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Endoscopic submucosal dissection (ESD) of fibrotic colorectal lesions is difficult and has a high complication rate. There are only a few reports on the utility of orthodontic rubber band (ORB) traction in reducing the difficulty of this procedure. This study aimed to investigate the risk factors for perforation when applying ORB traction during ESD of fibrotic colorectal lesions. We continuously collected the clinical data of 119 patients with fibrotic colorectal lesions who underwent ESD with ORB and clip traction between January 2019 and January 2024. Possible risk factors for perforation were analyzed. The median ORB-ESD operative time was 40 (IQR 28–62) min, and the en bloc and R0 resection rates were 94.1% and 84.0%, respectively. Perforation occurred in 16 of 119 patients (13.4%). The lesion size, lesion at the right half of the colon or across an intestinal plica, the degree of fibrosis, operation time, and the surgeon's experience were associated with perforation during ORB-ESD (P < 0.05). Multivariate logistic regression analysis showed that lesions in the right colon (OR 9.027; 95% CI 1.807–45.098; P = 0.007) and those across an intestinal plica (OR 7.771; 95% CI 1.298–46.536; P = 0.025) were independent risk factors for perforation during ORB-ESD. ORB-ESD is an effective and feasible approach to treat fibrotic colorectal lesions. Adequate preoperative evaluation is required for lesions in the right colon and across intestinal plicas to mitigate the risk of perforation. [ABSTRACT FROM AUTHOR]

To study and compare the value of the Kyoto classification risk scoring system and the modified Kyoto classification risk scoring system based on linked color imaging (LCI) in predicting the risk of early gastric cancer. One hundred and fifty patients with pathologically confirmed non-cardia early gastric cancer by endoscopic LCI and 150 non-gastric cancer patients matched for age and gender were included. Basic patient data and whole gastric endoscopic images under LCI were collected, and the images were scored according to the LCI-based Kyoto classification risk scoring system and the LCI-based modified Kyoto classification risk scoring system. Compared with the LCI-based Kyoto classification risk scoring system, the LCI-based modified Kyoto classification risk scoring system had a higher AUC for predicting the risk of early gastric cancer (0.723 vs. 0.784, p = 0.023), with a score of ≥3 being the best cutoff value for predicting the risk of early gastric cancer (sensitivity 61.33%, specificity 86.00%), and scores of 3 to 5 were significantly associated with early gastric carcinogenesis significantly (OR = 9.032, 95% CI: 4.995–16.330, p < 0.001). Compared with the LCI-based Kyoto classification risk scoring system, the LCI-based Kyoto modified classification risk scoring system has a better value for predicting the risk of early gastric cancer, and the score of 3 to 5 is a high-risk factor for the risk of early gastric cancer development, which is more strongly correlated with the risk of early gastric cancer. [ABSTRACT FROM AUTHOR]

Objective Endoscopic papillectomy(EP) is a minimally invasive treatment for early ampullary tumors. However, the optimal method is unclear. The aim of this study is to explore the efficacy and safety of traction-assisted EP treatments for ampullary early tumors. Methods We retrospective analyzed the patients with ampullary adenoma or early adenocarcinoma underwent endoscopic papillectomy between January 2010 and August 2023, including patient characteristics, lesion size, papilla type, pathological diagnosis and lesion surrounding conditions, en-bloc resection rate, complete resection rate, procedure time, complications, recurrences. Results During the study period, a total of 106 patients with ampullary adenoma or early adenocarcinoma underwent EP. The number of patients in traction group (clip combined with dental floss traction, CDT-EP) and non-traction group (hot snare papillectomy, HSP or endoscopic mucosal resection, EMR) were 45 and 61 respectively. The traction group has a higher en-bloc resection rate and complete resection rate than the non-traction group (92.86% vs. 68.85%, p = 0.003; 90.48% vs. 60.66%, p = 0.001), and the procedure time is slightly shorter[(1.57 ± 1.93)min vs. (1.98 ± 1.76)min, p = 0.039]. The complications and recurrence in the traction group were lower than those in the non-traction group (7.14% vs. 19.72%, p = 0.076; 7.14% vs. 11.78%, p = 0.466), and all complications were successfully treated by endoscopy or conservative medical treatment. There was no statistical difference between the two groups in terms of patient characteristics, papilla type, pathological diagnosis and lesion surrounding conditions (p > 0.050), but there were differences in lesion size[(13 ± 1.09)mm vs. (11 ± 1.65)mm, p = 0.002]. The recurrence rate of the traction group is lower than that of the non-traction group, but the difference is not significant(7.14% vs. 13.11%, p = 0.335), and the non-traction group mainly has early recurrence. Further analysis shows that the size of the lesion, whether en-bloc resection or not, and the method of resection as independent risk factors for incomplete resection (OR = 1.732, p = 0.031; OR = 3.716, p = 0.049; OR = 2.120, p = 0.027). Conclusions CDT- EP, HSP and EMR are all suitable methods for the treatment of ampullary adenoma or early adenocarcinoma. Assisted traction technology can reduce the operation difficulty of large and difficult to expose lesions, thereby improving the efficacy and safety of EP. [ABSTRACT FROM AUTHOR]

