Controlling the size and distribution of potential barriers within a medium of interacting particles can unveil unique collective behaviors and innovative functionalities.We introduce a unique superconducting hybrid d...Controlling the size and distribution of potential barriers within a medium of interacting particles can unveil unique collective behaviors and innovative functionalities.We introduce a unique superconducting hybrid device using a novel artificial spin ice structure composed of asymmetric nanomagnets.This structure forms a distinctive superconducting pinning potential that steers unconventional motion of superconducting vortices,thereby inducing a magnetic nonreciprocal effect,in contrast to the electric nonreciprocal effect commonly observed in superconducting diodes.Furthermore,the polarity of the magnetic nonreciprocity is in situ reversible through the tunable magnetic patterns of artificial spin ice.Our findings demonstrate that artificial spin ice not only precisely modulates superconducting characteristics but also opens the door to novel functionalities,offering a groundbreaking paradigm for superconducting electronics.展开更多
We compare Newton’s force law of universal gravitation with a corrected simple approach based on Bhandari’s recently presented work, where the gravitation constant G is maintained. A reciprocity relation exists betw...We compare Newton’s force law of universal gravitation with a corrected simple approach based on Bhandari’s recently presented work, where the gravitation constant G is maintained. A reciprocity relation exists between both alternative gravity formulas with respect to the distances between mass centers. We conclude a one-to-one mapping of the two gravitational formulas. We don’t need Einstein’s construct of spacetime bending by matter.展开更多
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 an...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.展开更多
Quantum nonreciprocity, such as nonreciprocal photon blockade, has attracted a great deal of attention due to its unique applications in quantum information processing. Its implementation primarily relies on rotating ...Quantum nonreciprocity, such as nonreciprocal photon blockade, has attracted a great deal of attention due to its unique applications in quantum information processing. Its implementation primarily relies on rotating nonlinear systems, based on the Sagnac effect. Here, we propose an all-optical approach to achieve nonreciprocal photon blockade in an on-chip microring resonator coupled to a V-type Rb atom, which arises from the Zeeman splittings of the atomic hyperfine sublevels induced by the fictitious magnetic field of a circularly polarized control laser. The system manifests single-photon blockade or multi-photon tunneling when driven from opposite directions. This nonreciprocity results from the directional detunings between the countercirculating probe fields and the V-type atom, which does not require the mechanical rotation and facilitates integration. Our work opens up a new route to achieve on-chip integrable quantum nonreciprocity, enabling applications in chiral quantum technologies.展开更多
Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether perf...Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.展开更多
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 ...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.展开更多
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 no...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.展开更多
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 silvicult...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.展开更多
Let G be a connected graph of order n and m_(RD)^(L)_(G)I denote the number of reciprocal distance Laplacian eigenvaluesof G in an interval I.For a given interval I,we mainly present several bounds on m_(RD)^(L)_(G)I ...Let G be a connected graph of order n and m_(RD)^(L)_(G)I denote the number of reciprocal distance Laplacian eigenvaluesof G in an interval I.For a given interval I,we mainly present several bounds on m_(RD)^(L)_(G)I in terms of various structuralparameters of the graph G,including vertex-connectivity,independence number and pendant vertices.展开更多
Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such ...Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such as work fatigue,heavy workloads,and inadequate support.These issues can impact job satisfaction,mental health,and care quality,leading to staff turnover.This study examines how optimism,social support,and psychological resilience relate to caregiving burden,aiming to understand their effects on caregivers’well-being and performance to enhance the quality of long-term care services.Methods:The participants were 542 long-term care workers.Descriptive statistics,t-tests,one-way ANOVA,and hierarchical regression were used for data analysis.Results:(1)Optimism and social support were significantly and positively correlated with psychological resilience and significantly and negatively associated with caregiving burden.(2)Regarding differences in optimism,social support,psychological resilience,and caregiving burden among long-term care workers,females scored significantly higher than males in“social support;”married workers scored significantly higher than unmarried workers in“optimism,”“social support,”and“psychological resilience”;workers aged 45–65 scored significantly higher than those aged 25–45 in“optimism”;workers aged 25–45 scored significantly higher than those aged 45–65 in“caregiving burden”;social workers scored significantly higher than nursing staff in“optimism.”(3)Psychological resilience partially mediated the relationship between social support and caregiving burden concerning explanatory and predictive power.Conclusions:These findings suggest that optimism,social support,and psychological resilience are essential factors in reducing the caregiving burden among long-term care workers.The study highlights the importance of promoting psychological resilience and providing social support to alleviate the burden of caregiving.展开更多
