Strong coupling and catenary field enhancement in the hybrid plasmonic metamaterial cavity and TMDC monolayers

Strong coupling between resonantly matched surface plasmons of metals and excitons of quantum emitters results in the formation of new plasmon-exciton hybridized energy states.In plasmon-exciton strong coupling,plasmonic nanocavities play a significant role due to their ability to confine light in an ultrasmall volume.Additionally,two-dimensional transition metal dichalcogenides(TMDCs) have a significant exciton binding energy and remain stable at ambient conditions,making them an excellent alternative for investigating light-matter interactions.As a result,strong plasmon-exciton coupling has been reported by introducing a single metallic cavity.However,single nanoparticles have lower spatial confinement of electromagnetic fields and limited tunability to match the excitonic resonance.Here,we introduce the concept of catenary-shaped optical fields induced by plasmonic metamaterial cavities to scale the strength of plasmon-exciton coupling.The demonstrated plasmon modes of metallic metamaterial cavities offer high confinement and tunability and can match with the excitons of TMDCs to exhibit a strong coupling regime by tuning either the size of the cavity gap or thickness.The calculated Rabi splitting of Au-MoSe_2 and Au-WSe_2 heterostructures strongly depends on the catenary-like field enhancement induced by the Au cavity,resulting in room-temperature Rabi splitting ranging between 77.86 and 320 me V.These plasmonic metamaterial cavities can pave the way for manipulating excitons in TMDCs and operating active nanophotonic devices at ambient temperature.

Tailoring MXene Thickness and Functionalization for Enhanced Room‑Temperature Trace NO_(2) Sensing

In this study,precise control over the thickness and termination of Ti3C2TX MXene flakes is achieved to enhance their electrical properties,environmental stability,and gas-sensing performance.Utilizing a hybrid method involving high-pressure processing,stirring,and immiscible solutions,sub-100 nm MXene flake thickness is achieved within the MXene film on the Si-wafer.Functionalization control is achieved by defunctionalizing MXene at 650℃ under vacuum and H2 gas in a CVD furnace,followed by refunctionalization with iodine and bromine vaporization from a bubbler attached to the CVD.Notably,the introduction of iodine,which has a larger atomic size,lower electronegativity,reduce shielding effect,and lower hydrophilicity(contact angle:99°),profoundly affecting MXene.It improves the surface area(36.2 cm^(2) g^(-1)),oxidation stability in aqueous/ambient environments(21 days/80 days),and film conductivity(749 S m^(-1)).Additionally,it significantly enhances the gas-sensing performance,including the sensitivity(0.1119Ωppm^(-1)),response(0.2% and 23%to 50 ppb and 200 ppm NO_(2)),and response/recovery times(90/100 s).The reduced shielding effect of the–I-terminals and the metallic characteristics of MXene enhance the selectivity of I-MXene toward NO2.This approach paves the way for the development of stable and high-performance gas-sensing two-dimensional materials with promising prospects for future studies.

p53 exerts anticancer effects by regulating enhancer formation and activity

The abnormality of the p53 tumor suppressor is crucial in lung cancer development,because p53 regulates target gene promoters to combat cancer.Recent studies have shown extensive p53 binding to enhancer elements.However,whether p53 exerts a tumor suppressor role by shaping the enhancer landscape remains poorly understood.In the current study,we employed several functional genomics approaches to assess the enhancer activity at p53 binding sites throughout the genome based on our established TP53 knockout(KO)human bronchial epithelial cells(BEAS-2B).A total of 943 active regular enhancers and 370 super-enhancers(SEs)disappeared upon the deletion of p53,indicating that p53 modulates the activity of hundreds of enhancer elements.We found that one p53-dependent SE,located on chromosome 9 and designated as KLF4-SE,regulated the expression of the Krüppel-like factor 4(KLF4)gene.Furthermore,the deletion of p53 significantly decreased the KLF4-SE enhancer activity and the KLF4 expression,but increased colony formation ability in the nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone-induced cell transformation model.Subsequently,in TP53 KO cells,the overexpression of KLF4 partially reversed the increased clonogenic capacity caused by p53 deficiency.Consistently,KLF4 expression also decreased in lung cancer tissues and cell lines.It appeared that overexpression of KLF4 significantly suppressed the proliferation and migration of lung cancer cells.Collectively,our results suggest that the regulation of enhancer formation and activity by p53 is an integral component of the p53 tumor suppressor function.Therefore,our findings offer some novel insights into the regulation mechanism of p53 in lung oncogenesis and introduce a new strategy for screening therapeutic targets.

