Laparoscopic liver resection for hepatocellular carcinoma complicated with significant portal hypertension:A propensity score-matched survival analysis

Background: Significant portal hypertension(SPH) is a relative contraindication for patients with resectable hepatocellular carcinoma(HCC). However, increasing evidence indicates that liver resection is feasible for HCC patients with SPH. Methods: HCC patients with cirrhosis who underwent laparoscopic liver resection(LLR) in two centers from January 2013 to April 2018 were included. Surgical and survival outcomes were analyzed to explore potential prognostic factors. Propensity score matching(PSM) analysis was performed to minimize bias. Results: A total of 165 patients were divided into two groups based on the presence(SPH, n = 76) or absence(non-SPH, n = 89) of SPH. Patients in the SPH group had longer operative time, more blood loss, and more advanced TNM stage than patients in the non-SPH group( P < 0.05). However, there were no significant differences in the postoperative 90-day mortality rate( n = 0), overall postoperative complications(47.4% vs. 41.6%, P = 0.455), Clavien-Dindo classification( P = 0.347), conversion to open surgery(9.2% vs. 6.7%, P = 0.557), or length of hospitalization(16 vs. 15 days, P = 0.203) between the SPH and non-SPH groups before PSM. Similar results were obtained after PSM. The 1-, 3-, and 5-year overall survival(OS) and recurrence-free survival rates in the SPH group were not significantly different from those in the non-SPH group both before and after PSM(log-rank P > 0.05). After PSM, alpha-fetoprotein(AFP) ≥ 400 μg/L [hazard ratio(HR) = 4.71, 95% confidence interval(CI): 2.69-8.25], ascites(HR = 2.18, 95% CI: 1.30-3.66), American Society of Anesthesiologists(ASA) classification(Ⅲ vs. Ⅱ)(HR = 2.13, 95% CI: 1.11-4.07) and tumor diameter > 5 cm(HR = 3.91, 95% CI: 2.02-7.56) independently predicted worse OS. Conclusions: LLR for patients with HCC complicated with SPH appears feasible at the price of increasing operative time and blood loss. AFP, ascites, ASA classification and tumor diameter may predict the prognosis of HCC complicated with SPH after LLR.

Significant wave height forecasts integrating ensemble empirical mode decomposition with sequence-to-sequence model

As wave height is an important parameter in marine climate measurement,its accurate prediction is crucial in ocean engineering.It also plays an important role in marine disaster early warning and ship design,etc.However,challenges in the large demand for computing resources and the improvement of accuracy are currently encountered.To resolve the above mentioned problems,sequence-to-sequence deep learning model(Seq-to-Seq)is applied to intelligently explore the internal law between the continuous wave height data output by the model,so as to realize fast and accurate predictions on wave height data.Simultaneously,ensemble empirical mode decomposition(EEMD)is adopted to reduce the non-stationarity of wave height data and solve the problem of modal aliasing caused by empirical mode decomposition(EMD),and then improves the prediction accuracy.A significant wave height forecast method integrating EEMD with the Seq-to-Seq model(EEMD-Seq-to-Seq)is proposed in this paper,and the prediction models under different time spans are established.Compared with the long short-term memory model,the novel method demonstrates increased continuity for long-term prediction and reduces prediction errors.The experiments of wave height prediction on four buoys show that the EEMD-Seq-to-Seq algorithm effectively improves the prediction accuracy in short-term(3-h,6-h,12-h and 24-h forecast horizon)and long-term(48-h and 72-h forecast horizon)predictions.

Detection of Clinically Significant Warm Reactive Anti-A1 in a Post Red Blood Cells Transfusion Patient with Acute Lymphoblastic Leukemia

The purpose of this article is to report that some anti-A1 that react at 37°C are IgG antibodies and are clinically significant, as they can cause the destruction of a proportion of A1 cells in vivo following the transfusion of red blood cells. Therefore, when a serum of an individual contains anti-A1, further testing of the plasma against group A1, A2, and O by referencing red blood cells and individual cells against anti-A1 lectin (Dolichos biflorus lectin) must be performed. Confirming the specificity of anti-A1 by referencing red blood cells is also important in selecting the appropriate blood for transfusion. ABO antibodies are naturally occurring and activate the complement cascade, making them more likely to cause severe transfusion reactions compared to antibodies to other RBC antigens.

