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Background: Neuroendocrine liver metastases (NELM) significantly reduce survival in patients with neuroendocrine tumor. The management of NELM is challenged by a low rate of resectability and a high rate of recurrence. Indocyanine green (ICG) fluorescence imaging offers potential advantages in real-time tumor visualization and margin assessment. This study evaluates the impact of ICG fluorescence on perioperative outcomes and recurrence-free survival (RFS) in NELM patients undergoing laparoscopic parenchyma-sparing hepatectomy (LPSH)., Methods: A retrospective cohort study was performed on patients with NELM who underwent LPSH from August 2013 to May 2023 at our single center. Data on sociodemographic characteristics, laboratory parameters, surgical results and follow-up outcomes were collected., Results: A total of 51 NELM patients were included. No significant differences in baseline characteristics were observed between the ICG and non-ICG groups. Postoperative complications occurred in 52.9% of patients, with bile leakage being most common. No perioperative mortality was reported. Pathologically positive margins were significantly lower in the ICG group (1.3 vs. 16.4%, p < 0.001). After a median follow-up of 36 months, 62.7% of patients experienced recurrence, mostly intrahepatic. Median recurrence-free survival (RFS) was longer in the ICG group, though not statistically significant (38.0 vs. 29.0 months, p = 0.086)., Conclusion: The use of ICG fluorescence imaging in LPSH may improve surgical margins and potentially enhance RFS in NELM patients. These findings are clinically significant, highlighting the need for larger prospective studies to confirm its impact on long-term prognosis., Competing Interests: Declarations. Disclosures: Drs. Gaoming Wang, Chenghao Liu, Weijun Qi, Long Li, and Dianrong Xiu have no conflicts of interest or financial ties to disclose., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Colorectal cancer (CRC) frequently metastasizes to the liver, significantly worsening patient outcomes. While hepatectomy offers the best curative option for colorectal liver metastases (CRLM), margin recurrence remains a major challenge post-surgery. Intraoperative ultrasound (IOUS) aids tumor identification and margin determination, but its limitations in laparoscopic surgery necessitate additional methods. Indocyanine green fluorescence imaging (ICGFI) has emerged as a promising tool for tumor localization and margin assessment in CRLM. However, existing studies lack large cohorts and long-term outcomes. This study evaluates perioperative and long-term results of ICGFI-assisted laparoscopic hepatectomy in CRLM patients., Method: A retrospective cohort study was performed on CRLM patients who underwent liver resection at our single center. The study population was divided into three groups: the L-ICG group (laparoscopic hepatectomy with ICGFI), the L-Non-ICG group (laparoscopic hepatectomy without ICGFI), and the open group (open liver resection). Robust statistical methods including multiple imputations and inverse probability of treatment weighting (IPTW) were employed to minimize bias., Results: A total of 340 CRLM patients who underwent hepatectomy were analyzed. The L-ICG group had a higher rate of neoadjuvant therapy and smaller tumor sizes compared to the open group. The L-ICG group also demonstrated shorter operative times, less blood loss, and a higher microscopically margin-negative (R0) resection rate than other two groups. Recurrence occurred in 70% of patients, with 77% being intrahepatic. Margin recurrence was significantly lower in the L-ICG group compared to the L-Non-ICG group (15.3% vs. 45.7%, p = 0.001). Median recurrence-free survival and overall survival did not differ significantly among groups after IPTW adjustment., Conclusion: ICGFI improves R0 resection rates, perioperative outcomes, and reduces margin recurrence in CRLM patients undergoing laparoscopic hepatectomy, though it does not significantly impact OS or RFS., Competing Interests: Declarations. Disclosures: Gaoming Wang, Chenghao Liu, Weijun Qi, Long Li, and Dianrong Xiu have no conflicts of interest or financial ties to disclose., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Although robotic distal pancreatectomy (RDP) has a lower conversion rate to open surgery and causes less blood loss than laparoscopic distal pancreatectomy (LDP), clear evidence on the impact of the surgical approach on morbidity is lacking. Prior studies have shown a higher rate of complications among obese patients undergoing pancreatectomy. The primary aim of this study is to compare short-term outcomes of RDP vs. LDP in patients with a BMI ≥ 30., Methods: In this multicenter study, all obese patients who underwent RDP or LDP for any indication between 2012 and 2022 at 18 international expert centers were included. The baseline characteristics underwent inverse probability treatment weighting to minimize allocation bias., Results: Of 446 patients, 219 (50.2%) patients underwent RDP. The median age was 60 years, the median BMI was 33 (31-36), and the preoperative diagnosis was ductal adenocarcinoma in 21% of cases. The conversion rate was 19.9%, the overall complication rate was 57.8%, and the 90-day mortality rate was 0.7% (3 patients). RDP was associated with a lower complication rate (OR 0.68, 95% CI 0.52-0.89; p = 0.005), less blood loss (150 vs. 200 ml; p < 0.001), fewer blood transfusion requirements (OR 0.28, 95% CI 0.15-0.50; p < 0.001) and a lower Comprehensive Complications Index (8.7 vs. 8.9, p < 0.001) than LPD. RPD had a lower conversion rate (OR 0.27, 95% CI 0.19-0.39; p < 0.001) and achieved better spleen preservation rate (OR 1.96, 95% CI 1.13-3.39; p = 0.016) than LPD., Conclusions: In obese patients, RDP is associated with a lower conversion rate, fewer complications and better short-term outcomes than LPD., (© 2023. The Author(s).)