Background and aims: Metformin has been reported to inhibit the occurrence and development of colorectal cancer (CRC) by mediating changes in intestinal flora. Studies have also indicated that the occurence of familial adenomatous polyposis (FAP) may also be associated with changes in the intestinal flora. Therefore, we investigated the efficacy and safety of metformin in treating FAP and the association with intestinal flora. Results: Compared with the baseline, the mean number and load of polyps in the areas of nanocarbon labeling and postoperative residuals in the test group were lower than those in the placebo group, while the diversity of intestinal flora species was increased. At the genus level, the relative abundance of g_Ruminococcus in the test group was lower than that at baseline, whereas the relative abundance of g_Lactobacillus was higher. These changes were statistically significant (P < 0.05). Conclusion: One-year metformin therapy for FAP is safe and effective, potentially mediated by modulating the intestinal flora. This study provides new insights and strategies for preventing adenomatous polyp carcinogenesis in FAP and explores possible preventive action. [ABSTRACT FROM AUTHOR]

There is no consensus on whether a gastroscopic biopsy is necessary during the emergency treatment of gastrointestinal (GI) diseases such as gastric ulcer bleeding. In this study, we examined the clinical utility and safety of an emergency gastroscopic biopsy for the assessment of gastric ulcer bleeding. We enrolled 150 patients with a single bleeding gastric ulcer after emergency gastroscopy (EG) from April 2020 to April 2022. The patients were randomly divided into the biopsy and no biopsy groups, and they were followed-up until June 2022 to examine whether recurrent gastric ulcer bleeding had occurred. Re-bleeding occurred in 15 out of 150 (10%) patients. We diagnosed malignancies in 17 (11.3%) patients and validated 14 (9.3%) of them during the initial gastroscopy procedure. Factors that could predict the occurrence of gastric ulcer re-bleeding with biopsy during EG included an absence of ischemic heart disease (odds ratio [OR] = 0.395, confidence interval [CI]: 0.24–0.65, p ≤.005), renal disease (OR = 1.74, CI: 0.77–1.59, p ≤.005), and using warfarin or oral anticoagulants (OR = 11.953, CI: 3.494–39.460, p ≤.005). No significant differences were observed in 60-day bleeding (p =.077) and the duration of hospitalization (p =.700) between the two groups. Patients undergoing biopsy during EG did not exhibit an increased risk of re-bleeding compared with those who did not undergo a biopsy. An early biopsy facilitates an early pathologic diagnosis, early clinical intervention, safe discharge of low-risk patients, and improved outcomes in high-risk patients. [ABSTRACT FROM AUTHOR]

Background and aims: Effective traction is an important prerequisite for successful endoscopic submucosal dissection (ESD). The combined orthodontic rubber band (ORB) and clip method was effective in colorectal cancer ESD. To date, the method was not reported in gastric ESD. This study aimed to investigate its efficacy and safety for gastric neoplasms ESD. Methods: We retrospectively analyzed data of 118 patients with gastric neoplasms treated by ESD from November 2020 to April 2022, 43 by ORB-ESD and 75 by the conventional ESD. The primary outcome measure was the ESD procedure time. Clinical data on efficacy and safety were also collected and analyzed. Propensity score matching (PSM) matched the patients in both groups. Results: PSM successfully matched 31 pairs of patients. The ORB-ESD operation time was shorter (median [interquartile range], 35 [30–48] vs. 49 [40–70] min, P < 0.001) and dissection speed was higher (median [interquartile range], 22.6 [14.4–29.3] vs. 13.5 [9.6–17.9] mm2/min, P < 0.001) than in the conventional ESD. The groups were similar in muscular injury rate, frequency and time of use of thermal hemostatic forceps, postoperative adverse events, en bloc resection, and R0 resection rate (P > 0.05). Conclusions: Compared to the conventional ESD, ORB-ESD significantly reduced the procedure time and increased the dissection speed, proving beneficial to gastric ESD. [ABSTRACT FROM AUTHOR]

Using the intelligent image recognition method to recognize the reading of the unintelligent manual reading meter is an important approach to expand the sensing means and reduce the cost of transformation of the Industrial Internet of Things. Traditional methods based on morphology and back propagation neural networks are difficult to solve the problems of shadow, deflection, and dimness in the industrial environment. In this article, the deep learning‐based capsule networks for pointer instruments and digital display instruments were proposed to implement unintelligent manual reading meter recognition using. Due to the complex structure and a large number of parameters, the basic capsule network is difficult to run on devices with low computing resources. To overcome this issue, the improved capsule network model was designed to reduce the parameters of the model. The experimental results show that the improved capsule network improves the recognition accuracy by 13% and reduces the parameters by 23%. [ABSTRACT FROM AUTHOR]

