Dual-Path Vision Transformer用于急性缺血性脑卒中辅助诊断

急性缺血性脑卒中是由于脑组织血液供应障碍导致的脑功能障碍,数字减影脑血管造影(DSA)是诊断脑血管疾病的金标准。基于患者的正面和侧面DSA图像,对急性缺血性脑卒中的治疗效果进行分级评估,构建基于Vision Transformer的双路径图像分类智能模型DPVF。为了提高辅助诊断速度,基于EdgeViT的轻量化设计思想进行了模型的构建;为了使模型保持轻量化的同时具有较高的精度,提出空间-通道自注意力模块,促进Transformer模型捕获更全面的特征信息,提高模型的表达能力;此外,对于DPVF的两分支的特征融合,构建交叉注意力模块对两分支输出进行交叉融合,促使模型提取更丰富的特征,从而提高模型表现。实验结果显示DPVF在测试集上的准确率达98.5%,满足实际需求。

Electron-distribution control via Pt/NC and MoC/NC dual junction:Boosted hydrogen electro-oxidation and theoretical study

The scarcity,high cost and susceptibility to CO of Platinum severely restrict its application in alkaline hydrogen oxidation reaction(HOR).Hybridizing Pt with other transition metals provides an effective strategy to modulate its catalytic HOR performance,but at the cost of mass activity due to the coverage of modifiers on Pt surface.Herein,we constructed dual junctions'Pt/nitrogen-doped carbon(Pt/NC)andδ-MoC/NC to modify electronic structure of Pt via interfacial electron transfer to acquire Pt-MoC@NC catalyst with electron-deficient Pt nanoparticles,simultaneously endowing it with high mass activity and durability of alkaline HOR.Moreover,the unique structure of Pt-MoC@NC endows Pt with a high COtolerance at 1,000 ppm CO/H_(2),a quality that commercial Pt-C catalyst lacks.The theoretical calculations not only confirm the diffusion of electrons from Pt/NC to Mo C/NC could occur,but also demonstrate the negative shift of Pt d-band center for the optimized binding energies of*H,*OH and CO.

A Stable Open-Shell Conjugated Diradical Polymer with Ultra-High Photothermal Conversion Efficiency for NIR-Ⅱ Photo-Immunotherapy of Metastatic Tumor

Massive efforts have been concentrated on the advance of eminent near-infrared(NIR) photothermal materials(PTMs) in the NIR-Ⅱ window(1000–1700 nm), especially organic PTMs because of their intrinsic biological safety compared with inorganic PTMs. However, so far, only a few NIR-Ⅱresponsive organic PTMs was explored, and their photothermal conversion efficiencies(PCEs) still remain relatively low. Herein, donor–acceptor conjugated diradical polymers with open-shell characteristics are explored for synergistically photothermal immunotherapy of metastatic tumors in the NIR-Ⅱ window. By employing side-chain regulation, the conjugated diradical polymer TTB-2 with obvious NIR-Ⅱ absorption was developed, and its nanoparticles realize a record-breaking PCE of 87.7% upon NIR-Ⅱ light illustration. In vitro and in vivo experiments demonstrate that TTB-2 nanoparticles show good tumor photoablation with navigation of photoacoustic imaging in the NIR-Ⅱ window, without any side-effect. Moreover, by combining with PD-1 antibody,the pulmonary metastasis of breast cancer is high-effectively prevented by the efficient photo-immunity effect. Thus, this study explores superior PTMs for cancer metastasis theranostics in the NIR-Ⅱ window, offering a new horizon in developing radical-characteristic NIR-Ⅱ photothermal materials.

Impact of propofol and sevoflurane anesthesia on cognition and emotion in gastric cancer patients undergoing radical resection

BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.

