Analyses of stable isotopes(C,O,H)in tree rings are increasingly important cross-disciplinary programs.The rapid development in this field documented in an increasing number of publications requires a comprehensive re...Analyses of stable isotopes(C,O,H)in tree rings are increasingly important cross-disciplinary programs.The rapid development in this field documented in an increasing number of publications requires a comprehensive review.This study includes a bibliometric analysis-based review to better understand research trends in tree ring stable isotope research.Overall,1475 publications were selected from the Web of Science Core Collection for 1974-2023.The findings are that:(1)numbers of annual publications and citations increased since 1974.From 1974 to 1980,there were around two relevant publications per year.However,from 2020 to 2022,this rose sharply to 109 publications per year.Likewise,average article citations were less than four per year before 1990,but were around four per article per year after 2000;(2)the major subjects using tree ring stable isotopes include forestry,geosciences,and environmental sciences,contributing to 42.5%of the total during 1974-2023;(3)the top three most productive institutions are the Chinese Academy of Sciences(423),the Swiss Federal Institute for Forest,Snow and Landscape Research(227),and the University of Arizona(204).These achievements result from strong collaborations;(4)review papers,for example,(Dawson et al.,Annu Rev Ecol Syst 33:507-559,2002)and(McCarroll and Loader,Quat Sci Rev 23:771-801,2004),are among the most cited,with more than 1000 citations;(5)tree ring stable isotope studies mainly focus on climatology and ecology,with atmospheric CO_(2) one of the most popular topics.Since 2010,precipitation and drought have received increasing attention.Based on this analysis,the research stages,key findings,debated issues,limitations and direc-tions for future research are summarized.This study serves as an important attempt to understand the progress on the use of stable isotopes in tree rings,providing scientific guid-ance for young researchers in this field.展开更多
Various invasive and non-invasive brain modulation methods are widely used to regulate sensory,cognitive,and motor functions both within local and large brain networks.This special issue provides innovative studies to...Various invasive and non-invasive brain modulation methods are widely used to regulate sensory,cognitive,and motor functions both within local and large brain networks.This special issue provides innovative studies to optimize relevant methods and understand their neural mechanisms,paving the way for personalized neuromodulation of cognitive function.The cover of this issue uses the image of the four heavenly Kings in Chinese culture who are in charge of good weather.It compares the process of neuroregulation technology that integrates the principles of sound,light electricity or magnetism in treating the diseased brain,to the moment when these gods cast their spells to bring sunshine and peace to the human brain in the midst of lightning and thunder.展开更多
To address the common issues of wrinkling,tearing,and uneven wall thickness in the actual sheet metal stamp-ing process of the outer ring of needle roller bearings,this study analyzes critical technical indicators suc...To address the common issues of wrinkling,tearing,and uneven wall thickness in the actual sheet metal stamp-ing process of the outer ring of needle roller bearings,this study analyzes critical technical indicators such asforming limits,thickness distribution,and principal strains in the forming process in detail.Three-dimensionalmodels of the concave and convex dies were constructed.The effects of different process parameters,includingstamping speed,edge pressure,sheet metal thickness,and friction coefficient,on the quality of the forming partswere investigated by varying these parameters.Subsequently,the orthogonal experimental method was used todetermine an optimal experimental group from multiple sets of experiments.It was found that under the processparameters of a stamping speed of 3000 mm/s,edge pressure of 2000 N,sheet metal thickness of 0.9 mm,andfriction coefficient of 0.125,the forming quality of the outer ring of the bearing is ideal.展开更多
The free vibration analysis of a rotating sandwich conical shell with a reentrant auxetic honeycomb core and homogenous isotropic face layers reinforced with a ring support is studied.The shell is modeled utilizing th...The free vibration analysis of a rotating sandwich conical shell with a reentrant auxetic honeycomb core and homogenous isotropic face layers reinforced with a ring support is studied.The shell is modeled utilizing the first-order shear deformation theory(FSDT)incorporating the relative,centripetal,and Coriolis accelerations alongside the initial hoop tension created by the rotation.The governing equations,compatibility conditions,and boundary conditions are attained using Hamilton’s principle.Utilizing trigonometric functions,an analytical solution is derived in the circumferential direction,and a numerical one is presented in the meridional direction via the differential quadrature method(DQM).The effects of various factors on the critical rotational speeds and forward and backward frequencies of the shell are studied.The present work is the first theoretical work regarding the dynamic analysis of a rotating sandwich conical shell with an auxetic honeycomb core strengthened with a ring support.展开更多
As one of the regions most affected by global cli-mate warming,the Tianshan mountains has experienced sev-eral ecological crises,including retreating glaciers and water deficits.Climate warming in these mountains is c...As one of the regions most affected by global cli-mate warming,the Tianshan mountains has experienced sev-eral ecological crises,including retreating glaciers and water deficits.Climate warming in these mountains is considered mainly to be caused by increases in minimum temperatures and winter temperatures,while the influence of maximum temperatures is unclear.In this study,a 300-year tree-ring chronology developed from the Western Tianshan Moun-tains was used to reconstruct the summer(June-August)maximum temperature(T_(max6-8))variations from 1718 to 2017.The reconstruction explained 53.1% of the variance in the observed T_(max6-8).Over the past 300 years,the T_(max6-8)reconstruction showed clear interannual and decadal vari-abilities.There was a significant warming trend(0.18°C/decade)after the 1950s,which was close to the increasing rates of the minimum and mean temperatures.The increase in maximum temperature was also present over the whole Tianshan mountains and its impact on climate warming has increased.The T_(max6-8) variations in the Western Tianshan mountains were influenced by frequent volcanic eruptions combined with the influence of solar activity and the sum-mer North Atlantic Oscillation.This study reveals that cli-mate warming is significantly influenced by the increase in maximum temperatures and clarifies possible driving mech-anisms of temperature variations in the Western Tianshan mountains which should aid climate predictions.展开更多
