Long-term settlement prediction of high-speed railway bridge pile foundation

The process and characteristics of loading on high-speed railway bridge pile foundation were firstly obtained by means of field research and analysis,and the corresponding loading function was presented.One-dimensional consolidation equation of elastic multilayered soils was then established with single drainage or double drainages under multilevel loading.Moreover,the formulas for calculating effective stress and settlement were derived from the Laplace numerical inversion transform.The three-dimensional composite analysis method of bridge pile group was improved,where the actual load conditions of pile foundation could be simulated,and the consolidation characteristics of soil layers beneath pile were also taken into account.Eventually,a corresponding program named LTPGS was developed to improve the calculation efficiency.The comparison between long-term settlement obtained from the proposed method and the in-situ measurements of pile foundation was illustrated,and a close agreement is obtained.The error between computed and measured results is less than 1 mm,and it gradually reduces with time.It is shown that the proposed method can effectively simulate the long-term settlement of pile foundation and program LTPGS can provide a reliable estimation.

Long-Term Settlement Characterization of High-Filling Foundation in the Mountain Excavation and City Construction Area of the Yan’an New District,China

Mountain Excavation and City Construction(MECC)represents a prominent anthropogenic endeavor aimed at facilitating urban expansion in the Loess Plateau of China.It is important to comprehend the long-term settlement behavior at MECC engineering sites to effectively assess the project’s success in reshaping landscapes and expanding urban areas.In this study,a typical MECC project,specifically the upstream area of the Liujiagou Valley within the new district of Yan’an City,is selected as a case study to investigate long-term settlement characteristics.The research involved conducting creep tests on soil samples with varying dry densities and moisture content and continuous in-situ monitoring of ground surface settlement at 17 specific points.Furthermore,a numerical model was developed and calibrated using the in-situ monitoring data to predict the long-term settlement.The findings reveal that an increase in soil dry density and a decrease in soil water content contribute to reduced deformation.Notably,settlement primarily manifests within the filled areas,with greater soil thickness exacerbating settlement effects.Over time,cumulative settlement exhibits a progressively diminishing rate of deformation until it attains a stable state.These results provide insights for assessing the long-term stability of MECC projects,facilitating decision-making in future endeavors within this region.

Spatial-temporal differentiation and influencing factors of rural settlements in mountainous areas: an example of Liangshan Yi Autonomous Prefecture, Southwestern China

Rural settlement is the basic spatial unit for compact communities in rural area. Scientific exploration of spatial-temporal differentiation and its influencing factors is the premise of spatial layout rationalization. Based on land use data of Liangshan Yi Autonomous Prefecture(hereinafter referred to as Liangshan Prefecture) in Sichuan Province, China from 1980 to 2020, compactness index, fractal dimension, imbalance index, location entropy and the optimal parameters-based geographical detector(OPGD) model are used to analyze the spatial-temporal evolution of the morphological characteristics of rural settlements, and to explore the influence of natural geographical factors, socioeconomic factors, and policy factors on the spatial differentiation of rural settlements. The results show that:(1) From 1980 to 2020, the rural settlements area in Liangshan Prefecture increased by 15.96 km^(2). In space, the rural settlements are generally distributed in a local aggregation, dense in the middle and sparse around the periphery. In 2015, the spatial density and expansion index of rural settlements reached the peak.(2) From 1980 to 2020, the compactness index decreased from 0.7636 to 0.7496, the fractal dimension increased from 1.0283 to 1.0314, and the fragmentation index decreased from 0.1183 to 0.1047. The spatial morphological structure of rural settlements tended to be loose, the shape contour tended to be complex, the degree of fragmentation decreased, and the spatial distribution was significantly imbalanced.(3) The results of OPGD detection in 2015 show that the influence of each factor is slope(0.2371) > traffic accessibility(0.2098) > population(0.1403) > regional GDP(0.1325) > elevation(0.0987) > poverty alleviation(0). The results of OPGD detection in 2020 show that the influence of each factor is slope(0.2339) > traffic accessibility(0.2198) > population(0.1432) > regional GDP(0.1219) > poverty alleviation(0.0992) > elevation(0.093). Natural geographical factors(slope and elevation) are the basic factors affecting the spatial distribution of rural settlements, and rural settlements are widely distributed in the river valley plain and the second half mountain area. Socioeconomic factors(traffic accessibility, population, and regional GDP) have a greater impact on the spatial distribution of rural settlements, which is an important factor affecting the spatial distribution of rural settlements. Policy factors such as poverty alleviation relocation have an indispensable impact on the spatial distribution of rural settlements. The research results can provide decisionmaking basis for the spatial arrangement of rural settlements in Liangshan Prefecture, and optimize the implementation of rural revitalization policies.