With the continuous integration of deep learning and the technique of molecular biology, target detection models must accurately detect the position of each cell in the image and classify it correctly. We present a model for the multi‐scale feature fusion of the existing human cell image dataset based on Gaussian mixedly clustering. First, a novel feature extraction network for extracting preliminary features at picture multi scales was presented, which was based on a residual neural network with Instance Normalization and a Mish activation function. Second, the presented model adopts the idea of feature fusion and introduced a new type of feature fusion network to integrate feature graphs on different scales. Furthermore, a Gaussian hybrid clustering algorithm was proposed to cluster the hyperparameters. Based on the experimental results, the average accuracy of the proposed model in the human cell image dataset exceeds 0.96, which improves by 11.9% compared with the existing target detection methods in the same field. Experiments show that the proposed model had been adapted to datasets with uneven sample distribution, providing new ideas for research on medical images. [ABSTRACT FROM AUTHOR]

To evaluate the value and compare the effectiveness of linked color imaging-based endoscopic grading of gastric intestinal metaplasia (LCI-EGGIM) and operative link on gastric intestinal metaplasia (OLGIM) in risk stratification of early gastric cancer (EGC). Eighty-one patients with EGC who underwent endoscopic submucosal dissection were included. The general data and EGC-related risk factors of all participants were recorded. LCI-EGGIM and OLGIM were used for both groups. The number of patients with LCI-EGGIM score ≥ 5 was significantly higher in the EGC group than in the control group (58.02% vs. 12.35%, p <.001). Furthermore, the number of patients with OLGIM stage III/IV in the EGC group was significantly higher than that in the control group (56.79% vs. 7.41%, p <.001). Multivariate analysis showed that OLGIM stage III/IV (adjusted odds ratio [AOR]: 29.74, 95% CI: 7.49–117.94) and LCI-EGGIM score ≥ 5 (AOR: 12.33, 95% CI: 3.71–41.02) were significantly associated with EGC. There was no significant difference in the area under the receiver operating characteristic curve between LCI-EGGIM and OLGIM in predicting the risk of EGC (0.74 vs. 0.77, p =.1116). OLGIM and LCI-EGGIM can be used and have the same value for predicting the risk stratification of EGC in patients with gastric intestinal metaplasia. [ABSTRACT FROM AUTHOR]

Rectal neuroendocrine tumors (R-NETs) usually invade the submucosa, and so complete resection is difficult. The treatment of choice for R-NETs ≤10 mm in size is endoscopic resection, but there is still controversy concerning the best endoscopic method. This study evaluated the efficacy and safety of ligation-assisted endoscopic submucosal resection combined with endoscopic ultrasonography (ESMR-LUS) for treatment of R-NETs. We retrospectively analyzed the data of 101 patients with R-NETs ≤10 mm in size who underwent ESMR-LUS (n = 48) or conventional ligation-assisted endoscopic submucosal resection (ESMR-L; n = 53) between May 2019 and September 2021 at the 900th Hospital of Joint Logistics Support Force. Complete resection rate, pathological complete resection rate, procedure time, and adverse events were compared between the two groups of patients. The endoscopic complete resection rate was slightly higher in the ESMR-LUS group than in the ESMR-L group (100 vs. 96.2%, p =.496). The pathological complete resection rate was also slightly higher in the ESMR-LUS group (97.9 vs. 88.7%, p =.152), these findings, though statistically non-significant, have practical clinical significance. Margin involvement was less common in ESMR-LUS patients than in ESMR-L patients (1 vs. 6). Involvement of the lateral resection margin was found one patient in the ESMR-LUS group versus two patients in the ESMR-L group, and deep resection margin involvement in no patient in the ESMR-LUS group versus four patients in the ESMR-L group. Mean procedure time was longer in the ESMR-LUS group than in the ESMR-L group (11.08 ± 1.89 min vs. 9.38 ± 2.09 min, p =.061). Immediate bleeding occurred in two patients in the ESMR-LUS group vs. seven patients in the ESMR-L group. Two patients in the ESMR-L group also suffered perforation; both patients were successfully treated by endoscopy. ESMR-LUS appears to be a safe and effective technique for removal of small rectal NETs confined to the submucosal layer without metastasis. Further studies are warranted to compare the efficacy and safety of different methods. [ABSTRACT FROM AUTHOR]

