BACKGROUND Cholangiocarcinoma(CCA)is a highly malignant cancer,characterized by frequent mucin overexpression.MUC1 has been identified as a critical oncogene in the progression of CCA.However,the comprehensive underst...BACKGROUND Cholangiocarcinoma(CCA)is a highly malignant cancer,characterized by frequent mucin overexpression.MUC1 has been identified as a critical oncogene in the progression of CCA.However,the comprehensive understanding of how the mucin family influences CCA progression and prognosis is still incomplete.AIM To investigate the functions of mucins on the progression of CCA and to establish a risk evaluation formula for stratifying CCA patients.METHODS Single-cell RNA sequencing data from 14 CCA samples were employed for elucidating the roles of mucins,complemented by bioinformatic analyses.Subse-quent validations were conducted through spatial transcriptomics and immuno-histochemistry.The construction of a risk evaluation model utilized the least absolute shrinkage and selection operator regression algorithm,which was further confirmed by independent cohorts and diverse data types.RESULTS CCA tumor cells with elevated levels of MUC1 and MUC4 showed activated nucleotide metabolic pathways and increased invasiveness.MUC5AC-high cells were found to promote CCA progression through WNT signaling.MUC5B-high cells exhibited robust cellular oxidation activities,leading to resistance against antitumoral treatments.MUC13-high cells were observed to secret chemokines,recruiting and transforming macrophages into the M2-polarized state,thereby suppressing antitumor immunity.MUC16-high cells were found to promote tumor progression through interleukin-1/nuclear factor kappa-light-chain-enhancer of activated B cells signaling upon interaction with neutrophils.Utilizing the expression levels of these mucins,a risk factor evaluation formula for CCA was developed and validated across multiple cohorts.CCA samples with higher risk factors exhibited stronger metastatic potential,chemotherapy resistance,and poorer prognosis.CONCLUSION Our study elucidates the functional mechanisms through which mucins contribute to CCA development,and provides tools for risk stratification in CCA.展开更多
BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.MET...BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.METHODS We extracted demographic,etiological,vital sign,laboratory test,comorbidity,complication,treatment,and severity score data of liver cirrhosis patients from the Medical Information Mart for Intensive Care IV(MIMIC-IV)and electronic ICU(eICU)collaborative research database(eICU-CRD).Predictor selection and model building were based on the MIMIC-IV dataset.The variables selected through least absolute shrinkage and selection operator analysis were further screened through multivariate regression analysis to obtain final predictors.The final predictors were included in the multivariate logistic regression model,which was used to construct a nomogram.Finally,we conducted external validation using the eICU-CRD.The area under the receiver operating characteristic curve(AUC),decision curve,and calibration curve were used to assess the efficacy of the models.RESULTS Risk factors,including the mean respiratory rate,mean systolic blood pressure,mean heart rate,white blood cells,international normalized ratio,total bilirubin,age,invasive ventilation,vasopressor use,maximum stage of acute kidney injury,and sequential organ failure assessment score,were included in the multivariate logistic regression.The model achieved AUCs of 0.864 and 0.808 in the MIMIC-IV and eICU-CRD databases,respectively.The calibration curve also confirmed the predictive ability of the model,while the decision curve confirmed its clinical value.CONCLUSION The nomogram has high accuracy in predicting in-hospital mortality.Improving the included predictors may help improve the prognosis of patients.展开更多