A strategy for strengthening chaotic mixing of dual shaft eccentric mixers by changing non-Newtonian fluids kinetic energy distribution

Efficiently modulating the velocity distribution and flow pattern of non-Newtonian fluids is a critical challenge in the context of dual shaft eccentric mixers for process intensification,posing a significant barrier for the existing technologies.Accordingly,this work reports a convenient strategy that changes the kinetic energy to controllably regulate the flow patterns from radial flow to axial flow.Results showed that the desired velocity distribution and flow patterns could be effectively obtained by varying the number and structure of baffles to change kinetic energy,and a more uniform velocity distribution,which could not be reached normally in standard baffle dual shaft mixers,was easily obtained.Furthermore,a comparative analysis of velocity and shear rate distributions is employed to elucidate the mechanism behind the generation of flow patterns in various dual-shaft eccentric mixers.Importantly,there is little difference in the power number of the laminar flow at the same Reynolds number,meaning that the baffle type has no effect on the power consumption,while the power number of both unbaffle and U-shaped baffle mixing systems decreases compared with the standard baffle mixing system in the transition flow.Finally,at the same rotational condition,the dimensionless mixing time of the U-shaped baffle mixing system is 15.3%and 7.9%shorter than that of the standard baffle and the unbaffle mixing system,respectively,which shows the advantage of the U-shaped baffle in stirring rate.

Free radicals trigger the closure of open pores in lignin-derived hard carbons toward improved sodium-storage capacity

The chemical activation of various precursors is effective for creating additional closed pores in hard carbons for sodium storage.However,the formation mechanism of closed pores under the influence of pore-forming agents is not well understood.Herein,an effective chemical activation followed by a high-temperature self-healing strategy is employed to generate interconnected closed pores in lignin-derived hard carbon(HCs).By systematic experimental design combined with electron paramagnetic res-onance spectroscopy,it can be found that the content of free radicals in the carbon matrix influences the closure of open pores at high temperatures.Excessively high activation temperature(>700 C)leads to a low free radical concentration,making it difficult to achieve self-healing of open pores at high tempera-tures.By activation at 700°C,a balance between pore making and self-healing is achieved in the final hard carbon.A large number of free radicals triggers rapid growth and aggregation of carbon microcrys-tals,blocking pre-formed open micropores and creating additional interconnected closed pores in as-obtained hard carbons.As a result,the optimized carbon anode(LK-700-1300)delivers a high reversible capacity of 330.8 mA h g^(-1) at 0.03 A g^(-1),which is an increase of 86 mA h g^(-1) compared to the pristine lignin-derived carbon anode(L-700-1300),and exhibits a good rate performance(202.1 mA h g^(-1) at 1 A g^(-1)).This work provides a universal and effective guidance for tuning closed pores of hard carbons from otherprecursors.

Dual Additives for Stabilizing Li Deposition and SEI Formation in Anode-Free Li-Metal Batteries

Anode-free Li-metal batteries are of significant interest to energy storage industries due to their intrinsically high energy.However,the accumulative Li dendrites and dead Li continuously consume active Li during cycling.That results in a short lifetime and low Coulombic efficiency of anode-free Li-metal batteries.Introducing effective electrolyte additives can improve the Li deposition homogeneity and solid electrolyte interphase(SEI)stability for anode-free Li-metal batteries.Herein,we reveal that introducing dual additives,composed of LiAsF6 and fluoroethylene carbonate,into a low-cost commercial carbonate electrolyte will boost the cycle life and average Coulombic efficiency of NMC‖Cu anode-free Li-metal batteries.The NMC‖Cu anode-free Li-metal batteries with the dual additives exhibit a capacity retention of about 75%after 50 cycles,much higher than those with bare electrolytes(35%).The average Coulombic efficiency of the NMC‖Cu anode-free Li-metal batteries with additives can maintain 98.3%over 100 cycles.In contrast,the average Coulombic efficiency without additives rapidly decline to 97%after only 50 cycles.In situ Raman measurements reveal that the prepared dual additives facilitate denser and smoother Li morphology during Li deposition.The dual additives significantly suppress the Li dendrite growth,enabling stable SEI formation on anode and cathode surfaces.Our results provide a broad view of developing low-cost and high-effective functional electrolytes for high-energy and long-life anode-free Li-metal batteries.

Influence of humanistic care-based operating room nursing on safety,recovery,and satisfaction after radical surgery for colorectal carcinoma

BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.