Post-disaster spatial reconstruction from the perspective of a rural settlement niche in the upper reaches of the Minjiang River

Post-disaster recovery and reconstruction provide an effective way to reduce the disaster vulnerability of, and promote leapfrog development in, an affected area. To date, studies that have used administrative boundaries to investigate the reconstruction of settlement space have not been able to clearly define the real boundaries of land use changes or quantify the degree of response to the ‘Build-Back-Better’ initiative, and have lacked any consideration of the fourth reconstruction stage–development period(10 years). This study constructed a mountain settlement niche and analyzed the characteristics, spatial reconstruction, and drivers of rural settlements during 2009–2019 in the upper reaches of the Minjiang River, southwest China. The results showed the following:(1) Natural factors were the basis for the formation and development of mountain settlement niches. The scale of the settlement niche and its land use structure depended on the physical geography features and the ethnic farming and grazing traditions. The settlement niche provided a realistic boundary for the spatial reconstruction.(2) The layout of residential land around cropland was the common feature of the mountain settlement niche. Of all the land use types, the roads and rural residential lands showed the most change over the 10 years;13,860 residential patches increased in size and 4,742 patches were abandoned.(3) The area of orchards, planted to reconstruct the economy in the mountains, increased by nearly 2.5 times.(4) Collapses, landslides, and debris flow disasters and the ecological red line influenced the spatial reconstruction. While the main focus of post-disaster recovery is spatial reconstruction, initiatives should include economic and spiritual recovery, and should also achieve sustainable development of the region.

An efficient physics-guided Bayesian framework for predicting ground settlement profile during excavations in clay

Recently,the application of Bayesian updating to predict excavation-induced deformation has proven successful and improved prediction accuracy significantly.However,updating the ground settlement profile,which is crucial for determining potential damage to nearby infrastructures,has received limited attention.To address this,this paper proposes a physics-guided simplified model combined with a Bayesian updating framework to accurately predict the ground settlement profile.The advantage of this model is that it eliminates the need for complex finite element modeling and makes the updating framework user-friendly.Furthermore,the model is physically interpretable,which can provide valuable references for construction adjustments.The effectiveness of the proposed method is demonstrated through two field case studies,showing that it can yield satisfactory predictions for the settlement profile.

Long-Term Performance and Microstructural Characterization of Dam Concrete in the Three Gorges Project

This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled from the Three Gorges Dam.The mechanical properties of the laboratory dam concrete,whether cured in natural or standard environments,continued to improve over time.Furthermore,the laboratory dam concrete exhibited good resistance to diffusion and a refined microstructure after 17 years.However,curing and long-term exposure to the local natural environment reduced the frost resistance.Microstructural analyses of the laboratory concrete samples demonstrated that moderate-heat cement and fine fly ash(FA)particles were almost fully hydrated to form compact micro structures consisting of large quantities of homogeneous calcium(alumino)silicate hydrate(C-(A)-S-H)gels and a few crystals.No obvious interfacial transition zones were observed in the microstructure owing to the longterm pozzolanic reaction.This dense and homogenous microstructure was the crucial reason for the excellent long-term performance of the dam concrete.A high FA volume also played a significant role in the microstructural densification and performance growth of dam concrete at a later age.The concrete drilled from the dam surface exhibited a loose microstructure with higher microporosity,indicating that concrete directly exposed to the actual service environment suffered degradation caused by water and wind attacks.In this study,both macro-performance and microstructural analyses revealed that the application of moderate-heat cement and FA resulted in a dense and homogenous microstructure,which ensured the excellent long-term performance of concrete from the Three Gorges Dam after 17 years.Long-term exposure to an actual service environment may lead to microstructural degradation of the concrete surface.Therefore,the retained long-term dam concrete samples need to be further researched to better understand its microstructural evolution and development of its properties.

