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关键词： Cervical Cancer   CDK15   Clinicopathological Characteristics   L1CAM   Recurrence and Metastasis  

摘要： Objective: To investigate the association of CDK15(cyclin-dependent kinase 15) and L1CAM L1 (cell adhesion molecule) expression with clinicopathological characteristics and recurrence and/or metastasis after radical hysterectomy of cervical cancer. Methodology: Retrospective analysis was performed on the clinical data of 80 patients with pathologically confirmed cervical cancer who underwent radical hysterectomy at Affiliated Hospital of Hebei University between January 2023 to January 2025. Differences in CDK15 and L1CAM L1 expression in cervical cancer tissues were compared across subgroups stratified by different clinicopathological characteristics, including age and International Federation of Gynecology and Obstetrics(FIGO) stage. Recurrence and metastasis in cervical cancer patients were documented within 12 months post-radical hysterectomy. The Kaplan-Meier method was employed to analyze the association of CDK15/L1CAM expression with recurrence-free survival(RFS). Results: The positive expression rates of CDK15 and L1CAM in cervical cancer tissues were 51.25% and 47.50%, respectively-both significantly higher than the corresponding rates of 22.50% and 18.75% in adjacent non-cancerous tissues(P<0.05). In cervical cancer tissues, the expression of CDK15 exhibited statistically significant differences across subgroups stratified by FIGO stage, histological differentiation, lymph node metastasis, and lymphovascular invasion(P<0.05);whereas the expression of L1CAM demonstrated statistically significant differences across subgroups stratified by FIGO stage, maximum tumor diameter, and lymph node metastasis(P<0.05). Kaplan-Meier analysis revealed that the 12 months RFS rate after radical hysterectomy was approximately 68.29% in cervical cancer patients with positive CDK15 expression, which was lower than the 89.74% in patients with negative CDK15 expression(Log-rank P=0.019). Conclusion: CDK15 and L1CAM are highly expressed in cervical cancer tissues. Consequently,

摘要： Purpose To compare the stainability, translucency, opalescence, whiteness, gloss, and hardness of 4 computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials after simulated coffee drinking and color correction. Materials and Methods Four CAD-CAM blocks were investigated (n = 40): resin nanoceramic (Cerasmart, CS), polymer-infiltrated ceramic network (Vita Enamic, VE), lithium disilicate glass ceramic (IPS *** CAD, EC), and zirconia-reinforced lithium silicate glass ceramic (Vita Suprinity, VS). The color stability (Delta E-00), relative translucency (RTP), opalescence (OP), and whiteness stability (Delta WID) were measured with a spectrophotometer. Gloss (GU) was recorded with a gloss meter, and hardness (HM) was detected with a Martens hardness testing device. The specimens were observed at baseline (T0), after coffee thermocycling (CTC) (T1), and after color correction (T2). Delta E-00 was analyzed by two-way ANOVA, Delta WID was analyzed with one-way ANOVA, and RTP, OP, WID, GU, and HM were assessed with repeated ANOVA to evaluate the effects of material type, treatment, and their interactions on the tested properties. Post hoc pairwise comparisons were assessed by Tukey HSD and Student t-tests (alpha = 0.05). Results Delta E-00, WID, OP, GU, and HM outcomes were significantly impacted by material type (p < 0.001) and treatment (p <= 0.028), whereas Delta WID and RTP were affected by material type (p <= 0.03). CS exceeded the Delta E-00 perceptibility threshold at T1. VS exhibited the highest stain resistance, RTP, and HM, and the least was in VE and CS. Color correction serums reversed CTC-induced staining among VS and VE (p < 0.001). Conclusions Zirconia-reinforced lithium silicate glass-ceramics demonstrated superior color stability and hardness when subjected to coffee thermocycling and color correction serum.

关键词： Heuristic modeling metrics   modeling operation evaluation network   modeling sequence recovery   self-supervised pretraining   Heuristic modeling metrics   modeling operation evaluation network   modeling sequence recovery   self-supervised pretraining  

摘要： 3-D modeling technologies play a crucial role in modern manufacturing. 3-D models are often exported as boundary representations for compatibility and data protection, which remove the modeling history and limit editability. To restore modeling sequences from such models, researchers employ neural networks to infer the possible modeling steps. This approach needs a large amount of labeled sequence data, and annotating such data is time-consuming. To address this issue, we propose a self-supervised pretraining method that generates modeling sequences directly from boundary representation models. Training data are first generated using a heuristic modeling sequences generation algorithm. Before training, each B-rep model is preprocessed into a zone graph representation. We then introduce the modeling operation evaluation network, which extracts features and scores each candidate operation to sequentially reconstruct the model. By selecting the most suitable operation at each step, the network progressively reconstructs the modeling sequence. This approach effectively reconstructs modeling sequences, restores the editability of B-rep models, and significantly reduces the reliance on labeled data.