Cells are capable of sensing and responding to the extracellular mechanical microenvironment via the actin skeleton.In vivo,tissues are frequently subject to mechanical forces,such as the rapid and significant shear f...Cells are capable of sensing and responding to the extracellular mechanical microenvironment via the actin skeleton.In vivo,tissues are frequently subject to mechanical forces,such as the rapid and significant shear flow encountered by vascular endothelial cells.However,the investigations about the transient response of intracellular actin networks under these intense external mechanical forces,their intrinsic mechanisms,and potential implications are very limited.Here,we observe that when cells are subject to the shear flow,an actin ring structure could be rapidly assembled at the periphery of the nucleus.To gain insights into the mechanism underlying this perinuclear actin ring assembly,we develop a computational model of actin dynamics.We demonstrate that this perinuclear actin ring assembly is triggered by the depolymerization of cortical actin,Arp2/3-dependent actin filament polymerization,and myosin-mediated actin network contraction.Furthermore,we discover that the compressive stress generated by the perinuclear actin ring could lead to a reduction in the nuclear spreading area,an increase in the nuclear height,and a decrease in the nuclear volume.The present model thus explains the mechanism of the perinuclear actin ring assembly under external mechanical forces and suggests that the spontaneous contraction of this actin structure can significantly impact nuclear morphology.展开更多
Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and ...Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and tree-ring chronologies developed on northern and western slopes from the Lubanling in the Funiu Mountains.Correlation analyses showed that two chronologies were mainly limited by temperatures in the previous June-August and the com-bination of temperatures and moisture in the current May-July.The difference of the climate response to slopes was small but not negligible.Radial growth of the LBLO1 site on the northern slope was affected by the combined maximum and minimum temperatures,while that of the LBLO2 site was affected by maximum temperatures.With regards to moisture,radial growth of the trees on the north slope was influenced by the relative humidity in the current May-July,while on the western slope,it was affected by the relative humidity in the previous June-August,the current May-July and the precipitation in the current May-July.With the change in climate,the effects of the main limiting factors on growth on different slopes were visible to a certain extent,but the differences in response of trees on different slopes gradually decreased,which might be caused by factors such as different slope directions and the change in diurnal temperature range.These results may provide information for forest protection and ecological construction in this region,and a scientific reference for future climate reconstruction.展开更多
Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and ...Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and treering chronologies developed on northern and western slopes from the Lubanling in the Funiu Mountains.Correlation analyses showed that two chronologies were mainly limited by temperatures in the previous June–August and the combination of temperatures and moisture in the current May–July.The difference of the climate response to slopes was small but not negligible.Radial growth of the LBL01 site on the northern slope was affected by the combined maximum and minimum temperatures,while that of the LBL02 site was affected by maximum temperatures.With regards to moisture,radial growth of the trees on the north slope was influenced by the relative humidity in the current May–July,while on the western slope,it was affected by the relative humidity in the previous June–August,the current May–July and the precipitation in the current May–July.With the change in climate,the effects of the main limiting factors on growth on different slopes were visible to a certain extent,but the differences in response of trees on different slopes gradually decreased,which might be caused by factors such as different slope directions and the change in diurnal temperature range.These results may provide information for forest protection and ecological construction in this region,and a scientific reference for future climate reconstruction.展开更多
This paper proposes the novel algebraic structure of a linear ring space. A linear ring space is an order triad consisting of two rings, and a linear map between the two rings. The definition of quasi-linearity is dis...This paper proposes the novel algebraic structure of a linear ring space. A linear ring space is an order triad consisting of two rings, and a linear map between the two rings. The definition of quasi-linearity is discussed, in addition to the examination of properties and classifications of linear ring spaces. Particularly, the ring of holomorphic functions on a region of the complex plane is examined, and the manner in which it generates an iterated linear ring space under the complex derivative operator. This notion is then generalized to all rings with nth order linear and surjective operators. Basic operator theory regarding the classifications of linear ring maps is also covered.展开更多
Due to the lack of a uniform and accurate defi-nition of‘drought’,several indicators have been introduced based on different variables and methods,and the efficiency of each of these is determined according to their...Due to the lack of a uniform and accurate defi-nition of‘drought’,several indicators have been introduced based on different variables and methods,and the efficiency of each of these is determined according to their relationship with drought.The relationship between two drought indices,SPI(standardized precipitation index)and SPEI(standard-ized precipitation-evapotranspiration index)in different sea-sons was investigated using annual rings of 15 tree samples to determine the effect of drought on the growth of oriental beech(Fagus orientalis Lipsky)in the Hyrcanian forests of northern Iran.The different evapotranspiration calcula-tion methods were evaluated on SPEI efficiency based on Hargreaves-Samani,Thornthwaite,and Penman-Monteith methods using the step-by-step M5 decision tree regression method.The results show that SPEI based on the Penman-Monteith in a three-month time scale(spring)had similar temporal changes and a better relationship with annual tree rings(R^(2)=0.81)at a 0.05 significant level.Abrupt change and a decreasing trend in the time series of annual tree rings are similar to the variation in the SPEI based on the Penman-Monteith method.Factors affecting evapotranspiration,temperature,wind speed,and sunshine hours(used in the Penman-Monteith method),increased but precipitation decreased.Using non-linear modeling methods,SPEI based on Penman-Monteith best illustrated climate changes affecting tree growth.展开更多
