IVAP)often manage their care at home during chemotherapy intervals,including maintaining the device,monitoring complications,and following medication instructions.Home care ensures continued support after discharge.However,due to factors such as age,gender,culture,psychological status,and family support,the quality of home care varies significantly.Understanding these factors can help provide targeted guidance to improve the care of cancer patients.AIM To explore IVAP chemotherapy on home care quality and its association with mental health and family support for cancer patients.METHODS This investigative study was based on a medical records system.It investigated the relationship between psychological status,family support,and home care quality in 180 patients with cancer undergoing IVAP chemotherapy.Psychological status was assessed using the State Anxiety Inventory(S-AI);family support was assessed using the Perceived Social Support Scale(PSSS),and home care quality was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30).Pearson’s correlation and Structural Equation Modeling were used to analyze the interplay between these factors.RESULTS The average S-AI score was 47.52±14.47,PSSS was 52.48±12.64,and EORTC QLQ-C30 was 70.09±17.32.A substantial inverse relationship was observed between the EORTC QLQ-C30 and S-AI scores(r=-0.712).A significant positive correlation was found between the EORTC QLQ-C30 and the PSSS,with a correlation coefficient of(r=0.744).The multiple linear regression analysis indicated that family social support,psychological status,and average monthly family income were the main factors influencing the variation in the quality of home care,explaining 71.9%of the variation.The Structural Equation Modeling results indicated that psychological status acted as a partial mediator in the association between family social support and home care quality of life,explaining 32.78%of the mediation effect.CONCLUSION Psychological status and family social support positively impacted cancer patients’home care quality,with psychology partially mediating this effect.

Distressing symptoms and health-related quality of life in patients with chronic kidney disease

BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.

Critical quality indicators of high-performance polyetherimide(ULTEM)over the MEX 3D printing key generic control parameters:Prospects for personalized equipment in the defense industry

Additive Manufacturing(AM)can provide customized parts that conventional techniques fail to deliver.One important parameter in AM is the quality of the parts,as a result of the material extrusion 3D printing(3D-P)procedure.This can be very important in defense-related applications,where optimum performance needs to be guaranteed.The quality of the Polyetherimide 3D-P specimens was examined by considering six control parameters,namely,infill percentage,layer height,deposition angle,travel speed,nozzle,and bed temperature.The quality indicators were the root mean square(Rq)and average(Ra)roughness,porosity,and the actual to nominal dimensional deviation.The examination was performed with optical profilometry,optical microscopy,and micro-computed tomography scanning.The Taguchi design of experiments was applied,with twenty-five runs,five levels for each control parameter,on five replicas.Two additional confirmation runs were conducted,to ensure reliability.Prediction equations were constructed to express the quality indicators in terms of the control parameters.Three modeling approaches were applied to the experimental data,to compare their efficiency,i.e.,Linear Regression Model(LRM),Reduced Quadratic Regression Model,and Quadratic Regression Model(QRM).QRM was the most accurate one,still the differences were not high even considering the simpler LRM model.

基于改进TextRank的科技文本关键词抽取方法

针对科技文本关键词抽取任务中抽取出现次数少但能较好表达文本主旨的词语效果差的问题,提出一种基于改进TextRank的关键词抽取方法。首先,利用词语的词频-逆文档频率(TF-IDF)统计特征和位置特征优化共现图中词语间的概率转移矩阵,通过迭代计算得到词语的初始得分;然后,利用K-Core(K-Core decomposition)算法挖掘KCore子图得到词语的层级特征,利用平均信息熵特征衡量词语的主题表征能力;最后,在词语初始得分的基础上融合层级特征和平均信息熵特征,从而确定关键词。实验结果表明,在公开数据集上,与TextRank方法和OTextRank(Optimized TextRank)方法相比,所提方法在抽取不同关键词数量的实验中,F1均值分别提高了6.5和3.3个百分点;在科技服务项目数据集上,与TextRank方法和OTextRank方法相比,所提方法在抽取不同关键词数量的实验中,F1均值分别提高了7.4和3.2个百分点。实验结果验证了所提方法抽取出现频率低但较好表达文本主旨关键词的有效性。

Principal Component Analysis of Cooked Rice Texture Qualities

Texture qualities of cooked rice are comprised of many indexes with the complex relationship, so it is difficult to analyze and evaluate cooked rice. In this paper, the related indexes of texture properties were conversed into the independent indexes of principal component based on the principal component analysis method. The results showed that the rice kernel types influenced the meanings of principal components indexes. For long and short rice, the first principal component was comprehensive index. But the second principal component was springiness for the short rice, while it was adhesiveness for long rice. Therefore, the first principal component can be used to express the quality of cooked rice with a few of indexes, and the rice type can be recognized according to the second principal component.

Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma:A large multicenter sample analysis

Objective:Quality assurance is crucial for oncological surgical treatment assessment.For rare diseases,singlequality indicators are not enough.We aim to develop a comprehensive and reproducible measurement,called the"Textbook Outcome"(TO),to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma(G-NEC)patients.Methods:Data from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were analyzed.TO included receiving a curative resection,≥15 lymph nodes examined,no severe postoperative complications,hospital stay≤21 d,and no hospital readmission≤30 d after discharge.Hospital variation in TO was analyzed using a case mix-adjusted funnel plot.Prognostic factors of survival and risk factors for non-Textbook Outcome(non-TO)were analyzed using Cox and logistic models,respectively.Results:TO was achieved in 56.6%of 860 G-NEC patients.TO patients had better overall survival(OS),disease-free survival(DFS),and recurrence-free survival(RFS)than non-TO patients(P<0.05).Moreover,TO patients accounted for 60.3%of patients without recurrence.Multivariate Cox analysis revealed non-TO as an independent risk factor for OS,DFS,and RFS of G-NEC patients(P<0.05).Increasing TO rates were associated with improved OS for G-NEC patients,but not hospital volume.Multivariate logistic regression revealed that nonlower tumors,open surgery,and>200 mL blood loss were independent risk factors for non-TO patients(P<0.05).Conclusions:TO is strongly associated with multicenter surgical quality and prognosis for G-NEC patients.Factors predicting non-TO are identified,which may help guide strategies to optimize G-NEC outcomes.

Laser additive manufacturing of zinc:formation quality,texture,and cell behavior

Laser powder bed fusion(LPBF)makes it possible for biodegradable zinc(Zn)to be used to produce customized orthopedic implants.In this research,we investigate the impact of laser power and scanning speed on the development of surface quality,relative densification,and texture during LPBF of Zn implants.Increasing laser power was able to decrease melt viscosity and surface tension,which improved the metallurgical bonding between adjacent tracks.Uneven and twisted tracks also became continuous and straight.Scanning speed could controlmolten-pool temperature to restrain grain natural orientation,achieving various crystal orientations and a weakened texture.Importantly,it further avoided the thermal expansion and contraction caused by excessive energy storage and accumulation in the matrix,thus reducing the generation of high-dislocation density.As a result,by selecting a reasonable laser power and scanning speed,the LPBF parts exhibited a flat surface morphology and a high density over 99.5%.Their average hardness,mechanical strength,and elongation reached 50.2 HV,127.8 MPa,and 7.6%,respectively.Additionally,the parts displayed a moderate degradation rate and excellent osteogenic properties.All these results provide a basis for selecting process parameters to optimize the comprehensive properties of LPBF-processed Zn parts for biodegradable applications.