Mathematical equations are often used to model biological processes. However, for many systems, determining analytically the underlying equations is highly challenging due to the complexity and unknown factors involved in the biological processes. In this work, we present a numerical procedure to discover dynamical physical laws behind biological data. The method utilizes deep learning methods based on neural networks, particularly residual networks. It is also based on recently developed mathematical tools of flow-map learning for dynamical systems. We demonstrate that with the proposed method, one can accurately construct numerical biological models for unknown governing equations behind measurement data. Moreover, the deep learning model can also incorporate unknown parameters in the biological process. A successfully trained deep neural network model can then be used as a predictive tool to produce system predictions of different settings and allows one to conduct detailed analysis of the underlying biological process. In this paper, we use three biological models-SEIR model, Morris-Lecar model and the Hodgkin-Huxley model-to show the capability of our proposed method.

Zhijin County is a typical mineral resource-based city in Southwest China. The problem of heavy metals (HM) in the soil in Zhijin County must be considered during regional economic and ecological development. A total of 2436 soil samples (0‒20 cm depth) were collected to analyze the soil pH, organic matter content, and HM spatial distribution and sources. The HM concentrations in the surface soil were found to be higher than the national surface soil background values. Absolute principal component sore-multivariate linear regression (APCS-MLR) showed that the HM sources in the surface soil of Zhijin County were industrial and agricultural activities (48.09%), natural sources (34.47%), and atmospheric deposition (17.43%); 65.53% of HM were produced by anthropogenic activities, which were mainly associated with the mineral industry. The impact of anthropogenic pollution decreased in the following order: paddy field (66.45%) > rainfed cropland (65.91%) > barren land (61.98%) > garden land (61.82%) > forest land (59.11%) > grassland (53.31%). The potential ecological risk of surface soil is moderate, while low-risk areas were mainly distributed in mountainous regions in the north, southwest, and east. The study emphasizes the source and risk assessment of HM in the surface soil of Zhijin County. The results can be used for environmental management planning, decision-making, and risk assessment., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Neuroendocrine tumors (NETs) are a group of heterogenous tumors originating from neuroendocrine system. Approximately, 40 percent will go through liver metastases, and liver-directed therapy was proved to improve the survival outcome. Parenchyma-sparing hepatectomy is advocated for the resection of NETs liver metastases while the possible relatively low negative margin rate is concerned. Indocyanine green (ICG) fluorescence imaging provides a real-time navigation on determination of surgical margins in colorectal cancer liver metastases. However, there was no previous study that reported the applications of ICG fluorescence imaging in NETs liver metastases. The present study aimed to evaluate the feasibility and security of using ICG fluorescence imaging to determine surgical margins of NETs liver metastases during operation., Methods: A retrospective two-arm cohort study was performed on 25 consecutive patients with NETs liver metastases who underwent laparoscopic parenchyma-sparing hepatectomy (LPSH). Patients were divided into two groups according to whether or not the ICG fluorescence imaging was used. Data on sociodemographic characteristics, laboratory parameters, pathology results, and surgical outcomes were collected., Results: A total of 145 tumors pathologically diagnosed with NETs liver metastases were resected from 25 patients. The pathological results indicated negative margins in all tumors (102/102) in LPSH with ICG fluorescence imaging group. The negative margin rate was significantly higher in LPSH using the ICG fluorescence imaging (100% v.s 88.4%, p = 0.002). Surgical outcomes, including operation time, estimated blood loss, intraoperative transfusion rate, and postoperative morbidity, were comparable between LPSH with and without ICG fluorescence imaging groups., Conclusion: ICG fluorescence imaging showed the potential to identify tumor boundaries and determine surgical margins. This technique may serve as a valuable intraoperative navigation in patients with NETs liver metastases., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Pancreatic cancer (PC) is one of the most aggressive malignancies, and it's difficult to diagnosis PC at an early stage, which leads to the poor prognosis of PC., Objectives: To identifiy the possible prognosis or dignosis metabolite biomarkers in the serum exosome of PC patients., Methods: We employed LC-DDA-MS based untargeted lipidomic analysis to search for potential candidate biomarkers in the serum exosome of PC patients. Then LC-MRM-MS based targeted lipid quantification was used to validate the trends of the candidate biomarkers in larger sample cohorts., Results: About 270 lipids belonging to 20 lipid species were found significantly dysregulated between the serum exosome of PC patients and healthy controls. 61 of them were validated in larger samples size. We further analysis the correlation between these dysregulated lipids and other PC related factors, and results show that LysoPC 22:0, PC (P-14:0/22:2) and PE (16:0/18:1) are all associated with tumor stage, CA19-9, CA242 and tumor diameter. What's more, PE (16:0/18:1) is also found to be significantly correlated with the patient's overall survival., Conclusion: These data reveal dysregulated lipids in serum exosome of PC patients, which have potential to be biomarkers for diagnosis, or unveil pathological relationship between exosome and PC progress.

