INTRODUCTIONThe diagnosis of UTUC has always presented challenges due to the limitations of available diagnostic tools. Cytology, CTU, and URS with biopsies can all yield inadequate results, leading to false negatives. To minimize the risk of biased diagnosis, a combination of these examinations is essential. The European Association of Urology (EAU) recommends the use of diagnostic ureteroscopy and biopsy when imaging and cytology alone are insufficient for accurate diagnosis and risk stratification of the tumor (1). Similarly, according to the guidelines provided by the American Urological Association (AUA), patients with suspected UTUC should undergo evaluation using diagnostic ureteroscopy. During this procedure, any identified lesion should be biopsied, and cytologic washing from the inspected upper tract system should be performed (2).Regrettably, despite the recommendations and guidelines in place, UTUC is frequently underestimated during pre-operative diagnosis. This underestimation can have serious consequences, leading to delayed or inadequate treatment and contributing to significant mortality rates.

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Title: Remarkable improvement of symptoms and signs of severe dry eye treated by ocular immersion hydrotherapy Yong Tao*, M.D., Haoran Cui, M.D., Shuang Zhang, M.D., Tao Zhang, M.D.Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, P. R. ChinaCorresponding author: Prof. Yong Tao, Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University; No. 8, South Road of Worker’s Stadium, Chaoyang District, Beijing 100020, China. Phone: +86-10-85231405. Fax: +86-10-85231405. E-mail: taoyong@mail.ccmu.edu.cnKey Words: Dry eye disease; Ocular immersion hydrotherapy; Ocular graft-versus-host disease; Corneal epithelial cell damage; Ocular surface inflammation

Commentary:

Habitat suitability assessment is crucial for the conservation of endangered species in the context of dramatic global climate change. To investigate changes in the distribution pattern of forest musk in China, the present study used the optimized MaxEnt model of the ENMeval language package to simulate changes in potential suitable areas and potential suitable areas for four shared socio-economic pathways of the endangered species, forest musk (Moschus berezovskii), in both the current and the future periods, and the migration trends of the four shared socioeconomic paths in the current and future periods are analyzed. The results showed that: the MaxEnt model reached the optimal solution when RM=3.4 and FC was LQH; the dominant environmental factors for the distribution of Linnaeus musculus in China were annual precipitation, slope, and cold-season average air temperature; the current suitable habitat accounted for 23.02% of the total area of the study area, which was mainly distributed around the Hengduan Mountain Range, the area around the Longmenshan to Daliangshan Mountains, and the Qinling Mountain System; Under the future climate change, the expansion area of the suitable area is larger than the loss area, and the center of mass of the suitable area has a tendency to migrate to the northeast, in which the fluctuation area of the suitable area is smaller under the SSP370 climate scenario. Critical habitat accounts for 20.04% of the current potential suitable area, which is mainly distributed in the mountain range at the junction of Yunnan-Tibet, the junction of the Zhongshan vein and Sichuan Basin, and the Qinling mountain system. This study suggests focusing on the Yarlung Tsangpo Grand Canyon and Tsatsum Tsibagou in Tibet and the fragmented habitat of forest musk in Cangshan Erhai, Yunnan, to improve the information construction and increase the protection efforts.