BACKGROUND As a less invasive technique,peroral endoscopic myotomy(POEM)has recently been widely accepted for treating achalasia with an excellent safety profile,durability,and efficacy in adults.In pediatric and geri...BACKGROUND As a less invasive technique,peroral endoscopic myotomy(POEM)has recently been widely accepted for treating achalasia with an excellent safety profile,durability,and efficacy in adults.In pediatric and geriatric patients,the treatment is more difficult.AIM To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.METHODS We conducted a comprehensive search of PubMed,Embase and Cochrane Library databases from inception to July 2024.The primary outcomes were technical and clinical success.Secondary outcomes of interest included adverse events and gastroesophageal reflux disease(GERD).The pooled event rates were calculated by comprehensive meta-analysis software.RESULTS A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study.The pooled event rates of technical success,clinical success,GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1%[95%confidence interval(CI):95.0%-98.3%;I^(2)=0%;P<0.000],93.2%(95%CI:90.5%-95.2%;I^(2)=0%;P<0.000),22.3%(95%CI:18.4%-26.7%;I^(2)=43.874%;P<0.000)and 20.4%(95%CI:16.6%-24.8%;I^(2)=67.217%;P<0.000),respectively.Furthermore,in geriatric patients,the pooled event rates were 97.7%(95%CI:95.8%-98.7%;I^(2)=15.200%;P<0.000),93.2%(95%CI:90.3%-95.2%;I^(2)=0%;P<0.000),23.9%(95%CI:19.4%-29.1%;I^(2)=75.697%;P<0.000)and 10.8%(95%CI:8.3%-14.0%;I^(2)=62.938%;P<0.000],respectively.CONCLUSION Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.展开更多
BACKGROUND Mucinous adenocarcinoma(MC)has attracted much attention as a distinct histologic subtype of colorectal cancer in recent years.However,data about its epidemiologic and prognostic characteristics are limited....BACKGROUND Mucinous adenocarcinoma(MC)has attracted much attention as a distinct histologic subtype of colorectal cancer in recent years.However,data about its epidemiologic and prognostic characteristics are limited.Therefore,patient data extracted from the National Cancer Institute’s Surveillance,Epidemiology,and End Results Program were collected to analyze the epidemiologic and clinicopathological characteristics of MC.AIM To determine the epidemiologic and clinicopathological characteristics of MC.METHODS The incidence trend of MC was calculated through the Joinpoint Regression Program.Cox regression analyses were performed to identify prognostic factors associated with overall survival(OS).A nomogram was established to predict the survival probability of individual patients with MC.RESULTS We found that rates of MC decreased from 4.50/100000 in 2000 to 1.54/100000 in 2018.Rates of MCs in patients aged≤50 years decreased 2.27%/year during 2000-2018.The incidence of appendiceal MCs increased from 0.14/100000 in 2000 to 0.24/100000 in 2018,while the incidence in other anatomic subsites continued to decrease.On multivariable Cox analyses,age,race,tumor site,T stage,N stage,M stage,surgery,and chemotherapy were associated with OS.A nomogram was developed based on these factors,and the area under the curve for 1-year,3-year,and 5-year OS in the training cohort was 0.778,0.778,and 0.768,respectively.CONCLUSION Our results demonstrated that MC incidence decreased in almost all anatomic subgroups except for the appendix.A nomogram predicting the survival probability of patients with MCs showed good performance.展开更多
BACKGROUND There are systematic differences in clinical features between women and men with schizophrenia(SCZ).The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ.Brain-derived...BACKGROUND There are systematic differences in clinical features between women and men with schizophrenia(SCZ).The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ.Brain-derived neurotrophic factor(BDNF)and sex hormones have complex interacting actions that contribute to the etiology of SCZ.AIM To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.METHODS The serum levels of follicle-stimulating hormone,luteinizing hormone(LH),estradiol(E2),progesterone,testosterone(T),prolactin(PRL)and BDNF were compared between chronic antipsychotic-treated male(CATM)patients with SCZ(n=120)and healthy controls(n=120).The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms,while neuropsychological tests were used to assess cognition.Neuropsychological tests,such as the Digit Cancellation Test(DCT),Semantic Verbal Fluency(SVF),Spatial Span Test(SS),Paced Auditory Serial Addition Test(PASAT),Trail Making Task(TMT-A),and Block Design Test(BDT),were used to assess executive functions(BDT),attention(DCT,TMT-A),memory(SS,PASAT),and verbal proficiency(SVF).RESULTS Although E2 levels were significantly lower in the patient group compared to the healthy controls,T,PRL,and LH levels were all significantly higher.Additionally,the analysis revealed that across the entire sample,there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time.In CATM patients with SCZ,a significant correlation between the negative symptoms score and PRL levels was observed.CONCLUSION Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.展开更多