A Meta-Analysis of the Prognostic and Clinicopathological Significance of circZFR in Human Gastrointestinal Cancers

Background: Studies of gastrointestinal (GIT) cancers have shown that circZFR could be involved in the development and progression of various GIT cancers. However, small sample sizes limit the clinical significance of these studies. Here, a meta-analysis was conducted to ascertain the actual involvement of circZFR in the development and prognosis of GIT cancers. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched up to December 31, 2023. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to evaluate the association between circZFR expression and overall survival (OS). Publication bias was measured using the funnel plot and Egger’s test. Results: 10 studies having 659 participants were enrolled for meta-analysis. High circZFR expression was associated with poor OS (HR = 1.4, 95% CI: 1.20, 1.70). High circZFR expression also predicted larger tumor size (OR = 4.38, 95% CI 2.65, 7.25), advanced clinical stage (OR = 5.33, 95% CI 3.10, 9.16), and tendency for distant metastasis (OR = 2.89, 95% CI: 1.62, 5.11), but was not related to age, gender, and histological grade. Conclusions: In summary, high circZFR expression was associated with poor OS, larger tumor size, advanced stage cancer and tendency for distant metastasis. These findings suggested that circZFR could be a prognostic marker for GIT cancers.

Flower morphology of Allium(Amaryllidaceae)and its systematic significance

Allium is a complicated genus that includes approximately 1000 species.Although its morphology is well studied,the taxonomic importance of many morphological traits,including floral traits,are poorly understood.Here,we examined and measured the floral characteristics of 87 accessions of 74 Allium taxa(belonging to 30 sections and nine subgenera)from Central to Eastern Asian countries.We then examined the taxonomic relationships between select flower characteristics and a phylogenetic tree based on ITS sequences.Our results confirm that floral morphology provides key taxonomic information to assess species delimitation in Allium.We found that perianth color is an important characteristic within the subg.Melanocrommyum,Polyprason,and Reticulatobulbosa.In subg.Allium,Cepa,and Rhizirideum,significant characteristics include ovary shape,perianth shape,and inner tepal apex.For species in subg.Angunium,the key taxonomic character is ovule number(only one ovule in per locule).In the subg.Allium,Cepa,Polyprason,and Reticulatobulbosa,which belong to the third evolutionary line of Allium,hood-like appendages occur in the ovary,although these do not occur in subg.Rhizirideum.Our results also indicated that the flower morphology of several species in some sections are not clearly distinguished,e.g.,sect.Sacculiferum(subg.Cepa)and sect.Tenuissima(subg.Rhizirideum).This study provides detailed photographs and descriptions of floral characteristics and information on general distributions,habitats,and phenology of the studied taxa.

What benefit can be obtained from magnetic resonance imaging diagnosis with artificial intelligence in prostate cancer compared with clinical assessments?

The present study aimed to explore the potential of artificial intelligence(AI)methodology based on magnetic resonance(MR)images to aid in the management of prostate cancer(PCa).To this end,we reviewed and summarized the studies comparing the diagnostic and predictive performance for PCa between AI and common clinical assessment methods based on MR images and/or clinical characteristics,thereby investigating whether AI methods are generally superior to common clinical assessment methods for the diagnosis and prediction fields of PCa.First,we found that,in the included studies of the present study,AI methods were generally equal to or better than the clinical assessment methods for the risk assessment of PCa,such as risk stratification of prostate lesions and the prediction of therapeutic outcomes or PCa progression.In particular,for the diagnosis of clinically significant PCa,the AI methods achieved a higher summary receiver operator characteristic curve(SROC-AUC)than that of the clinical assessment methods(0.87 vs.0.82).For the prediction of adverse pathology,the AI methods also achieved a higher SROC-AUC than that of the clinical assessment methods(0.86 vs.0.75).Second,as revealed by the radiomics quality score(RQS),the studies included in the present study presented a relatively high total average RQS of 15.2(11.0–20.0).Further,the scores of the individual RQS elements implied that the AI models in these studies were constructed with relatively perfect and standard radiomics processes,but the exact generalizability and clinical practicality of the AI models should be further validated using higher levels of evidence,such as prospective studies and open-testing datasets.