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 hav...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.展开更多
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 admitte...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.展开更多
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 ...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.展开更多
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 char...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.展开更多
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...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.展开更多
Marine heatwaves(MHWs)can cause irreversible damage to marine ecosystems and livelihoods.Appropriate MHW characterization remains difficult,because the choice of a sea surface temperature(SST)temporal baseline strongl...Marine heatwaves(MHWs)can cause irreversible damage to marine ecosystems and livelihoods.Appropriate MHW characterization remains difficult,because the choice of a sea surface temperature(SST)temporal baseline strongly influences MHW identification.Following a recent work suggesting that there should be a communicating baseline for long-term ocean temperature trends(LTT)and MHWs,we provided an effective and quantitative solution to calculate LTT and MHWs simultaneously by using the ensemble empirical mode decomposition(EEMD)method.The long-term nonlinear trend of SST obtained by EEMD shows superiority over the traditional linear trend in that the data extension does not alter prior results.The MHWs identified from the detrended SST data exhibited low sensitivity to the baseline choice,demonstrating the robustness of our method.We also derived the total heat exposure(THE)by combining LTT and MHWs.The THE was sensitive to the fixed-period baseline choice,with a response to increasing SST that depended on the onset time of a perpetual MHW state(identified MHW days equal to the year length).Subtropical areas,the Indian Ocean,and part of the Southern Ocean were most sensitive to the long-term global warming trend.展开更多
The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy...The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy development. Previous attempts to address this problem has been unsatisfactory because they can only reduce the strength decline rate. This study presents a new solution to this problem by incorporating fly ash to the traditional silica-cement systems. The influences of fly ash and silica on the strength retrogression behavior of oil well cement systems directly set and cured under the condition of 200°C and 50 MPa are investigated. Test results indicate that the slurries containing only silica or fly ash experience severe strength retrogression from 2 to 30 d curing, while the slurries containing both fly ash and silica experience strength enhancement from 2 to 90 d. The strength test results are corroborated by further evidences from permeability tests as well as microstructure analysis of set cement. Composition of set cement evaluated by quantitative X-ray diffraction analyses with partial or no known crystal structure(PONKCS) method and thermogravimetry analyses revealed that the conversion of amorphous C-(A)-S-H to crystalline phases is the primary cause of long-term strength retrogression.The addition of fly ash can reduce the initial amount of C-(A)-S-H in the set cement, and its combined use with silica can prevent the crystallization of C-(A)-S-H, which is believed to be the working mechanism of this new admixture in improving long-term strength stability of oil well cement systems.展开更多
In this work,we report long-term trends in the abundance and breeding performance of Adélie penguins(Pygoscelis adeliae)nesting in three Antarctic colonies(i.e.,at Martin Point,South Orkneys Islands;Stranger Poin...In this work,we report long-term trends in the abundance and breeding performance of Adélie penguins(Pygoscelis adeliae)nesting in three Antarctic colonies(i.e.,at Martin Point,South Orkneys Islands;Stranger Point/Cabo Funes,South Shetland Islands;and Esperanza/Hope Bay in the Antarctic Peninsula)from 1995/96 to 2022/23.Using yearly count data of breeding groups selected,we observed a decline in the number of breeding pairs and chicks in crèche at all colonies studied.However,the magnitude of change was higher at Stranger Point than that in the remaining colonies.Moreover,the index of breeding success,which was calculated as the ratio of chicks in crèche to breeding pairs,exhibited no apparent trend throughout the study period.However,it displayed greater variability at Martin Point compared to the other two colonies under investigation.Although the number of chicks in crèche of Adélie penguins showed a declining pattern,the average breeding performance was similar to that reported in gentoo penguin colonies,specifically,those undergoing a population increase(even in sympatric colonies facing similar local conditions).Consequently,it is plausible to assume a reduction of the over-winter survival as a likely cause of the declining trend observed,at least in the Stranger Point and Esperanza colonies.However,we cannot rule out local effects during the breeding season affecting the Adélie population of Martin Point.展开更多
