Search

Accurate bowel preparation assessment is essential for determining colonoscopy screening intervals. Patients with suboptimal bowel preparation are at a high risk of missing >5 mm adenomas and should undergo an early repeat colonoscopy. In this study, we used artificial intelligence (AI) to evaluate bowel preparation and validated the ability of the system to accurately identify patients who are at high risk of having >5 mm adenomas missed due to inadequate bowel preparation. This prospective, single-center, observational study was conducted at the Eighth Affiliated Hospital, Sun Yat-sen University, from October 8, 2021, to November 9, 2022. Eligible patients who underwent screening colonoscopy were consecutively enrolled. The AI assessed bowel preparation using the e-Boston Bowel Preparation Scale (e-BBPS) while endoscopists made evaluations using BBPS. If both BBPS and e-BBPS deemed preparation adequate, the patient immediately underwent a second colonoscopy; otherwise, the patient underwent bowel re-cleansing before the second colonoscopy. Among the 393 patients, 72 adenomas >5 mm in size were detected; 27 adenomas >5 mm in size were missed. In unqualified-AI patients, the >5 mm adenoma miss rate (AMR) was significantly higher than in qualified-AI patients (35.71% vs 13.19% [ P =.0056]; odds ratio [OR],.2734 [95% CI,.1139-.6565]), as were the AMR (50.89% vs 20.79% [ P <.001]; OR,.2532 [95% CI,.1583-.4052]) and >5 mm polyp miss rate (35.82% vs 19.48% [ P =.0152]; OR,.4335 [95% CI,.2288-.8213]). This study confirmed that patients classified as inadequate by AI exhibited an unacceptable >5 mm AMR, providing key evidence for implementing AI in guiding bowel re-cleansing and potentially standardizing future colonoscopy screening. (Clinical trial registration number: NCT05145712.) [ABSTRACT FROM AUTHOR]

The efficacy and safety of colonoscopy performed by artificial intelligence (AI)-assisted novices remain unknown. The aim of this study was to compare the lesion detection capability of novices, AI-assisted novices, and experts. This multicenter, randomized, noninferiority tandem study was conducted across 3 hospitals in China from May 1, 2022, to November 11, 2022. Eligible patients were randomized into 1 of 3 groups: the CN group (control novice group, withdrawal performed by a novice independently), the AN group (AI-assisted novice group, withdrawal performed by a novice with AI assistance), or the CE group (control expert group, withdrawal performed by an expert independently). Participants underwent a repeat colonoscopy conducted by an AI-assisted expert to evaluate the lesion miss rate and ensure lesion detection. The primary outcome was the adenoma miss rate (AMR). A total of 685 eligible patients were analyzed: 229 in the CN group, 227 in the AN group, and 229 in the CE group. Both AMR and polyp miss rate were lower in the AN group than in the CN group (18.82% vs 43.69% [ P <.001] and 21.23% vs 35.38% [ P <.001], respectively). The noninferiority margin was met between the AN and CE groups of both AMR and polyp miss rate (18.82% vs 26.97% [ P =.202] and 21.23% vs 24.10% [ P <.249]). AI-assisted colonoscopy lowered the AMR of novices, making them noninferior to experts. The withdrawal technique of new endoscopists can be enhanced by AI-assisted colonoscopy. (Clinical trial registration number: NCT05323279.) [ABSTRACT FROM AUTHOR]

Super-critical transporting continua are often discussed in the context of an Euler beam model. Here Timoshenko beam theory is applied to study free vibration of high-speed transporting continua. Therefore, effects of rotary inertia and shear deformation on transverse vibration of super-critical transporting beams are discovered for the first time. The Galerkin method is applied to solve natural frequencies with the simply supported boundary conditions. Meanwhile, the weighted residual method (WRM) is employed to deal with the fixed ends. The natural frequencies of super-critical continua are verified by using the discrete Fourier transform (DFT). In the super-critical regime, the straight configuration of the beam loses its stability. The buckling configurations, due to the nonlinear stiffness, are deduced from the nonlinear static equilibrium equation. Furthermore, the governing equation for the transverse vibration of the super-critical transporting Timoshenko beam is derived based on the buckling shape. Time histories are calculated by using the finite difference method (FDM). Furthermore, natural frequencies of nonlinear free vibration are determined by using the DFT. In addition, the effect of nonlinear stiffness on the natural frequencies is discovered. On the other hand, a partially linearized equation is deduced by regarding buckling configurations and its spatial derivatives as constant coefficients. Then, natural frequencies are extracted by using the Galerkin method. The two different approaches are compared. Numerical results show that the rotary inertia and the shear deformation significantly affect vibration characteristics of the super-critical transporting beam for some configurations. Moreover, comparisons with an Euler-Bernoulli beam model reveal that the fundamental frequency of the Timoshenko beam is higher when the speed is slightly greater than the critical value. [ABSTRACT FROM AUTHOR]