Elevating Image Steganography:A Fusion of MSB Matching and LSB Substitution for Enhanced Concealment Capabilities

In today’s rapidly evolving landscape of communication technologies,ensuring the secure delivery of sensitive data has become an essential priority.To overcome these difficulties,different steganography and data encryption methods have been proposed by researchers to secure communications.Most of the proposed steganography techniques achieve higher embedding capacities without compromising visual imperceptibility using LSB substitution.In this work,we have an approach that utilizes a combinationofMost SignificantBit(MSB)matching andLeast Significant Bit(LSB)substitution.The proposed algorithm divides confidential messages into pairs of bits and connects them with the MSBs of individual pixels using pair matching,enabling the storage of 6 bits in one pixel by modifying a maximum of three bits.The proposed technique is evaluated using embedding capacity and Peak Signal-to-Noise Ratio(PSNR)score,we compared our work with the Zakariya scheme the results showed a significant increase in data concealment capacity.The achieved results of ourwork showthat our algorithmdemonstrates an improvement in hiding capacity from11%to 22%for different data samples while maintaining a minimumPeak Signal-to-Noise Ratio(PSNR)of 37 dB.These findings highlight the effectiveness and trustworthiness of the proposed algorithm in securing the communication process and maintaining visual integrity.

Staging liver fibrosis with various diffusion-weighted magnetic resonance imaging models

BACKGROUND Diffusion-weighted imaging(DWI)has been developed to stage liver fibrosis.However,its diagnostic performance is inconsistent among studies.Therefore,it is worth studying the diagnostic value of various diffusion models for liver fibrosis in one cohort.AIM To evaluate the clinical potential of six diffusion-weighted models in liver fibrosis staging and compare their diagnostic performances.METHODS This prospective study enrolled 59 patients suspected of liver disease and scheduled for liver biopsy and 17 healthy participants.All participants underwent multi-b value DWI.The main DWI-derived parameters included Mono-apparent diffusion coefficient(ADC)from mono-exponential DWI,intravoxel incoherent motion model-derived true diffusion coefficient(IVIM-D),diffusion kurtosis imaging-derived apparent diffusivity(DKI-MD),stretched exponential model-derived distributed diffusion coefficient(SEM-DDC),fractional order calculus(FROC)model-derived diffusion coefficient(FROC-D)and FROC model-derived microstructural quantity(FROC-μ),and continuous-time random-walk(CTRW)model-derived anomalous diffusion coefficient(CTRW-D)and CTRW model-derived temporal diffusion heterogeneity index(CTRW-α).The correlations between DWI-derived parameters and fibrosis stages and the parameters’diagnostic efficacy in detecting significant fibrosis(SF)were assessed and compared.RESULTS CTRW-D(r=-0.356),CTRW-α(r=-0.297),DKI-MD(r=-0.297),FROC-D(r=-0.350),FROC-μ(r=-0.321),IVIM-D(r=-0.251),Mono-ADC(r=-0.362),and SEM-DDC(r=-0.263)were significantly correlated with fibrosis stages.The areas under the ROC curves(AUCs)of the combined index of the six models for distinguishing SF(0.697-0.747)were higher than each of the parameters alone(0.524-0.719).The DWI models’ability to detect SF was similar.The combined index of CTRW model parameters had the highest AUC(0.747).CONCLUSION The DWI models were similarly valuable in distinguishing SF in patients with liver disease.The combined index of CTRW parameters had the highest AUC.

Advanced preparation and application of bimetallic materials in lithium-sulfur batteries:A review

Lithium-sulfur(Li-S)batteries are considered highly promising as next-generation energy storage systems due to high theoretical capacity(2600 Wh kg^(-1))and energy density(1675 mA h g^(-1))as well as the abundant natural reserves,low cost of elemental sulfur,and environmentally friendly properties.However,several challenges impede its commercialization including low conductivity of sulfur itself,the severe“shuttle effect”caused by lithium polysulfides(LiPSs)during charge–discharge processes,volume expansion effects and sluggish reaction kinetics.As a solution,polar metal particles and their compounds have been introduced as the main hosts for sulfur cathode due to their robust catalytic activity and adsorption capability,effectively suppressing the“shuttle effect”of Li PSs.Bimetallic alloys and their compounds with multi-functional properties exhibit remarkable electrochemical performance more readily when compared to single-metal materials.Well-designed bimetallic materials demonstrate larger specific surface areas and richer active sites,enabling simultaneous high adsorption capability and strong catalytic properties.The synergistic effect of the“adsorption-catalysis”sites accelerates the adsorptiondiffusion-conversion process of Li PSs,ultimately achieving a long-lasting Li-S battery.Herein,the latest progress and performance of bimetallic materials in cathodes,separators,and interlayers of Li-S batteries are systematically reviewed.Firstly,the principles and challenges of Li-S batteries are briefly analyzed.Then,various mechanisms for suppressing“shuttle effects”of Li PSs are emphasized at the microscale.Subsequently,the performance parameters of various bimetallic materials are comprehensively summarized,and some improvement strategies are proposed based on these findings.Finally,the future prospects of bimetallic materials are discussed,with the hope of providing profound insights for the rational design and manufacturing of high-performance bimetallic materials for LSBs.