In fermentation of filamentous fungi, selecting suitable impellers and controlling fungal morphology are crucial for product yield. Previously, we revealed the AGΔ-GAGΔ strain of Aspergillus oryzae, lacking both α-1,3-glucan (AG) and galactosaminogalactan (GAG), showed improved hyphal dispersion, reduced culture viscosity, and increased recombinant protein production. Here, we used computational fluid dynamics (CFD) to explore the importance of impeller selection. High-performance impellers (HS100/HR100) were compared with the conventional flat-blade turbine and flat-blade paddle combination (6FT/4FP). CFD analysis using viscosity data of the wild-type strain showed gas cavities formed behind the 6FT/4FP blades, with flow velocities and shear stresses concentrated around the impellers; in contrast, HS100/HR100 displayed a broader and more evenly spread range of flow velocities and shear stress values. CFD analysis comparing the mixing properties of AGΔ-GAGΔ and wild-type strain cultures agitated by HS100/HR100 demonstrated that slipping occurred at the impeller periphery–wall boundary in the wild-type culture, while AGΔ-GAGΔ exhibited a wide shear stress distribution and reduced gas cavity formation. The simulation results agreed well with measured volumetric oxygen mass transfer coefficient ( KLa) and mixing time. These findings suggest that an appropriate stirring system, combined with the AGΔ-GAGΔ strain, can drastically improve the mixing characteristics in filamentous fungal fermentation.

Purpose: This scoping review contributes to understanding the utilization of end-of-life anticancer drugs in gastrointestinal cancer patients, a topic posing significant public health challenges due to its prevalence, impact on morbidity and mortality, and associated healthcare costs. Insight into unique treatment patterns at the end of life is vital for enhancing the appropriateness of cancer care for these patients. Methods: Extensive searches were conducted in Medline and Embase to locate articles on the use of anticancer drugs in the end-of-life phase of gastrointestinal cancer patients. Results: We identified 30 publications and described treatment frequencies alongside methodological characteristics. On average, 7.0% and 13.2% of patients received anticancer drugs in the last two and four weeks of life, respectively, with 3.3% commencing new anticancer regimens in the final four weeks. Conclusion: This review offers a comprehensive overview of primary studies reporting end-of-life treatments in gastrointestinal cancer patients. However, methodological inconsistencies present significant challenges, highlighting a notable proportion of patients potentially experiencing overtreatment. Therefore, there is a pressing need for more standardized research methods to ensure robust evaluations and enhance the quality of care for these patients.

This study presents a novel framework This study proposes a new framework for evaluating the performance of distribution networks using a comprehensive approach. This method combines Principal Component Analysis (PCA) for extracting key performance indicators, Improved Analytic Hierarchy Process (IAHP) for determining objective weights of these indicators, and CRITIC method for determining subjective weights. Then, aggregate weights are used to calculate the comprehensive performance score of each part of the distribution network. On the premise of reducing computing resources, K-means clustering analysis is applied to classify the status of distribution network projects, providing data reference for project maintenance and repair. Finally, a case study and corresponding analysis of the evaluation results were presented, providing detailed insights into the practical application of the proposed framework. The limitations of current research and future research approaches were also discussed. The results indicate that the designed strategy performs well in terms of accuracy and computational convenience, and has potential application prospects

Objective To investigate inequalities in antenatal care initiation and to assess whether early pregnancy recognition may reduce these inequalities. Design Population-based birth cohort study. Setting Rotterdam, the Netherlands. Population A cohort of N=4196 pregnant women from Generation R. Methods The association of individual and socioeconomic factors and gestational age at pregnancy recognition with timing of antenatal care initiation were assessed using linear regression analyses. G-methods were used to estimate the reduction of the inequalities in antenatal care initiation, if everyone would have recognized the pregnancy within 6 weeks after the first day of menstrual period. Main Outcome Measures Antenatal care initiation was derived from electronic patient files of 10 midwifery practices in Rotterdam. Results Those who recognized their pregnancy within 6 weeks (81.7%) had their first antenatal care visit 1.26 weeks (95%CI:-1.59; -0.93) earlier than those who recognized their pregnancy after 6 weeks. All factors were significantly associated with timing of antenatal care initiation. Modeling a situation in which people would recognize their pregnancy within 6 weeks resulted in a significant reduction in the inequalities in antenatal care initiation for age, migration background, pregnancy intention, education, employment, household income, housing, and neighborhood deprivation. Conclusions Early recognition of pregnancy would reduce the impact of socio-economic inequalities in timely initiation of prenatal care.