Objectives: The uncommon p.L747P mutation in epidermal growth factor receptor (EGFR) exon 19 reveals to alter the response to tyrosine kinase inhibitors (TKIs) in patients diagnosed with advanced non-small cell lung cancer (NSCLC). However, the underlying mechanism is still not clear. This study aimed to investigate the clinical outcomes, binding affinities, and modes of action of currently available EGFR TKIs towards p.L747P mutation. Materials and Methods: Clinical data of NSCLC patients harboring p.L747P mutation who had received different generations of EGFR TKIs were collected from medical records. Computational structure of p.L747P was constructed and in vitro cellular kinase inhibition assay and mice xenograft experiment were performed to predict and confirm the binding affinities and antitumor activities of diverse EGFR TKIs. Results: A total of five metastatic NSCLC patients with p.L747P mutation were included in the final analysis. Patients treated with second-generation (2G) TKI afatinib achieved numerically longer progression-free survival (range 2.4-8.5 months) than that with first-generation (1G, range 1.4-5.5 months) or third-generation (3G, range 1.6-7.5 months) TKIs. None of the patients administered 1G or 3G TKIs achieved tumor response, but two-thirds of them treated with afatinib achieved partial response. Dynamics simulation predicted that 2G TKIs presented the best binding affinity to p.L747P mutation. The cellular kinase inhibition assay and mice xenograft experiment confirmed that afatinib could potently inhibit p.L747P-mutant cells and significantly reduce p.L747P-mutant tumor growth (P < 0.001), together with reduced phosphorylation of EGFR and its downstream signalings. Conclusions: The uncommon p.L747P mutation in EGFR exon 19 resulted in a poor response to first-generation EGFR TKIs. Afatinib revealed a better clinical response and binding affinity compared with osimertinib for this specific alteration. [ABSTRACT FROM AUTHOR]

Background. Colorectal endoscopic submucosal dissection (ESD) is a complex operation. Effective traction is crucial. We have successfully used an orthodontic rubber band (ORB) combined with the clip traction method to assist ESD (ORB-ESD). The aim of this retrospective study is to describe the method and to compare the efficacy and safety of ORB-ESD versus conventional ESD in the treatment of superficial colorectal tumors. Methods. We retrospectively analyzed the data of patients with superficial colorectal tumor (with diameter ≥ 20 mm) who received either ORB-ESD (n = 34) or conventional ESD (n = 90) between January 2019 and September 2020. Propensity score matching (PSM) was used to match the clinical data of 31 pairs of patients in each group. Results. Operation time was significantly shorter for ORB-ESD than for conventional ESD (34.5 minutes vs. 56 minutes, P ≤ 0.001). In the propensity-matched cohorts, the operation time remained significantly shorter in the ORB-ESD patients (35 minutes vs. 50 minutes, P = 0.001). Postoperative adverse events, en bloc resection rate, and R0 resection rate were comparable between the two groups (P > 0.05), both before and after propensity score matching. In the ORB subgroup analysis, the trainee and expert ESD operation times were similar (37 (26–53) vs. 33.5 (26–37) minutes, respectively; P = 0.274). Conclusion. ORB-ESD appears to be an effective technique for ESD of colorectal cancer. Our findings need to be confirmed in large prospective multicenter studies. [ABSTRACT FROM AUTHOR]

Internet of Things will play a vital role in the public transport systems to achieve the concepts of smart cities, urban brains, etc., by mining continuously generated data from sensors deployed in public transportation. In this sense, smart cities applied artificial intelligence techniques to offload data for social governance. Bicycle sharing is the last mile of urban transport. The number of the bike in the sharing stations, to be rented in future periods, is predicted to get the vehicles ready for deployment. It is an important tool for the implementation of smart cities using artificial intelligence technologies. We propose a DBSCAN-TCN model for predicting the number of rentals at shared bicycle stations. The proposed model first clusters all shared bicycle stations using the DBSCAN clustering algorithm. Based on the results of the clustering, the data on the number of shared bicycle rentals are fed into a TCN neural network. The TCN neural network structure is optimized. The effects of convolution kernel size and Dropout rate on the model performance are discussed. Finally, the proposed DBSCAN-TCN model is compared with the LSTM model, Kalman filtering model, and autoregressive moving average model. Through experimental validation, the proposed DBSCAN-TCN model outperforms the traditional three models in terms of two metrics, root mean squared logarithmic error, and error rate, in terms of prediction performance. [ABSTRACT FROM AUTHOR]

Cumulative evidence suggests that linked color imaging (LCI) can be used to identify gastric intestinal metaplasia (GIM). We aimed to develop endoscopic grading for GIM (EGGIM) with LCI. Two hundred and seventy-seven patients who underwent high-resolution white-light gastroscopy followed by LCI for EGGIM estimation were included. LCI was performed for the entire mucosa, and images of five areas each were recorded from the lesser and greater curvatures of the antrum and corpus, and for the incisura. For each area, scores of 0 (no GIM), 1 (focal GIM, ≤30% of the area), and 2 (extensive GIM, >30% of the area) were attributed for 10 points. If GIM was suspected based on endoscopy findings, targeted biopsies were performed; if GIM was not evident, random biopsies were performed according to the Sydney system to estimate the operative link on GIM (OLGIM). GIM was staged as OLGIM 0, I, II, III, and IV in 136, 70, 37, 28, and 6 patients, respectively. For OLGIM III/IV diagnosis, the area under the receiver operating curve was 0.949 (95% CI 0.916–0.972). EGGIM of 4, with sensitivity and specificity of 94.12% (95% CI 80.3%–99.3%) and 86.42% (95% CI 81.5%–90.5%), respectively, was determined the best cut-off value for identifying OLGIM III/IV patients. Our findings demonstrated the ability of EGGIM for diagnosing the extent of intestinal metaplasia and showed that EGGIM is related to OLGIM staging. EGGIM of 4 was the best cut-off value for identifying OLGIM III/IV patients. [ABSTRACT FROM AUTHOR]

