课程文献中心 更多>>

摘要： OBJECTIVE Automated insulin delivery (AID) requiring manual premeal boluses are the standard of care for people with type 1 diabetes (T1D). We evaluated the safety and feasibility of the Automated Insulin Delivery as an Adaptive NETwork (AIDANET) system used without meal announcements in both supervised and home settings across a diverse population of people with T1D. RESEARCH DESIGN AND METHODS Adults (age >25 years), young adults (age 18-25 years), and adolescents (age 14-18 years) were enrolled at three sites in the U.S. to compare the AIDANET system used in fully closed-loop (FCL) with usual care (UC) in a randomized crossover study. Participants spent similar to 5 days using FCL in a supervised environment followed by similar to 7 days of use at home. The prespecified primary outcome was defined as the change in mean sensor glucose (MSG) between the 2nd week of UC and the week of the FCL at-home period. RESULTS Overall, 34 participants (12 adults, 10 young adults, 12 adolescents;mean age 25.4 +/- 12.6 years;62% female;mean HbA(1c) 8.0 +/- 1.1%;94% hybrid closed loop users during UC) completed the study. MSG improved from 178 to 164 mg/dL (UC vs. FCL P = 0.0058). The percentages of time in range (70-180 mg/dL), time in tight range (70-140 mg/dL), and time above range (>180 mg/dL and >250 mg/dL) also significantly improved, primarily overnight. The percentage of time <70 and <54 mg/dL were significantly noninferior in FCL compared with UC. CONCLUSIONS FCL therapy with the AIDANET system can significantly improve average glycemic control while removing the need for mealtime bolusing for a broad population of people with T1D.

关键词： Cognition   Surveys   Artificial intelligence   Electronic mail   Benchmark testing   Mathematical models   Problem-solving   Computational modeling   Transformers   Training   System 2 reasoning   slow-thinking   large language models   human-like cognitive abilities   human-like reasoning   advanced AI architectures   decision making in AI   AGI  

摘要： Achieving human-level intelligence requires refining the transition from the fast, intuitive System 1 to the slower, more deliberate System 2 reasoning. While System 1 excels in quick, heuristic decisions, System 2 relies on logical reasoning for more accurate judgments and reduced biases. Foundational Large Language Models (LLMs) excel at fast decision-making but lack the depth for complex reasoning, as they have not yet fully embraced the step-by-step analysis characteristic of true System 2 thinking. Recently, reasoning LLMs like OpenAI's o1/o3 and DeepSeek's R1 have demonstrated expert-level performance in fields such as mathematics and coding, closely mimicking the deliberate reasoning of System 2 and showcasing human-like cognitive abilities. This survey begins with a brief overview of the progress in foundational LLMs and the early development of System 2 technologies, exploring how their combination has paved the way for reasoning LLMs. Next, we discuss how to construct reasoning LLMs, trace the evolution of various reasoning models, and examine the core methods that enable advanced reasoning behind them. Additionally, we provide an overview of reasoning benchmarks, offering an in-depth comparison of the performance of representative reasoning LLMs. Finally, we explore promising directions for advancing reasoning LLMs and maintain a real-time GitHub Repository to track the latest developments. We hope this survey will serve as a valuable resource to inspire innovation and drive progress in this rapidly evolving field.