A case report of drug-Induced hemorrhagic bullae

Although efforts to estimate Ne, Nc, and their ratio in wild populations are expanding, few empirical studies investigate interannual changes in these parameters. Hence, we do not know how representative many estimates may be. Answering this question requires studies of long-term population dynamics. We non-lethally sampled N=5400 brook trout (Salvelinus fontinalis) from seven populations during 6 consecutive years (2014-2019) and genotyped them at 33 microsatellites to examine variation in Ne, Nc and their ratio. Nc was estimated by Mark-Recapture (Nc(MR)) (2014-2018) as well as by Close-Kin-Mark-Recapture (Nc(CKMR)) (2015-2017). Within populations, annual variation in Ne (max/min Ne) ranged from 1.6-fold to 58-fold. Over all 7 populations, median annual variation in Ne was 5-fold. These results reflect important interannual changes in reproductive success variance. Within population Nc(MR) varied by a median of 2.7. Thus, Ne varied nearly twice as much as did Nc(MR) . Our results suggest that, at least in small populations, any single annual estimate of Ne is unlikely to be representative of long-term dynamics. At least 3-4 annual estimates may be required for an estimate of contemporary Ne to be representative. For five of the seven populations, Nc(MR) was indistinguishable from Nc(CKMR). The two populations with discordant estimates exhibited the largest annual Ne variation (58-fold and 35.4-fold). These results suggest sampling effort in these two streams may have been insufficient to capture the genetic diversity of the entire population. Our study demonstrates how knowledge of temporal variation in Ne can be used to identify potential biases in Nc(CKMR).

Colorectal cancer is one of the most prevalent malignancies worldwide， with a tendency of increasing incidence in developed countries, which poses a significant threats to the patients’ physical and mental health. The development of colorectal cancer involves numerous genetic alterations, which indicate that transcription factors may play an important role in this process. Changes in the level of zinc finger proteins, the most prevalent transcription factor, may play an important trigger for the development of colorectal cancer. Different zinc finger proteins play different roles in terms of promoting or inhibiting cancer development. This paper briefly reviews the classification, functional characteristics, and expression changes of zinc finger proteins in colorectal cancer, it focuses on how they regulate gene transcription, influence on common signaling pathways and their potential for translational studies and clinical applications. The objective is to stimulate new ideas for their study in colorectal cancer while also providing foundational information to guide drug development and treatment strategies for colorectal cancer patients in clinical settings.

Human immunodeficiency virus (HIV) infection is still a global public health issue, and the development of an effective prophylactic HIV vaccine inducing potent neutralizing antibodies remains a significant challenge for the scientific community. This study aims to explore the protein factors associated with the induction of neutralizing antibodies by the rTV vaccine. In our study, we employed the Olink chip to analyze the inflammation-related proteins in plasma in healthy individuals receiving HIV candidate vaccine (DNA priming and recombinant vaccinia virus rTV boosting) and compared the differences between neutralizing antibody-positive and -negative groups. We identified 25 differentially expressed factors and conducted enrichment analysis and correlation analysis on them. Our results revealed significant expression differences in artemin (ARTN) and C-C motif chemokine ligand 23 (CCL23) between individuals who were positive and negative for neutralizing antibodies. Notably, the expression of CCL23 was inversely proportional to the capacity to produce neutralizing antibodies and correlated with the intensity of the cellular immune response. Additionally, the immune response of T cells in the positive group exhibited higher specificity, further supporting our conclusions. This study not only enriches our understanding of the immune mechanism of the rTV vaccine, but also provides important data for future vaccines.

