Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.

Esophageal cancer screening,early detection and treatment:Current insights and future directions

Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 deaths.The 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and distribution.Squamous cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local population.Conversely,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United States.The role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of controversy.The effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated topic.The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses.In areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive treatments.These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality.Early screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.

A mixed-coordination electron trapping-enabled high-precision touch-sensitive screen for wearable devices

Touch-sensitive screens are crucial components of wearable devices.Materials such as reduced graphene oxide(rGO),carbon nanotubes(CNTs),and graphene offer promising solutions for flexible touch-sensitive screens.However,when stacked with flexible substrates to form multilayered capacitive touching sensors,these materials often suffer from substrate delamination in response to deformation;this is due to the materials having different Young’s modulus values.Delamination results in failure to offer accurate touch screen recognition.In this work,we demonstrate an induced charge-based mutual capacitive touching sensor capable of high-precision touch sensing.This is enabled by electron trapping and polarization effects related to mixed-coordinated bonding between copper nanoparticles and vertically grown graphene nanosheets.Here,we used an electron cyclotron resonance system to directly fabricate graphene-metal nanofilms(GMNFs)using carbon and copper,which are firmly adhered to flexible substrates.After being subjected to 3000 bending actions,we observed almost no change in touch sensitivity.The screen interaction system,which has a signal-to-noise ratio of 41.16 dB and resolution of 650 dpi,was tested using a handwritten Chinese character recognition trial and achieved an accuracy of 94.82%.Taken together,these results show the promise of touch-sensitive screens that use directly fabricated GMNFs for wearable devices.

Colorectal cancer screening:A review of current knowledge and progress in research

Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide,being the third most commonly diagnosed malignancy and the second leading cause of cancer-related deaths globally.Despite the progress in screening,early diagnosis,and treatment,approximately 20%-25%of CRC patients still present with metastatic disease at the time of their initial diagnosis.Furthermore,the burden of disease is still expected to increase,especially in individuals younger than 50 years old,among whom early-onset CRC incidence has been increasing.Screening and early detection are pivotal to improve CRC-related outcomes.It is well established that CRC screening not only reduces incidence,but also decreases deaths from CRC.Diverse screening strategies have proven effective in decreasing both CRC incidence and mortality,though variations in efficacy have been reported across the literature.However,uncertainties persist regarding the optimal screening method,age intervals and periodicity.Moreover,adherence to CRC screening remains globally low.In recent years,emerging technologies,notably artificial intelligence,and non-invasive biomarkers,have been developed to overcome these barriers.However,controversy exists over the actual impact of some of the new discoveries on CRC-related outcomes and how to effectively integrate them into daily practice.In this review,we aim to cover the current evidence surrounding CRC screening.We will further critically assess novel approaches under investigation,in an effort to differentiate promising inno-vations from mere novelties.

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Significantly Improved High-Temperature Energy Storage Performance of BOPP Films by Coating Nanoscale Inorganic Layer

Biaxially oriented polypropylene(BOPP)is one of the most commonly used commercial capacitor films,but its upper operating temperature is below 105℃due to the sharply increased electrical conduction loss at high temperature.In this study,growing an inorganic nanoscale coating layer onto the BOPP film's surface is proposed to suppress electrical conduction loss at high temperature,as well as increase its upper operating temperature.Four kinds of inorganic coating layers that have different energy band structure and dielectric property are grown onto the both surface of BOPP films,respectively.The effect of inorganic coating layer on the high-temperature energy storage performance has been systematically investigated.The favorable coating layer materials and appropriate thickness enable the BOPP films to have a significant improvement in high-temperature energy storage performance.Specifically,when the aluminum nitride(AIN)acts as a coating layer,the AIN-BOPP-AIN sandwich-structured films possess a discharged energy density of 1.5 J cm^(-3)with an efficiency of 90%at 125℃,accompanying an outstandingly cyclic property.Both the discharged energy density and operation temperature are significantly enhanced,indicating that this efficient and facile method provides an important reference to improve the high-temperature energy storage performance of polymer-based dielectric films.

Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer

The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced stages.The efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other tools.Nevertheless,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation rate.These barriers could include a full range of social and political aspects,especially the type of financial provision of each health service.In Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including CRC.Interestingly,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.

Flexible, Transparent and Conductive Metal Mesh Films with Ultra‑High FoM for Stretchable Heating and Electromagnetic Interference Shielding

Despite the growing demand for transparent conductive films in smart and wearable electronics for electromagnetic interference(EMI)shielding,achieving a flexible EMI shielding film,while maintaining a high transmittance remains a significant challenge.Herein,a flexible,transparent,and conductive copper(Cu)metal mesh film for EMI shielding is fabricated by self-forming crackle template method and electroplating technique.The Cu mesh film shows an ultra-low sheet resistance(0.18Ω□^(-1)),high transmittance(85.8%@550 nm),and ultra-high figure of merit(>13,000).It also has satisfactory stretchability and mechanical stability,with a resistance increases of only 1.3%after 1,000 bending cycles.As a stretchable heater(ε>30%),the saturation temperature of the film can reach over 110°C within 60 s at 1.00 V applied voltage.Moreover,the metal mesh film exhibits outstanding average EMI shielding effectiveness of 40.4 dB in the X-band at the thickness of 2.5μm.As a demonstration,it is used as a transparent window for shielding the wireless communication electromagnetic waves.Therefore,the flexible and transparent conductive Cu mesh film proposed in this work provides a promising candidate for the next-generation EMI shielding applications.