Background: The purpose of treatment for hepatolithiasis is reducing recurrent cholangitis. This study was designed to determine the long-term outcome of Oddi sphincterotomy for hepatolithiasis., Methods: Thirty-two consecutive hepatolithiasis patients, including 15 cases that had undergone conventional open surgical transduodenal sphincteroplasty (COSTS) and 17 cases with endoscopic sphincterotomy (EST), were followed up for a long term. We compared the post-treatment rates of recurrent cholangitis and acute cholangitis severe type (ACST) with the ones of pretreatment in each group, respectively. Paired chi(2) test was used., Results: In the COSTS group, neither the post-operative rate of recurrent cholangitis (86.7%, 13/15 vs. 100%, 15/15) nor ACST (26.7%, 4/15 vs. 46.7%, 7/15) decreased (p > 0.05) compared with before the operation. In the EST group, the situation was the same: neither the rate of post-EST recurrent cholangitis (76.5%, 13/17 vs. 82.4%, 14/17) nor ACST (29.4%, 5/17 vs. 23.5%, 4/17) were reduced significantly (p > 0.05)., Conclusions: Both eradication of hepatobiliary lesions and keeping Oddi sphincter intact should be emphasized in the management of hepatolithiasis. Neither COSTS nor EST is an effective method or can achieve the goal of reducing cholangitis for hepatolithiasis.

Predicting the evolution of diseases is challenging, especially when the data availability is scarce and incomplete. The most popular tools for modelling and predicting infectious disease epidemics are compartmental models. They stratify the population into compartments according to health status and model the dynamics of these compartments using dynamical systems. However, these predefined systems may not capture the true dynamics of the epidemic due to the complexity of the disease transmission and human interactions. In order to overcome this drawback, we propose Sparsity and Delay Embedding based Forecasting (SPADE4) for predicting epidemics. SPADE4 predicts the future trajectory of an observable variable without the knowledge of the other variables or the underlying system. We use random features model with sparse regression to handle the data scarcity issue and employ Takens' delay embedding theorem to capture the nature of the underlying system from the observed variable. We show that our approach outperforms compartmental models when applied to both simulated and real data., (© 2023. The Author(s), under exclusive licence to Society for Mathematical Biology.)

Background: Laparoscopic surgery for gastric cancer has become widely used; minimally invasive surgery has become the mainstream of treatment. This randomized controlled trial (RCT) aimed to compare long-term quality of life (QoL) and weight loss rates in patients who underwent single-port laparoscopic gastrectomy (SLG) or multi-port laparoscopic gastrectomy (MLG) for gastric cancer., Methods: This single-center RCT compared MLG and SLG in patients with clinical stage I gastric cancer, all of which underwent distal gastrectomy between April 2016 and September 2018. A total of 101 patients were evaluated for eligibility; all were randomized into either the SLG group (n = 50) or MLG group (n = 51). Blood tests, weight measurements, and postoperative questionnaires (DAUGS20, EORTC QLQ-C30, PGSAS-45) were performed at 3, 6, 12, and 36 months after surgery to compare the QoL., Results: At six months postoperatively, there was a higher trend toward lower weight loss in the SLG group compared with the MLG group. At 1, 3, 6, and 36 months postoperatively, the neutrophil-to-lymphocyte ratio was significantly lower in the SLG group than that in the MLG group. The QoL, as measured using the postoperative questionnaires, was generally comparable. However, some favorable results, such as fewer diarrheas, were achieved., Conclusions: SLG was partially superior to MLG in terms of long-term QoL, in addition to assurance of esthetics and reduced pain. In addition, systemic inflammatory markers and weight loss rates were lower, suggesting a potential long-term benefit. SLG may be an option for stage I gastric cancer surgery. Further follow-up and multicenter studies should be considered., Competing Interests: Declarations. Disclosures: Kohei Fujita, Takeshi Omori, Hisashi Hara, Naoki Shinno, Masayoshi Yasui, Hiroshi Wada, Hirofumi Akita, Masayuki Ohue, Hiroshi Miyata, and Shuji Takiguchi have declared no conflict of interests. Ethical approval: This study was approved by the Institutional Review Board of the Osaka International Cancer Institute (number 1512046225) and follows the Declaration of Helsinki (1975). Written informed consent was obtained from all patients. The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000022218)., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Thyroglobulin is a major autoantigen to which autoimmune response, destroying the thyroid gland in Hashimoto's thyroiditis, is directed. To detect a pathological autoimmune response to thyroglobulin, as well as the successful induction of experimental autoimmune thyroiditis, thyroglobulin carrying thyroiditogenic epitopes is necessary. It is not known which features of thyroglobulin structure determine the presence of thyroiditogenic epitopes and can serve as markers of their presence. We compared structure of thyroglobulin bearing thyroiditogenic epitopes (freshly isolated thyroglobulin) and thyroglobulin which had lost thyroiditogenic epitopes (lyophilized thyroglobulin). Fourier-transform infrared (FTIR) spectroscopy was used to elucidate the structure of thyroglobulin. The markers indicating the presence of thyroiditogenic epitopes on thyroglobulin are the vibrations of diiodotyrosine, monoiodotyrosine/diiodotyrosine relation in the range of 0.24-0.43 (95% confidence interval) and relatively high (> 32%) α-helix content. The loss of thyroiditogenic epitopes on thyroglobulin is associated with a weakening or complete disappearance of diiodotyrosine oscillations and a decrease in the proportion of α-helices in secondary structure. Thyroglobulin extracted with phenylmethylsulfonyl fluoride (PMSF) added is characterized by the same relatively high monoiodotyrosine/diiodotyrosine relation and low proportion of alpha helices as thyroglobulin without thyroiditogenic epitopes. Therefore, serine protease inhibitor PMSF is not suitable for extraction of native thyroglobulin bearing thyroiditogenic epitopes. FTIR spectroscopy can be used to detect thyroiditogenic epitopes on thyroglobulin., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Immunosuppressive regulatory cells (IRCs) play important roles in negatively regulating immune response, and are mainly divided into myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs). Large numbers of preclinical and clinical studies have shown that inhibition or reduction of IRCs could effectively elevate antitumor immune responses. However, several studies also reported that excessive inhibition of IRCs function is one of the main reasons causing the side effects of cancer immunotherapy. Therefore, the reasonable regulation of IRCs is crucial for improving the safety and efficiency of cancer immunotherapy. In this review, we summarised the recent research advances in the cancer immunotherapy by regulating the proportion of IRCs, and discussed the roles of IRCs in regulating tumour immune evasion and drug resistance to immunotherapies. Furthermore, we also discussed how to balance the potential opportunities and challenges of using IRCs to improve the safety of cancer immunotherapies., (© 2024. The Author(s) under exclusive licence to Japan Human Cell Society.)

