Toward less invasive coloproctology: The future is out there

Medical care has undergone remarkable improvements over the past few decades.One of the most important innovative breakthroughs in modern medicine is the advent of minimally and less invasive treatments.The trend towards employing less invasive treatment has been vividly shown in the field of gastroenterology,particularly coloproctology.Parallel to foregut interventions,colorectal surgery has shifted towards a minimally invasive approach.Coloproctology,including both medical and surgical management of colorectal diseases,has undergone a remarkable paradigm shift.The treatment of both benign and malignant colorectal conditions has gradually transitioned towards more conservative and less inva-sive approaches.An interesting paradigm shift was the trend to avoid the need for radical resection of rectal cancer altogether in patients who showed complete response to neoadjuvant treatment.The trend of adopting less invasive appro-aches to treat various colorectal conditions does not seem to be stopping soon as further research on novel,more effective and safer methods is ongoing.

Traction power systems for electrified railways:evolution,state of the art,and future trends

Traction power systems(TPSs)play a vital role in the operation of electrified railways.The transformation of conventional railway TPSs to novel structures is not only a trend to promote the development of electrified railways toward high-efficiency and resilience but also an inevitable requirement to achieve carbon neutrality target.On the basis of sorting out the power supply structures of conventional AC and DC modes,this paper first reviews the characteristics of the existing TPSs,such as weak power supply flexibility and low-energy efficiency.Furthermore,the power supply structures of various TPSs for future electrified railways are described in detail,which satisfy longer distance,low-carbon,high-efficiency,high-reliability and high-quality power supply requirements.Meanwhile,the application prospects of different traction modes are discussed from both technical and economic aspects.Eventually,this paper introduces the research progress of mixed-system electrified railways and traction power supply technologies without catenary system,speculates on the future development trends and challenges of TPSs and predicts that TPSs will be based on the continuous power supply mode,employing power electronic equipment and intelligent information technology to construct a railway comprehensive energy system with renewable energy.

Evaluation and projection of marine heatwaves in the South China Sea: insights from CMIP6 multi-model ensemble

This study evaluates the performance of 16 models sourced from the coupled model intercomparison project phase 6(CMIP6)in simulating marine heatwaves(MHWs)in the South China Sea(SCS)during the historical period(1982−2014),and also investigates future changes in SCS MHWs based on simulations from three shared socioeconomic pathway(SSP)scenarios(SSP126,SSP245,and SSP585)using CMIP6 models.Results demonstrate that the CMIP6 models perform well in simulating the spatial-temporal distribution and intensity of SCS MHWs,with their multi-model ensemble(MME)results showing the best performance.The reasonable agreement between the observations and CMIP6 MME reveals that the increasing trends of SCS MHWs are attributed to the warming sea surface temperature trend.Under various SSP scenarios,the year 2040 emerges as pivotal juncture for future shifts in SCS MHWs,marked by distinct variations in changing rate and amplitudes.This is characterized by an accelerated decrease in MHWs frequency and a notably heightened increase in mean intensity,duration,and total days after 2040.Furthermore,the projection results for SCS MHWs suggest that the spatial pattern of MHWs remains consistent across future periods.However,the intensity shows higher consistency only during the near-term period(2021−2050),while notable inconsistencies are observed during the medium-term(2041−2070)and long-term(2071−2100)periods under the three SSP scenarios.During the nearterm period,the SCS MHWs are characterized by moderate and strong events with high frequencies and relatively shorter durations.In contrast,during the medium-term period,MHWs are also characterized by moderate and strong events,but with longer-lasting and more intense events under the SSP245 and SSP585 scenarios.However,in the long-term period,extreme MHWs become the dominant feature under the SSP585 scenario,indicating a substantial intensification of SCS MHWs,effectively establishing a near-permanent state.

Spatiotemporal Evaluation and Future Projection of Diurnal Temperature Range over the Tibetan Plateau in CMIP6 Models

