Colorectal cancer screening:The value of early detection and modern challenges

The screening of colorectal cancer(CRC)is pivotal for both the prevention and treatment of this disease,significantly improving early-stage tumor detection rates.This advancement not only boosts survival rates and quality of life for patients but also reduces the costs associated with treatment.However,the adoption of CRC screening methods faces numerous challenges,including the technical limitations of both noninvasive and invasive methods in terms of sensitivity and specificity.Moreover,socioeconomic factors such as regional disparities,economic conditions,and varying levels of awareness affect screening uptake.The coronavirus disease 2019 pandemic further intensified these challenges,leading to reduced screening participation and increased waiting periods.Additionally,the growing prevalence of early-onset CRC necessitates innovative screening approaches.In response,research into new methodologies,including artificial intelligence-based systems,aims to improve the precision and accessibility of screening.Proactive measures by governments and health organizations to enhance CRC screening efforts are underway,including increased advocacy,improved service delivery,and international cooperation.The role of technological innovation and global health collaboration in advancing CRC screening is undeniable.Technologies such as artificial intelligence and gene sequencing are set to revolutionize CRC screening,making a significant impact on the fight against this disease.Given the rise in early-onset CRC,it is crucial for screening strategies to continually evolve,ensuring their effectiveness and applicability.

Single-incision laparoscopic colorectal surgery for cancer: State of art

A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases.

Alternatives to left lateral segment for pediatric liver transplantation, or required surgeon toolkit?

We read with great interest the systematic review on modified grafts for pediatric liver transplantation by Gavriilidis et al.(1)recently published in Hepatobiliary Surgery and Nutrition.The authors aimed to review existing literature related to liver transplantation(LT)in small pediatric recipients using modified left lateral segment(LLS)grafts-reduced/hyper-reduced LLS or monosegments-and how comparable these techniques are to the standard practice using LLS.We congratulate the authors on their publication and would like to highlight some important findings of this study.Gavriilidis et al.’s(1)systematic review included a final cohort of 330 small pediatric recipients of modified LLS over two decades.The discrepancy between years evaluated and number of reported cases included in the systematic review is striking,and somehow not surprising.In the Unites States alone,the pre-transplant mortality amongst candidates younger than 1 year is reported to be 21.7 deaths per 100 patient-years(2).

Recycling is not enough to make the world a greener place:Prospects for the circular economy

1.Introduction.The rapid growth of the global population,combined with increasing industrialization and consumerism,has fueled a significant surge in the demand for material resources,fundamentally transforming the global socioeconomic metabolism[1,2].The global use of materials was at 90 billion tonnes in 2017 and is projected to grow to 165-195 billion tonnes by 2060[3,4].Particularly,the extraction of minerals and ores represents over half of the total resources demand since 2010[5,6].Remarkably,about 60%of these extracted minerals and ores are presently still in use as anthropogenic stocks[7],which is capable of meeting 35%of the projected demand by 2050 if reused.

Advances in subsea carbon dioxide utilization and storage

Decisive steps in innovation and competitiveness are needed to meet global greenhouse gas emissions and climate goals.As an effective method for reducing carbon emissions,carbon dioxide(CO_(2))storage and utilization on the seabed enable the transport of captured CO_(2)via pipelines or ships to permanent storage sites,such as saline aquifers or depleted oil and gas reservoirs in subsea sediments,or by injecting CO_(2)for the replacement and displacement of subsea resources(oil,gas,gas hydrates,etc.).Subsea CO_(2)utilization and storage(SCUS)involves several research hotspots worldwide,including international and local laws and regulations,security,economics,environmental impact,and public acceptance.Its current research and engineering progress are also of great interest.In addition,the vigorous implementation of the energy transition and the rapid development of renewable energy sources globally have resulted in significant advancements in SCUS.This paper provides an overview of carbon dioxide storage and utilization mechanism in the seabed,analyzes key technical and economic issues,and summarizes existing research on safety risks,monitoring technologies,and investment and operating cost control to identify remaining knowledge gaps.This is followed by an overview of global engineering practice to update on current progress.Finally,combined with the actualities of China,the potential and trend of China's seabed carbon storage and utilization are summarized.This review demonstrates the enormous development prospects for seabed carbon storage and utilization,although some risks remain including leakage and contamination,with which innovation in monitoring technologies and the self-sealing effect of gas hydrate,safe subsea utilization and storage of CO_(2)can be achieved.Additionally,considering the development of renewable energy and the demand for large-scale energy storage,hydrogen,ammonia,or other energy carriers and carbon dioxide storage and utilization can be coupled into an industrial chain to form an economically competitive carbon geological storage mode.