关键词： Microvascular decompression   Teflon   Trigeminal neuralgia   Vein  

摘要： BACKGROUND AND OBJECTIVES:Microvascular decompression (MVD) is accepted as the most effective surgery for patients with trigeminal neuralgia (TN), but controversy remains regarding operative ***:A prospective registry of 523 patients undergoing MVD for unilateral Type 1 TN from July 1999 through September 2022 was reviewed. Patients with Type 2 TN, secondary TN, bilateral TN, vertebrobasilar compression, or previous MVD were excluded. The goal at surgery was to have nothing contacting the trigeminal nerve: arteries in contact with the trigeminal nerve were mobilized away from the nerve root whenever possible and secured with Teflon whereas veins in contact with the trigeminal nerve were sacrificed. Partial sensory rhizotomy was performed if the vascular compression was insignificant or no vascular compression was noted. The primary outcome was pain-free survival without medications. The median follow-up after surgery was 8.2 ***:More patients were women (n = 310, 59.3%), the median age was 63 years, the median pain duration was 5 years, and 110 patients (21.0%) had previous ablative procedures. Operative technique was arterial transposition (n = 255, 48.8%), arterial transposition and vein sacrifice (n = 182, 34.8%), vein sacrifice (n = 64, 12.2%), and partial sensory rhizotomy (n = 22, 4.2%). Initially, 485 patients (92.7%) were pain-free without medications. Pain-free survival estimates at 5, 10, and 15 years were 77.6%, 72.5%, and 69.7%, respectively. Women (hazards ratios = 1.48, P = .03) had a lower rate of pain-free survival. Eighty-three patients (15.9%) had postoperative complications;the most common was new facial numbness (n = 37, 7.1%). Three patients (0.6%) had venous infarctions, and 2 patients (0.4%) had reported Teflon ***:A noncompressive MVD using vein sacrifice, arterial transposition whenever possible, and Teflon implantation provided long-term pain relief for most patients with Type 1 TN with a low risk o

关键词： Mpox   Mpox virus (MPXV)   Clade IIb   Lineage C.1   Phylogenomic   Atypical course of infection  

摘要： We describe an atypical case of mpox virus (MPXV) infection in a Polish patient, with a focus on clinical presentation, virological characterisation, and the phylogenetic placement of the viral isolate within the emerging C.1 lineage of Clade IIb. The report aims to contribute to a better understanding of MPXV lineage-specific disease features and viral evolution in non-endemic settings. The patient presented with numerous localised lesions and minimal systemic symptoms. Genomic analysis confirmed infection with an MPXV C.1 lineage of Clade IIb responsible for the 2022-2025 global outbreaks. Infection with C.1 lineage may lead to atypical presentations, particularly in immunocompetent individuals. Continued genomic surveillance and clade-specific clinical correlation are essential for accurate diagnosis, risk stratification, and public health response.

关键词： dental pulp stem cells   ethylenediaminetetraacetic acid   growth factors   maleic acid   vital pulp treatment  

摘要： Aim: The success of vital pulp treatment (VPT) has been linked to the release of growth factors (GFs) from the dentine matrix, which stimulate dental pulp stem cell (DPSC) activities. Ethylenediaminetetraacetic acid (EDTA) is a commonly used chelating agent that induces the release of GFs bound in the dentine matrix. A 7% Maleic acid (MA) solution has been shown to have better smear layer removal capability and less cytotoxicity compared with 17% EDTA. However, no study has evaluated the effect of 7% MA on the release of GFs from circumpulpal dentine and subsequent DPSC behaviour. This study aimed to evaluate the effect of 17% EDTA and 7% MA conditioning of circumpulpal dentine on the release of transforming growth factor-beta 1 (TGF-beta 1), as well as the DPSC activities. Methodology: Dentine slices treated with phosphate-buffered saline (PBS) acted as the control, while the experimental groups comprised 17% EDTA and 7% MA. The release of TGF-beta 1 was quantified using ELISA following treatment with the experimental solutions. DPSC proliferation was evaluated with the MTT assay, cell migration was assessed through scratch wound and transwell migration assays. Osteogenic differentiation potential of DPSCs was verified using Alizarin Red staining and an alkaline phosphatase (AP) activity assay. Results: 7% MA induced the highest release of TGF-beta 1 compared with 17% EDTA and PBS (p < 0.001). 7% MA at 1/1000 dilution significantly increased DPSC proliferation compared with 17% EDTA and PBS (p < 0.001). The scratch wound healing and transwell migration assays demonstrated superior DPSC migration in the 7% MA compared with the 17% EDTA group (p < 0.001). Alizarin Red staining and quantification indicated the highest formation of mineralized nodules in the 7% MA compared with the 17% EDTA group (p < 0.0001). The AP activity assay showed similar enzyme activity in 7% MA and 17% EDTA treated samples. Conclusions: Within the limitations of this study 7% MA performed bet