Predicting urban traffic is of great importance to smart city systems and public security; however, it is a very challenging task because of several dynamic and complex factors, such as patterns of urban geographical location, weather, seasons, and holidays. To tackle these challenges, we are stimulated by the deep-learning method proposed to unlock the power of knowledge from urban computing and proposed a deep-learning model based on neural network, entitled Capsules TCN Network, to predict the traffic flow in local areas of the city at once. Capsules TCN Network employs a Capsules Network and Temporal Convolutional Network as the basic unit to learn the spatial dependence, time dependence, and external factors of traffic flow prediction. In specific, we consider some particular scenarios that require accurate traffic flow prediction (e.g., smart transportation, business circle analysis, and traffic flow assessment) and propose a GAN-based superresolution reconstruction model. Extensive experiments were conducted based on real-world datasets to demonstrate the superiority of Capsules TCN Network beyond several state-of-the-art methods. Compared with HA, ARIMA, RNN, and LSTM classic methods, respectively, the method proposed in the paper achieved better results in the experimental verification. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic resection of colorectal polyps is widely established as the optimal method to manage precancerous lesions. But the optimal technique for removal of the polyps is uncertain. The aim of this study was to compare the efficacy and safety of three methods for the management of 6–20mm colorectal polyps. Methods: A prospective, randomised controlled trial was conducted at the 900TH Hospital of Joint Logistics Support Force in Fujian, China. Endoscopically diagnosed colorectal polyps, 6–20 mm in size, were randomly assigned to the cold snare polypectomy (CSP), cold snare endoscopic mucosal resection (CS-EMR) or endoscopic mucosal resection (EMR) group. After polypectomy, additional 3–5 forceps biopsies by leading narrow-band imaging (NBI) were performed at the base and margins of polypectomy sites to assess the presence of residual polyp tissue and all samples were sent for histopathological analysis to assess completeness of resection. Polypectomy timing, tissue retrieval and complications were recorded at the time of the procedure. Results: A total of 781 polyps in 404 patients were assessed and randomly assigned to each group. Of these, 763 polyps were finally analyzed based on the pathology results. The complete resection rates with CSP, CS-EMR and EMR were 81.6%, 94.1% and 95.5%, respectively (p <.001). The intraprocedural bleeding rate, immediately after polypectomy, was significantly higher in the CSP group than in the CS-EMR and EMR group (9.4% vs. 4.4% vs. 1.9%; p <.001). However,delayed bleeding was higher in the EMR group than in the CSP and CS-EMR group (2.6% vs. 1.2% vs. 0.8%, respectively; p =.215). In the multivariate analysis showed that the operation method, lesion size, morphology and the number of resection were independent risk factors for complete resection rate (CRR) (p <.05), but the location and pathological classification of polyps had no significant influence on CRR. Conclusions: CS-EMR is safe and effective in the treatment of 6–20 mm colorectal polyps. Especially for 6–15 mm non-pedunculated polyps, CS-EMR has a high histological complete resection rate comparable to EMR, and retains the low risk of delayed complications after polypectomy with cold snare. CS-EMR is expected to become a more valuable new cold-cutting technique after cold snare polypectomy. [ABSTRACT FROM AUTHOR]

Background: Oesophageal submucosal tumours are usually benign. We report a rare case of esophageal squamous cell carcinoma presenting as a submucosal tumour.Case Presentation: A 58-year-old man undergoing screening oesophago-gastroduodenoscopy was found to have a smooth-surfaced 0.6-cm sized submucosal tumour in the oesophagus 30 cm from the incisor. Endoscopic ultrasonography showed the tumour to be located in the muscularis mucosa; the lesion was heterogeneously hypoechoic and had a clear boundary. With a provisional diagnosis of leiomyoma, the tumour was removed by endoscopic submucosal dissection. Pathological examination showed it to be a moderately differentiated infiltrating squamous cell carcinoma, with normal overlying squamous epithelium. Immunohistochemistry indicated that it was caused by malignant transformation in mucosal glandular duct epithelium. Positron emission tomography-computer tomography showed no tumour spread to any other site. The patient was treated by oesophageal resection.Conclusion: The clinician should be aware that oesophageal submucosal tumours with smooth overlying mucosa may not always be benign; malignancy must be ruled out. [ABSTRACT FROM AUTHOR]