The evolution of threats and scenarios requires continuous performance improvements of ballistic protections for armed forces.From a modeling point of view,it is necessary to use sufficiently precise material behavior...The evolution of threats and scenarios requires continuous performance improvements of ballistic protections for armed forces.From a modeling point of view,it is necessary to use sufficiently precise material behavior models to accurately describe the phenomena observed during the impact of a projectile on a protective equipment.In this context,the goal of this paper is to characterize the behavior of a small caliber steel jacket by combining experimental and numerical approaches.The experimental method is based on the lateral compression of ring specimens directly machined from the thin and small ammunition.Various speeds and temperatures are considered in a quasi-static regime in order to reveal the strain rate and temperature dependencies of the tested material.The Finite Element Updating Method(FEMU)is used.Experimental results are coupled with an inverse optimization method and a finite element numerical model in order to determine the parameters of a constitutive model representative of the jacket material.Predictions of the present model are verified against experimental results and a parametric study as well as a discussion on the identified material parameters are proposed.The results indicate that the strain hardening parameter can be neglected and the behavior of the thin steel jacket can be described by a modeling without strain hardening sensitivity.展开更多
The electrochemical CO_(2) reduction reaction(CO_(2)RR) to controllable chemicals is considered as a promising pathway to store intermittent renewable energy. Herein, a set of catalysts based on copper-nitrogendoped c...The electrochemical CO_(2) reduction reaction(CO_(2)RR) to controllable chemicals is considered as a promising pathway to store intermittent renewable energy. Herein, a set of catalysts based on copper-nitrogendoped carbon xerogel(Cu-N-C) are successfully developed varying the copper amount and the nature of the copper precursor, for the efficient CO_(2)RR. The electrocatalytic performance of Cu-N-C materials is assessed by a rotating ring-disc electrode(RRDE), technique still rarely explored for CO_(2)RR. For comparison, products are also characterized by online gas chromatography in a H-cell. The as-synthesized Cu-NC catalysts are found to be active and highly CO selective at low overpotentials(from -0.6 to -0.8 V vs.RHE) in 0.1 M KHCO_(3), while H_(2) from the competitive water reduction appears at larger overpotentials(-0.9 V vs. RHE). The optimum copper acetate-derived catalyst containing Cu-N_(4) moieties exhibits a CO_(2)-to-CO turnover frequency of 997 h^(-1) at -0.9 V vs. RHE with a H_(2)/CO ratio of 1.8. These results demonstrate that RRDE configuration can be used as a feasible approach for identifying electrolysis products from CO_(2)RR.展开更多
BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and...BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and neutral mucus,respectively.However,the clinical importance of the special combined AB and PAS stain is unclear.AIM To investigate AB expression,PAS expression and the AB-to-PAS(A/P)ratio in gastric SRCC patients and to assess patient prognosis.METHODS Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS,and signet ring cell positivity was assessed quantitatively.Immuno-histochemical staining for Ki67,protein 53(P53)and human epidermal growth factor receptor 2(HER2)was performed simultaneously.The cancer-specific survival(CSS)rate was estimated via Kaplan-Meier analysis.Cox proportional hazards models were used for univariate and multivariate survival analyses.RESULTS Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup(P<0.001).The 3-year CSS rate in the A/P≤0.5 group was significantly greater than that in the A/P>0.5 group(P=0.042).Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter,lymph node metastasis,vessel carcinoma embolus,tumor stage,the A/P ratio and the expression of Ki67,P53 and the PAS.Cox multivariate regression analysis confirmed that low PAS expression[hazard ratio(HR)=3.809,95%confidence interval(CI):1.563-9.283,P=0.003]and large tumor diameter(HR=2.761,95%CI:1.086-7.020,P=0.033)were independent risk factors for poor prognosis.CONCLUSION A/P>0.5 is potentially a risk factor for prognosis,and low PAS expression is an independent risk factor in the prognosis of gastric SRCC.PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.展开更多
●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.展开更多
Design and synthesis of superior cost-effective non-fullerene acceptors(NFAs)are still big challenges for facilitating the commercialization of organic solar cells(OSCs),yet to be realized.Herein,two medium bandgap fu...Design and synthesis of superior cost-effective non-fullerene acceptors(NFAs)are still big challenges for facilitating the commercialization of organic solar cells(OSCs),yet to be realized.Herein,two medium bandgap fully non-fused ring electron acceptors(NFREAs,medium bandgap,i,e.,1,3-1,8 eV),namely PTR-2Cl and PTR-4Cl are synthesized with only four steps by using intramolecular noncovalent interaction central core,structured alkyl side chain orientation linking units and flanking with different electron-withdrawing end group.Among them,PTR-4C1 exhibits increased average electrostatic potential(ESP)difference with polymer donor,enhanced crystallinity and compactπ-πstacking compared with the control molecule PTR-2CI.As a result,the PTR-4Cl-based OSC achieved an impressive power conversion efficiency(PCE)of 14.72%,with a much higher open-circuit voltage(V_(OC))of 0.953 V and significantly improved fill factor(FF)of 0.758,demonstrating one of the best acceptor material in the top-performing fully NFREA-based OSCs with both high PCE and V_(OC).Notably,PTR-4Cl-based cells maintain a good T_80lifetime of its initial PCE after over 936 h under a continuous thermal annealing treatment and over1300 h T_(80)lifetime without encapsulation.This work provides a cost-effective design strategy for NFREAs on obtaining high V_(OC),efficient exciton dissociation,and ordered molecular packing and thus high-efficiency and stable OSCs.展开更多