Recently, 3D-printed biodegradable scaffolds have shown great potential for bone repair in critical-size fractures. The differentiation of the cells on a scaffold is impacted among other factors by the surface deformation of the scaffold due to mechanical loading and the wall shear stresses imposed by the interstitial fluid flow. These factors are in turn significantly affected by the material properties, the geometry of the scaffold, as well as the loading and flow conditions. In this work, a numerical framework is proposed to study the influence of these factors on the expected osteochondral cell differentiation. The considered scaffold is rectangular with a 0/90 lay-down pattern and a four-layered strut made of polylactic acid with a 5% steel particle content. The distribution of the different types of cells on the scaffold surface is estimated through a scalar stimulus, calculated by using a mechanobioregulatory model. To reduce the simulation time for the computation of the stimulus, a probabilistic machine learning (ML)-based reduced-order model (ROM) is proposed. Then, a sensitivity analysis is performed using the Shapley additive explanations to examine the contribution of the various parameters to the framework stimulus predictions. In a final step, a multiobjective optimization procedure is implemented using genetic algorithms and the ROM, aiming to identify the material parameters and loading conditions that maximize the percentage of surface area populated by bone cells while minimizing the area corresponding to the other types of cells and the resorption condition. The results of the performed analysis highlight the potential of using ROMs for the scaffold design, by dramatically reducing the simulation time while enabling the efficient implementation of sensitivity analysis and optimization procedures., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Central to the clinical adoption of patient-specific modeling strategies is demonstrating that simulation results are reliable and safe. Indeed, simulation frameworks must be robust to uncertainty in model input(s), and levels of confidence should accompany results. In this study, we applied a coupled uncertainty quantification-finite element (FE) framework to understand the impact of uncertainty in vascular material properties on variability in predicted stresses. Univariate probability distributions were fit to material parameters derived from layer-specific mechanical behavior testing of human coronary tissue. Parameters were assumed to be probabilistically independent, allowing for efficient parameter ensemble sampling. In an idealized coronary artery geometry, a forward FE model for each parameter ensemble was created to predict tissue stresses under physiologic loading. An emulator was constructed within the UncertainSCI software using polynomial chaos techniques, and statistics and sensitivities were directly computed. Results demonstrated that material parameter uncertainty propagates to variability in predicted stresses across the vessel wall, with the largest dispersions in stress within the adventitial layer. Variability in stress was most sensitive to uncertainties in the anisotropic component of the strain energy function. Moreover, unary and binary interactions within the adventitial layer were the main contributors to stress variance, and the leading factor in stress variability was uncertainty in the stress-like material parameter that describes the contribution of the embedded fibers to the overall artery stiffness. Results from a patient-specific coronary model confirmed many of these findings. Collectively, these data highlight the impact of material property variation on uncertainty in predicted artery stresses and present a pipeline to explore and characterize forward model uncertainty in computational biomechanics., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cancer due to its heterogeneous nature and large prevalence has tremendous socioeconomic impacts on populations across the world. Therefore, it is crucial to discover effective panels of biomarkers for diagnosing cancer at an early stage. Cancer leads to alterations in cell growth and differentiation at the molecular level, some of which are very unique. Therefore, comprehending these alterations can aid in a better understanding of the disease pathology and identification of the biomolecules that can serve as effective biomarkers for cancer diagnosis. Metabolites, among other biomolecules of interest, play a key role in the pathophysiology of cancer whose levels are significantly altered while 'reprogramming the energy metabolism', a cellular condition favored in cancer cells which is one of the hallmarks of cancer. Metabolomics, an emerging omics technology has tremendous potential to contribute towards the goal of investigating cancer metabolites or the metabolic alterations during the development of cancer. Diverse metabolites can be screened in a variety of biofluids, and tumor tissues sampled from cancer patients against healthy controls to capture the altered metabolism. In this review, we provide an overview of different metabolomics approaches employed in cancer research and the potential of metabolites as biomarkers for cancer diagnosis. In addition, we discuss the challenges associated with metabolomics-driven cancer research and gaze upon the prospects of this emerging field., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Meningioma is the most common central nervous system (CNS) tumor. In recent decades, several efforts have been made to eradicate this disease. Surgery and radiotherapy remain the standard treatment options for these tumors. Drug therapy comes to play its role