A Polyvinyl Alcohol/Acrylamide Hydrogel with Enhanced Mechanical Properties Promotes Full-Thickness Skin Defect Healing by Regulating Immunomodulation and Angiogenesis Through Paracrine Secretion

Hydrogel-based tissue-engineered skin has attracted increased attention due to its potential to restore the structural integrity and functionality of skin.However,the mechanical properties of hydrogel scaffolds and natural skin are substantially different.Here,we developed a polyvinyl alcohol(PVA)/acrylamide based interpenetrating network(IPN)hydrogel that was surface modified with polydopamine(PDA)and termed Dopa-gel.The Dopa-gel exhibited mechanical properties similar to native skin tissue and a superior ability to modulate paracrine functions.Furthermore,a tough scaffold with tensile resistance was fabricated using this hydrogel by three-dimensional printing.The results showed that the interpenetration of PVA,alginate,and polyacrylamide networks notably enhanced the mechanical properties of the hydrogel.Surface modification with PDA endowed the hydrogels with increased secretion of immunomodulatory and proangiogenic factors.In an in vivo model,Dopa-gel treatment accelerated wound closure,increased vascularization,and promoted a shift in macrophages from a proinflammatory M1 phenotype to a prohealing and anti-inflammatory M2 phenotype within the wound area.Mechanistically,the focal adhesion kinase(FAK)/extracellular signal-related kinase(ERK)signaling pathway may mediate the promotion of skin defect healing by increasing paracrine secretion via the Dopa-gel.Additionally,proangiogenic factors can be induced through Rho-associated kinase-2(ROCK-2)/vascular endothelial growth factor(VEGF)-mediated paracrine secretion under tensile stress conditions.Taken together,these findings suggest that the multifunctional Dopa-gel,which has good mechanical properties similar to those of native skin tissue and enhanced immunomodulatory and angiogenic properties,is a promising scaffold for skin tissue regeneration.

Superwetting Ag/α-Fe_(2)O_(3) anchored mesh with enhanced photocatalytic and antibacterial activities for efficient water purification

Superwetting materials have drawn unprecedented attention in the treatment of oily wastewater due to their preferable anti-fouling property and selective oil/water separation.However,it is still a challenge to fabricate multifunctional and environmentally friendly materials,which can be stably applied to purify the actual complicated wastewater.Here,a Ag/Ag/α-Fe_(2)O_(3) heterostructure anchored copper mesh was intentionally synthesized using a facile two-step hydrothermal method.The resultant mesh with superhydrophilicity and underwater superoleophobicity was capable of separating various oil/water mixtures with superior separation efficiency and high permeationflux driven by gravity.Benefiting from the joint effects of the smaller band gap of Ag/α-Fe_(2)O_(3) heterojunction,inherent antibacterial capacity of Ag/α-Fe_(2)O_(3) and Ag nanoparticles,favorable conductive substrate,as well as the hierarchical structure with superwettability,such mesh presented remarkably enhanced degradation capability toward organic dyes under visible light irradiation and antibacterial activity against both Escherichia coli(E.coli)and Staphylococcus aureus(S.aureus)compared with the pure Ag/α-Fe_(2)O_(3) coated mesh.Impressively,the mesh exhibited bifunctional water purification performance,in which organic dyes were eliminated simultaneously from water during oil/water separation in onefiltration process.More importantly,this mesh behaved exceptional chemical resistance,mechanical stability and long-term reusability.Therefore,this material with multifunctional integration may hold promising potential for steady water purification in practice.

Research on Enhanced Contraband Dataset ACXray Based on ETL

To address the shortage of public datasets for customs X-ray images of contraband and the difficulties in deploying trained models in engineering applications,a method has been proposed that employs the Extract-Transform-Load(ETL)approach to create an X-ray dataset of contraband items.Initially,X-ray scatter image data is collected and cleaned.Using Kafka message queues and the Elasticsearch(ES)distributed search engine,the data is transmitted in real-time to cloud servers.Subsequently,contraband data is annotated using a combination of neural networks and manual methods to improve annotation efficiency and implemented mean hash algorithm for quick image retrieval.The method of integrating targets with backgrounds has enhanced the X-ray contraband image data,increasing the number of positive samples.Finally,an Airport Customs X-ray dataset(ACXray)compatible with customs business scenarios has been constructed,featuring an increased number of positive contraband samples.Experimental tests using three datasets to train the Mask Region-based Convolutional Neural Network(Mask R-CNN)algorithm and tested on 400 real customs images revealed that the recognition accuracy of algorithms trained with Security Inspection X-ray(SIXray)and Occluded Prohibited Items X-ray(OPIXray)decreased by 16.3%and 15.1%,respectively,while the ACXray dataset trained algorithm’s accuracy was almost unaffected.This indicates that the ACXray dataset-trained algorithm possesses strong generalization capabilities and is more suitable for customs detection scenarios.