With the significant population growth in megacities everywhere, traffic congestion is becoming a severe impediment, leading to long travel delays and large economic loss on a global scale. Platooning is a promising intelligent transportation framework that can improve road capacity, on-road safety, and fuel efficiency. Furthermore, enabling inter-vehicle communications within a platoon and among platoons (in a multiplatoon) can potentially enhance platoon control by keeping constant inter-vehicle and inter-platoon distances. However, an efficient resource allocation (RA) approach is required for the timely and successful delivery of inter-vehicle information within multiplatoons. In this paper, subchannel allocation scheme and power control mechanism are proposed for LTE-based inter-vehicle communications in a multiplatooning scenario. We jointly consider the evolved multimedia broadcast multicast services and device-to-device (D2D) multicast communications to enable intra- and inter-platoon communications such that a desired tradeoff between the required cellular resources and the imposed communication delay can be achieved. Simulation results are given to demonstrate that the proposed approaches can reduce the communication delay comparing to D2D-unicast based RA scheme, especially in a multiplatoon scenario with a large number of vehicles. [ABSTRACT FROM AUTHOR]

Platooning has been identified as a promising framework to improve road capacity, on-road safety, and energy efficiency. Enabling communications among vehicles in platoons is expected to enhance platoon control by keeping constant intervehicle and interplatoon distances. Characterizing the performance of intra- and interplatoon communications in terms of throughput and packet transmission delays is crucial for validating the effectiveness of information sharing on platoon control. In this paper, we introduce an IEEE 802.11p-based communication model for multiplatooning (a chain of platoons) scenarios. We present a probabilistic performance analysis of distributed-coordination-function-based intra- and interplatoon communications. Expressions for the transmission attempt probability, collision probability, packet delay, packet-dropping probability, and network throughput are derived. Numerical results show that the performance of interplatoon communications is affected by the transmissions of the first and last vehicles in a multiplatoon. This effect is reduced with an increase of the platoon number in the multiplatoon. In addition, the communication performance for three typical multiplatooning application scenarios is investigated, indicating that the IEEE 802.11p-based communication can support the timely delivery of vehicle information among platoons for diverse on-road applications. [ABSTRACT FROM PUBLISHER]

Background: Endoscopic surgery has been a novel treatment for colon polyps or even early colorectal cancer. However, the exact re-inspection after colonic polypectomy to detect the scar from polyp removal was difficult to be performed. In our previous study, colon cancer tattooed with carbon nanoparticles was easily found during surgery. We speculated that carbon nanoparticles could be used in exact re-inspection after colonic polypectomy.Objective: To evaluate the efficiency of carbon nanoparticles for re-inspection after colonic polypectomy.Methods: Twenty-four patients with precancerous lesion or early colorectal cancer that underwent colonoscopic polypectomy between October 2012 and December 2013 were enrolled in the study. Participants were divided into two groups. Group A patients were injected with carbon nanoparticles beneath the lesion sites 3 cm. Group B patients were not treated with nanoparticles. All patients underwent quarterly colonoscopies. Once the colonoscope was withdrawn from the site last time record, the time spent searching for lesions was recorded.Results: There were no significant differences between general conditions or lesion pathology between the groups. The time spent searching for lesions in Group B was much longer than that in Group A (13.67 ± 8.07 vs. 1.21 ± 0.39 min, P < 0.001). Carbon nanoparticles marked lesions for 12 months in some patients, and no adverse reactions were reported.Limitations: It was a small sample study.Conclusions: Tattooing lesions using carbon nanoparticles suspensions is safe. The durability of dye enables lesions to be re-checked by colonoscopy or laparoscopy for up to 1 year. [ABSTRACT FROM AUTHOR]

Background: Severe acute pancreatitis (SAP) usually results in acute renal failure. Matrix metalloproteinase 9 (MMP-9) and vasodilator-stimulated phosphoprotein (VASP) may participate in disease progression.Aim: To investigate the renal expression of MMP-9 and VASP in SAP rats with acute kidney injury.Methods: A total of 100 rats were randomly assigned to sham 6-h, sham 12-h, sham 24-h, sham 36-h, sham 48-h, SAP 6-h, SAP 12-h, SAP 24-h, SAP 36-h, and SAP 48-h treatment groups (n = 10 per group). Levels of serum amylase (AMY), creatinine (Cr), and blood urea nitrogen (BUN) were determined. Renal pathology and ultrastructural examinations were performed, and renal mRNA and protein expression of MMP-9 and VASP were determined by real-time RT-PCR and Western blot, respectively. The activity of MMP-9 was assessed by gelatin zymography.Results: In the SAP groups, serum levels of AMY, Cr, and BUN were markedly higher than in the sham groups. The peak value of AMY was observed from 12 to 24 h, but that of Cr and BUN was observed at 36 h. Capillary endothelial cells in the renal interstitium were impaired and expression of MMP-9 and VASP in the kidney was significantly increased when compared with the sham groups. Expression of MMP-9 and VASP declined when renal damage reached a maximum after 24 h.Conclusions: In the presence of acute kidney injury in SAP, the renal expression of MMP-9 and VASP is related to damage of endothelial cells in capillaries, which reached a maximum at 24 h and declined afterwards. [ABSTRACT FROM AUTHOR]