Heterotopic pancreas(HP) is a relatively uncommon entity that is defined as pancreatic tissue without a true anatomical or vascular connection to the pancreas. HP does not cause symptoms in most cases but can occasion...Heterotopic pancreas(HP) is a relatively uncommon entity that is defined as pancreatic tissue without a true anatomical or vascular connection to the pancreas. HP does not cause symptoms in most cases but can occasionally produce various manifestations, including nausea, vomiting, abdominal pain, and even heterotopic pancreatitis. Here, we report an unusual case in which heterotopic pancreatitis complicated by the formation of a pseudocyst that caused gastric outlet obstruction was diagnosed based on serum hyperamylasemia and findings from endoscopic ultrasonography(EUS)-guided fine needle aspiration(EUS-FNA) cytology. EUS-guided single pigtail stent insertion was successfully performed for recurrent gastric outlet obstruction. The patient has remained healthy and symptom-free during 4 years of surveillance. In the context of the relevant literature, the described case is a rare case of HP complicated by a pseudocyst treated via EUS-FNA and stent insertion.展开更多
BACKGROUND： One of the major limitations of biliary stents is the stent occlusion, which is closely related to the over- growth of bacteria. This study aimed to evaluate the feasibility of a novel silver=nanoparticle...BACKGROUND： One of the major limitations of biliary stents is the stent occlusion, which is closely related to the over- growth of bacteria. This study aimed to evaluate the feasibility of a novel silver=nanoparticle-coated polyurethane （Ag/PU） stent in bacterial cholangitis model in swine. METHODS： Ag/PU was designed by coating silver nanopar- tides on polyurethane （PU） stent. Twenty-four healthy pigs with bacterial cholangitis using Ag/PU and PU stents were ran- domly divided into an Ag/PU stent group （n=12） and a PU stem group （n=12）, respectively. The stents were inserted by standard endoscopic retrograde cholangiopancreatography. Laboratory assay was performed for white blood cell （WBC） count, alanine aminotransferase （ALT）, interleukin-1 [l （IL- 1 p）, tumor necrosis factor-a （TNF-~） at baseline time, 8 hours, 1, 2, 3, and 7 days after stent placements. The segment of bile duct containing the stent was examined histologically ex vivo. Implanted bili- ary stents were examined by a scan electron microscope. The amount of silver release was also measured in vitro. RESULTS： The number of inflammatory cells and level of ALT, IL-1β and TNF-α were significantly lower in the Ag/PU stent group than in the PU stent group. Hyperplasia of the mucosa was more severe in the PU stent group than in the Ag/PU stent group. In contrast to the biofilm of bacteria on the PU stent, fewer bacteria adhered to the Ag/PU stent. CONCLUSIONS： PU biliary stents modified with silver nanoparticles are able to alleviate the inflammation of pigs with bacterial cholangitis. Silver-nanoparticle-coated stents are resistant to bacterial adhesion.展开更多
AIM to compare the efficacy and safety of a hook knife(HO) with a hybrid knife(HK) during endoscopic submucosal tunnel dissection(EStD) procedure.METHODS Between August 2012 and December 2015, the ESt D procedure was ...AIM to compare the efficacy and safety of a hook knife(HO) with a hybrid knife(HK) during endoscopic submucosal tunnel dissection(EStD) procedure.METHODS Between August 2012 and December 2015, the ESt D procedure was performed for 83 upper GI submucosal lesions, which originated from the muscularis propria layer identified by upper endoscopy and endoscopic ultrasonography. Of these, 34 lesions were treated by a HO, whereas 49 lesions were treated by a HK. Data regarding age, gender, presenting symptoms, tumor location and size, procedure time, complications, en bloc resection rate and others were analyzed and compared between the two groups.RESULTS there were no significant differences in the age, gender, presenting symptoms and tumor location between the two groups. EStD was successfully completed in all the patients, and no case was converted to laparoscopy. the mean procedure time was significantly shorter in the HK group than in the HO group(41.3 ± 20.3 min vs 57.2 ± 28.0 min, p = 0.004). the mean frequency of device exchange was 1.4 ± 0.6 in the HK group and significantly less than 3.3 ± 0.6 in the HO group(p < 0.001). the differences in tumor size and histopathological diagnoses were not significant between the two groups(p = 0.813, p = 0.363, respectively). Both groups had an equal en bloc resection rate and complete resection rate. Additionally, the complication rate was similar between the two groups(p = 0.901). During the follow-up, no recurrence occurred in either group.CONCLUSION We demonstrate for the first time that HO and HK do not differ in efficacy or safety, but HK reduces the frequency of device exchange and procedure time.展开更多