Facile electrochemical surface-alloying and etching of Au wires to enable high-performance substrates for surface enhanced Raman scattering

Surface-enhanced Raman Spectroscopy(SERS)is a nondestructive technique for rapid detection of analytes even at the single-molecule level.However,highly sensitive and reliable SERS substrates are mostly fabricated with complex nanofabrication techniques,greatly restricting their practical applications.A convenient electrochemical method for transforming the surface of commercial gold wires/foils into silver-alloyed nanostructures is demonstrated in this report.Au substrates are treated with repetitive anodic and cathodic bias in an electrolyte of thiourea,in a one-pot one-step manner.X-rays absorption fine structure(XAFS)spectroscopy confirms that the AuAg alloy is induced at the surface.The unique AuAg alloyed surface nanostructures are particularly advantageous when served as SERS substrates,enabling a remarkably sensitive detection of Rhodamine B(a detection limit of 10^(-14)M,and uniform strong response throughout the substrates at 10^(-12)M).

Effects of fracture evolution and non-Darcy flow on the thermal performance of enhanced geothermal system in 3D complex fractured rock

In fractured geothermal reservoirs,the fracture networks and internal fluid flow behaviors can significantly impact the thermal performance.In this study,we proposed a non-Darcy rough discrete fracture network(NR-DFN)model that can simultaneously consider the fracture evolution and non-Darcy flow dynamics in studying the thermo-hydro-mechanical(THM)coupling processes for heat extraction in geothermal reservoir.We further employed the model on the Habanero enhanced geothermal systems(EGS)project located in Australia.First,our findings illustrate a clear spatial-temporal variation in the thermal stress and pressure perturbations,as well as uneven spatial distribution of shear failure in 3D fracture networks.Activated shear failure is mainly concentrated in the first fracture cluster.Secondly,channeling flow have also been observed in DFNs during heat extraction and are further intensified by the expansion of fractures driven by thermal stresses.Moreover,the combined effect of non-Darcy flow and fracture evolution triggers a rapid decline in the resulting heat rate and temperature.The NR-DFN model framework and the Habanero EGS's results illustrate the importance of both fracture evolution and non-Darcy flow on the efficiency of EGS production and have the potential to promote the development of more sustainable and efficient EGS operations for stakeholders.

Eco-friendly calcium alginate microspheres enable enhanced profile control and oil displacement

Polymer microspheres(PMs),such as polyacrylamide,have been widely applied for enhanced oil recovery(EOR),yet with environmental concerns.Here,we report a microfluid displacement technology containing a bio-based eco-friendly material,i.e.,calcium alginate(CaAlg)microspheres for EOR.Two dominant mechanisms responsible for EOR over Ca Alg fluid have been verified,including the microscopic oil displacement efficacy augmented by regulating capillary force(determined by the joint action of interfacial tension and wettability between different phases)and macroscopic sweep volume increment through profile control and mobility ratio reduction.This comprehensive effectiveness can be further impacted when the CaAlg microsphere is embellished ulteriorly by using appropriate amount of sodium dodecyl sulfonate(SDS).The core flooding and nuclear magnetic resonance(NMR)tests demonstrate that CaAlg-SDS microsphere can balance the interphase property regulation(wettability alteration and IFT reduction)and rheology properties,enabling simultaneous profile control and oil displacement.Excessive introduction of SDS will have a negative impact on rheological properties,which is not favored for EOR.Our results show that the involvement of 4-m M SDS will provide the best behavior,with an EOR rate of 34.38%.This cost-effective and environmentally-friendly bio-microspherebased microfluidic displacement technology is expected to achieve“green”oil recovery in future oilfield exploitation.