On the demand of many applications, vehicle to vehicle (V2V) communications have attracted many researchers’ attentions. In the developments of traffic safety applications based on VANET, the dissemination delay is critical. The dissemination delay of safety messages in the form of text has been studied thoroughly. In contrast, the dissemination delays of video or audio safety messages are just emerging and there are still a lot of things to be done. Considering the poor communication environment of multimedia safety messages dissemination in V2V, the analysis of multimedia message dissemination delay has great significance in the traffic safety applications. By extending and integrating previous achievements of analyzing MAC access delay in video stream dissemination, we proposed a method for modeling the relay access delay of IEEE 802.11p in the multihop relay chain of VANETs. Simulation results showed that the cumulative distribution function, the expectation, and the standard deviation of the relay access delays can be calculated effectively. In addition, the impacts of the number of hops and the length of packets on the relay access delays have been properly evaluated. Our study would open these research issues for discussion, which will contribute to the design and implementation of traffic safety. [ABSTRACT FROM AUTHOR]

The molecular mechanism underlying cancer invasiveness and metastasis of gastric carcinoma remains elusive. Here, we reported significant decrease in microRNA (miRNA)-34a and significant increase in phosphorylated epidermal growth factor receptor (EGFR) and matrix metalloproteinase-7 (MMP7) in the resected gastric carcinoma from the patients, compared with adjacent normal tissue. Moreover, strong correlation was detected among these three factors. To examine whether a causal link exists, we used two human gastric carcinoma lines, SNU-5 and HGC27, to study the molecular basis of miRNA-34a, EGFR signaling, and MMP7 activation. We found that EGF-induced EGFR phosphorylation in SNU-5 or HGC27 cells activated MMP7 and consequently cancer invasiveness. Both an inhibitor for EGFR and an inhibitor for Akt significantly inhibited the EGF-induced activation of MMP7, suggesting a phosphatidylinositol 3-kinase (PI3K) signaling cascade dependent pathway. Moreover, miRNA-34a levels were not affected by EGF-induced EGFR phosphorylation. However, overexpression of miRNA-34a antagonized EGF-induced MMP7 activation without affecting EGFR phosphorylation in SNU-5 or HGC27 cells. Taken together, our data suggest that miRNA-34 inhibits EGFR signaling via downstream PI3K signaling cascades to regulate MMP7 expression in gastric carcinoma. Thus, miRNA-34a, EGFR, and MMP7 appear to be promising therapeutic targets for preventing the metastasis of gastric carcinoma. [ABSTRACT FROM AUTHOR]

Background: The newest trend in the field of thoracic surgery, thoracic natural orifice transluminal endoscopic surgery (NOTES), is still in the early stages of development and limited to animal experiments. Transumbilical endoscopic surgery could work as a viable intermediate step before pure NOTES. We describe our experiences performing transumbilical-diaphragmatic thoracic sympathectomy with an ultrathin flexible endoscope for palmar and axillary hyperhidrosis in human patients. Methods: From April 2010 to January 2012, a total of 38 patients underwent transumbilical-diaphragmatic thoracic sympathectomy. Through the incision in the umbilicus, a newly developed long trocar was inserted into the abdominal cavity. An ultrathin endoscope was introduced through the long trocar and then passed through the rigid incision made in the left and right diaphragm and into the thoracic cavity. The ganglion was ablated at the desired thoracic level. Results: Sympathectomy was performed successfully in all patients. Mean operation time was 68 ± 16 (range, 48-107) minutes. There was no mortality and no conversion to open surgery during the operation of any patient. At a median follow-up of 11 (range, 4-12) months after surgery, no diaphragmatic hernia was observed. The rate of palmar hyperhidrosis and axillary hyperhidrosis resolution was 100 and 75 %, respectively. Conclusions: Transumbilical endoscopic thoracic sympathectomy is technically feasible and safe, which has the possible advantages of pure NOTES and can be performed in routine clinical practice. [ABSTRACT FROM AUTHOR]

Localization, which determines the geographical locations of sensors, is a crucial issue in wireless sensor networks. In this paper, we propose a novel lightweight equilateral triangle localization algorithm (LETLA) that accurately localizes sensors and minimizes the power consumption. In the LETLA, the approximate coordinates substituted for the real coordinates of the unknown node, and the corresponding optimization problem is formulated to minimize the estimation error. With the sequences that represent the ranking of distances from the anchors to the unknown node, a simple and robust technique is developed to quickly and efficiently estimate a region containing the approximate coordinates, and a condition under which the approximate error can be minimized is given. This condition employs a new geometric construct of anchor layout called equilateral triangle diagrams. Extensive simulations show that the LETLA performs better than other state-of-the-art approaches in terms of energy consumption with the same localization precision. [ABSTRACT FROM AUTHOR]