This research investigates the comparative efficacy of generating zero divisor graphs (ZDGs) of the ring of integers ℤ<sub>n</sub> modulo n using MAPLE algorithm. Zero divisor graphs, pivotal in the study ...This research investigates the comparative efficacy of generating zero divisor graphs (ZDGs) of the ring of integers ℤ<sub>n</sub> modulo n using MAPLE algorithm. Zero divisor graphs, pivotal in the study of ring theory, depict relationships between elements of a ring that multiply to zero. The paper explores the development and implementation of algorithms in MAPLE for constructing these ZDGs. The comparative study aims to discern the strengths, limitations, and computational efficiency of different MAPLE algorithms for creating zero divisor graphs offering insights for mathematicians, researchers, and computational enthusiasts involved in ring theory and mathematical computations.展开更多
BACKGROUND Gastric signet ring cell carcinoma(GSRC)represents a specific subtype of gastric cancer renowned for its contentious epidemiological features,treatment principles,and prognostic factors.AIM To investigate t...BACKGROUND Gastric signet ring cell carcinoma(GSRC)represents a specific subtype of gastric cancer renowned for its contentious epidemiological features,treatment principles,and prognostic factors.AIM To investigate the epidemiology of GSRC and establish an improved model for predicting the prognosis of patients with locally advanced GSRC(LAGSRC)after surgery.METHODS The annual rates of GSRC incidence and mortality,covering the years 1975 to 2019,were extracted from the Surveillance,Epidemiology,and End Results(SEER)database to explore the temporal trends in both disease incidence and mortality rates using Joinpoint software.The clinical data of 3793 postoperative LAGSRC patients were collected from the SEER database for the analysis of survival rates.The Cox regression model was used to explore the independent prognostic factors for overall survival(OS).The risk factors extracted were used to establish a prognostic nomogram.RESULTS The overall incidence of GSRC increased dramatically between 1975 and 1998,followed by a significant downward trend in incidence after 1998.In recent years,there has been a similarly optimistic trend in GSRC mortality rates.The trend in GSRC showed discrepancies based on age and sex.Receiver operating characteristic curves,calibration curves,and decision curve analysis for 1-year,3-year,and 5-year OS demonstrated the high discriminative ability and clinical utility of this nomogram.The area under the curve indicated that the performance of the new model outperformed that of the pathological staging system.CONCLUSION The model we established can aid clinicians in the early prognostication of LAGSRC patients,resulting in improved clinical outcomes by modifying management strategies and patient health care.展开更多
BACKGROUND Chylous ascites is caused by disruption of the lymphatic system,which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity.The two most ...BACKGROUND Chylous ascites is caused by disruption of the lymphatic system,which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity.The two most common causes are cirrhosis and tuberculosis,and colon signer ring cell carcinoma(SRCC)due to the use of immunosuppressants is extremely rare in cirrhotic patients after liver transplantation,making it prone to misdiagnosis and missed diagnosis.CASE SUMMARY A 52-year-old man who underwent liver transplantation and was administered with immunosuppressants for 8 months was admitted with a 3-month history of progressive abdominal distention.Initially,based on lymphoscintigraphy and lymphangiography,lymphatic obstruction was considered,and cystellar chyli decompression with band lysis and external membrane stripping of the lymphatic duct was performed.However,his abdominal distention was persistent without resolution.Abdominal paracentesis revealed allogenic cells in the ascites,and immunohistochemistry analysis revealed adenocarcinoma cells with phenotypic features suggestive of a gastrointestinal origin.Gastrointestinal endoscopy was performed,and biopsy showed atypical signet ring cells in the ileocecal valve.The patient eventually died after a three-month follow-up due to progression of the tumor.CONCLUSION Colon SRCC,caused by immunosuppressants,is an unusual but un-neglected cause of chylous ascites.展开更多
BACKGROUND Upper gastrointestinal(GI)signet ring cell carcinomas(SRCC)confer a poor prognosis.The benefit of operative intervention for this patient group is contro-versial in terms of overall survival.AIM To investig...BACKGROUND Upper gastrointestinal(GI)signet ring cell carcinomas(SRCC)confer a poor prognosis.The benefit of operative intervention for this patient group is contro-versial in terms of overall survival.AIM To investigate factors relating to survival in patients with upper GI SRCC.METHODS A retrospective,tertiary,single-centre review of patients who were diagnosed with oesophageal,gastroesophageal junction and gastric SRCC was performed.The primary outcome was to compare mortality of patients who underwent operative management with those who had nonoperative management.Secon-dary outcomes included assessing the relationship between demographic and histopathological factors,and survival.RESULTS One hundred and thirty-one patients were included.The one-year survival for the operative group was 81%and for the nonoperative group was 19.1%.The five-year survival in the operative group was 28.6%vs 1.5%in the nonoperative group.The difference in overall survival between groups was statistically significant(HR 0.19,95%CI(0.13-0.30),P<0.001).There was no difference in survival when ad-justing for age,smoking status or gender.On multivariate analysis,patients who underwent surgical management,those with a lower stage of disease,and those with a lower Charlson Comorbidity Index(CCI)had significantly improved sur-vival.CONCLUSION Well-selected patients with upper GI SRCC appear to have reasonable medium-term survival following surgery.Offering surgery to a carefully selected patient group may improve the outcome for this disease.展开更多
基金This study was supported by the National Natural Science Foundation of China(Grant Number:42007407,42022059)the Sino-German mobility program(M-0393)+1 种基金the Key Research Program of the Institute of Geology and Geophysics(CAS Grant IGGCAS-201905)the CAS Youth Interdisciplinary Team(JCTD-2021-05).