关键词： Alpha angle   femoroacetabular impingement   hip arthroscopy   patient-reported outcomes   posterolateral cam lesion  

摘要： Background: Femoroacetabular impingement syndrome (FAIS) is a common hip disorder that can lead to joint degeneration and osteoarthritis. Posterolateral (PL) cam lesions, characterised by an alpha angle >60 degrees on anteroposterior (AP) pelvis and Dunn views, present significant surgical challenges due to their anatomical location and proximity to critical vascular structures. Effective surgical intervention relies on achieving optimal postoperative resection, yet clear radiographic thresholds for surgical success remain undefined. Objective: This study aimed to investigate the relationship between postoperative alpha angle measurements on pelvis AP radiographs and clinical outcomes in patients undergoing hip arthroscopy for PL cam lesions. Additionally, it seeks to determine an optimal postoperative alpha angle threshold that correlates with improved patient-reported outcomes at 2 years. Methods: A retrospective analysis was performed on a cohort of 117 patients (121 hips) who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) between the years 2013 and 2022, with a minimum follow-up period of 2 years. Preoperative and postoperative alpha angles were measured on the pelvis AP and Dunn views. Clinical outcomes were assessed using the Hip Outcome Score-Activities of Daily Living (HOS-ADL), the modified Harris Hip Score (mHHS), and the Non-Arthritic Hip Score (NAHS). Receiver operating characteristic (ROC) curve analysis was used to establish an alpha angle cutoff associated with better functional recovery. Results: Patients with a postoperative alpha angle below 55 degrees demonstrated significantly better functional outcomes across all scoring systems. ROC analysis confirmed that alpha < 55 degrees was a strong predictor of achieving a patient-acceptable symptomatic state (PASS), with an area under the curve (AUC) of 0.849 for mHHS, 0.741 for NAHS, and 0.721 for HOS-ADL (p < 0.001). Sensitivity and specificity values varied across scoring s

关键词： Bspline   NURBS   Pocket   Smoothing   Dynamic behavior   HSM  

摘要： In recent years, smoothing techniques have emerged as one of the most significant research topics in the field of CAD/CAM. Accordingly, a tool path smoothing approach based on spline trajectories has been developed for pocket milling applications in high-speed machining (HSM). This study proposes an optimization framework for parametric curves employed in the smoothing of CAM milling strategies. The "Morph Spiral" strategy was selected as the case study and modeled using Bspline and NURBS interpolations. The influence of interpolation order and discretization parameters on machine tool dynamics and machining accuracy was systematically investigated. The obtained results indicate that the integration of parametric curves within CAM strategies considerably enhances the efficiency of HSM operations. The optimal configuration was identified as an interpolation order of 2 with a discretization parameter of n = 1000. Under these conditions, the proposed smoothing approach reduced the milling cycle time by approximately 60% for both Bspline and NURBS interpolations, while maintaining acceptable chordal deviations. Increasing the interpolation order from 2 to 5 resulted in a 9.7% increase in chord error for Bspline curves, whereas its effect on NURBS interpolation was negligible. Conversely, increasing the discretization parameter from n = 1000 to n = 3000 led to a reduction in chord error of 64.49% for Bspline and 77.39% for NURBS. These findings confirm the effectiveness of the proposed methodology in optimizing the trade-off between machining accuracy and productivity in freeform high-speed milling applications.

关键词： Hepatocellular carcinoma   CAD   macrophage   dihydroorotic acid   UBE4B   metastasis  

摘要： Background and Aims:Portal vein tumor thrombosis (PVTT), an indicator of clinical metastasis, significantly shortens hepatocellular carcinoma (HCC) patients' lifespan, and no effective treatment has been established. We aimed to illustrate mechanisms underlying PVTT formation and tumor metastasis, and identified potential targets for clinical intervention. Approach and Results:Multi-omics data of 159 HCC patients (including 37 cases with PVTT) was analyzed to identify contributors to PVTT formation and tumor metastasis. In vitro and in vivo experiments were performed to confirm the critical role of carbamoyl-phosphate synthetase 2, aspartate transcarbamylase, and dihydroorotase (CAD) in HCC metastasis. Metabolomics and transcriptomics techniques, single-cell RNA sequencing, combined with experimental verification were complemented to illustrate mechanisms underlying CAD induced pro-metastatic efficacy. Analysis of proteogenomic data of HCC cohort identified CAD as the key contributor to PVTT formation and tumor metastasis in HCC. Further experiments confirmed that high CAD expression could significantly promote HCC metastasis, and vice versa. Mechanistically, CAD manipulated de novo pyrimidine anabolism, leading to dihydroorotic acid (DHO) accumulation which directly bound to ubiquitination factor E4B (UBE4B). UBE4B subsequently regulated JAK1 ubiquitination and activated the NF-kappa B pathway to promote epithelial-mesenchymal transition (EMT) of HCC cells. Additionally, CAD generated an immunosuppressive milieu conducive to HCC metastasis by recruiting and reprogramming macrophages into a "pro-tumor" phenotype. Consequently, the metastatic capability of HCC was remarkably enhanced. Conclusion:Therapy targeting CAD may offer a promising approach to curb HCC metastasis by reducing tumor cells' metastatic potential and also shifting the tumor microenvironment towards a less pro-metastatic state.