Long-term thinning decreases the contribution of heterotrophic respiration to soil respiration in subalpine plantations

Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.

Soil bacterial and fungal communities resilience to long-term nitrogen addition in subtropical forests in China

Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.

Prediction of subsurface settlement induced by shield tunnelling in sandy cobble stratum

This study focuses on the analytical prediction of subsurface settlement induced by shield tunnelling in sandy cobble stratum considering the volumetric deformation modes of the soil above the tunnel crown.A series of numerical analyses is performed to examine the effects of cover depth ratio(C/D),tunnel volume loss rate(h t)and volumetric block proportion(VBP)on the characteristics of subsurface settle-ment trough and soil volume loss.Considering the ground loss variation with depth,three modes are deduced from the volumetric deformation responses of the soil above the tunnel crown.Then,analytical solutions to predict subsurface settlement for each mode are presented using stochastic medium theory.The influences of C/D,h t and VBP on the key parameters(i.e.B and N)in the analytical expressions are discussed to determine the fitting formulae of B and N.Finally,the proposed analytical solutions are validated by the comparisons with the results of model test and numerical simulation.Results show that the fitting formulae provide a convenient and reliable way to evaluate the key parameters.Besides,the analytical solutions are reasonable and available in predicting the subsurface settlement induced by shield tunnelling in sandy cobble stratum.

Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

Assessment of the Influence of Tunnel Settlement on Operational Performance of Subway Vehicles

In the realm of subway shield tunnel operations,the impact of tunnel settlement on the operational performance of subway vehicles is a crucial concern.This study introduces an advanced analytical model to investigate rail geometric deformations caused by settlement within a vehicle-track-tunnel coupled system.The model integrates the geometric deformations of the track,attributed to settlement,as track irregularities.A novel“cyclic model”algorithm was employed to enhance computational efficiency without compromising on precision,a claim that was rigorously validated.The model’s capability extends to analyzing the time-history responses of vehicles traversing settlement-affected areas.The research primarily focuses on how settlement wavelength,amplitude,and vehicle speed influence operational performance.Key findings indicate that an increase in settlement wavelength can improve vehicle performance,whereas a rise in amplitude can degrade it.The study also establishes settlement thresholds,based on vehicle operation comfort and safety.These insights are pivotal for maintaining and enhancing the safety and efficiency of subway systems,providing a valuable framework for urban infrastructure management and long-term maintenance strategies in metropolitan transit systems.

Prediction of high-embankment settlement combining joint denoising technique and enhanced GWO-v-SVR method

Reliable long-term settlement prediction of a high embankment relates to mountain infrastructure safety.This study developed a novel hybrid model(NHM)that combines a joint denoising technique with an enhanced gray wolf optimizer(EGWO)-n-support vector regression(n-SVR)method.High-embankment field measurements were preprocessed using the joint denoising technique,which in-cludes complete ensemble empirical mode decomposition,singular value decomposition,and wavelet packet transform.Furthermore,high-embankment settlements were predicted using the EGWO-n-SVR method.In this method,the standard gray wolf optimizer(GWO)was improved to obtain the EGWO to better tune the n-SVR model hyperparameters.The proposed NHM was then tested in two case studies.Finally,the influences of the data division ratio and kernel function on the EGWO-n-SVR forecasting performance and prediction efficiency were investigated.The results indicate that the NHM suppresses noise and restores details in high-embankment field measurements.Simultaneously,the NHM out-performs other alternative prediction methods in prediction accuracy and robustness.This demonstrates that the proposed NHM is effective in predicting high-embankment settlements with noisy field mea-surements.Moreover,the appropriate data division ratio and kernel function for EGWO-n-SVR are 7:3 and radial basis function,respectively.