BACKGROUND Liver cirrhosis is the leading cause of liver-related mortality worldwide. It is currently a global health challenge.AIM This research intended to explore and analyse research trends and frontiers in this f...BACKGROUND Liver cirrhosis is the leading cause of liver-related mortality worldwide. It is currently a global health challenge.AIM This research intended to explore and analyse research trends and frontiers in this field during the last 10 years, providing new inspiration for clinical decisionmaking and scientific research.METHODS Publications on hepatic cirrhosis research were retrieved from the Web of Science Core Collection on April 4, 2021. Bibliometric visualisation was conducted through VOSviewer and CiteSpace.RESULTS The analytic research was based on original articles and reviews. A total of 7775records of hepatic cirrhosis published from 2011 to 2020 were retrieved. In the past ten years, the number of related annual publications has increased significantly, especially in the United States and China. All publications were distributed among 109 countries. The United States contributed the most(21.95%)and was consistently the leading driving force, with a solid academic reputation in this area. The University of Barcelona distributed the most related articles(177articles) and was cited the most frequently. The Journal of Hepatology ranked third in the top 10journals, which has the highest impact factor(impact factor 2019 = 20.582). Jasmohan S. Bajaj was the most productive author(72 articles). Burst keywords(e.g., sofosbuvir, burden, care, sarcopenia,chronic liver failure, human gut microbiome, and nonalcoholic fatty liver disease) and a succession of reference citation bursts have provided clues about research frontiers in recent years.CONCLUSION This study identified developing trends in the evolution of liver cirrhosis to provide new inspiration for researchers.展开更多
BACKGROUND The use of radiofrequency ablation(RFA)has been reported in the treatment of gastric low-grade intraepithelial neoplasia(LGIN).However,its efficacy and prognostic risk factors have not been well analyzed.AI...BACKGROUND The use of radiofrequency ablation(RFA)has been reported in the treatment of gastric low-grade intraepithelial neoplasia(LGIN).However,its efficacy and prognostic risk factors have not been well analyzed.AIM To explore the efficacy and prognostic risk factors of RFA for gastric LGIN in a large,long-term follow-up clinical study.METHODS The clinical data of 271 consecutive cases from 198 patients who received RFA for treatment of gastric LGIN at the Chinese PLA General Hospital from October 2014 to October 2020 were reviewed in this retrospective study.Data on operative parameters,complications,and follow-up outcomes including curative rates were recorded and analyzed.RESULTS The curative rates of endoscopic RFA for gastric LGIN at 3 mo,6 mo,and 1-5 years after the operation were 93.3%,92.8%,91.5%,90.3%,88.5%,85.7%,and 83.3%,respectively.Multivariate analyses revealed that Helicobacter pylori(H.pylori)infection and disease duration>1 year had a significant effect on the curative rate(P<0.001 and P=0.013,respectively).None of patients had bleeding,perforation,infection,or other serious complications after RFA,and the main discomfort was postoperative abdominal pain.CONCLUSION RFA was safe and effective for gastric LGIN during long-term follow-up.H.pylori infection and disease course>1 year may be the main risk factors for relapse of LGIN after RFA.展开更多