Homogeneous films with tailored microporous structures are crucial for several applications, yet fabricating such films presents significant challenges. This is primarily because most microporous materials have crystal sizes in the nano- and micrometer ranges, which inevitably generates intergranular spaces in the films, thereby complicating the fabrication of these thin films. We used functionalized metal-organic polyhedra (MOPs) as discrete microporous units and assembled them into homogenous microporous films. This study focused on avoiding the generation of intergranular spaces while controlling packing parameters and film thicknesses. Initially, the MOP units, influenced by van der Waals forces between the functionalized acyl carbon chains, displayed an affinity to form spindle-shaped blocks and islands. As the MOP concentration increased, these structures self-assembled into a hexagonally packed structure with an in-plane orientation and a maximum stacking of two layers of MOPs. By contrast, un-functionalized MOPs yielded a disordered film structure formed by random agglomeration. Evidently, functionalized adipoyl chloride influences the orientation of the MOP network films with uniformly distributed micropores, effectively preventing the formation of intergranular spaces. Additionally, formaldehyde adsorption and desorption experiments revealed that the MOP network films possess superior adsorption and desorption capacities. The proposed approach signifies a breakthrough in the fabrication of homogenous microporous films.

Land degradation (LD) is a global canker that is of major concern for the United Nations Convention to Combat Desertification (UNCCD) which has led to a UNCCD target 15.3 of achieving land degradation neutral world by 2030. In order to attain this target, LD needs to be assessed, hence geospatial techniques integrated with analytical hierarchy process (AHP) to assess LD in the Birim North district of the Eastern region of Ghana. The AHP assigned weights to the criterions, and with weighted overlay algorithms in ArcGIS, the land degradation assessment map was generated. The results shown that 28.21% and 38.96 % has experienced no degradation and slight degradation respectively, whilst 24.32 % and 8.51% of the study area experienced medium and high degradation respectively. The spatial distribution of the LD was displayed on a map. The findings of this study would be a stepping stone for researchers, stakeholders and government to implement rehabilitation models to reverse LD in the Birim North district.

Introduction:Cortical basal ganglia degeneration (CBD) is currently considered to be a rare neurodegenerative disease characterized by pathological tau deposition, neuronal loss, ballooning, and glial degeneration in atrophic cerebral cortex and subcortical regions (including the substantia nigra and striatum) (1). On CBD magnetic resonance, the majority showed asymmetric cortical atrophy in the frontal, temporal, and parietal lobes of the brain. Typical MRI findings are asymmetric cortical atrophy in the premotor area, supplementary motor area and posterior cingulate gyrus, and middle frontal lobe (2).In this paper, we report a case of CBD misdiagnosed as Parkinson’s disease to summarize its clinical manifestations and imaging features, and have some experience in encountering such diseases in the future.

Carbon capture and storage (CCS) is one of the few strategies for reducing CO2 emissions by injecting it into deep geologic formations. The injection of CO2 into heterogeneous rock formations triggers complex coupled flow and transport processes that are not trivial to describe and predict. Advanced numerical simulation is often used as a standard tool to predict the spatial-temporal evolution of CO2 plume and induced pressure changes. However, numerical simulation is computationally demanding, limits the use of standard field management workflows, and hinders real-time analysis and decision-making for risk mitigation. Standard deep learning models provide powerful alternative prediction tools. However, they have important limitations, including lack of interpretability, extensive data needs, and physical inconsistency. To overcome these limitations, a Fluid Flow-based Deep Learning (FFDL) architecture is presented for spatial-temporal prediction of the injected CO2 in storage formations. The architecture of FFDL consists of a physics-based encoder to construct physically meaningful latent variables, and a residual-based processor to predict the evolution of state variables. The FFDL model uses physical operators that serve as nonlinear activation functions and impose hard constraints to respect the general structure of the fluid flow equations. A comprehensive investigation of FFDL, based on a field-scale saline aquifer, is used to demonstrate its superior performance compared to standard deep learning models. The results show that FFDL exhibits strong generalization capability and provides more reliable and physically consistent predictions of CO2 plume migration. The flexibility of FFDL makes it suitable for various applications, including decision-making, optimization, and inverse modeling.