关键词： adaptive radiation   Bromeliaceae   Crassulacean acid metabolism   drought tolerance   genetic redundancy   key innovation trait  

摘要： Crassulacean acid metabolism (CAM) is a water-efficient photosynthetic strategy involving a coordinated suite of complex traits including metabolic, anatomical and regulatory aspects that shift across the diel cycle. While CAM has evolved repeatedly in land plants, the evolutionary routes enabling this convergence remain elusive. Whereas the same core CAM (de)carboxylation genes are consistently involved, a key question is whether distinct CAM phenotypes also depend on a shared set of auxiliary genes, reflecting a quantitative continuum of expression, or whether they can instead emerge through divergent or redundant peripheral solutions. The bromeliad subgenus Tillandsia, with diverse photosynthetic strategies, offers an ideal system to explore this question. Using physiological and transcriptomic analyses of well-watered and water-limited accessions of two closely related species, we characterised facultative and constitutive CAM. By comparing orthologous gene expression and orthogroup recruitment, we found that while both species performed CAM upon water-withholding, transcriptional shifts in pathways related to stomatal movement, sugar/malate transport, aquaporins and starch metabolism showed minimal overlap. Core enzymes involved in the CAM (de)carboxylation cycle exhibited broadly shared expression patterns, yet the facultative CAM species uniquely upregulated PPC2 at night instead of the canonical CAM-related PEPC ortholog PPC1. Our study reveals that, while the expression of certain core CAM enzymes is conserved, the surrounding transcriptional architecture can differ substantially even between closely related species. This supports a model in which CAM evolves through a mosaic recruitment of functionally equivalent, yet nonorthologous genes-underscoring its flexible and modular genetic architecture. These insights advance our understanding of the mechanisms enabling the repeated evolution of CAM and its capacity to facilitate adaptive diversification.

关键词： Artificial intelligence   CAD   Screening   Mammography   Business   Retrospective   Non-inferiority  

摘要： AimThe AI case malignancy score (AI-CMS) represents the AI algorithm's confidence (from 0 to 100%) that a mammography exam is malignant. This work aims to retrospectively evaluate, through simulation on real-world data, a strategy that integrates AI-CMS into a standard screening scenario to reduce the radiologists' *** total of 89176 consecutive screening exams from the 2023-2024 Reggio Emilia Breast Screening Program (REBSP) were retrospectively considered, which included 479 biopsy-proven cancers (interval cancers were only partially available, therefore false negatives beyond those detected in the real screening workflow could not be assessed). In the proposed strategy, computer-aided detection (CAD) acts as a reader (CR), recalling women with an AI-CMS greater than a predefined threshold (ranging from 5 to 25%). If the first radiologist (HR1) disagrees with CR, the case goes to a second radiologist (HR2) and, in case of human disagreement, to a third radiologist (HR3). For each threshold, final recall rate (RR), cancer detection rate (CDR), number of detected cancers (DC), predictive positive value (PPV) of recalls, false positive rate (FPR), human reading workload, and economic impact were *** AI-CMS thresholds of 5%, 8%, 10%, 15%, 20%, and 25%, human workload decrease ranged from 13.4% to 36.1%. The final RR decreased between 4.3% and 4.0%, slightly lower than the current 4.4% with human double reading. The PPV ranged from 12.6% to 13.3%, higher than the current PPV of 12.2%. The FPR ranged from 3.8% to 3.5%, down from the current 3.9%. With thresholds up to 5%, no true positive cases were missed, maintaining the CDR of 5.4 parts per thousand of those detected by current double reading. Considering CAD payback periods of either 6 or 8 years, financial savings from our strategy ranged from approximately 17800 to over 590,000.ConclusionIntegrating AI-CMS support into a standard screening scenario could substantially reduce the

关键词： CAM   CPM   Physical therapy   Knee replacement   Range of motion   TKR  

摘要： IntroductionRehabilitation following total knee arthroplasty (TKA) includes various therapeutic interventions, such as continuous active motion (CAM) and continuous passive motion (CPM). This meta-analysis aimed to compare the effects of CAM and CPM on pain, function, and range of motion post-TKA, focusing on the early postoperative *** systematic literature search was conducted in databases including Medline, Cochrane Library, Embase, and CINAHL to identify randomized controlled trials (RCTs) comparing CAM and CPM post-TKA. Studies were required to include at least two postoperative measurements and combine the interventions with standard physiotherapy. The methodological quality of the included studies was assessed using the JBI appraisal tool, and statistical analysis was performed on suitable *** RCTs involving 501 patients were included. Meta-analysis indicated significant pain reduction and improved functional outcomes with CAM compared to CPM, particularly in postoperative pain assessments. CAM showed advantages in functional tests, including the Sit-to-Stand and Timed-Up-and-Go tests. However, no significant differences were found for active and passive range of motion (ROM). Patient-reported outcome measures (PROMs) showed high heterogeneity, limiting clear *** demonstrates significant benefits in pain reduction and functional recovery compared to CPM following TKA. However, variability in outcome measures and intervention protocols limits comparability across studies and therefore generalizability. CAM's requirement for active patient engagement may present practical challenges, while CPM's standardization allows for easier integration into routine postoperative care.