关键词： Type 1 diabetes mellitus   BCG   Glycemic control   Regulatory T-cells  

摘要： ObjectiveTo study the effect of two doses of BCG vaccination on immune-regulatory markers and glycemic control in patients with type 1 diabetes (T1DM).MethodsIn this single-centre, double-blinded, randomised, placebo-controlled pilot trial, children with new-onset T1DM (diagnosed within the last 6 months) were included and were randomised 1:1 into BCG and placebo groups, with 20 children in each group. Two doses of 0.1-mL BCG vaccine or 0.1 mL of normal saline was administered intradermally 1 month apart in the BCG group and placebo group, respectively. The primary outcome parameters included changes in regulatory T cell (T-regs) percentage, changes in pancreatic autoantibody titres and serum IL-10, IL-17, and TNF-alpha cytokine levels. The secondary outcome parameters included changes in various glycemic control *** the end of 6 months, no significant differences were observed in Treg percentages, cytokine levels, and autoantibody titres between the BCG and placebo groups. We observed a reduction of HbA1c (p = 0.421) and a lesser fall of C-peptide (p = 0.496) values in the BCG group. The mean fasting, random blood sugar, and median total/basal/bolus insulin dose did not vary significantly between the two groups at 6 *** administration did not significantly improve immune-regulatory markers and glycemic control parameters among children with new-onset T1DM who have been vaccinated at birth. However, there was a trend towards improvement of glycemic parameters in BCG group.

摘要： M. Zhai, Z. Liu, B. Zhang, L. Jing, B. Li, K. Li, X. Chen, M. Zhang, B. Yu, K. Ren, Y. Yang, W. Yi, J. Yang, J. Liu, D. Yi, H. Liang, Z. Jin, R. J. Reiter, W. Duan, and S. Yu, "Melatonin Protects Against the Pathological Cardiac Hypertrophy Induced by Transverse Aortic Constriction Through Activating PGC-1β: In Vivo and In Vitro Studies," Journal of Pineal Research 63, no. 3 (2017): e12433, https://***/10.1111/jpi.12433. This Expression of Concern is for the above article, published online on 14 July 2017 in Wiley Online Library (***), and has been issued by agreement between the journal Editor-in-Chief, Gianluca Tosini; and John Wiley & Sons Ltd. A third party raised concerns of image overlap between the 4 wk TAC image and the 8 wk Sham + Mel image in Figure 2D. An investigation by the publisher confirmed this concern and also found overlap between the Perivascular (8 wk) and Interstitial (8 wk) images in Figure 4A. The authors did not respond to an inquiry and request for original data by the publisher, and as such the data in this article related to the concerns cannot be validated. This Expression of Concern has been published in order to inform and alert readers about the concerns of image overlap in Figures 2D and 4A. The authors were informed of this Expression of Concern.

关键词： Gliomas   Transcription factor   Sp1   Treatments   Diagnoses  

摘要： Gliomas present a significant challenge to modern medicine as some of the most diverse and malignant brain tumors. Despite considerable developments in curative measures, the prognosis remains unsatisfactory. A prime reason is that much is obscured about the genetic regulation of glioma pathogenesis. In recent years, specificity protein 1 (Sp1) has been recognized as a central transcription factor that promotes gliomagenesis. Sp1, which is overexpressed in glioma tissues, modulates gene transcription by targeting GC boxes through its zinc finger motifs. As a result, it can influence tumor formation, proliferation, invasion, and distant migration. The present review summarizes the structure, function, and regulation of Sp1. Furthermore, this study elucidates the underlying mechanism by which Sp1 interacts with signaling pathways to fuel tumor growth and chemoresistance. Finally, the current state of Sp1's clinical implications is outlined. These findings reveal the potential benefits of Sp1 as a therapeutic target and diagnostic tool, laying the foundation for future studies.