New Rural Community Construction or Retention Development:A Comparative Analysis of Rural Settlement Transition Mechanism in Plain Agriculture Area of China Based on Actor Network Theory

It is an important way to realize rural revitalization and sustainable development to guide rural settlement transition(RST)in an appropriate way.This paper uses actor network theory(ANT)to construct a theoretical framework for the study of RST.Taking two typical villages with different transition paths in rural areas of North China Plain as examples,this paper reveals the mechanism of RST and makes a comparative analysis.The results show that:1)after identifying problems and obligatory passage point,key actors recruit heterogeneous actors into the actor network by entrusting them with common interests,and realize RST under the system operation.2)Rural settlements under different transition paths have similarities in the problems to be solved,collective actions and policy factors,but there are differences in the transition process,mechanism and effect.The actor network and mechanism of RST through the path of new rural community construction are more complex and the transition effect is more thorough.In contrast,the degree of RST of retention development path is limited if there is no resource and location advantage.3)Based on the applicable conditions of different paths,this paper designs a logical framework of‘Situation-Structure-Behavior-Result’to scientifically guide the identification of RST paths under the background of rural revitalization.

Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there have been no specific studies on predicting long-term survival after TIPS placement.AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.METHODS A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS implantation.Through univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after TIPS.Consequently,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)level.Furthermore,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing models.RESULTS The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement.The NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation cohorts.Additionally,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients and guide follow-up management after TIPS implantation.

Long-Term Mortality of Children with Congenital Heart Disease Admitted to the Departmental University Hospital of Borgou/Alibori from 2011 to 2022

Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.

Reflections on the Improvement of Rural Human Settlement Environment from the Perspective of Beauty and Livability

The construction of beautiful and livable villages is one of the important tasks of ruralrevitalization in the new era, and the development of rural areas attaches more and more importanceto the improvement of human settlement environment. By investigating the construction status andexisting problems of Zhaoba Village in Nanjing, it tries to take “beauty” and “livability” as the planningrequirements. The village positioning is planned accurately, and the functional layout is carried outreasonably. According to the characteristic industries, landscape features and infrastructure of ZhaobaVillage, humanized construction strategies are put forward, thus improving the quality of human settlementenvironment in Zhaoba Village.

Long-term performance of recycled asphalt mixtures containing high RAP and RAS

The application of reclaimed asphalt pavement(RAP)and reclaimed asphalt shingles(RAS)on asphalt pavement can reduce the asphalt paving cost,conserve energy and protect the environment.However,the use of high contents of RAP and RAS in asphalt pavement may lead to durability issues,especially the fatigue cracking and thermal cracking.It is necessary to conduct a series of analyses on asphalt mixtures containing high RAP and RAS,and seek methods to enhance their long-term performance.This paper provides a comprehensive over-view of the long-term performance of recycled asphalt mixtures containing high contents of RAP and RAS.The findings in this research show that rutting resistance of high recycled asphalt mixtures is not a concern,whereas their resistance to fatigue and thermal cracking is not conclusive.Recycling agents can be used to improve the thermal cracking resistance of high recycled asphalt mixtures.An optimum decision on recycling agents will improve the durability properties of high recycled asphalt mixtures.It is recommended that to use a balanced mixture design approach with testing of the blended asphalt binders will provide better understanding of long-term performance of recycled asphalt mixtures containing high RAP and RAS.