OptoGPT: A foundation model for inverse design in optical multilayer thin film structures

Optical multilayer thin film structures have been widely used in numerous photonic applications.However,existing inverse design methods have many drawbacks because they either fail to quickly adapt to different design targets,or are difficult to suit for different types of structures,e.g.,designing for different materials at each layer.These methods also cannot accommodate versatile design situations under different angles and polarizations.In addition,how to benefit practical fabrications and manufacturing has not been extensively considered yet.In this work,we introduce OptoGPT(Opto Generative Pretrained Transformer),a decoder-only transformer,to solve all these drawbacks and issues simultaneously.

Numerical and experimental study on the falling film flow characteristics with the effect of co-current gas flow in hydrogen liquefaction process

Liquid hydrogen storage and transportation is an effective method for large-scale transportation and utilization of hydrogen energy. Revealing the flow mechanism of cryogenic working fluid is the key to optimize heat exchanger structure and hydrogen liquefaction process(LH2). The methods of cryogenic visualization experiment, theoretical analysis and numerical simulation are conducted to study the falling film flow characteristics with the effect of co-current gas flow in LH2spiral wound heat exchanger.The results show that the flow rate of mixed refrigerant has a great influence on liquid film spreading process, falling film flow pattern and heat transfer performance. The liquid film of LH2mixed refrigerant with column flow pattern can not uniformly and completely cover the tube wall surface. As liquid flow rate increases, the falling film flow pattern evolves into sheet-column flow and sheet flow, and liquid film completely covers the surface of tube wall. With the increase of shear effect of gas-phase mixed refrigerant in the same direction, the liquid film gradually becomes unstable, and the flow pattern eventually evolves into a mist flow.

Highly Flexible Graphene-Film-Based Rectenna for Wireless Energy Harvesting

Herein,we report the design,fabrication,and performance of two wireless energy harvesting devices based on highly flexible graphene macroscopic films(FGMFs).We first demonstrate that benefiting from the high conductivity of up to 1×10^(6)S m^(-1)and good resistive stability of FGMFs even under extensive bending,the FGMFs-based rectifying circuit(GRC)exhibits good flexibility and RF-to-DC efficiency of 53%at 2.1 GHz.Moreover,we further expand the application of FGMFs to a flexible wideband monopole rectenna and a 2.45 GHz wearable rectenna for harvesting wireless energy.The wideband rectenna at various bending conditions produces a maximum conversion efficiency of 52%,46%,and 44%at the 5th Generation(5G)2.1 GHz,Industrial Long-Term Evolution(LTE)2.3 GHz,and Scientific Medical(ISM)2.45 GHz,respectively.A 2.45 GHz GRC is optimized and integrated with an AMC-backed wearable antenna.The proposed 2.45 GHz wearable rectenna shows a maximum conversion efficiency of 55.7%.All the results indicate that the highly flexible graphene-film-based rectennas have great potential as a wireless power supplier for smart Internet of Things(loT)applications.

Reliability of a computerized system for strabismus screening

AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.

Colorectal cancer screening: Modalities and adherence

In the last decade,several studies have explored various modalities and strategies for colorectal cancer(CRC)screening,taking into account epidemiological data,individual characteristics,and socioeconomic factors.In this editorial,we comment further on a retrospective study by Agatsuma et al published in the recent issue of the World Journal of Gastroenterology.Our focus is on screening trends,particularly in relation to efforts to improve the currently suboptimal uptake among the general population worldwide,aiming to enhance early diagnosis rates of CRC.There is a need to raise awareness through health edu-cation programs and to consider the use of readily available,non-invasive screening methods.These strategies are crucial for attracting screen-eligible populations to participate in first-line screening,especially those in high-or average-risk groups and in regions with limited resources.Liquid biopsies and biomarkers represent rapidly evolving trends in screening and diagnosis;however,their clinical relevance has yet to be standardized.

Optimization of colorectal cancer screening strategies: New insights

In this editorial,we discuss the article by Agatsuma et al.We concentrate specifically on the current routinely used screening tests recommended by society guidelines and delve into the significance of early diagnosis of colorectal cancer(CRC)and its substantial impact on both incidence and mortality rates.Screening is highly recommended,and an early diagnosis stands out as the most crucial predictor of survival for CRC patients.Therefore,it is essential to identify and address the barriers hindering adherence to screening measures,as these barriers can vary among different populations.Furthermore,we focus on screening strategy optimization by selecting high-risk groups.Patients with comorbidities who regularly visit hospitals have been diagnosed at an early stage,showing no significant difference compared to patients undergoing regular screening.This finding highlights the importance of extending screening measures to include patients with comorbidities who do not routinely visit the hospital.

Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

Consensus on rapid screening for prodromal Alzheimer's disease in China

Alzheimer's disease(AD)is a common cause of dementia,characterised by cerebral amyloid-βdeposition,pathological tau and neurodegeneration.The prodromal stage of AD(pAD)refers to patients with mild cognitive impairment(MCl)and evidence of AD's pathology.At this stage,disease-modifying interventions should be used to prevent the progression to dementia.Given the inherent heterogeneity of MCl,more specific biomarkers are needed to elucidate the underlying AD's pathology.Although the uses of cerebrospinal fluid and positron emission tomography are widely accepted methods for detecting AD's pathology,their clinical applications are limited by their high costs and invasiveness,particularly in low-income areas in China.Therefore,to improve the early detection of Alzheimer's disease(AD)pathology through cost-effective screening methods,a panel of 45neurologists,psychiatrists andgerontologistswas invited to establish a formal consensus on the screening of pAD in China.The supportive evidence and grades of recommendations are based on a systematic literature review andfocus group discussion.National meetings were held to allow participants to review,vote and provide their expert opinions to reach a consensus.A majority(two-thirds)decision was used for questions for which consensus could not be reached.Recommended screening methods are presented in this publication,including neuropsychological assessment,peripheral biomarkers and brain imaging.In addition,a general workflow for Screening pAD in China is established,which will help clinicians identify individuals at high risk and determine therapeutic targets.

Centimeter-Scale Above-Room-Temperature Ferromagnetic Fe_(3)GaTe_(2)Thin Films by Molecular Beam Epitaxy

Fe_(3)GaTe_(2),as a layered ferromagnetic material,has a Curie temperature(T_(c))higher than room temperature,making it the key material in next-generation spintronic devices.To be used in practical devices,large-sized high-quality Fe_(3)GaTe_(2)thin films need to be prepared.Here,the centimeter-scale thin film samples with high crystal quality and above-room-temperature ferromagnetism with strong perpendicular magnetic anisotropy were prepared by molecular beam epitaxy technology.Furthermore,the Tc of the samples raises as the film thickness increases,and reaches 367K when the film thickness is 60 nm.This study provides material foundations for the new generation of van der Waals spintronic devices and paves the way for the commercial application of Fe_(3)GaTe_(2).

Ultrathin Limit on the Anisotropic Superconductivity of Single-Layered Cuprate Films

Exploring dimensionality effects on cuprates is important for understanding the nature of high-temperature superconductivity.By atomically layer-by-layer growth with oxide molecular beam epitaxy,we demonstrate that La_(2−x)Sr_(x)CuO_(4)(x=0.15)thin films remain superconducting down to 2 unit cells of thickness but quickly reach the maximum superconducting transition temperature at and above 4 unit cells.By fitting the critical magnetic field(μ0H_(c2)),we show that the anisotropy of the film’s superconductivity increases with decreasing film thickness,indicating that the superconductivity of the film gradually evolves from weak three-to two-dimensional character.These results are helpful to gain more insight into the nature of high-temperature superconductivity with dimensionality.

Effect of drying methods on perovskite films and solar cells

The high efficiency,solution processibility,and flexibility of perovskite solar cells make them promising candidates for the photovoltaic industry[1−8].The deposition method is one of the most critical factors that affect the performance of perovskite films.Various deposition methods have been developed to make perovskite films,including spin-coating,slotdie coating.

Study on the clogging mechanism of punching screen in sand control by the punching structure parameters

As an independent sand control unit or a common protective shell of a high-quality screen,the punching screen is the outermost sand retaining unit of the sand control pipe which is used in geothermal well or oil and gas well.However,most screens only consider the influence of the internal sand retaining medium parameters in the sand control performance design while ignoring the influence of the plugging of the punching screen on the overall sand retaining performance of the screen.To explore the clogging mechanism of the punching screen,this paper established the clogging mechanism calculation model of a single punching screen sand control unit by using the computational fluid mechanics-discrete element method(CFD-DEM)combined method.According to the combined motion of particles and fluids,the influence of the internal flow state on particle motion and accumulation was analyzed.The results showed that(1)the clogging process of the punching sand control unit is divided into three stages:initial clogging,aggravation of clogging and stability of clogging.In the initial stage of blockage,coarse particles form a loose bridge structure,and blockage often occurs preferentially at the streamline gathering place below chamfering inside the sand control unit.In the stage of blockage intensification,the particle mass develops into a relatively complete sand bridge,which develops from both ends of the opening to the center of the opening.In the stable plugging stage,the sand deposits show a“fan shape”and form a“V-shaped”gully inside the punching slot element.(2)Under a certain reservoir particle-size distribution,The slit length and opening height have a large influence on the permeability and blockage rate,while the slit width size has little influence on the permeability and blockage rate.The microscopic clogging mechanism and its law of the punching screen prevention unit are proposed in this study,which has some field guidance significance for the design of punching screen and sand prevention selection.