文摘Analyses of stable isotopes(C,O,H)in tree rings are increasingly important cross-disciplinary programs.The rapid development in this field documented in an increasing number of publications requires a comprehensive review.This study includes a bibliometric analysis-based review to better understand research trends in tree ring stable isotope research.Overall,1475 publications were selected from the Web of Science Core Collection for 1974-2023.The findings are that:(1)numbers of annual publications and citations increased since 1974.From 1974 to 1980,there were around two relevant publications per year.However,from 2020 to 2022,this rose sharply to 109 publications per year.Likewise,average article citations were less than four per year before 1990,but were around four per article per year after 2000;(2)the major subjects using tree ring stable isotopes include forestry,geosciences,and environmental sciences,contributing to 42.5%of the total during 1974-2023;(3)the top three most productive institutions are the Chinese Academy of Sciences(423),the Swiss Federal Institute for Forest,Snow and Landscape Research(227),and the University of Arizona(204).These achievements result from strong collaborations;(4)review papers,for example,(Dawson et al.,Annu Rev Ecol Syst 33:507-559,2002)and(McCarroll and Loader,Quat Sci Rev 23:771-801,2004),are among the most cited,with more than 1000 citations;(5)tree ring stable isotope studies mainly focus on climatology and ecology,with atmospheric CO_(2) one of the most popular topics.Since 2010,precipitation and drought have received increasing attention.Based on this analysis,the research stages,key findings,debated issues,limitations and direc-tions for future research are summarized.This study serves as an important attempt to understand the progress on the use of stable isotopes in tree rings,providing scientific guid-ance for young researchers in this field.
文摘Various invasive and non-invasive brain modulation methods are widely used to regulate sensory,cognitive,and motor functions both within local and large brain networks.This special issue provides innovative studies to optimize relevant methods and understand their neural mechanisms,paving the way for personalized neuromodulation of cognitive function.The cover of this issue uses the image of the four heavenly Kings in Chinese culture who are in charge of good weather.It compares the process of neuroregulation technology that integrates the principles of sound,light electricity or magnetism in treating the diseased brain,to the moment when these gods cast their spells to bring sunshine and peace to the human brain in the midst of lightning and thunder.
基金supported by the China Postdoctoral Science Foundation(Grant No.2022M721395)the National Natural Science Foundation of China(Grant No.72072089).
文摘To address the common issues of wrinkling,tearing,and uneven wall thickness in the actual sheet metal stamp-ing process of the outer ring of needle roller bearings,this study analyzes critical technical indicators such asforming limits,thickness distribution,and principal strains in the forming process in detail.Three-dimensionalmodels of the concave and convex dies were constructed.The effects of different process parameters,includingstamping speed,edge pressure,sheet metal thickness,and friction coefficient,on the quality of the forming partswere investigated by varying these parameters.Subsequently,the orthogonal experimental method was used todetermine an optimal experimental group from multiple sets of experiments.It was found that under the processparameters of a stamping speed of 3000 mm/s,edge pressure of 2000 N,sheet metal thickness of 0.9 mm,andfriction coefficient of 0.125,the forming quality of the outer ring of the bearing is ideal.
文摘The free vibration analysis of a rotating sandwich conical shell with a reentrant auxetic honeycomb core and homogenous isotropic face layers reinforced with a ring support is studied.The shell is modeled utilizing the first-order shear deformation theory(FSDT)incorporating the relative,centripetal,and Coriolis accelerations alongside the initial hoop tension created by the rotation.The governing equations,compatibility conditions,and boundary conditions are attained using Hamilton’s principle.Utilizing trigonometric functions,an analytical solution is derived in the circumferential direction,and a numerical one is presented in the meridional direction via the differential quadrature method(DQM).The effects of various factors on the critical rotational speeds and forward and backward frequencies of the shell are studied.The present work is the first theoretical work regarding the dynamic analysis of a rotating sandwich conical shell with an auxetic honeycomb core strengthened with a ring support.
基金This study was supported by the Second Tibetan Plateau Scientific Expedition and Research(2019QZKK0101)the China Desert Meteorological Science Research Foundation(Sqj2022012)+3 种基金the Natural Science Basic Research Program of Shaanxi Province(2023-JC-QN-0307)the National Natural Science Foundation of China(42361144712)the Chinese Academy of Sciences(XDB40010300)the State Key Laboratory of Loess and Quaternary Geology,Institute of Earth Environment,CAS(SKLLQG2022).
文摘As one of the regions most affected by global cli-mate warming,the Tianshan mountains has experienced sev-eral ecological crises,including retreating glaciers and water deficits.Climate warming in these mountains is considered mainly to be caused by increases in minimum temperatures and winter temperatures,while the influence of maximum temperatures is unclear.In this study,a 300-year tree-ring chronology developed from the Western Tianshan Moun-tains was used to reconstruct the summer(June-August)maximum temperature(T_(max6-8))variations from 1718 to 2017.The reconstruction explained 53.1% of the variance in the observed T_(max6-8).Over the past 300 years,the T_(max6-8)reconstruction showed clear interannual and decadal vari-abilities.There was a significant warming trend(0.18°C/decade)after the 1950s,which was close to the increasing rates of the minimum and mean temperatures.The increase in maximum temperature was also present over the whole Tianshan mountains and its impact on climate warming has increased.The T_(max6-8) variations in the Western Tianshan mountains were influenced by frequent volcanic eruptions combined with the influence of solar activity and the sum-mer North Atlantic Oscillation.This study reveals that cli-mate warming is significantly influenced by the increase in maximum temperatures and clarifies possible driving mech-anisms of temperature variations in the Western Tianshan mountains which should aid climate predictions.