[Objectives]To analyze the changes in of forest carbon sink and forestry economic development,provide reference for relevant management decisions,ecological governance and resource and environment management,and promo...[Objectives]To analyze the changes in of forest carbon sink and forestry economic development,provide reference for relevant management decisions,ecological governance and resource and environment management,and promote the development of green low-carbon economy in China.[Methods]Based on the data of six forest resource inventories from 1989 to 2018 and related studies,the comprehensive evaluation model of forest carbon sink and forestry economic development,the coupling degree model of forest carbon sink and forestry economic development,and the coupling coordination degree model of forest carbon sink and forestry economic development were adopted.The coupling degree of forest carbon sink and forestry economic development from 1992 to 2018 was analyzed.Stepwise regression and ARIMA model were used to analyze the influencing factors and lagging characteristics of forest carbon sink.The coupling degree between forest carbon sink and forestry economic development in China from 2019 to 2030 was predicted by autoregression and ADF test.The coupling between forest carbon sink and forestry economic development in China and its long-term change characteristics were also discussed in this study.[Results](i)The investment of ecological construction and protection,the actual investment of forestry key ecological projects,GDP and the import of forest products had a significant impact on forest resources carbon stock.The total output value of forestry industry,the actually completed investment of forestry key ecological projects and the export volume of forest products had a significant impact on the forest carbon sink,and the actually completed investment of forestry key ecological projects has the greatest impact on the two.(ii)The impact of actually completed investment of forestry key ecological projects had a lag of 2 years on the forest resources carbon stock and a lag of 1 year on the forest carbon sink.When investing in forest carbon sink,it is necessary to make a good plan in advance,and do a good job in forest resources management and time optimization.(iii)From 1992 to 2018,the coupling degree of forest resources carbon stock,forest carbon sink and long-term development of forestry economy in China was gradually increasing.Although there were some fluctuations in the middle time,the coupling degree of forest resources carbon stock and the long-term development of forestry economy increased by 9.24%annually,and the degree of coupling coordination increased from"serious imbalance"in 1992 to"high-quality coordination"in 2018.From 1993 to 2018,the coupling degree of forest carbon sink and long-term development of forestry economy increased by 9.63%annually,slightly faster than the coupling coordination degree of forest resources carbon stock and long-term development of forestry economy.The coordination level also rose from level 2 in 1993 to level 10 in 2018.(iv)The prediction shows that the coupling coordination degree of forest resources carbon stock,forest carbon sink and the long-term development of forestry economy would increase from 2019 to 2030.The coupling coordination degree(D)values of both were close to 1,the coordination level was also 10 for a long time,and the degree of coupling coordination was also maintained at the"high-quality coordination"level for a long time.[Conclusions]Forest has multiple benefits of society,economy and ecology,and forest carbon sink is only a benefit output.The long-term coupling analysis of forest carbon sink and forestry economic development is a key point to multiple benefit analysis.The analysis shows that the spillover effect and co-evolution effect of forest carbon sink in China are significant.From 1992 to 2018,the coupling coordination degree of forest carbon sink and forestry economic development was gradually rising.The prediction analysis also indicate that the coupling coordination degree between the forest carbon sink and the long-term development of forestry economy will remain at the level of"high-quality coordination"for a long time from 2019 to 2030.Therefore,improving the level of forest management and maintaining the current trend of increasing forest resources are the key to achieving the goal of carbon peaking and carbon neutrality in China.展开更多
With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and t...With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.62288101 and 62274086)the National Key R&D Program of China(Grant No.2021YFA0718802)the Jiangsu Outstanding Postdoctoral Program。
文摘Controlling the size and distribution of potential barriers within a medium of interacting particles can unveil unique collective behaviors and innovative functionalities.We introduce a unique superconducting hybrid device using a novel artificial spin ice structure composed of asymmetric nanomagnets.This structure forms a distinctive superconducting pinning potential that steers unconventional motion of superconducting vortices,thereby inducing a magnetic nonreciprocal effect,in contrast to the electric nonreciprocal effect commonly observed in superconducting diodes.Furthermore,the polarity of the magnetic nonreciprocity is in situ reversible through the tunable magnetic patterns of artificial spin ice.Our findings demonstrate that artificial spin ice not only precisely modulates superconducting characteristics but also opens the door to novel functionalities,offering a groundbreaking paradigm for superconducting electronics.