Non-invasive assessment of esophageal varices:Status of today

With increasing burden of compensated cirrhosis,we desperately need noninvasive methods for assessment of clinically significant portal hypertension.The use of liver and spleen stiffness measurement helps in deferring unnecessary endoscopies for low risk esophageal varices.This would reduce cost and patient discomfort.However,these special techniques may not be feasible at remote areas where still we need only biochemical parameters.More prospective studies validating the non-invasive risk prediction models are definitely needed.

Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions:Clinical significance

Transoral endoscopic resections in treating upper gastrointestinal submucosal lesions have the advantages of maintaining the integrity of the gastrointestinal lumen,avoiding perforation and reducing gastrointestinal fistulae.They are becoming more widely used in clinical practice,but,they may also present a variety of complications.Gas-related complications are one of the most common,which can be left untreated if the symptoms are mild,but in severe cases,they can lead to rapid changes in the respiratory and circulatory systems in a short period,which can be life-threatening.Therefore,it is important to predict the occurrence of gas-related complications early and take preventive measures actively.Based on the authors'results in the prepublication of the article“Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions,”and in conjunction with our evaluation and additions to the relevant content,radiographs may help screen patients at high risk for gas-related complications.Controlling blood glucose levels,shortening the duration of surgery,and choosing the most appropriate surgical resection may positively impact the prognosis of patients at high risk for gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions.

A Study on the Educational Significance Guidance Plan Value of the Jumong Myth Using STEAM

Jumong is a legendary figure in Korean mythology.He is depicted as a genius archer,a brilliant mind with horses,a god who rules the rivers and the sky.Jumong is a mythical character who is believed to be of divine descent and to possess superhuman abilities that humans cannot match.The myth of Jumong is a very competitive content that can compete on a global scale.However,in order for it to be successful,it is necessary to be able to reinterpret our mythology to suit the times and reproduce it culturally.To this end,the realistic globalization of Korean classical literature should commence with the genre of Korean mythology.This paper presents the educational significance of the Jumong myth as a teaching-learning model,via STEAM(science,technology,engineering,arts,and mathematics),on the theme of Korean mythology.As we enter the era of artificial intelligence(AI)through the 4th Industrial Revolution,the most appropriate teaching and learning method,the convergence class,will provide an opportunity for students living in modern times to discover the cultural archetypes that allow them to recognise themselves as individuals and us as a collective,and to find the roots of the myth to positively renew their identity.Furthermore,it is my hope that they will rediscover and appreciate the representative work of Korean mythology,Gojomong,the eponymous story of Goguryeo.

Analysis of the History and Current Situation of the Development of General Practice Teaching Clinics in China

A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.

Exploring the Significance and Implementation Strategies of Mental Health Education for College Students

College students are influenced by diverse cultures in the new era,thus their inner world is rich and changing rapidly.The acceleration of social rhythm can easily lead to different kinds of psychological problems.Mental health education is people-oriented,using scientific methods and means to train high-quality talents with all-round development across the world.A healthy psychological state can promote the sound development of students,make them establish correct core social values,and realize self-value.At present,there are some problems in university mental health education,such as single form and imperfect system.At the same time,college education plays an important role in the formation of ideas for college students’ideological values.As a front-line student worker,college counselors should cooperate with the school’s psychological departments to improve the college psychological education system,rationally plan the psychological teaching program,and pay attention to the college students’mental health education.The government should also take into account the need to ensure that the education system is not undermined by the lack of a comprehensive and effective education system.