基金Project supported by the National Natural Science Foundation of China (Nos. 12025207 and 11872357)the Fundamental Research Funds for the Central Universities。
文摘Cells are capable of sensing and responding to the extracellular mechanical microenvironment via the actin skeleton.In vivo,tissues are frequently subject to mechanical forces,such as the rapid and significant shear flow encountered by vascular endothelial cells.However,the investigations about the transient response of intracellular actin networks under these intense external mechanical forces,their intrinsic mechanisms,and potential implications are very limited.Here,we observe that when cells are subject to the shear flow,an actin ring structure could be rapidly assembled at the periphery of the nucleus.To gain insights into the mechanism underlying this perinuclear actin ring assembly,we develop a computational model of actin dynamics.We demonstrate that this perinuclear actin ring assembly is triggered by the depolymerization of cortical actin,Arp2/3-dependent actin filament polymerization,and myosin-mediated actin network contraction.Furthermore,we discover that the compressive stress generated by the perinuclear actin ring could lead to a reduction in the nuclear spreading area,an increase in the nuclear height,and a decrease in the nuclear volume.The present model thus explains the mechanism of the perinuclear actin ring assembly under external mechanical forces and suggests that the spontaneous contraction of this actin structure can significantly impact nuclear morphology.
基金supported by the National Natural Science Foundation of China (No.42077417,41671042).
文摘Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and tree-ring chronologies developed on northern and western slopes from the Lubanling in the Funiu Mountains.Correlation analyses showed that two chronologies were mainly limited by temperatures in the previous June-August and the com-bination of temperatures and moisture in the current May-July.The difference of the climate response to slopes was small but not negligible.Radial growth of the LBLO1 site on the northern slope was affected by the combined maximum and minimum temperatures,while that of the LBLO2 site was affected by maximum temperatures.With regards to moisture,radial growth of the trees on the north slope was influenced by the relative humidity in the current May-July,while on the western slope,it was affected by the relative humidity in the previous June-August,the current May-July and the precipitation in the current May-July.With the change in climate,the effects of the main limiting factors on growth on different slopes were visible to a certain extent,but the differences in response of trees on different slopes gradually decreased,which might be caused by factors such as different slope directions and the change in diurnal temperature range.These results may provide information for forest protection and ecological construction in this region,and a scientific reference for future climate reconstruction.
基金the National Natural Science Foundation of China(No.4207741741671042)。
文摘Global warming will affect growth strategies and how trees will adapt.To compare the response of tree radial growth to climate warming in different slope directions,samples of Pinus armandii Franch were collected and treering chronologies developed on northern and western slopes from the Lubanling in the Funiu Mountains.Correlation analyses showed that two chronologies were mainly limited by temperatures in the previous June–August and the combination of temperatures and moisture in the current May–July.The difference of the climate response to slopes was small but not negligible.Radial growth of the LBL01 site on the northern slope was affected by the combined maximum and minimum temperatures,while that of the LBL02 site was affected by maximum temperatures.With regards to moisture,radial growth of the trees on the north slope was influenced by the relative humidity in the current May–July,while on the western slope,it was affected by the relative humidity in the previous June–August,the current May–July and the precipitation in the current May–July.With the change in climate,the effects of the main limiting factors on growth on different slopes were visible to a certain extent,but the differences in response of trees on different slopes gradually decreased,which might be caused by factors such as different slope directions and the change in diurnal temperature range.These results may provide information for forest protection and ecological construction in this region,and a scientific reference for future climate reconstruction.
文摘This paper proposes the novel algebraic structure of a linear ring space. A linear ring space is an order triad consisting of two rings, and a linear map between the two rings. The definition of quasi-linearity is discussed, in addition to the examination of properties and classifications of linear ring spaces. Particularly, the ring of holomorphic functions on a region of the complex plane is examined, and the manner in which it generates an iterated linear ring space under the complex derivative operator. This notion is then generalized to all rings with nth order linear and surjective operators. Basic operator theory regarding the classifications of linear ring maps is also covered.
基金This work was supported by Iran National Science Foundation(INSF)(grant no.96012844).
文摘Due to the lack of a uniform and accurate defi-nition of‘drought’,several indicators have been introduced based on different variables and methods,and the efficiency of each of these is determined according to their relationship with drought.The relationship between two drought indices,SPI(standardized precipitation index)and SPEI(standard-ized precipitation-evapotranspiration index)in different sea-sons was investigated using annual rings of 15 tree samples to determine the effect of drought on the growth of oriental beech(Fagus orientalis Lipsky)in the Hyrcanian forests of northern Iran.The different evapotranspiration calcula-tion methods were evaluated on SPEI efficiency based on Hargreaves-Samani,Thornthwaite,and Penman-Monteith methods using the step-by-step M5 decision tree regression method.The results show that SPEI based on the Penman-Monteith in a three-month time scale(spring)had similar temporal changes and a better relationship with annual tree rings(R^(2)=0.81)at a 0.05 significant level.Abrupt change and a decreasing trend in the time series of annual tree rings are similar to the variation in the SPEI based on the Penman-Monteith method.Factors affecting evapotranspiration,temperature,wind speed,and sunshine hours(used in the Penman-Monteith method),increased but precipitation decreased.Using non-linear modeling methods,SPEI based on Penman-Monteith best illustrated climate changes affecting tree growth.