The diurnal temperature range(DTR) serves as a vital indicator reflecting both natural climate variability and anthropogenic climate change. This study investigates the historical and projected multitemporal DTR variations over the Tibetan Plateau. It assesses 23 climate models from phase 6 of the Coupled Model Intercomparison Project(CMIP6) using CN05.1 observational data as validation, evaluating their ability to simulate DTR over the Tibetan Plateau. Then, the evolution of DTR over the Tibetan Plateau under different shared socioeconomic pathway(SSP) scenarios for the near,middle, and long term of future projection are analyzed using 11 selected robustly performing models. Key findings reveal:(1) Among the models examined, BCC-CSM2-MR, EC-Earth3, EC-Earth3-CC, EC-Earth3-Veg, EC-Earth3-Veg-LR,FGOALS-g3, FIO-ESM-2-0, GFDL-ESM4, MPI-ESM1-2-HR, MPI-ESM1-2-LR, and INM-CM5-0 exhibit superior integrated simulation capability for capturing the spatiotemporal variability of DTR over the Tibetan Plateau.(2) Projection indicates a slightly increasing trend in DTR on the Tibetan Plateau in the SSP1-2.6 scenario, and decreasing trends in the SSP2-4.5, SSP3-7.0, and SPP5-8.5 scenarios. In certain areas, such as the southeastern edge of the Tibetan Plateau, western hinterland of the Tibetan Plateau, southern Kunlun, and the Qaidam basins, the changes in DTR are relatively large.(3) Notably, the warming rate of maximum temperature under SSP2-4.5, SSP3-7.0, and SPP5-8.5 is slower compared to that of minimum temperature, and it emerges as the primary contributor to the projected decrease in DTR over the Tibetan Plateau in the future.

Theoretical Framework for a Polymorphic Network Environment

The question of whether an ideal network exists with global scalability in its full life cycle has always been a first-principles problem in the research of network systems and architectures.Thus far,it has not been possible to scientifically practice the design criteria of an ideal network in a unimorphic network system,making it difficult to adapt to known services with clear application scenarios while supporting the ever-growing future services with unexpected characteristics.Here,we theoretically prove that no unimorphic network system can simultaneously meet the scalability requirement in a full cycle in three dimensions—the service-level agreement(S),multiplexity(M),and variousness(V)—which we name as the“impossible SMV triangle”dilemma.It is only by transforming the current network development paradigm that the contradiction between global scalability and a unified network infrastructure can be resolved from the perspectives of thinking,methodology,and practice norms.In this paper,we propose a theoretical framework called the polymorphic network environment(PNE),the first principle of which is to separate or decouple application network systems from the infrastructure environment and,under the given resource conditions,use core technologies such as the elementization of network baselines,the dynamic aggregation of resources,and collaborative software and hardware arrangements to generate the capability of the“network of networks.”This makes it possible to construct an ideal network system that is designed for change and capable of symbiosis and coexistence with the generative network morpha in the spatiotemporal dimensions.An environment test for principle verification shows that the generated representative application network modalities can not only coexist without mutual influence but also independently match well-defined multimedia services or custom services under the constraints of technical and economic indicators.

Advancements in Humanoid Robots: A Comprehensive Review and Future Prospects

This paper provides a comprehensive review of the current status, advancements, and future prospects of humanoid robots, highlighting their significance in driving the evolution of next-generation industries. By analyzing various research endeavors and key technologies, encompassing ontology structure,control and decision-making, and perception and interaction, a holistic overview of the current state of humanoid robot research is presented. Furthermore, emerging challenges in the field are identified, emphasizing the necessity for a deeper understanding of biological motion mechanisms, improved structural design,enhanced material applications, advanced drive and control methods, and efficient energy utilization. The integration of bionics, brain-inspired intelligence, mechanics, and control is underscored as a promising direction for the development of advanced humanoid robotic systems. This paper serves as an invaluable resource, offering insightful guidance to researchers in the field,while contributing to the ongoing evolution and potential of humanoid robots across diverse domains.

Machine learning ensemble model prediction of northward shift in potato cyst nematodes(Globodera rostochiensis and G.pallida)distribution under climate change conditions

Potato cyst nematodes(PCNs)are a significant threat to potato production,having caused substantial damage in many countries.Predicting the future distribution of PCN species is crucial to implementing effective biosecurity strategies,especially given the impact of climate change on pest species invasion and distribution.Machine learning(ML),specifically ensemble models,has emerged as a powerful tool in predicting species distributions due to its ability to learn and make predictions based on complex data sets.Thus,this research utilised advanced machine learning techniques to predict the distribution of PCN species under climate change conditions,providing the initial element for invasion risk assessment.We first used Global Climate Models to generate homogeneous climate predictors to mitigate the variation among predictors.Then,five machine learning models were employed to build two groups of ensembles,single-algorithm ensembles(ESA)and multi-algorithm ensembles(EMA),and compared their performances.In this research,the EMA did not always perform better than the ESA,and the ESA of Artificial Neural Network gave the highest performance while being cost-effective.Prediction results indicated that the distribution range of PCNs would shift northward with a decrease in tropical zones and an increase in northern latitudes.However,the total area of suitable regions will not change significantly,occupying 16-20%of the total land surface(18%under current conditions).This research alerts policymakers and practitioners to the risk of PCNs’incursion into new regions.Additionally,this ML process offers the capability to track changes in the distribution of various species and provides scientifically grounded evidence for formulating long-term biosecurity plans for their control.