when both surgery and radiotherapy fail to treat the tumor. This mostly happens when the tumors are close to vital brain structures and are nonbenign. Although a wide variety of chemotherapeutic drugs and molecular targeted drugs such as tyrosine kinase inhibitors, alkylating agents, endocrine drugs, interferon, and targeted molecular pathway inhibitors have been studied, the roles of numerous drugs remain unexplored. Recent interest is growing toward studying and engineering exosomes for the treatment of different types of cancer including meningioma. The latest studies have shown the involvement of exosomes in the theragnostic of various cancers such as the lung and pancreas in the form of biomarkers, drug delivery vehicles, and vaccines. Proper attention to this new emerging technology can be a boon in finding the consistent treatment of meningioma., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Soil pollution by heavy metals can cause continuing damage to ecosystems and the human body. In this study, we collected nine fresh topsoil samples and 18 maize samples (including nine leaf samples and nine corn samples) from agricultural soils in the Baiyin mining areas. The results showed that the order of heavy metal concentrations (mg/kg) in agricultural soils was as follows: Zn (377.40) > Pb (125.06) > Cu (75.06) > Ni (28.29) > Cd (5.46) > Hg (0.37). Cd, Cu, Zn, and Pb exceeded the Chinese risk limit for agricultural soil pollution. The average the pollution load index (4.39) was greater than 3, indicating a heavy contamination level. The element that contributed the most to contamination and high ecological risk in soil was Cd. Principal component analysis (PCA) and Pearson's correlation analysis indicated that the sources of Ni, Cd, Cu, and Zn in the soil were primarily mixed, involving both industrial and agricultural activities, whereas the sources of Hg and Pb included both industrial and transportation activities. Adults and children are not likely to experience non-carcinogenic impacts from the soil in this region. Nonetheless, it was important to be aware of the elevated cancer risk presented by Cd, Pb, and especially Ni. The exceedance rates of Cd and Pb in corn were 66.67% and 33.3%, respectively. The results of this research provide data to improve soil protection, human health monitoring, and crop management in the Baiyin district., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Although laparoscopic cholecystectomy is applicable for the treatment of early gallbladder cancer (GBC), minimally invasive surgery is not widely used for advanced GBC. This is because advanced GBCs necessitate complicated surgical techniques, including lymph node dissection and liver resection. Robotic extended cholecystectomy (REC) is thought to overcome the limitations of laparoscopic surgery, but oncological safety studies are lacking. Therefore, in this study, we aimed to evaluate the oncologic outcomes of REC compared with those of open extended cholecystectomy (OEC)., Methods: A total of 125 patients, who underwent extended cholecystectomy for GBC with tentative T2 or higher stage between 2018 and 2021, were included and stratified by surgical methods. To minimize the confounding factors, 1:1 propensity-score matching was performed between the patients who underwent REC and those who underwent OEC., Results: Regarding short-term outcomes, the REC group showed significantly lower estimated blood loss (382.7 vs. 717.2 mL, P = 0.020) and shorter hospital stay (6.9 vs. 8.5 days, P = 0.042) than the OEC group. In addition, the REC group had significantly lower subjective pain scores than the OEC group from the day of surgery through the 5th postoperative day (P = 0.006). Regarding long-term outcomes, there were no significant differences in the 3-year [5-year] overall survival (OS) and disease-free survival (DFS) rates between the REC group [OS, 92.3% (92.3%); DFS, 84.6% (72.5%)] and the OEC group [OS, 96.8% (96.8%); DFS, 78.2% (78.2%)] (P = 0.807 for OS and 0.991 for DFS)., Conclusions: In this study, REC showed superior short-term outcomes to OEC and no difference in long-term survival outcomes. Additionally, REC was superior to OEC in terms of postoperative pain. Therefore, REC may be a feasible option with early recovery compared with OEC for patients with advanced GBC., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Using a dataset encompassing 228 cities in China spanning from 2005 to 2019, this study explores the nonlinear relationship between air quality and housing prices and devises a strategy that incorporates the instrumental variable and machine learning to address the endogeneity issue. Both traditional models and machine learning models find air pollution affects housing prices in a diminishing manner. The negative impact of air pollution on housing prices decreases when the degree of air pollution intensifies. Such a characteristic is more pronounced in Eastern China and cities with fewer land resource constraints and larger populations. Mechanism analysis also reveals that air pollution could affect residents' perceived air quality and the industrial structure, further contributing to the nonlinear relationship between air quality and housing prices. The further SHapley Additive exPlanations (SHAP) evaluates the importance of air quality in determining housing prices and finds that air quality's contribution outweighs educational and medical resources. The contribution of air quality also shows a distinct regional disparity and has become increasingly important in recent years. The findings refine the benefit assessment accuracy related to air quality improvement., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: There