Objective:To study the effect of berberine combined with risperidone therapy on endocrine hormones and oxidative stress in patients with schizophrenia.Methods: A total of 90 patients with schizophrenia who were treate...Objective:To study the effect of berberine combined with risperidone therapy on endocrine hormones and oxidative stress in patients with schizophrenia.Methods: A total of 90 patients with schizophrenia who were treated in our hospital between May 2014 and May 2016 were collected, reviewed and then divided into the control group (n=47) who received risperidone therapy and the observation group (n=47) who received berberine combined with risperidone therapy. Serum insulin resistance index levels, thyroid hormone and prolactin contents as well as oxidative stress index contents before and after treatment were compared between two groups of patients.Results: Before treatment, differences in serum insulin resistance index levels, thyroid hormone and prolactin contents as well as oxidative stress index contents were not statistically significant between two groups of patients. After treatment, serum FINS and HOMA-IR levels in observation group were lower than those in control group;serum T3 content was higher than that in control group while PRL content was lower than that in control group;serum MDA content was lower than that in control group while SOD, GSH-Px and CAT contents were higher than those in control group.Conclusion: Berberine combined with risperidone therapy for patients with schizophrenia won't cause severe endocrine hormone level disorder, and helps to reduce the systemic oxidative stress response.展开更多
How to solve the hypersonic aerothermodynamics around large-scale uncontrolled spacecraft during falling disintegrated process from outer space to earth,is the key to resolve the problems of the uncontrolled Tiangong-...How to solve the hypersonic aerothermodynamics around large-scale uncontrolled spacecraft during falling disintegrated process from outer space to earth,is the key to resolve the problems of the uncontrolled Tiangong-No.1 spacecraft reentry crash.To study aerodynamics of spacecraft reentry covering various flow regimes,a Gas-Kinetic Unified Algorithm(GKUA)has been presented by computable modeling of the collision integral of the Boltzmann equation over tens of years.On this basis,the rotational and vibrational energy modes are considered as the independent variables of the gas molecular velocity distribution function,a kind of Boltzmann model equation involving in internal energy excitation is presented by decomposing the collision term of the Boltzmann equation into elastic and inelastic collision terms.Then,the gas-kinetic numerical scheme is constructed to capture the time evolution of the discretized velocity distribution functions by developing the discrete velocity ordinate method and numerical quadrature technique.The unified algorithm of the Boltzmann model equation involving thermodynamics non-equilibrium effect is presented for the whole range of flow regimes.The gas-kinetic massive parallel computing strategy is developed to solve the hypersonic aerothermodynamics with the processor cores 500~45,000 at least 80%parallel efficiency.To validate the accuracy of the GKUA,the hypersonic flows are simulated including the reentry Tiangong-1 spacecraft shape with the wide range of Knudsen numbers of 220~0.00005 by the comparison of the related results from the DSMC and N-S coupled methods,and the low-density tunnel experiment etc.For uncontrolling spacecraft falling problem,the finite-element algorithm for dynamic thermalforce coupling response is presented,and the unified simulation of the thermal structural response and the hypersonic flow field is tested on the Tiangong-1 shape under reentry aerodynamic environment.Then,the forecasting analysis platform of end-of-life largescale spacecraft flying track is established on the basis of ballistic computation combined with reentry aerothermodynamics and deformation failure/disintegration.展开更多
Background:With the wide application of endoscopic submucosal dissection(ESD)for early gastric neoplasms,metachronous gastric neoplasms(MGN)have gradually become a concern.This study aimed to analyze the characteristi...Background:With the wide application of endoscopic submucosal dissection(ESD)for early gastric neoplasms,metachronous gastric neoplasms(MGN)have gradually become a concern.This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients.Methods:A total of 814 patients were retrospectively enrolled.All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People’s Liberation Army General Hospital.The risk factors for MGN were analyzed using Cox hazard proportional model.Moreover,the cumulative incidence,the correlation of initial lesions and MGN lesions,and the treatment and follow-up outcomes of MGN patients were analyzed.Results:A total of 4.5%(37/814)of patients had MGN after curative ESD.The 3-,5-,and 7-year cumulative incidences of MGN were 3.5%,5.1%,and 6.9%,respectively,and ultimately reaching a plateau of 11.3%at 99 months after ESD.There was no significant correlation between initial lesions and MGN lesions in terms of gross type(P=0.178),location(long axis:P=0.470;short axis:P=0.125),and histological type(P=0.832).Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN(hazard ratio:4.3,95%confidence interval:2.0-9.4,P<0.001).Seventy-three percent of patients with MGN were treated by endoscopic resection.During follow-up,two patients with MGN died of gastric cancer with lymph node metastasis.The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN(94.6%vs.99.6%,P=0.006).Conclusions:The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD.Thus,regular and long-term surveillance endoscopy may be helpful,especially for patients with initial multiple neoplasms.展开更多