Enhanced activation of peroxymonosulfate by Fe/N co-doped ordered mesoporous carbon with dual active sites for efficient removal of m-cresol

The novel Fe-N co-doped ordered mesoporous carbon with high catalytic activity in m-cresol removal was prepared by urea-assisted impregnation and simple pyrolysis method.During the preparation of the Fe-NC catalyst,the complexation of N elements in urea could anchor Fe,and the formation of C3N4during urea pyrolysis could also prevent migration and aggregation of Fe species,which jointly improve the dispersion and stability of Fe.The FeN4sites and highly dispersed Fe nanoparticles synergistically trigger the dual-site peroxymonosulfate (PMS) activation for highly efficient m-cresol degradation,while the ordered mesoporous structure of the catalyst could improve the mass transfer rate of the catalytic process,which together promote catalytic degradation of m-cresol by PMS activation.Reactive oxygen species (ROS) analytic experiments demonstrate that the system degrades m-cresol by free radical pathway mainly based on SO_(4)^(-)·and·OH,and partially based on·OH as the active components,and a possible PMS activation mechanism by 5Fe-50 for m-cresol degradation was proposed.This study can provide theoretical guidance for the preparation of efficient and stable catalysts for the degradation of organic pollutants by activated PMS.

A dual-RPA based lateral flow strip for sensitive,on-site detection of CP4-EPSPS and Cry1Ab/Ac genes in genetically modified crops

Traditional transgenic detection methods require high test conditions and struggle to be both sensitive and efficient.In this study,a one-tube dual recombinase polymerase amplification(RPA)reaction system for CP4-EPSPS and Cry1Ab/Ac was proposed and combined with a lateral flow immunochromatographic assay,named“Dual-RPA-LFD”,to visualize the dual detection of genetically modified(GM)crops.In which,the herbicide tolerance gene CP4-EPSPS and the insect resistance gene Cry1Ab/Ac were selected as targets taking into account the current status of the most widespread application of insect resistance and herbicide tolerance traits and their stacked traits.Gradient diluted plasmids,transgenic standards,and actual samples were used as templates to conduct sensitivity,specificity,and practicality assays,respectively.The constructed method achieved the visual detection of plasmid at levels as low as 100 copies,demonstrating its high sensitivity.In addition,good applicability to transgenic samples was observed,with no cross-interference between two test lines and no influence from other genes.In conclusion,this strategy achieved the expected purpose of simultaneous detection of the two popular targets in GM crops within 20 min at 37°C in a rapid,equipmentfree field manner,providing a new alternative for rapid screening for transgenic assays in the field.

Defining the association between the prolonged operative time and 90-day complications in patients undergoing radical cystectomy

Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).

Detection of Oxidants Such as Hydroxyl Radicals and Chlorine Electrogenerated on a BDD Electrode by Simple Methods

The aim of this work is to detect electrogenerated hydroxyl radicals and chlorine by simple and less expensive methods. Preparative electrolyses of perchloric acid (HClO4) and sodium chloride (NaCl) were performed on a boron-doped diamond (BDD) electrode. The hydroxyl radicals were quantified indirectly by assaying the samples from the HClO4 (0.1 M) electrolysis with a 10−4 M potassium permanganate solution. The investigations showed that the amount of hydroxyl radicals depends on the concentration of HClO4 and the current density. As for chlorine, a qualitative determination was carried out. A mixture of the electrolyte solution of HClO4 (0.1 M) + NaI (0.2 M) + 2 mL of hexane, taken in this order, leads to a purplish-pink coloration attesting to the presence of Cl2. The same test was carried out with NaBr and NaI giving pale and very pale pink colourations, respectively, showing that the intensity of the colouration depends on the strength of the oxidant present. In addition, oxidants were detected during the electrooxidation of metronidazole (MNZ). The results showed the participation of electrogenerated hydroxyl radicals. The generation of chlorine has also been proven. Furthermore, the degradation leads to a chemical oxygen demand (COD) removal rate of 83.48% and the process is diffusion-controlled.