Mental illness is a significant global health issue with a steady prevalence. High heritability is suspected, but genome-wide association studies only identified a small number of risk genes associated with mental disorders. This 'missing inheritance' can be partially explained by epigenetic heredity. Evidence from numerous animal models and human studies supports the possibility that preconception paternal mental health influences their offspring's mental health via nongenetic means. Here, we review two potential pathways, including sperm epigenetics and seminal plasma components. The current review highlights the role of sperm epigenetics and explores epigenetic message origination and susceptibility to chronic stress. Meanwhile, possible spatiotemporal windows and events that induce sexually dimorphic modes and effects of paternal stress transmission are inferred in this review. Additionally, we discuss emerging interventions that could potentially block the intergenerational transmission of paternal psychiatric disorders and reduce the incidence of mental illness. Understanding the underlying mechanisms by which preconception paternal stress impacts offspring health is critical for identifying strategies supporting healthy development and successfully controlling the prevalence of mental illness. • Preconception Paternal Mental Disorders affect the neurodevelopment, affective, and behavior of the child. • The non-genetic mechanism, especially epigenetics, plays an important role in this kind of paternal effect. • This effect can be prevented by exerting some environmental factors (e.g., running and drugs) on the father. [ABSTRACT FROM AUTHOR]

Abstract: Molodtsov’s soft set theory was originally proposed as a general mathematical tool for dealing with uncertainty. By combining the multi-fuzzy set and soft set models, the purpose of this paper is to introduce the concept of multi-fuzzy soft sets. Some operations on a multi-fuzzy soft set are defined, such as complement operation, “AND” and “OR” operations, Union and Intersection operations. Then, the DeMorgan’s laws are proved. Finally, by means of level soft set, an algorithm is presented, and a decision problem is analyzed using multi-fuzzy soft set. [Copyright &y& Elsevier]

High-speed flow pipes suffer from severe vibration problems. When the fluid velocity is higher than the critical value, the straight equilibrium configuration of the pipe will lose stability. What follows is the supercritical vibration of the pipe near the non-trivial static equilibrium configuration. This paper attempts to reveal multiple resonance responses of forced vibration of pipes in the supercritical regime. Based on Timoshenko beam theory, the nonlinear coupled partial differential equations are deduced. The non-trivial static equilibrium configuration causes the parameters to vary with space variable. The approximate responses of the pipe are obtained and verified numerically. The results show that the flow velocity near the critical value is more prone to cause severe vibration. Unlike in the subcritical regime, there are third-order super-harmonic resonance and second-order super-harmonic resonance in the supercritical regime. So there are more resonance areas in the supercritical regime. High flow velocity or large external excitation can aggravate the difference between the Euler-Bernoulli model and the Timoshenko model, and the relative error of two models varies non-monotonically. Even for slender pipes, the difference between the two models is still very clear. Therefore, the Timoshenko model is more necessary to analyze the vibration of the high-speed pipe. • Dynamics of forced vibration for a Timoshenko pipe conveying supercritical high-speed fluid. • Complex effects of the supercritical flow speed on the primary resonance of the pipe. • Different dynamics phenomena of the pipe in the subcritical and supercritical regime. • Difference between the Timoshenko pipe and Euler-Bernoulli pipe in the two speed regimes. [ABSTRACT FROM AUTHOR]

To determine the risk of stroke in patients with subclavian steal syndrome (SSS). We identified 165 patients with imaging-proven SSS from two hospitals. Demographic, clinical and imaging data were retrospectively collected. Patients were followed up for stroke events. Stroke occurred in 43 patients with a median follow-up of 28 months. Seven of these cases were identified prospectively and 36 cases retrospectively. On multivariate analysis, presence of symptoms at presentation ( p = 0.029) was a significant predictor of stroke. Presence of symptoms at presentation predicted stroke in imaging-proven SSS. [ABSTRACT FROM AUTHOR]

Bifunctional non-precious electrocatalysts with high performance are highly desired for renewable energy but remain challenging. Herein, a CoFeP/rGO heterostructure was rational developed based on the synergistic effect, including superior conductivity, increased catalytic active sites of rGO support and the regulated electron distribution of bimetallic phosphide. At a current of 10 mA cm−2, the CoFeP/rGO-2 composite exhibits excellent HER activity with low overpotentials of 101 mV and 76 mV in 1.0 M KOH and 0.5 M H 2 SO 4 electrolyte, respectively. And highly active alkaline OER performance was provided with an overpotential of only 275 mV to reach a current density of 10 mA cm−2. By the way, the CoFeP/rGO-2 electrode showed a pleasured working voltage of 1.58 V for overall water splitting in alkaline environment. More importantly, the long term durability and higher stability of the catalysts demonstrated their feasibility of bimetallic phosphide/rGO system as bifunctional electrocatalysts. [Display omitted] • Bifunctional electrocatalysts was established based on synergistic benefits. • The CoFeP/rGO-2 electrode showed excellent performance for HER and OER. • The CoFeP/rGO-2 delivers an overpotential of 76 mV for HER under acidic environment. • A rather low cell voltage of 1.58 V is obtained for overall water splitting. [ABSTRACT FROM AUTHOR]

The objective of the current study was to explore the possible mechanism in a non-clinical population. A self-reported survey was conducted among 2016 Chinese college students through questionnaires assessing Type D, coping tendency and mental symptoms. As a normal personality subtype, the incidence of Type D in the sample is higher. Compared with the scores of type D− group, the type D+ group's score of positive coping tendency was lower and that of mental symptoms was higher. Type D can exert an effect on mental health directly, and indirectly through coping tendency. Moreover, there was a gender difference in the mediating path. The mediation effect of coping tendency is more prominent in men, and the male have more mental symptoms than the female while they have the same Type D score. • Of the participants in the present study, 33.23% were classified as Type D. • There were differences between Type D and non-Type D in all comparison items. • Type D could affect mental health directly and indirectly through coping tendency. • The mediation impact of coping tendency was stronger in males. [ABSTRACT FROM AUTHOR]