are risks of choledocholithiasis in symptomatic gallstones, and some surgeons have proposed the identification of choledocholithiasis before cholecystectomy. Our goal was to evaluate the diagnostic accuracy of the latest guidelines and create computational prediction models for the accurate prediction of choledocholithiasis., Methods: We retrospectively reviewed symptomatic gallstone patients hospitalized with suspected choledocholithiasis. The diagnostic performance of 2019 and 2010 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE) and 2019 guideline of the European Society of Gastrointestinal Endoscopy (ESGE) in different risks. Lastly, we developed novel prediction models based on the preoperative predictors., Results: A total of 1199 patients were identified and 681 (56.8%) had concurrent choledocholithiasis and were included in the analysis. The specificity of the 2019 ASGE, 2010 ASGE, and 2019 ESGE high-risk criteria was 85.91%, 72.2%, and 88.42%, respectively, and their positive predictive values were 85.5%, 77.4%, and 87.3%, respectively. For Mid-risk patients who followed 2019 ASGE about 61.8% of them did not have CBD stones in our study. On the choice of surgical procedure, laparoscopic cholecystectomy + laparoscopic transcystic common bile duct exploration can be considered the optimal treatment choice for cholecysto-choledocholithiasis instead of Endoscopic Retrograde Cholangio-Pancreatography (ERCP). We build seven machine learning models and an AI diagnosis prediction model (ModelArts). The area under the receiver operating curve of the machine learning models was from 0.77 to 0.81. ModelArts AI model showed predictive accuracy of 0.97, recall of 0.97, precision of 0.971, and F1 score of 0.97, surpassing any other available methods., Conclusion: The 2019 ASGE guideline and 2019 ESGE guideline have demonstrated higher specificity and positive predictive value for high-risk criteria compared to the 2010 ASGE guideline. The excellent diagnostic performance of the new artificial intelligence prediction model may make it a better choice than traditional guidelines for managing patients with suspected choledocholithiasis in future., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The stage, when tissues and organs are growing, is very vulnerable to environmental influences, but it's not clear how exposure during this time causes changes to the epigenome and increases the risk of hormone-related illnesses like uterine fibroids (UFs)., Methods: Developmental reprogramming of myometrial stem cells (MMSCs), the putative origin from which UFs originate, was investigated in vitro and in the Eker rat model by RNA-seq, ChIP-seq, RRBS, gain/loss of function analysis, and luciferase activity assays., Results: When exposed to the endocrine-disrupting chemical (EDC) diethylstilbestrol during Eker rat development, MMSCs undergo a reprogramming of their estrogen-responsive transcriptome. The reprogrammed genes in MMSCs are known as estrogen-responsive genes (ERGs) and are activated by mixed lineage leukemia protein-1 (MLL1) and DNA hypo-methylation mechanisms. Additionally, we observed a notable elevation in the expression of ERGs in MMSCs from Eker rats exposed to natural steroids after developmental exposure to EDC, thereby augmenting estrogen activity., Conclusion: Our studies identify epigenetic mechanisms of MLL1/DNA hypo-methylation-mediated MMSC reprogramming. EDC exposure epigenetically targets MMSCs and leads to persistent changes in the expression of a subset of ERGs, imparting a hormonal imprint on the ERGs, resulting in a "hyper-estrogenic" phenotype, and increasing the hormone-dependent risk of UFs., (© 2023. The Author(s).)

Background: Resection of initially oligometastatic pancreatic ductal adenocarcinoma (PDAC) following response to first-line chemotherapy is controversial. We herein updated a previous case series to investigate the oncologic outcomes and preoperative factors that could drive the decision-making process., Methods: This retrospective analysis was limited to patients with liver-only synchronous metastases who experienced complete regression of the metastatic component and underwent pancreatectomy between October 2008 and July 2020 at two high-volume institutions. Clinical-pathologic variables were captured, and inflammation-based prognostic scores were calculated. Recurrence and survival analyses were performed using standard statistical methods., Results: Overall, 52 patients were included. FOLFIRINOX was the most employed chemotherapy regimen (63.5%). Post-treatment tumor size, serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were significantly decreased relative to baseline evaluation. The median time from diagnosis to pancreatectomy was 10.2 months, while the median time from chemotherapy completion to pancreatectomy was 2 months. Major postoperative complications occurred in 26.9% of patients, while postoperative mortality was nil. The median disease-free survival (DFS) and overall survival (OS) from pancreatectomy were 16.5 and 23.0 months, respectively, and the median OS from diagnosis was 37.2 months. At multivariable analysis, vascular resection, operative time, prognostic nutrition index (PNI) and neutrophil-to-lymphocyte ratio (NLR) were associated with OS. Operative time, platelet × neutrophil/lymphocyte count (SII), and PNI were associated with DFS., Conclusions: We confirm promising outcomes of selected patients who underwent pancreatectomy following downstaging of liver metastases. The absence of vascular involvement of the primary tumor, good nutritional status, and low inflammatory index scores could be useful to select candidates for resection., (© 2022. Society of Surgical Oncology.)