Enhanced Precision Therapy of Multiple Myeloma Through Engineered Biomimetic Nanoparticles with Dual Targeting

Multiple myeloma(MM)is the second most prevalent hematological malignancy.Current MM treatment strategies are hampered by systemic toxicity and suboptimal therapeutic efficacy.This study addressed these limitations through the development of a potent MM-targeting chemotherapy strategy,which capitalized on the high binding affinity of alendronate for hydroxyapatite in the bone matrix and the homologous targeting of myeloma cell membranes,termed T-PB@M.The results from our investigations highlight the considerable bone affinity of T-PB@M,both in vitro and in vivo.Additionally,this material demonstrated a capability for drug release triggered by low pH conditions.Moreover,T-PB@M induced the generation of reactive oxygen species and triggered cell apoptosis through the poly(ADP-ribose)polymerase 1(PARP1)-Caspase-3-B-cell lymphoma-2(Bcl-2)pathway in MM cells.Notably,T-PB@M preferentially targeted bone-involved sites,thereby circumventing systemic toxic side effects and leading to prolonged survival of MM orthotopic mice.Therefore,this designed target-MM nanocarrier presents a promising and potentially effective platform for the precise treatment of MM.

SUMS OF DUAL TOEPLITZ PRODUCTS ON THE ORTHOGONAL COMPLEMENTS OF FOCK-SOBOLEV SPACES

We consider dual Toeplitz operators on the orthogonal complements of the FockSobolev spaces of all nonnegative real orders.First,for symbols in a certain class containing all bounded functions,we study the problem of when an operator which is finite sums of the dual Toeplitz products is compact or zero.Next,for bounded symbols,we construct a symbol map and exhibit a short exact sequence associated with the C^(*)-algebra generated by all dual Toeplitz operators with bounded symbols.

A Sustainable Dual Cross‑Linked Cellulose Hydrogel Electrolyte for High‑Performance Zinc‑Metal Batteries

Aqueous rechargeable Zn-metal batteries(ARZBs)are considered one of the most promising candidates for grid-scale energy storage.However,their widespread commercial application is largely plagued by three major challenges:The uncontrollable Zn dendrites,notorious parasitic side reactions,and sluggish Zn^(2+) ion transfer.To address these issues,we design a sustainable dual crosslinked cellulose hydrogel electrolyte,which has excellent mechanical strength to inhibit dendrite formation,high Zn^(2+) ions binding capacity to suppress side reaction,and abundant porous structure to facilitate Zn^(2+) ions migration.Consequently,the Zn||Zn cell with the hydrogel electrolyte can cycle stably for more than 400 h under a high current density of 10 mA cm^(−2).Moreover,the hydrogel electrolyte also enables the Zn||polyaniline cell to achieve high-rate and long-term cycling performance(>2000 cycles at 2000 mA g^(−1)).Remarkably,the hydrogel electrolyte is easily accessible and biodegradable,making the ARZBs attractive in terms of scalability and sustainability.

Finely regulated luminescent Ag-In-Ga-S quantum dots with green-red dual emission toward white light-emitting diodes

Ag-In-Ga-S(AIGS)quantum dots(QDs)have recently attracted great interests due to the outstanding optical properties and eco-friendly components,which are considered as an alternative replacement for toxic Pb-and Cd-based QDs.However,enormous attention has been paid to how to narrow their broadband spectra,ignoring the application advantages of the broadband emission.In this work,the AIGS QDs with controllable broad green-red dual-emission are first reported,which is achieved through adjusting the size distribution of QDs by controlling the nucleation and growth of AIGS crystals.Resultantly,the AIGS QDs exhibit broad dual-emission at green-and red-band evidenced by photoluminescence(PL)spectra,and the PL relative intensity and peak position can be finely adjusted.Furthermore,the dual-emission is the intrinsic characteristics from the difference in confinement effect of large particles and tiny particles confirmed by temperature-dependent PL spectra.Accordingly,the AIGS QDs(the size consists of 17 nm and 3.7 nm)with 530 nm and 630 nm emission could successfully be synthesized at 220°C.By combining the blue light-emitting diode(LED)chips and dual-emission AIGS QDs,the constructed white light-emitting devices(WLEDs)exhibit a continuous and broad spectrum like natural sunlight with the Commission Internationale de l’Eclairage(CIE)chromaticity coordinates of(0.33,0.31),a correlated color temperature(CCT)of 5425 K,color rendering index(CRI)of 90,and luminous efficacy of radiation(LER)of 129 lm/W,which indicates that the AIGS QDs have huge potential for lighting applications.