Expression of CD151 in Gastric Cancer Tissues and Its Clinical Significance

Objective:To explore the expression of CD151 in gastric cancer tissues and its clinical significance.Methods:Immunohistochemistry was employed to detect the expression of CD151 in gastric cancer tissues and adjacent normal tissues.The relationship between CD151 expression and the clinicopathological characteristics of gastric cancer was analyzed.Results:The expression of CD151 in gastric cancer tissues was significantly higher than in adjacent normal tissues(P<0.05).It was associated with the degree of differentiation,depth of invasion,lymph node metastasis,and TNM staging of gastric cancer.The survival time of patients with high CD151 expression was significantly shorter than that of those with low expression(P<0.05).Conclusion:High expression of CD151 in gastric cancer tissues is correlated with the malignant biological behavior of gastric cancer and can serve as an indicator for evaluating the prognosis of gastric cancer.

Analysis of the Significance of Key Points of Patient Interventional Psychological Care and Pain Care

Interventional therapy has become increasingly popular in clinical practice due to advancements in medical technology.However,patients often experience psychological and physiological pressure due to its invasive nature.The management of patient discomfort and tension is crucial to ensure effective treatment.Psychological and pain management are essential components of interventional therapy,as they significantly impact patient recovery and prognosis.This article discussed the importance of interventional psychological and pain care for patients,starting with the development and spread of interventional therapy.The significance of providing high-quality nursing services to patients and improving their quality of life was also discussed.

Research on Smart Logistics Development Based on Blockchain Technology

Blockchain technology has been incorporated into the field of next-generation information infrastructure in China and is experiencing rapid development.Utilizing blockchain and other emerging technologies to develop intelligent logistics is essential for logistics enterprises to reduce costs,enhance efficiency,and improve quality.By analyzing and summarizing the issues within the development of China’s logistics industry,this paper discusses its growth from three perspectives:policy,technology,and industry.

The Research on the Logic and Value of“Two Combinations”

Through the comprehensive analysis of the connotation and logic,inheritance and innovation and the value of social governance,and the dialectical relationship of“two combination”,the inheritance of the idea of Marxism,the inheritance of excellent traditional culture and the governance of contemporary society.

The validation of the significant wave height product of HY-2altimeter–primary results

The HY-2 satellite was successfully launched on 16 August 2011. The HY-2 significant wave height （SWH） is validated by the data from the South China Sea （SCS） field experiment, National Data Buoy Center （NDBC/ buoys and Jason-1/2 altimeters, and is corrected using a linear regression with in-situ measurements. Com- pared with NDBC SWH, the HY-2 SWH show a RMS of 0.36 m, which is similar to Jason- 1 and Jason-2 SWH with the RMS of 0.35 m and 0.37 m respectively; the RMS of corrected HY-2 SWH is 0.27 m, similar to 0.27 m and 0.23 m of corrected Jason-1 and Jason-2 SWH. Therefore the accuracy of HY-2 SWH products is close to that of Jason-1/2 SWH, and the linear regression function derived can improve the accuracy of HY-2 SWH products.

The validation of HY-2 altimeter measurements of a significant wave height based on buoy data

HY-2 has been launched by China on August 16, 2011 which assembles multi-microwave remote sensing payloads in a body and has the ability of monitoring ocean dynamic environments. The HY-2 satellite data need to be calibrated and validated before being put into use. Based on the in-situ buoys from the Nation- al Data Buoy Center （NDBC）, Ku-band significant wave heights （SWH, hs） of HY-2 altimeter are validated. Eleven months of HY-2 altimeter Level 2 products data are chose from October 1, 2011 to August 29, 2012. Using NDBC 60 buoys yield 902 collocations for HY-2 by adopting collocation criteria of 30 min for tempo- ral window and 50 km for a spatial window. An overall RMS difference of the SWH between HY-2 and buoy data is 0.297 m. A correlation coefficient between these is 0.964. An ordinary least squares （OLS） regression is performed with the buoy data as an independent variable and the altimeter data as a dependent vari- able. The regression equation of hs is hs （HY-2）=0.891 × hs （NDBC）＋0.022. In addition, 2016 collocations are matched with temporal window of 30 rain at the crossing points of HY-2 and Jason-2 orbits. RMS difference of Ku-band SWH between the two data sets is 0.452 m.