Landslide prediction is critical for the early warning of a landslide occurrence. Existing stepwise landslide displacement prediction methods are mostly data-driven approaches. However, these models are vulnerable to overfitting, and the low-dimensional numerical features with high numerical volatility prevent them from precisely quantifying the rapid increase in daily displacement in the acceleration phase. Therefore, we propose a semantic information-driven stepwise landslide displacement prediction model comprising an identifier in the displacement phase and a predictor in the acceleration phase. First, the raw landslide monitoring data are converted into text-based semantic information and the semantic features are fused. Subsequently, based on the daily displacement and velocity, we propose a sliding window phase division algorithm to divide the stepwise landslide phase into stationary and acceleration phases. Finally, the landslide displacement phase is identified, and the displacement during the acceleration phase is predicted. The experimental results of the model on the Xinpu and Qingshi landslides in Chongqing, China, show that the proposed model exploits the derived semantic information to identify the landslide acceleration phase qualitatively, and predict the daily displacement of the acceleration phase quantitatively. The proposed model provides a valuable reference for the early warning of stepwise landslides., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Platelet to lymphocyte ratio (PLR) is associated with survival in oesophageal cancer. We explored whether PLR changes during different stages of treatment correlate with survival outcomes., Methods: A retrospective single-centre study was performed. Consecutive patients who received neoadjuvant chemotherapy followed by surgery for oesophageal adenocarcinoma were identified. Changes in PLR were calculated during two time periods: the first spanning the neoadjuvant period (T1); the second the perioperative period (T2). Differences in PLR were calculated for clinicopathological variables during both T1 and T2 and for variables with regards to their association with median overall survival (OS). Variables found to be significant on univariate analysis were included in a multivariate Cox regression model. Using ROC analysis, optimal cut-offs for PLR changes were identified and plotted on a Kaplan-Meir curve., Results: Of the 370 patients identified, 110 (29.7%) were included in the analysis. During T1 a positive correlation was noted between higher positive lymph node ratio and PLR change. During T2, PLR change was positively higher in patients who suffered major postoperative complications. Median survival for the cohort as a whole was 42.3 months and 5-year OS was 57.3%. Survival at 5 years was associated with lower PLR changes during T2. On univaraite analysis, median OS was significantly less for patients with a tumour size > 3 cm, poor differentiation and change in PLR ≥ 43.4 during T2. The latter two variables remained significant on multivariate analysis. Using the same PLR threshold, the survival curve comparing changes in PLR during T2 remained statistically significant., Conclusion: Perioperative PLR changes are highly prognostic of survival outcomes in patients treated for oesophageal adenocarcinoma., (© 2022. Society of Surgical Oncology.)

Purpose: Pancreatic cancer is one of the common types of malignant cancer. Low-dose-rate (LDR) brachytherapy has shown great efficacy in curing pancreatic cancer. However, a long preoperative planning time and an insufficient tumor dose are common issues. In this paper, we present and validate a method for inverse planning using simulated annealing (SA) for the treatment of pancreatic cancer., Methods: The SA method was used for the inverse planning process. With the help of parallel computation and a quick dose field estimation algorithm. This method allowed inverse planning to be performed quickly. A novel length-control method was used to consider and limit the dose of the organ at risk. The effect of this system was validated by calculating the dose-volume histogram metric and time consumption., Results: Regarding the percentage of the volume receiving 100% of the prescribed dose (V100), this approach yielded an average difference in V100 of 5.01% for the tumor and of 1.32% for the organ at risk in the small tumor group; in the large tumor group, the average difference in V100 was 2.3% for the tumor and - 4.49% for the organ at risk. The average time required for inverse planning was 1.63 ± 0.26 s for small tumors and 3.81 ± 0.51 s for large tumors. Compared with other inverse planning methods, the optimal quality of the plans yielded by this method was further improved., Conclusion: This paper presents a new type of inverse planning method for the treatment of pancreatic cancer based on SA. Compared with other LDR inverse planning methods, the method presented here can provide the prescribed dose to the tumor while considering the dose of the organ at risk. Also, the required time is significantly lower than other methods. All the experimental results indicate that this method is ready to be applied in further clinical studies., (© 2021. CARS.)

In the present study, the effect of physical and operational uncertainties on the hydrodynamic and hemocompatibility characteristics of a centrifugal blood pump designed by the U.S. food and drug administration is investigated. Physical uncertainties include the randomness in the blood density and viscosity, while the operational uncertainties are composed of the pump rotational speed, mass flow rate, and turbulence intensity. The non-intrusive polynomial chaos expansion has been employed to conduct the uncertainty quantification analysis. Additionally, to assess each stochastic parameter's influence on the quantities of interest, the sensitivity analysis is utilized through the Sobol' indices. For numerical simulation of the pump's blood flow, the SST [Formula: see text] turbulence model and a power-law model of hemolysis were employed. The pump's velocity field is profoundly affected by the rotational speed in the bladed regions and the mass flow rate in other zones. Furthermore, the hemolysis index is dominantly sensitive to blood viscosity. According to the results, pump hydraulic characteristics (i.e., head and efficiency) show a more robust behavior than the hemocompatibility characteristics (i.e., hemolysis index) regarding the operational and physical uncertainties. Finally, it was found that the probability distribution function of the hemolysis index covers the experimental measurements., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Variations in the vessel radius of segmented surfaces of intracranial aneurysms significantly influence the fluid velocities given by computer simulations. It is important to generate models that capture the effect of these variations in order to have a better interpretation of the numerically predicted hemodynamics. Also, it is highly relevant to develop methods that combine experimental observations with uncertainty modeling to get a closer approximation to the blood flow behavior., Methods: This work applies polynomial chaos expansion to model the effect of geometric uncertainties on the simulated fluid velocities of intracranial aneurysms. The radius of the vessel is defined as the uncertainty variable. Proper orthogonal decomposition is applied to characterize the solution space of fluid velocities. Next, a process of projecting the 4D-Flow MRI velocities on the basis vectors followed by coefficient mapping using generalized dynamic mode decomposition enables the merging of 4D-Flow MRI with the uncertainty propagated fluid velocities., Results: Polynomial chaos expansion propagates the fluid velocities with an error of 2% in velocity magnitude relative to computer simulations. Also, the bifurcation region (or impingement location) shows a standard deviation of 0.17 m/s (since an available reported variance in the vessel radius is adopted to model the uncertainty, the expected standard deviation may be different). Numerical phantom experiments indicate that the proposed approach reconstructs the fluid velocities with 0.3% relative error in presence of geometric uncertainties., Conclusion: Polynomial chaos expansion is an effective approach to propagate the effect of the uncertainty variable in the blood flow velocities of intracranial aneurysms. Merging 4D-Flow MRI and uncertainty propagated fluid velocities leads to more realistic flow trends relative to ignoring the uncertainty in the vessel radius.