CO_(2)flooding in shale oil reservoir with radial borehole fracturing for CO_(2)storage and enhanced oil recovery

This study introduces a novel method integrating CO_(2)flooding with radial borehole fracturing for enhanced oil recovery and CO_(2)underground storage,a solution to the limited vertical stimulation reservoir volume in horizontal well fracturing.A numerical model is established to investigate the production rate,reservoir pressure field,and CO_(2)saturation distribution corresponding to changing time of CO_(2)flooding with radial borehole fracturing.A sensitivity analysis on the influence of CO_(2)injection location,layer spacing,pressure difference,borehole number,and hydraulic fractures on oil production and CO_(2)storage is conducted.The CO_(2)flooding process is divided into four stages.Reductions in layer spacing will significantly improve oil production rate and gas storage capacity.However,serious gas channeling can occur when the spacing is lower than 20 m.Increasing the pressure difference between the producer and injector,the borehole number,the hydraulic fracture height,and the fracture width can also increase the oil production rate and gas storage rate.Sensitivity analysis shows that layer spacing and fracture height greatly influence gas storage and oil production.Research outcomes are expected to provide a theoretical basis for the efficient development of shale oil reservoirs in the vertical direction.

Hybrid Optimization Algorithm for Handwritten Document Enhancement

The Gannet Optimization Algorithm (GOA) and the Whale Optimization Algorithm (WOA) demonstrate strong performance;however, there remains room for improvement in convergence and practical applications. This study introduces a hybrid optimization algorithm, named the adaptive inertia weight whale optimization algorithm and gannet optimization algorithm (AIWGOA), which addresses challenges in enhancing handwritten documents. The hybrid strategy integrates the strengths of both algorithms, significantly enhancing their capabilities, whereas the adaptive parameter strategy mitigates the need for manual parameter setting. By amalgamating the hybrid strategy and parameter-adaptive approach, the Gannet Optimization Algorithm was refined to yield the AIWGOA. Through a performance analysis of the CEC2013 benchmark, the AIWGOA demonstrates notable advantages across various metrics. Subsequently, an evaluation index was employed to assess the enhanced handwritten documents and images, affirming the superior practical application of the AIWGOA compared with other algorithms.

Model Parameters Identification and Backstepping Control of Lower Limb Exoskeleton Based on Enhanced Whale Algorithm

Exoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition.However,due to unknown model parameters such as the mass,moment of inertia and mechanical size,the dynamic model of exoskeletons is difficult to construct.Hence,an enhanced whale optimization algorithm(EWOA)is proposed to identify the exoskeleton model parameters.Meanwhile,the periodic excitation trajectories are designed by finite Fourier series to input the desired position demand of exoskeletons with mechanical physical constraints.Then a backstepping controller based on the identified model is adopted to improve the human-robot wearable comfortable performance under cooperative motion.Finally,the proposed Model parameters identification and control are verified by a two-DOF exoskeletons platform.The knee joint motion achieves a steady-state response after 0.5 s.Meanwhile,the position error of hip joint response is less than 0.03 rad after 0.9 s.In addition,the steady-state human-robot interaction torque of the two joints is constrained within 15 N·m.This research proposes a whale optimization algorithm to optimize the excitation trajectory and identify model parameters.Furthermore,an enhanced mutation strategy is adopted to avoid whale evolution’s unsatisfactory local optimal value.

Modified electronic structure and enhanced hydroxyl adsorption make quaternary Pt-based nanosheets efficient anode electrocatalysts for formic acid-/alcohol-air fuel cells

Surface/interface engineering of a multimetallic nanostructure with diverse electrocatalytic properties for direct liquid fuel cells is desirable yet challenging.Herein,using visible light,a class of quaternary Pt_(1)Ag_(0.1)Bi_(0.16)Te_(0.29)ultrathin nanosheets is fabricated and used as high-performance anode electrocatalysts for formic acid-/alcohol-air fuel cells.The modified electronic structure of Pt,enhanced hydroxyl adsorption,and abundant exterior defects afford Pt_(1)Ag_(0.1)Bi_(0.16)Te_(0.29)/C high intrinsic anodic electrocatalytic activity to boost the power densities of direct formic acid-/methanol-/ethanol-/ethylene glycol-/glycerol-air fuel cells,and the corresponding peak power density of Pt_(1)Ag_(0.1)Bi_(0.16)Te_(0.29)/C is respectively 129.7,142.3,105.4,124.3,and 128.0 mW cm^(-2),considerably outperforming Pt/C.Operando in situ Fourier transform infrared reflection spectroscopy reveals that formic acid oxidation on Pt_(1)Ag_(0.1)Bi_(0.16)Te_(0.29)/C occurs via a CO_(2)-free direct pathway.Density functional theory calculations show that the presence of Ag,Bi,and Te in Pt_(1)Ag_(0.1)Bi_(0.16)Te_(0.29)suppresses CO^(*)formation while optimizing dehydrogenation steps and synergistic effect and modified Pt effectively enhance H_(2)O dissociation to improve electrocatalytic performance.This synthesis strategy can be extended to 43 other types of ultrathin multimetallic nanosheets(from ternary to octonary nanosheets),and efficiently capture precious metals(i.e.,Pd,Pt,Rh,Ru,Au,and Ag)from different water sources.