The Martian surface composition appears mainly mafic but recent observations have revealed the presence of differentiated rocks, only in the Highlands. Here, we demonstrate that differentiated melts can form during the construction of thick crustal regions on Mars by fractional crystallisation of a mafic protolith, without plate tectonics. On a stagnant-lid planet, regions of thicker crusts contain more heat-producing elements and are associated to thinner lithospheres and to higher mantle melt fractions. This induces larger crustal extraction rates where the crust is thicker. This positive feedback mechanism is favoured at large wavelengths and can explain the formation of the Martian dichotomy. We further develop an asymmetric parameterised thermal evolution model accounting for crustal extraction, where the well-mixed convective mantle is topped by two lithospheres (North/South) characterised by specific thermal and crustal structures. We use this model in a Bayesian inversion to investigate the conditions that allow crustal temperatures to be maintained above the basalt solidus during crustal growth, resulting in the formation of evolved melts. Among the thermal evolution models matching constraints on the structure of the Martian crust and mantle provided by the InSight NASA mission, a non-negligible fraction allows partial melting and differentiation of the crust in the south, which can occur very early (<100 Myr) as well as during the Hesperian ; partial melting in the north appears unlikely. Although crustal differentiation may occur on a hemispheric scale on Mars, its vertical extent is limited to less than a third of the crustal thickness.

Innovation is a vital scientific activity for improvement of human production, quality of life and economic development in the globe. This review aims to discuss innovative strategies for a series of challenges of public health and sustainable growth as well as human diseases. Currently, there are huge challenges of public health due to both major viral infectious diseases (such as HIV infection and Covid-19) and major non-communicable diseases (such as cardiovascular disease, diabetes, and cancer), as well as aging, climate change, industrialization, and urbanization. These challenges and risks greatly affect modern economic and social development not only in China but also in the globe. Herein, we should “know more, do better, and be smarter” about related knowledge and information, “reject misinformation and accept uncertainty”, and further understand the important roles of policies and laws as agents (PLA) in fighting against the infection of SARS-CoV-2 and its major variants, and effectively halting climate change for global health and sustainable growth. All in all, these innovative strategies and experiences in combating Covid-19 infection and climate change will help to get better economic and social development as well as sustainable growth in the countries worldwide, in particular the Covid-19 pandemic and post-COVID-19 era.

Background: Global influenza-associated acute respiratory infections contribute to 3-5 million severe illnesses requiring hospitalization annually, with 90% of hospitalizations occurring among children <5 years in developing countries. In Bangladesh, limited availability of nationally representative, robust estimates of influenza-associated hospitalizations limit allocation of resources for prevention and control measures. Methods: This study used data from the Hospital Based Influenza Surveillance (HBIS) system in Bangladesh from 2010-2019 and Healthcare Utilization Surveys to determine hospital utilization patterns in the catchment area. We estimated annual influenza-associated hospitalization numbers and rates for all age groups in Bangladesh using methods outlined by the World Health Organization and adjusted for enrolment, laboratory testing practices, and healthcare seeking behavior. We then estimated national hospitalization rates by multiplying age-specific hospitalization rates with the corresponding annual national census population. Results: Annual influenza-associated hospitalization rates per 100,000 population for all ages ranged from 31 (95% CI: 27-36) in 2011 to 139 (95% CI: 130-149) in 2019. Children <5 years old had the highest rates of influenza-associated hospitalization, ranging from 114 (95% CI: 90-138) in 2011 to 529 (95% CI: 481-578) in 2019, followed by adults aged ≥65 years with rates ranging from 46 (95% CI: 34-57) in 2012 to 252 (95% CI: 213-292) in 2019. The national hospitalization estimates for all ages from 2010-2019 ranged from 47,891 to 236,380 per year. Conclusions: The impact of influenza-associated hospitalizations in Bangladesh may be considerable, particularly for young children and older adults. Targeted interventions, such as influenza vaccination for these age groups, should be prioritized and evaluated.