文摘We compare Newton’s force law of universal gravitation with a corrected simple approach based on Bhandari’s recently presented work, where the gravitation constant G is maintained. A reciprocity relation exists between both alternative gravity formulas with respect to the distances between mass centers. We conclude a one-to-one mapping of the two gravitational formulas. We don’t need Einstein’s construct of spacetime bending by matter.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022 and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.2021-1-I2M-003+1 种基金Undergraduate Innovation Program,No.2023-zglc-06034National Key Clinical Specialty Construction Project,No.ZK108000。
文摘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.
基金supported by the National Natural Science Foundation of China (Grant Nos.12305020 and 92365107)the National Key R&D Program of China (Grant No.2019YFA0308700)+2 种基金the Program for Innovative Talents and Teams in Jiangsu (Grant No.JSSCTD202138)China Postdoctoral Science Foundation (Grant No.2023M731613)Jiangsu Funding Program for Excellent Postdoctoral Talent (Grant No.2023ZB708)。
文摘Quantum nonreciprocity, such as nonreciprocal photon blockade, has attracted a great deal of attention due to its unique applications in quantum information processing. Its implementation primarily relies on rotating nonlinear systems, based on the Sagnac effect. Here, we propose an all-optical approach to achieve nonreciprocal photon blockade in an on-chip microring resonator coupled to a V-type Rb atom, which arises from the Zeeman splittings of the atomic hyperfine sublevels induced by the fictitious magnetic field of a circularly polarized control laser. The system manifests single-photon blockade or multi-photon tunneling when driven from opposite directions. This nonreciprocity results from the directional detunings between the countercirculating probe fields and the V-type atom, which does not require the mechanical rotation and facilitates integration. Our work opens up a new route to achieve on-chip integrable quantum nonreciprocity, enabling applications in chiral quantum technologies.
文摘Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.
基金the financial supports provided by the National Natural Science Foundation of China(U2040222,52293431,and 52278259)。
文摘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.
基金supported by the National Science Foundation of China(No.31770672 and 3137062)the National Basic Research Program of China(No.2010CB950602)。
文摘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.
基金supported by the National Natural Science Foundation of China (Grant Nos.41701296 and 42277481)the Natural Science Foundation of Gansu Province (GrantNo.22JR5RA058)the Youth Science and Technology Fund Program of Gansu Province (Grant No.22JR5RA087).
文摘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.
基金supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region of China“Graph problems of topological parameters based on the spectra of graph matrices”(2021D01C069)the National Natural Science Foundation of the People's Republic of China“The investigation of spectral properties of graph operations and their related problems”(12161085)。
文摘Let G be a connected graph of order n and m_(RD)^(L)_(G)I denote the number of reciprocal distance Laplacian eigenvaluesof G in an interval I.For a given interval I,we mainly present several bounds on m_(RD)^(L)_(G)I in terms of various structuralparameters of the graph G,including vertex-connectivity,independence number and pendant vertices.
文摘Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such as work fatigue,heavy workloads,and inadequate support.These issues can impact job satisfaction,mental health,and care quality,leading to staff turnover.This study examines how optimism,social support,and psychological resilience relate to caregiving burden,aiming to understand their effects on caregivers’well-being and performance to enhance the quality of long-term care services.Methods:The participants were 542 long-term care workers.Descriptive statistics,t-tests,one-way ANOVA,and hierarchical regression were used for data analysis.Results:(1)Optimism and social support were significantly and positively correlated with psychological resilience and significantly and negatively associated with caregiving burden.(2)Regarding differences in optimism,social support,psychological resilience,and caregiving burden among long-term care workers,females scored significantly higher than males in“social support;”married workers scored significantly higher than unmarried workers in“optimism,”“social support,”and“psychological resilience”;workers aged 45–65 scored significantly higher than those aged 25–45 in“optimism”;workers aged 25–45 scored significantly higher than those aged 45–65 in“caregiving burden”;social workers scored significantly higher than nursing staff in“optimism.”(3)Psychological resilience partially mediated the relationship between social support and caregiving burden concerning explanatory and predictive power.Conclusions:These findings suggest that optimism,social support,and psychological resilience are essential factors in reducing the caregiving burden among long-term care workers.The study highlights the importance of promoting psychological resilience and providing social support to alleviate the burden of caregiving.