Background: Ectopic spleen is extremely rare. Most cases are congenital, acquired ectopic spleen may be a consequence of surgery or trauma to the spleen. The ectopic spleen in the gastric wall we reported is even rarer.Case Presentation: We report a 41-year-old female patient, with a past history of splenectomy, who presented with heartburn. Gastroscopy revealed a swelling in the fundus in the stomach. Ultrasonography and computed tomographic examination suggested the possibility of gastrointestinal stromal tumor. We performed endoscopic resection of the mass. Pathological examination of the resected mass showed ectopic spleen.Conclusion: When a patient with a history of splenectomy presents with a gastric submucosal tumor, ectopic spleen should also be considered in the differential diagnoses. And minimally invasive endoscopic treatment can achieve the purpose of diagnosis and treatment for unobvious submucosal tumors. [ABSTRACT FROM AUTHOR]

As a kind of transportation in a smart city, urban public bicycles have been adopted by major cities and bear the heavy responsibility of the "last mile" of urban public transportation. At present, the main problem of the urban public bicycle system is that it is difficult for users to rent a bike during peak h, and real-time monitoring cannot be solved adequately. Therefore, predicting the demand for bicycles in a certain period and performing redistribution in advance is of great significance for solving the lag of bicycle system scheduling with the help of IoT. Based on the HOSVD-LSTM prediction model, a prediction model of urban public bicycles based on the hybrid model is proposed by transforming the source data (multiple time series) into a high-order tensor time series. Furthermore, it uses the tensor decomposition technology (HOSVD decomposition) to extract new features (kernel tenor) from higher-order tensors. At the same time, these kernel tenors are directly used to train tensor LSTM models to obtain new kernel tenors. The inverse tensor decomposition and high-dimensional, multidimensional, and tensor dimensionality reduction were introduced. The new kernel tenor obtains the predicted value of the source sequence. Then the bicycle rental amount is predicted. [ABSTRACT FROM AUTHOR]

Background: Duchenne muscular dystrophy (DMD) is the most common form of inherited muscular dystrophy. Germline mutations in dystrophin (DMD) gene cause DMD, with a X‐linked recessive mode of inheritance. Patients with DMD are usually characterized by weakness of muscle, usually started since childhood and gradually the patient will unable to stand and walk. Methods: In our present study, we identified four unrelated Chinese patients with DMD from four Chinese families. Whole exome sequencing was performed for genetic molecular analysis for these probands. Results: Whole exome sequencing and confirmatory Sanger sequencing identified four novel nonsense mutations in these four unrelated Chinese patients, respectively. All these four mutations lead to the formation of a truncated DMD protein by formation of a premature stop codon. According to the variant interpretation guidelines of American College of Medical Genetics and Genomics (ACMG), these four novel nonsense mutations are categorized as "likely pathogenic" variants. Conclusion: Our present finding not only identified four novel loss‐of‐function mutations in dystrophin (DMD) gene but also strongly emphasized the significance of whole exome sequencing as the most efficient way of identifying the candidate genes and mutations which enables us for easy and rapid clinical diagnosis, follow‐up, and management of DMD patients. [ABSTRACT FROM AUTHOR]

Background: Telepathology (TP) provides remote pathology services for primary diagnosis practices, including intraoperative consultation of surgical pathology; it has not been widely implemented in China. In this study, the results of an implementation were reported, which lasted for two and a half years, and demonstrated the experience of the diagnosis of the intraoperative frozen sections by using TP consultation platform of Southern Medical University and Guangzhou Huayin Medical Laboratory Center (SMU-HUAYIN TP) in China. Methods: The SMU-HUAYIN TP consultation platform connects 71 participating basic hospitals and 11 senior pathologists. Nanfang Hospital is a high-level hospital located in a large city in China. This retrospective study summarizes the experience and results of TP for frozen section diagnosis by comparing the data of the platform and Nanfang Hospital over a period of 2.5 years from January 2015 to June 2017. Results: A total of 5233 cases were submitted to the platform, including 1019 cases in 2015, 2320 cases in 2016, and 1894 cases in 2017. The most common cases were breast (30.42%), followed by thyroid (29.05%) and gynecological (24.86%). Average turn-around time (TAT) of the cases from the platform in 2015 and 2016 was controlled within 30 min. In most TP cases (90.31%) and cases from Nanfang Hospital (86.14%), a definitive diagnosis was provided. The coincidence rate was 99.77% in the TP cases and 99.35% in the cases from Nanfang Hospital. The false positive and false negative rates of TP cases were 0.04 and 0.19%, respectively and no significant difference was found among different senior pathologists (P = 0.974, P = 0.989, P > 0.05). Similarly, there was no significant difference between TP cases and cases from Nanfang Hospital that were diagnosed by the same senior pathologist (P > 0.05). Conclusions: Our results indicate that TP in frozen section diagnosis could improve patient care and solve the problem of unevenly distributed pathology resources in China. We believe that in the near future, TP in frozen section diagnosis will become an important component of telemedicine and will play a significant role in health care reform in China. [ABSTRACT FROM AUTHOR]