Mg/Fe site-specific dual-doping to boost the performance of cobalt-free nickle-rich layered oxide cathode for high-energy lithium-ion batteries

Layer-type LiNi0.9Mn0.1O2is promising to be the primary cathode material for lithium-ion batteries(LIBs)due to its excellent electrochemical performance.Unfortunately,the cathode with high nickel content suffers from severely detrimental structural transformation that causes rapid capacity attenuation.Herein,site-specific dual-doping with Fe and Mg ions is proposed to enhance the structural stability of LiNi0.9Mn0.1O2.The Fe3+dopants are inserted into transition metal sites(3b)and can favorably provide additional redox potential to compensate for charge and enhance the reversibility of anionic redox.The Mg ions are doped into the Li sites(3a)and serve as O_(2)^(-)-Mg^(2+)-O_(2)^(-)pillar to reinforce the electrostatic cohesion between the two adjacent transition-metal layers,which further suppress the cracking and the generation of harmful phase transitions,ultimately improving the cyclability.The theoretical calculations,including Bader charge and crystal orbital Hamilton populations(COHP)analyses,confirm that the doped Fe and Mg can form stable bonds with oxygen and the electrostatic repulsion of O_(2)^(-)-O_(2)^(-)can be effectively suppressed,which effectively mitigates oxygen anion loss at the high delithiation state.This dual-site doping strategy offers new avenues for understanding and regulating the crystalline oxygen redox and demonstrates significant potential for designing high-performance cobalt-free nickel-rich cathodes.

The impact of chemotherapy-naïve open radical cystectomy delay and perioperative transfusion on the recurrence-free survival: A perioperative parameters-based nomogram

Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential predictors.Methods: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve analysis.Results: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the nomogram.Conclusion: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.

Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication in Chinese population:A prospective,multicenter,randomized,two-stage study

BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(H.pylori)is controversial.AIM To evaluate the efficacy of VAT in the Chinese population.METHODS This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).H.pylori-infected patients were randomized to bismuth quadruple therapy(BQT),BQT-Vonoprazan(BQT-V),seven-day VAT(VAT-7),ten-day VAT(VAT-10),and fourteen-day VAT(VAT-14)groups.The primary endpoint was the H.pylori eradication rate.The secondary endpoint was the frequency of adverse events.This study was registered with the Chinese Clinical Trial Registry,ChiCTR2100045778.RESULTS In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were eradicated.In the second stage,the eradication rates for BQT,VAT-10,and VA-14 were 80.2%[95%confidence interval(95%CI):71.4%-86.8%],93.2%(86.6%-96.7%),92.2%(85.3%-96.0%)in the intention-to-treat(ITT)analysis,and 80.9%(95%CI:71.7%-87.5%),94.0%(87.5%-97.2%),and 93.9%(87.4%-97.2%)in the per-protocol analysis.The ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group(P=0.022 and P=0.046,respectively).The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group(25.27%and 13.73%vs 37.62%,respectively;P<0.001).CONCLUSION VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT,with a more tolerable safety profile in H.pylori-infected patients in Fujian.Huang XP et al.VAT for H.pylori eradication.

A Dual-Cluster-Head Based Medium Access Control for Large-Scale UAV Ad-Hoc Networks

Unmanned Aerial Vehicle(UAV)ad hoc network has achieved significant growth for its flexibility,extensibility,and high deployability in recent years.The application of clustering scheme for UAV ad hoc network is imperative to enhance the performance of throughput and energy efficiency.In conventional clustering scheme,a single cluster head(CH)is always assigned in each cluster.However,this method has some weaknesses such as overload and premature death of CH when the number of UAVs increased.In order to solve this problem,we propose a dual-cluster-head based medium access control(DCHMAC)scheme for large-scale UAV networks.In DCHMAC,two CHs are elected to manage resource allocation and data forwarding cooperatively.Specifically,two CHs work on different channels.One of CH is used for intra-cluster communication and the other one is for inter-cluster communication.A Markov chain model is developed to analyse the throughput of the network.Simulation result shows that compared with FM-MAC(flying ad hoc networks multi-channel MAC,FM-MAC),DCHMAC improves the throughput by approximately 20%~50%and prolongs the network lifetime by approximately 40%.