基金Supported by the Talent Training Plan during the"14th Five-Year Plan"period of Beijing Shijitan Hospital Affiliated to Capital Medical University,No.2023LJRCLFQ.
文摘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.
文摘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.
基金supported by National Natural Science Fund for Excellent Young Scientists Fund Program (Overseas) (Grant No.22FAA02811)Pearl River Talent Plan for the Introduction of High-level Talents (Young Top-notch Talents) (Grant No.2021QN02G744)+1 种基金National Natural Science Foundation of China (Grant No.52178426)the Fundamental Research Funds for the Central Universities (Grant No.SCUT 2022ZYGXZR066 and 2023ZYGXZR001).
文摘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.
基金Supported by Development Program of Shaanxi Province,No.2021SF-221.
文摘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.
基金Supported by the New National Excellence Program of the Ministry for Innovation and Technology From the Source of the National Research,Development and Innovation Fund,No.ÚNKP-22-4-SZTE-296,No.ÚNKP-23-3-SZTE-268,and No.ÚNKP-23-5-SZTE-719the EU’s Horizon 2020 Research and Innovation Program under Grant Agreement,No.739593.
文摘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.
基金Supported by the National Natural Science Foundation of China(Nos.41821004,42276025)the Natural Science Foundation of Shandong Province(No.ZR2021MD027)+1 种基金the National Key Research and Development Program of China(No.2022YFE0140500)the Project of“Development of China-ASEAN blue partnership”started in 2021.
文摘Marine heatwaves(MHWs)can cause irreversible damage to marine ecosystems and livelihoods.Appropriate MHW characterization remains difficult,because the choice of a sea surface temperature(SST)temporal baseline strongly influences MHW identification.Following a recent work suggesting that there should be a communicating baseline for long-term ocean temperature trends(LTT)and MHWs,we provided an effective and quantitative solution to calculate LTT and MHWs simultaneously by using the ensemble empirical mode decomposition(EEMD)method.The long-term nonlinear trend of SST obtained by EEMD shows superiority over the traditional linear trend in that the data extension does not alter prior results.The MHWs identified from the detrended SST data exhibited low sensitivity to the baseline choice,demonstrating the robustness of our method.We also derived the total heat exposure(THE)by combining LTT and MHWs.The THE was sensitive to the fixed-period baseline choice,with a response to increasing SST that depended on the onset time of a perpetual MHW state(identified MHW days equal to the year length).Subtropical areas,the Indian Ocean,and part of the Southern Ocean were most sensitive to the long-term global warming trend.
基金National Natural Science Foundation of China(No.51974352 and No.52288101)China University of Petroleum(East China)(No.2018000025 and No.2019000011)。
文摘The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy development. Previous attempts to address this problem has been unsatisfactory because they can only reduce the strength decline rate. This study presents a new solution to this problem by incorporating fly ash to the traditional silica-cement systems. The influences of fly ash and silica on the strength retrogression behavior of oil well cement systems directly set and cured under the condition of 200°C and 50 MPa are investigated. Test results indicate that the slurries containing only silica or fly ash experience severe strength retrogression from 2 to 30 d curing, while the slurries containing both fly ash and silica experience strength enhancement from 2 to 90 d. The strength test results are corroborated by further evidences from permeability tests as well as microstructure analysis of set cement. Composition of set cement evaluated by quantitative X-ray diffraction analyses with partial or no known crystal structure(PONKCS) method and thermogravimetry analyses revealed that the conversion of amorphous C-(A)-S-H to crystalline phases is the primary cause of long-term strength retrogression.The addition of fly ash can reduce the initial amount of C-(A)-S-H in the set cement, and its combined use with silica can prevent the crystallization of C-(A)-S-H, which is believed to be the working mechanism of this new admixture in improving long-term strength stability of oil well cement systems.
基金Nacional de Promoción Científica y Tecnológica(Grant:PICTO 2010-0111)the Instituto Antártico Argentino-Dirección Nacional del Antártico(PINST-05)provided financial and logistical support.