Purpose: Pancreatic adenocarcinoma remains a malignancy with poor prognosis. Black patients experience poorer overall survival compared with other races. Recent studies have elucidated certain prognostic factors at the time of diagnosis of pancreatic cancer which have largely not been studied for differences between racial groups. We present a study examining differences in blood levels between Black and non-Black patients and their effects on overall survival., Methods: This is a retrospective cohort study. One hundred sixty-three patients were confirmed to carry a tissue diagnosis of pancreatic adenocarcinoma and included in analysis; 27 of the patients were self-identified as "Black"; 136 were analyzed together as "Non-Black" with the majority identifying as "White". Various blood markers were drawn at the time of diagnosis. Kaplan-Meier and multivariable Cox regression models were used to examine differences in these factors between Black and non-Black patients, as well as their effect on overall survival., Results: Black patients were younger at diagnosis (p = 0.001) and were more likely to experience significant weight loss leading up to diagnosis (p = 0.009); Black patients also had a lower neutrophil-to-lymphocyte ratio (NLR) (p = 0.001) and higher lymphocyte-to-monocyte ratio (LMR) (p = 0.001) at diagnosis. In multivariable analysis, an NLR > 3.5 had a significantly negative impact on overall survival (p = 0.002), as did the presence of metastatic disease (p < 0.001)., Conclusion: Black patients demonstrated a "favorable" white blood cell profile (higher LMR, lower NLR) compared with non-Black patients. This may suggest that the immune response in pancreatic adenocarcinoma is not what is driving disparately poor outcomes in Black patients. Further study is warranted to ascertain the role of immune response in pancreatic adenocarcinoma, the prognostic use of these measurements at diagnosis, and possible other factors, such as genetics, which may better explain poorer outcomes in Black patients.

The emergence of migrant grandparent caregivers in urban China calls for research attention to the impact on their well-being. Given the stressful nature of grandparent caregiving and changes to social support under migration, in this study, we aimed to investigate the impact of grandparental stress and social support on migrant grandparent caregivers&apos; affective well-being. Cross-sectional data were collected from nine kindergartens using multistage clustered sampling in Eastern China. The total sample consisted of 483 migrant Chinese grandparent caregivers (mean age = 56.54 years, 67.7% female). Structural equation modeling was used to validate the hypotheses. The results indicated that grandparental stress had a direct negative impact on positive affect (r = -0.130) and a direct positive effect on negative affect (r = 0.125). Both informal (r = 0.368) and formal social support (r = 0.126) were positively associated with positive affect, while only informal social support (r = -0.105) had a significant negative association with negative affect. Additionally, grandparent stress decreased informal social support (r = -0.414) and indirectly influenced both positive and negative affect. In turn, a lack of social support may intensify grandparental stress. The findings validate the integrated theoretical models for studying migrant grandparent caregivers in urban China. Implications for policies and interventions are also discussed., Author(s): Haoyi Guo [sup.1] , Steven Sek-yum Ngai [sup.2] , Tao Sun [sup.1] Author Affiliations: (1) https://ror.org/01yqg2h08, grid.19373.3f, 0000 0001 0193 3564, School of Humanities and Social Sciences, Harbin Institute [...]

The loss of a child is considered one of the most tragic experiences that parents can go through. The present systematic review aims to compile the most recently published interventions in bereavement support for these parents, being particularly interested in those made from a meaning-centered approach. The search for the units of analysis was guided by the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement and was entered in Web of Science, Scopus and EBSCO, obtaining a total of 485 papers of which 21 have been included in this article. The results found are heterogeneous in terms of the type of intervention used and results, but they all seem to have something in common: the lack of research and reliable interventions that exist for this population. With this systematic review we intend to achieve a better understanding of these parents' needs and to highlight the enormous work that still remains ahead in order to make their bereavement experience a little less devastating., Author(s): L. Pelacho-Rios [sup.1] , G. Bernabe-Valero [sup.1] Author Affiliations: (1) grid.440831.a, 0000 0004 1804 6963, MEB Lab (Mind, Emotion, and Behavior Research Laboratory), Catholic University of Valencia San Vicente [...]