This study investigates the performance of four machine learning(ML)algorithms to evaluate the earthquake-induced liquefaction potential of soil based on the cone penetration test field case history records using the ...This study investigates the performance of four machine learning(ML)algorithms to evaluate the earthquake-induced liquefaction potential of soil based on the cone penetration test field case history records using the Bayesian belief network(BBN)learning software Netica.The BBN structures that were developed by ML algorithms-K2,hill climbing(HC),tree augmented naive(TAN)Bayes,and Tabu search were adopted to perform parameter learning in Netica,thereby fixing the BBN models.The performance measure indexes,namely,overall accuracy(OA),precision,recall,F-measure,and area under the receiver operating characteristic curve,were used to evaluate the training and testing BBN models’performance and highlight the capability of the K2 and TAN Bayes models over the Tabu search and HC models.The sensitivity analysis results showed that the cone tip resistance and vertical effective stress are the most sensitive factors,whereas the mean grain size is the least sensitive factor in the prediction of seismic soil liquefaction potential.The results of this study can provide theoretical support for researchers in selecting appropriate ML algorithms and improving the predictive performance of seismic soil liquefaction potential models.展开更多
The unprecedented liquefaction-related land damage during earthquakes has highlighted the need to develop a model that better interprets the liquefaction land damage vulnerability(LLDV)when determining whether liquefa...The unprecedented liquefaction-related land damage during earthquakes has highlighted the need to develop a model that better interprets the liquefaction land damage vulnerability(LLDV)when determining whether liquefaction is likely to cause damage at the ground's surface.This paper presents the development of a novel comprehensive framework based on select case history records of cone penetration tests using a Bayesian belief network(BBN)methodology to assess seismic soil liquefaction and liquefaction land damage potentials in one model.The BBN-based LLDV model is developed by integrating multi-related factors of seismic soil liquefaction and its induced hazards using a machine learming(ML)algorithm-K2 and domain knowledge(DK)data fusion methodology.Compared with the C4.5 decision tree-J48 model,naive Bayesian(NB)classifier,and BBN-K2 ML prediction methods in terms of overall accuracy and the Cohen's kappa coefficient,the proposed BBN K2 and DK model has a better performance and provides a substitutive novel LLDV framework for characterizing the vulnerability of land to liquefaction-induced damage.The proposed model not only predicts quantitatively the seismic soil liquefaction potential and its ground damage potential probability but can also identify the main reasons and fault-finding state combinations,and the results are likely to assist in decisions on seismic risk mitigation measures for sustainable development.The proposed model is simple to perform in practice and provides a step toward a more sophisticated liquefaction risk assessment modeling.This study also interprets the BBN model sensitivity analysis and most probable explanation of seismic soil liquefed sites based on an engineering point of view.展开更多