文摘In this work,we report long-term trends in the abundance and breeding performance of Adélie penguins(Pygoscelis adeliae)nesting in three Antarctic colonies(i.e.,at Martin Point,South Orkneys Islands;Stranger Point/Cabo Funes,South Shetland Islands;and Esperanza/Hope Bay in the Antarctic Peninsula)from 1995/96 to 2022/23.Using yearly count data of breeding groups selected,we observed a decline in the number of breeding pairs and chicks in crèche at all colonies studied.However,the magnitude of change was higher at Stranger Point than that in the remaining colonies.Moreover,the index of breeding success,which was calculated as the ratio of chicks in crèche to breeding pairs,exhibited no apparent trend throughout the study period.However,it displayed greater variability at Martin Point compared to the other two colonies under investigation.Although the number of chicks in crèche of Adélie penguins showed a declining pattern,the average breeding performance was similar to that reported in gentoo penguin colonies,specifically,those undergoing a population increase(even in sympatric colonies facing similar local conditions).Consequently,it is plausible to assume a reduction of the over-winter survival as a likely cause of the declining trend observed,at least in the Stranger Point and Esperanza colonies.However,we cannot rule out local effects during the breeding season affecting the Adélie population of Martin Point.
基金Supported by National Natural Science Foundation of China(72173011).
文摘[Objectives]To analyze the changes in of forest carbon sink and forestry economic development,provide reference for relevant management decisions,ecological governance and resource and environment management,and promote the development of green low-carbon economy in China.[Methods]Based on the data of six forest resource inventories from 1989 to 2018 and related studies,the comprehensive evaluation model of forest carbon sink and forestry economic development,the coupling degree model of forest carbon sink and forestry economic development,and the coupling coordination degree model of forest carbon sink and forestry economic development were adopted.The coupling degree of forest carbon sink and forestry economic development from 1992 to 2018 was analyzed.Stepwise regression and ARIMA model were used to analyze the influencing factors and lagging characteristics of forest carbon sink.The coupling degree between forest carbon sink and forestry economic development in China from 2019 to 2030 was predicted by autoregression and ADF test.The coupling between forest carbon sink and forestry economic development in China and its long-term change characteristics were also discussed in this study.[Results](i)The investment of ecological construction and protection,the actual investment of forestry key ecological projects,GDP and the import of forest products had a significant impact on forest resources carbon stock.The total output value of forestry industry,the actually completed investment of forestry key ecological projects and the export volume of forest products had a significant impact on the forest carbon sink,and the actually completed investment of forestry key ecological projects has the greatest impact on the two.(ii)The impact of actually completed investment of forestry key ecological projects had a lag of 2 years on the forest resources carbon stock and a lag of 1 year on the forest carbon sink.When investing in forest carbon sink,it is necessary to make a good plan in advance,and do a good job in forest resources management and time optimization.(iii)From 1992 to 2018,the coupling degree of forest resources carbon stock,forest carbon sink and long-term development of forestry economy in China was gradually increasing.Although there were some fluctuations in the middle time,the coupling degree of forest resources carbon stock and the long-term development of forestry economy increased by 9.24%annually,and the degree of coupling coordination increased from"serious imbalance"in 1992 to"high-quality coordination"in 2018.From 1993 to 2018,the coupling degree of forest carbon sink and long-term development of forestry economy increased by 9.63%annually,slightly faster than the coupling coordination degree of forest resources carbon stock and long-term development of forestry economy.The coordination level also rose from level 2 in 1993 to level 10 in 2018.(iv)The prediction shows that the coupling coordination degree of forest resources carbon stock,forest carbon sink and the long-term development of forestry economy would increase from 2019 to 2030.The coupling coordination degree(D)values of both were close to 1,the coordination level was also 10 for a long time,and the degree of coupling coordination was also maintained at the"high-quality coordination"level for a long time.[Conclusions]Forest has multiple benefits of society,economy and ecology,and forest carbon sink is only a benefit output.The long-term coupling analysis of forest carbon sink and forestry economic development is a key point to multiple benefit analysis.The analysis shows that the spillover effect and co-evolution effect of forest carbon sink in China are significant.From 1992 to 2018,the coupling coordination degree of forest carbon sink and forestry economic development was gradually rising.The prediction analysis also indicate that the coupling coordination degree between the forest carbon sink and the long-term development of forestry economy will remain at the level of"high-quality coordination"for a long time from 2019 to 2030.Therefore,improving the level of forest management and maintaining the current trend of increasing forest resources are the key to achieving the goal of carbon peaking and carbon neutrality in China.
文摘With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.