Pediatric stricturing Crohn's disease

Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD develop stricturing CD(SCD)that requires intervention.Symptomatic stricturing diseases refractory to pharmacological management frequently require non-pharmacological interventions.Non-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured seg-ment.However,strictures tend to recur postoperatively regardless of treatment modality.The lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.

Link between childhood obesity and gut microbiota

Childhood obesity is a critical global health concern with rising prevalence and significant long-term health implications.Recent studies have implicated gut microbiota in the development and progression of obesity.This editorial analyzes the research conducted by Li et al,who utilized 16S rRNA gene sequencing to compare the gut microbiome of overweight and healthy-weight children.The study found significant differences in microbial diversity and composition between the two groups,with potential implications for understanding and managing childhood obesity.We analyzed the study’s advantages and drawbacks,proposing potential areas for future research to better understand the connection between gut microbiota and obesity.

Thornthwaite moisture index and depth of suction change under current and future climate‒An Australian study

Climate change is one of the major global challenges and it can have a significant influence on the behaviour and resilience of geotechnical structures.The changes in moisture content in soil lead to effective stress changes and can be accompanied by significant volume changes in reactive/expansive soils.The volume change leads to ground movement and can exert additional stresses on structures founded on or within a shallow depth of such soils.Climate change is likely to amplify the ground movement potential and the associated problems are likely to worsen.The effect of atmospheric boundary interaction on soil behaviour has often been correlated to Thornthwaite moisture index(TMI).In this study,the long-term weather data and anticipated future projections for various emission scenarios were used to generate a series of TMI maps for Australia.The changes in TMI were then correlated to the depth of suction change(H s),an important input in ground movement calculation.Under all climate scenarios considered,reductions in TMI and increases in H s values were observed.A hypothetical design scenario of a footing on expansive soil under current and future climate is discussed.It is observed that a design that might be considered adequate under the current climate scenario,may fail under future scenarios and accommodations should be made in the design for such events.

Historical Changes and Multi-scenario Prediction of Land Use and Terrestrial Ecosystem Carbon Storage in China

Terrestrial carbon storage(CS)plays a crucial role in achieving carbon balance and mitigating global climate change.This study employs the Shared Socioeconomic Pathways and Representative Concentration Pathways(SSPs-RCPs)published by the Intergovernmental Panel on Climate Change(IPCC)and incorporates the Policy Control Scenario(PCS)regulated by China’s land management policies.The Future Land Use Simulation(FLUS)model is employed to generate a 1 km resolution land use/cover change(LUCC)dataset for China in 2030 and 2060.Based on the carbon density dataset of China’s terrestrial ecosystems,the study analyses CS changes and their relationship with land use changes spanning from 1990 to 2060.The findings indicate that the quantitative changes in land use in China from 1990 to 2020 are characterised by a reduction in the area proportion of cropland and grassland,along with an increase in the impervious surface and forest area.This changing trend is projected to continue under the PCS from 2020 to 2060.Under the SSPs-RCPs scenario,the proportion of cropland and impervious surface predominantly increases,while the proportions of forest and grassland continuously decrease.Carbon loss in China’s carbon storage from 1990 to 2020 amounted to 0.53×10^(12)kg,primarily due to the reduced area of cropland and grassland.In the SSPs-RCPs scenario,more significant carbon loss occurs,reaching a peak of8.07×10^(12)kg in the SSP4-RCP3.4 scenario.Carbon loss is mainly concentrated in the southeastern coastal area and the Beijing-TianjinHebei(BTH)region of China,with urbanisation and deforestation identified as the primary drivers.In the future,it is advisable to enhance the protection of forests and grassland while stabilising cropland areas and improving the intensity of urban land.These research findings offer valuable data support for China’s land management policy,land space optimisation,and the achievement of dual-carbon targets.

Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality worldwide.Cardiac rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients.Physical activity,lifestyle,and psychological support are core components of a successful CR program.CR has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of participating.An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients.The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency.It is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR program.There are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or activity.In the present editorial,we present all the updated knowledge and recommendations in CR programs.

PCG-Based Exercise Fatigue Detection Method Using FRFT-Based Fusion Model

Accurate detection of exercise fatigue based on physiological signals is vital for reason-able physical activity.As a non-invasive technology,phonocardiogram(PCG)signals possess arobust capability to reflect cardiovascular information,and their data acquisition devices are quiteconvenient.In this study,a novel hybrid approach of fractional Fourier transform(FRFT)com-bined with linear and discrete wavelet transform(DWT)features extracted from PCG is proposedfor PCG multi-class classification.The proposed system enhances the fatigue detection performanceby combining optimized FRFT features with an effective aggregation of linear features and DWTfeatures.The FRFT technique is employed to convert the 1-D PCG signal into 2-D image which issent to a pre-trained convolutional neural network structure,called VGG-16.The features from theVGG-16 were concatenated with the linear and DWT features to form fused features.The fusedfeatures are sent to support vector machine(SVM)to distinguish six distinct fatigue levels.Experi-mental results demonstrate that the proposed fused features outperform other feature combinationssignificantly.