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.

Bio-Inspired Intelligent Routing in WSN: Integrating Mayfly Optimization and Enhanced Ant Colony Optimization for Energy-Efficient Cluster Formation and Maintenance

Wireless Sensor Networks(WSNs)are a collection of sensor nodes distributed in space and connected through wireless communication.The sensor nodes gather and store data about the real world around them.However,the nodes that are dependent on batteries will ultimately suffer an energy loss with time,which affects the lifetime of the network.This research proposes to achieve its primary goal by reducing energy consumption and increasing the network’s lifetime and stability.The present technique employs the hybrid Mayfly Optimization Algorithm-Enhanced Ant Colony Optimization(MFOA-EACO),where the Mayfly Optimization Algorithm(MFOA)is used to select the best cluster head(CH)from a set of nodes,and the Enhanced Ant Colony Optimization(EACO)technique is used to determine an optimal route between the cluster head and base station.The performance evaluation of our suggested hybrid approach is based on many parameters,including the number of active and dead nodes,node degree,distance,and energy usage.Our objective is to integrate MFOA-EACO to enhance energy efficiency and extend the network life of the WSN in the future.The proposed method outcomes proved to be better than traditional approaches such as Hybrid Squirrel-Flying Fox Optimization Algorithm(HSFLBOA),Hybrid Social Reindeer Optimization and Differential Evolution-Firefly Algorithm(HSRODE-FFA),Social Spider Distance Sensitive-Iterative Antlion Butterfly Cockroach Algorithm(SADSS-IABCA),and Energy Efficient Clustering Hierarchy Strategy-Improved Social Spider Algorithm Differential Evolution(EECHS-ISSADE).

Research progress and potential of new enhanced oil recovery methods in oilfield development

This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the problems of EOR methods,and proposes the relevant research prospects.The basic research means for oilfield development include in-situ acquisition of formation rock/fluid samples and non-destructive testing.The EOR methods for conventional and shale oil development are classified as improved water flooding(e.g.nano-water flooding),chemical flooding(e.g.low-concentration middle-phase micro-emulsion flooding),gas flooding(e.g.micro/nano bubble flooding),thermal recovery(e.g.air injection thermal-aided miscible flooding),and multi-cluster uniform fracturing/water-free fracturing,which are discussed in this paper for their mechanisms,approaches,and key technique researches and field tests.These methods have been studied with remarkable progress,and some achieved ideal results in field tests.Nonetheless,some problems still exist,such as inadequate research on mechanisms,imperfect matching technologies,and incomplete industrial chains.It is proposed to further strengthen the basic researches and expand the field tests,thereby driving the formation,promotion and application of new technologies.

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

Safety and feasibility of enhanced recovery after surgery-based management model for ambulatory pediatric surgical procedures

BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safety and feasibility of the enhanced recovery after surgery(ERAS)-based management model for ambulatory pediatric surgical procedures.METHODS We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People’s Hospital of Liangshan Yi Autonomous Prefecture.Of these,220 received ERAS-based management(research group)and 100 received routine management(control group).General information,postoperative ambulation activities,surgical outcomes(operation time,postoperative gastro-intestinal ventilation time,and hospital stay),postoperative pain visual analogue scale,postoperative complications(incision infection,abdominal distension,fever,nausea,and vomiting),and family satisfaction were compared.RESULTS The general information of the research group(sex,age,disease type,single parent,family history,etc.)was comparable to that of the control group(P>0.05),but the rate of postoperative(2 h,4 h,and 6 h after surgery)ambulation activities was statistically higher(P<0.01),and operation time,postoperative gastrointestinal ventilation time,and hospital stay were markedly shorter(P<0.05).The research group had lower visual analogue scale scores(P<0.01)at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group(P=0.001).The research group had higher family satisfaction than the control group(P=0.007).CONCLUSION The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion.

Enhanced recovery after surgery:Progress in adapted pathways for implementation in standard and emerging surgical settings

The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an element in the field of perioperative care.ERAS had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service cost.ERAS has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and modified.Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal transplantation.The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative pathways.ERAS costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are higher.ERAS is in progress in the fields of anesthetic tasks,pediatric surgery,and organ transplantation.Although ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of ERAS.Several challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included.

Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic technique.This topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative diagnosis.Therefore,further studies on the efficacy of TXI in clinical practice are required.