Characteristics of early gastric tumors with different differentiation and predictors of long-term outcomes after endoscopic submucosal dissection

BACKGROUND Gastric cancer is a common malignant tumor of the digestive tract,and endosco-pic submucosal dissection(ESD)is the preferred treatment for early-stage gastric cancer.The analysis of the epidemiological characteristics of gastric mucosal tumors with different differentiation degrees and the influencing factors of long-term ESD efficacy may have certain significance for revealing the development of gastric cancer and ESD.AIM To analyze the features of gastric mucosal tumors at different differentiation levels,and to explore the prognostic factors of ESD.METHODS We retrospectively studied 301 lesions in 285 patients at The Second Affiliated Hospital of Xi'an Jiaotong University from 2014 to 2021,according to the latest Japanese guidelines(sixth edition),and divided them into low-grade intrae-pithelial neoplasia(LGIN),high-grade intraepithelial neoplasia(HGIN),and computed tomography at 3,6 and 12 months after ESD.We compared clinicopathologic characteristics,ESD efficacy,and complications with different degrees of differentiation,and analyzed the related factors associated with ESD.RESULTS HGIN and differentiated carcinoma patients were significantly older compared with LGIN patients(P<0.001)and accounted for more 0-IIc(P<0.001),atrophic gastritis was common(P<0.001),and irregular microvascular patterns(IMVPs)and demarcation lines(DLs)were more obvious(P<0.001).There was more infiltration in the undifferentiated carcinoma tissue(P<0.001),more abnormal folds and poorer mucosal peristalsis(P<0.001),and more obvious IMVPs,irregular microsurface patterns and DLs(P<0.05)than in the LGIN and HGIN tissues.The disease-free survival rates at 2,5,and 8 years after ESD were 95.0%,90.1%,and 86.9%,respectively.Undifferen-tiated lesions(HR 5.066),white moss(HR 7.187),incomplete resection(HR 3.658),and multiple primary cancers(HR 2.462)were significantly associated with poor prognosis.CONCLUSION Differentiations of gastric mucosal tumors have different epidemiological and endoscopic characteristics,which are closely related to the safety and efficacy of ESD.

Model-Based Systems Engineering Approach to Design a Human Settlement to Better Serve Displaced People

The challenge of transitioning from temporary humanitarian settlements to more sustainable human settlements is due to a significant increase in the number of forcibly displaced people over recent decades, difficulties in providing social services that meet the required standards, and the prolongation of emergencies. Despite this challenging context, short-term considerations continue to guide their planning and management rather than more integrated, longer-term perspectives, thus preventing viable, sustainable development. Over the years, the design of humanitarian settlements has not been adapted to local contexts and perspectives, nor to the dynamics of urbanization and population growth and data. In addition, the current approach to temporary settlement harms the environment and can strain limited resources. Inefficient land use and ad hoc development models have compounded difficulties and generated new challenges. As a result, living conditions in settlements have deteriorated over the last few decades and continue to pose new challenges. The stakes are such that major shortcomings have emerged along the way, leading to disruption, budget overruns in a context marked by a steady decline in funding. However, some attempts have been made to shift towards more sustainable approaches, but these have mainly focused on vague, sector-oriented themes, failing to consider systematic and integration views. This study is a contribution in addressing these shortcomings by designing a model-driving solution, emphasizing an integrated system conceptualized as a system of systems. This paper proposes a new methodology for designing an integrated and sustainable human settlement model, based on Model-Based Systems Engineering and a Systems Modeling Language to provide valuable insights toward sustainable solutions for displaced populations aligning with the United Nations 2030 agenda for sustainable development.

Long-term outcomes after endoscopic removal of malignant colorectal polyps:Results from a 10-year cohort

BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020.Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were invest-igated.Event rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were performed.Potential risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were enrolled.The proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,respectively.Tumor differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,respectively.Residual tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection.Univariate analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance examinations.Adverse outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance only.CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy needs improvement.Long-term adverse outcome rates might be higher than previously reported,irrespective of whether secondary surgery was performed.