Aims: Omalizumab is an anti-immunoglobulin E (IgE) monoclonal antibody that was first approved by the United States (US) Food and Drug Administration (FDA) for the treatment of allergic asthma in 2003. The pivotal trials supporting the initial approval of omalizumab used dosing determined by patient’s baseline IgE and body weight, with the goal of reducing the mean free IgE level to approximately 25 ng/mL or less. While the underlying parameters supporting the dosing table remained the same, subsequent studies and analyses have resulted in approved alternative versions of the dosing table, including the European Union (EU) asthma dosing table, which differs in weight bands and maximum allowable baseline IgE and omalizumab dose. In this study, we leveraged modeling and simulation approaches to predict and compare the free IgE reduction and forced expiratory volume in 1 second (FEV1) improvement with omalizumab dosing based on the US and EU asthma dosing tables. Methods: Previously established population pharmacokinetic-IgE and IgE-FEV1 models were used to predict and compare post-treatment free IgE and FEV1 based on the US and EU dosing tables. Clinical trial simulations (with virtual asthma populations) and Monte Carlo simulations were performed to provide both breadth and depth in the comparisons. Results/Conclusions: The US and EU asthma dosing tables were predicted to result in generally comparable free IgE suppression and FEV1 improvement. However, this has not been clinically validated with respect to the registrational endpoint of reduction in annualized asthma exacerbations.

A touch sensor is an essential component in meeting the growing demand for human-machine interfaces. These sensors have been developed in wearable, attachable, and even implantable forms to acquire a wide range of information from humans. To be applied to the human body, sensors are required to be biocompatible and not restrict the natural movement of the body. Ionic materials are a promising candidate for soft touch sensors due to their outstanding properties, which include high stretchability, transparency, ionic conductivity, and biocompatibility. Here, this review discusses the unique features of soft ionic touch position sensors, focusing on the ionic material and its key role in the sensor. The touch sensing mechanisms include piezocapacitive, piezoresistive, surface capacitive, piezoelectric, and triboelectric and triboresistive sensing. This review analyzes the implementation hurdles and future research directions of the soft ionic touch sensors for the transformative potential.

The JN1 variant harbors Leu455Ser and three mutations in non-spike proteins contributing to increased transmissibility and immune escape ability, also pseudovirus assay showed that the infectivity of JN.1 was significantly higher than its predecessor (1). JN.1 is about 3 to 5 times less susceptible to neutralizing antibodies than the XBB.1.5 variant that is in the updated booster raising concerns about its potential impact on public health (2) Recent data indicates a significant rise in cases associated with this variant, underscoring the need for immediate action. The antiviral Paxlovid, Remdesivir, and Molnupiravir continue to show activity against XBB-derived and BA.2.86 variants, suggesting that the current therapeutic tools remain effective(3).

Technique for order preference by similarity to ideal solution (TOPSIS) is a popular approach in multiple attribute decision-making. It ranks by estimating the separations between alternatives and the positive ideal solution (PIS) as well as the negative ideal solution (NIS). When setting the ranking rules, there are three limitations to the TOPSIS. First, there is controversy surrounding the addition of negative and positive indicators in the denominator of the ranking index, as these measurements represent opposite aspects. Second, the ranking index is also irrespective of the relative magnitudes of the distances from alternatives to PIS and NIS, resulting in incomparable situations. Third, the ranking results derived from the distances to PIS, the distances to NIS, and the relative closeness are inconsistent. To address these limitations, this paper first analyzes the inconsistency through a spatial partition diagram, that helps access the possible results under different indexes. Then, we define strong, weak, and no priority relationships between alternatives based on the differences in the distances to PIS and NIS, making the comparability enhanced. For further incorporating their differences in ranking, we also generate a relationship matrix based on the priority relationships from one alternative to all other alternatives, and devise a new, rational ranking index to address the non-additivity debate. Simulations and numerical example of a real-life case are conducted to demonstrate the rationality and superiority of the modified TOPSIS.