基金co-funded by the Direction Générale de l'Armement (DGA)the French-German Institute of Saint Louis (ISL)。
文摘The evolution of threats and scenarios requires continuous performance improvements of ballistic protections for armed forces.From a modeling point of view,it is necessary to use sufficiently precise material behavior models to accurately describe the phenomena observed during the impact of a projectile on a protective equipment.In this context,the goal of this paper is to characterize the behavior of a small caliber steel jacket by combining experimental and numerical approaches.The experimental method is based on the lateral compression of ring specimens directly machined from the thin and small ammunition.Various speeds and temperatures are considered in a quasi-static regime in order to reveal the strain rate and temperature dependencies of the tested material.The Finite Element Updating Method(FEMU)is used.Experimental results are coupled with an inverse optimization method and a finite element numerical model in order to determine the parameters of a constitutive model representative of the jacket material.Predictions of the present model are verified against experimental results and a parametric study as well as a discussion on the identified material parameters are proposed.The results indicate that the strain hardening parameter can be neglected and the behavior of the thin steel jacket can be described by a modeling without strain hardening sensitivity.
基金Grant PID2020-115848RB-C21 "STORELEC" projectTED2021-129694B-C22 "DEFY-CO2" project funded by MCIN/AEI/10.13039/501100011033+3 种基金LMP253_ (2)1 project funded by Gobierno de AragónGrant IJC2019-041874-I funded by the MCIN/AEI/10.13039/501100011033CSIC for her JAE Intro ICU 2021-ICB-04 grantthe Y2020/EMT-6419 "CEOTRES" project funded by the Comunidad Autonoma de Madrid。
文摘The electrochemical CO_(2) reduction reaction(CO_(2)RR) to controllable chemicals is considered as a promising pathway to store intermittent renewable energy. Herein, a set of catalysts based on copper-nitrogendoped carbon xerogel(Cu-N-C) are successfully developed varying the copper amount and the nature of the copper precursor, for the efficient CO_(2)RR. The electrocatalytic performance of Cu-N-C materials is assessed by a rotating ring-disc electrode(RRDE), technique still rarely explored for CO_(2)RR. For comparison, products are also characterized by online gas chromatography in a H-cell. The as-synthesized Cu-NC catalysts are found to be active and highly CO selective at low overpotentials(from -0.6 to -0.8 V vs.RHE) in 0.1 M KHCO_(3), while H_(2) from the competitive water reduction appears at larger overpotentials(-0.9 V vs. RHE). The optimum copper acetate-derived catalyst containing Cu-N_(4) moieties exhibits a CO_(2)-to-CO turnover frequency of 997 h^(-1) at -0.9 V vs. RHE with a H_(2)/CO ratio of 1.8. These results demonstrate that RRDE configuration can be used as a feasible approach for identifying electrolysis products from CO_(2)RR.
基金the Startup Fund for Scientific Research of Fujian Medical University,No.2020QH1170.
文摘BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and neutral mucus,respectively.However,the clinical importance of the special combined AB and PAS stain is unclear.AIM To investigate AB expression,PAS expression and the AB-to-PAS(A/P)ratio in gastric SRCC patients and to assess patient prognosis.METHODS Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS,and signet ring cell positivity was assessed quantitatively.Immuno-histochemical staining for Ki67,protein 53(P53)and human epidermal growth factor receptor 2(HER2)was performed simultaneously.The cancer-specific survival(CSS)rate was estimated via Kaplan-Meier analysis.Cox proportional hazards models were used for univariate and multivariate survival analyses.RESULTS Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup(P<0.001).The 3-year CSS rate in the A/P≤0.5 group was significantly greater than that in the A/P>0.5 group(P=0.042).Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter,lymph node metastasis,vessel carcinoma embolus,tumor stage,the A/P ratio and the expression of Ki67,P53 and the PAS.Cox multivariate regression analysis confirmed that low PAS expression[hazard ratio(HR)=3.809,95%confidence interval(CI):1.563-9.283,P=0.003]and large tumor diameter(HR=2.761,95%CI:1.086-7.020,P=0.033)were independent risk factors for poor prognosis.CONCLUSION A/P>0.5 is potentially a risk factor for prognosis,and low PAS expression is an independent risk factor in the prognosis of gastric SRCC.PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.
基金the financial support by Hong Kong Scholar program(XJ2021-038)Young Talent Fund of Xi’an Association for Science and Technology(959202313080)+6 种基金the Natural Science Foundation Research Project of Shaanxi Province(2022JM-269)the Postgraduate Innovation and Practical Ability Training Program of Xi’an Shiyou University(YCS21212144)the National Natural Science Foundation of China(52103221,52172048,12175298)the Shandong Provincial Natural Science Foundation(ZR2021QB179,ZR2021QB024,ZR2021ZD06)the Guangdong Natural Science Foundation of China(2023A1515012323,2023A1515010943)the National Key Research and Development Program of China(2022YFB4200400)funded by MOSTthe Fundamental Research Funds of Shandong University。
文摘Design and synthesis of superior cost-effective non-fullerene acceptors(NFAs)are still big challenges for facilitating the commercialization of organic solar cells(OSCs),yet to be realized.Herein,two medium bandgap fully non-fused ring electron acceptors(NFREAs,medium bandgap,i,e.,1,3-1,8 eV),namely PTR-2Cl and PTR-4Cl are synthesized with only four steps by using intramolecular noncovalent interaction central core,structured alkyl side chain orientation linking units and flanking with different electron-withdrawing end group.Among them,PTR-4C1 exhibits increased average electrostatic potential(ESP)difference with polymer donor,enhanced crystallinity and compactπ-πstacking compared with the control molecule PTR-2CI.As a result,the PTR-4Cl-based OSC achieved an impressive power conversion efficiency(PCE)of 14.72%,with a much higher open-circuit voltage(V_(OC))of 0.953 V and significantly improved fill factor(FF)of 0.758,demonstrating one of the best acceptor material in the top-performing fully NFREA-based OSCs with both high PCE and V_(OC).Notably,PTR-4Cl-based cells maintain a good T_80lifetime of its initial PCE after over 936 h under a continuous thermal annealing treatment and over1300 h T_(80)lifetime without encapsulation.This work provides a cost-effective design strategy for NFREAs on obtaining high V_(OC),efficient exciton dissociation,and ordered molecular packing and thus high-efficiency and stable OSCs.