Dynamically triggered seismicity on a tectonic scale:A review

Earthquakes triggered by dynamic disturbances have been confirmed by numerous observations and experiments.In the past several decades,earthquake triggering has attracted increasing attention of scholars in relation to exploring the mechanism of earthquake triggering,earthquake prediction,and the desire to use the mechanism of earthquake triggering to reduce,prevent,or trigger earthquakes.Natural earthquakes and large‐scale explosions are the most common sources of dynamic disturbances that trigger earthquakes.In the past several decades,some models have been developed,including static,dynamic,quasi‐static,and other models.Some reviews have been published,but explosiontriggered seismicity was not included.In recent years,some new results on earthquake triggering have emerged.Therefore,this paper presents a new review to reflect the new results and include the content of explosion‐triggered earthquakes for the reference of scholars in this area.Instead of a complete review of the relevant literature,this paper primarily focuses on the main aspects of dynamic earthquake triggering on a tectonic scale and makes some suggestions on issues that need to be resolved in this area in the future.

Automatic recognition of depression based on audio and video:A review

Depression is a common mental health disorder.With current depression detection methods,specialized physicians often engage in conversations and physiological examinations based on standardized scales as auxiliary measures for depression assessment.Non-biological markers-typically classified as verbal or non-verbal and deemed crucial evaluation criteria for depression-have not been effectively utilized.Specialized physicians usually require extensive training and experience to capture changes in these features.Advancements in deep learning technology have provided technical support for capturing non-biological markers.Several researchers have proposed automatic depression estimation(ADE)systems based on sounds and videos to assist physicians in capturing these features and conducting depression screening.This article summarizes commonly used public datasets and recent research on audio-and video-based ADE based on three perspectives:Datasets,deficiencies in existing research,and future development directions.

Emerging molecules,tools,technology,and future of surgical knife in gastroenterology

The 21^(st) century has started with several innovations in the medical sciences,with wide applications in health care management.This development has taken in the field of medicines(newer drugs/molecules),various tools and technology which has completely changed the patient management including abdominal surgery.Surgery for abdominal diseases has moved from maximally invasive to minimally invasive(laparoscopic and robotic)surgery.Some of the newer medicines have its impact on need for surgical intervention.This article focuses on the development of these emerging molecules,tools,and technology and their impact on present surgical form and its future effects on the surgical intervention in gastroenterological diseases.

An Exploration of the Three Dimensions and Epochal Strengths of Building a Human Community With a Shared Future

The idea of a human community with a shared future was proposed by the Communist Party of China(CPC)Central Committee with Comrade Xi Jinping at its core for the future development of human beings to face up to the most important question in today's world:“What is happening to the world and what should we do?”It profoundly answers the question of the world,history,and the times.The theory of a human community with a shared future is an innovative theory with a multidimensional formation logic that guides humanity toward continually seeking common interests and values.This paper dives into the profound motivations behind building a human community with a shared future from historical,cultural,and practical dimensions and analyzes its epochal value from both domestic and international perspectives.This not only helps exert China's role in the international community,contributing Chinese strength to the construction of a peaceful,stable,and prosperous human society,but also enhances the influence of the idea of a human community with a shared future in the international community,accelerating the building of a human community with a shared future that considers the legitimate concerns of all countries,and aiding in solving the crises facing the world.

Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease

Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.

China's Maritime Governance:Practical Evolution and Theoretical Construction

Increasingly engaged in maritime governance,China has developed its distinct vision and gradually established a complete theoretical system surrounding it.In terms of discourse,China has proposed a collection of concepts and ideas including a maritime community with a shared future,the 2lst Century Maritime Silk Road,Blue Partnerships,and marine ecological civilization.In terms of connotations,China champions such values as lasting peace,common prosperity,openness and inclusiveness,and cleanness and beautifulness.Exteriorly and interiorly,we can observe the unique character of China's vision concerning maritime governance,which will continue to upgrade and bear fruit in future practices,boosting the development of Chinese maritime governance theories,multilateral maritime cooperation,and ocean-related international legislation.Guided by its vision,China is expected to contribute more to global maritime security and marine ecological civilization.

China’s Change through Future Leaders’Eyes

Together for a Shared Future Compiled by Global Young Leaders Dialogue Price:RMB 118 Paperback,250 pages Published by Foreign Languages Press Together for a Shared Future is co-authored by 35 young people from 26 countries who participated in the project China Tour of the Global Young Leaders Dialogue(GYLD),an institutional platform for idea-sharing among young people from different countries.