文摘This research investigates the comparative efficacy of generating zero divisor graphs (ZDGs) of the ring of integers ℤ<sub>n</sub> modulo n using MAPLE algorithm. Zero divisor graphs, pivotal in the study of ring theory, depict relationships between elements of a ring that multiply to zero. The paper explores the development and implementation of algorithms in MAPLE for constructing these ZDGs. The comparative study aims to discern the strengths, limitations, and computational efficiency of different MAPLE algorithms for creating zero divisor graphs offering insights for mathematicians, researchers, and computational enthusiasts involved in ring theory and mathematical computations.
基金Supported by the TCM Science and Technology Plan Project of Zhejiang Province,No.2022ZB323the Medical and Health Science and Technology Plan Project of Zhejiang Province,No.2022KY1114the Basic Research Program of Ningbo,No.2023Z210.
文摘BACKGROUND Gastric signet ring cell carcinoma(GSRC)represents a specific subtype of gastric cancer renowned for its contentious epidemiological features,treatment principles,and prognostic factors.AIM To investigate the epidemiology of GSRC and establish an improved model for predicting the prognosis of patients with locally advanced GSRC(LAGSRC)after surgery.METHODS The annual rates of GSRC incidence and mortality,covering the years 1975 to 2019,were extracted from the Surveillance,Epidemiology,and End Results(SEER)database to explore the temporal trends in both disease incidence and mortality rates using Joinpoint software.The clinical data of 3793 postoperative LAGSRC patients were collected from the SEER database for the analysis of survival rates.The Cox regression model was used to explore the independent prognostic factors for overall survival(OS).The risk factors extracted were used to establish a prognostic nomogram.RESULTS The overall incidence of GSRC increased dramatically between 1975 and 1998,followed by a significant downward trend in incidence after 1998.In recent years,there has been a similarly optimistic trend in GSRC mortality rates.The trend in GSRC showed discrepancies based on age and sex.Receiver operating characteristic curves,calibration curves,and decision curve analysis for 1-year,3-year,and 5-year OS demonstrated the high discriminative ability and clinical utility of this nomogram.The area under the curve indicated that the performance of the new model outperformed that of the pathological staging system.CONCLUSION The model we established can aid clinicians in the early prognostication of LAGSRC patients,resulting in improved clinical outcomes by modifying management strategies and patient health care.
基金Supported by National Natural Science Foundation of China,No.82270649.
文摘BACKGROUND Chylous ascites is caused by disruption of the lymphatic system,which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity.The two most common causes are cirrhosis and tuberculosis,and colon signer ring cell carcinoma(SRCC)due to the use of immunosuppressants is extremely rare in cirrhotic patients after liver transplantation,making it prone to misdiagnosis and missed diagnosis.CASE SUMMARY A 52-year-old man who underwent liver transplantation and was administered with immunosuppressants for 8 months was admitted with a 3-month history of progressive abdominal distention.Initially,based on lymphoscintigraphy and lymphangiography,lymphatic obstruction was considered,and cystellar chyli decompression with band lysis and external membrane stripping of the lymphatic duct was performed.However,his abdominal distention was persistent without resolution.Abdominal paracentesis revealed allogenic cells in the ascites,and immunohistochemistry analysis revealed adenocarcinoma cells with phenotypic features suggestive of a gastrointestinal origin.Gastrointestinal endoscopy was performed,and biopsy showed atypical signet ring cells in the ileocecal valve.The patient eventually died after a three-month follow-up due to progression of the tumor.CONCLUSION Colon SRCC,caused by immunosuppressants,is an unusual but un-neglected cause of chylous ascites.
文摘BACKGROUND Upper gastrointestinal(GI)signet ring cell carcinomas(SRCC)confer a poor prognosis.The benefit of operative intervention for this patient group is contro-versial in terms of overall survival.AIM To investigate factors relating to survival in patients with upper GI SRCC.METHODS A retrospective,tertiary,single-centre review of patients who were diagnosed with oesophageal,gastroesophageal junction and gastric SRCC was performed.The primary outcome was to compare mortality of patients who underwent operative management with those who had nonoperative management.Secon-dary outcomes included assessing the relationship between demographic and histopathological factors,and survival.RESULTS One hundred and thirty-one patients were included.The one-year survival for the operative group was 81%and for the nonoperative group was 19.1%.The five-year survival in the operative group was 28.6%vs 1.5%in the nonoperative group.The difference in overall survival between groups was statistically significant(HR 0.19,95%CI(0.13-0.30),P<0.001).There was no difference in survival when ad-justing for age,smoking status or gender.On multivariate analysis,patients who underwent surgical management,those with a lower stage of disease,and those with a lower Charlson Comorbidity Index(CCI)had significantly improved sur-vival.CONCLUSION Well-selected patients with upper GI SRCC appear to have reasonable medium-term survival following surgery.Offering surgery to a carefully selected patient group may improve the outcome for this disease.