Liquefaction-induced lateral displacement is responsible for considerable damage to engineered structures during major earthquakes.Therefore,an accurate estimation of lateral displacement in liquefaction-prone regions...Liquefaction-induced lateral displacement is responsible for considerable damage to engineered structures during major earthquakes.Therefore,an accurate estimation of lateral displacement in liquefaction-prone regions is an essential task for geotechnical experts for sustainable development.This paper presents a novel probabilistic framework for evaluating liquefaction-induced lateral displacement using the Bayesian belief network(BBN)approach based on an interpretive structural modeling technique.The BBN models are trained and tested using a wide-range casehistory records database.The two BBN models are proposed to predict lateral displacements for free-face and sloping ground conditions.The predictive performance results of the proposed BBN models are compared with those of frequently used multiple linear regression and genetic programming models.The results reveal that the BBN models are able to learn complex relationships between lateral displacement and its influencing factors as cause-effect relationships,with reasonable precision.This study also presents a sensitivity analysis to evaluate the impacts of input factors on the lateral displacement.展开更多
文摘BACKGROUND Cholangiocarcinoma(CCA)is a highly malignant cancer,characterized by frequent mucin overexpression.MUC1 has been identified as a critical oncogene in the progression of CCA.However,the comprehensive understanding of how the mucin family influences CCA progression and prognosis is still incomplete.AIM To investigate the functions of mucins on the progression of CCA and to establish a risk evaluation formula for stratifying CCA patients.METHODS Single-cell RNA sequencing data from 14 CCA samples were employed for elucidating the roles of mucins,complemented by bioinformatic analyses.Subse-quent validations were conducted through spatial transcriptomics and immuno-histochemistry.The construction of a risk evaluation model utilized the least absolute shrinkage and selection operator regression algorithm,which was further confirmed by independent cohorts and diverse data types.RESULTS CCA tumor cells with elevated levels of MUC1 and MUC4 showed activated nucleotide metabolic pathways and increased invasiveness.MUC5AC-high cells were found to promote CCA progression through WNT signaling.MUC5B-high cells exhibited robust cellular oxidation activities,leading to resistance against antitumoral treatments.MUC13-high cells were observed to secret chemokines,recruiting and transforming macrophages into the M2-polarized state,thereby suppressing antitumor immunity.MUC16-high cells were found to promote tumor progression through interleukin-1/nuclear factor kappa-light-chain-enhancer of activated B cells signaling upon interaction with neutrophils.Utilizing the expression levels of these mucins,a risk factor evaluation formula for CCA was developed and validated across multiple cohorts.CCA samples with higher risk factors exhibited stronger metastatic potential,chemotherapy resistance,and poorer prognosis.CONCLUSION Our study elucidates the functional mechanisms through which mucins contribute to CCA development,and provides tools for risk stratification in CCA.
基金Supported by Natural Science Foundation of Sichuan Province,No.2022NSFSC1378.
文摘BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.METHODS We extracted demographic,etiological,vital sign,laboratory test,comorbidity,complication,treatment,and severity score data of liver cirrhosis patients from the Medical Information Mart for Intensive Care IV(MIMIC-IV)and electronic ICU(eICU)collaborative research database(eICU-CRD).Predictor selection and model building were based on the MIMIC-IV dataset.The variables selected through least absolute shrinkage and selection operator analysis were further screened through multivariate regression analysis to obtain final predictors.The final predictors were included in the multivariate logistic regression model,which was used to construct a nomogram.Finally,we conducted external validation using the eICU-CRD.The area under the receiver operating characteristic curve(AUC),decision curve,and calibration curve were used to assess the efficacy of the models.RESULTS Risk factors,including the mean respiratory rate,mean systolic blood pressure,mean heart rate,white blood cells,international normalized ratio,total bilirubin,age,invasive ventilation,vasopressor use,maximum stage of acute kidney injury,and sequential organ failure assessment score,were included in the multivariate logistic regression.The model achieved AUCs of 0.864 and 0.808 in the MIMIC-IV and eICU-CRD databases,respectively.The calibration curve also confirmed the predictive ability of the model,while the decision curve confirmed its clinical value.CONCLUSION The nomogram has high accuracy in predicting in-hospital mortality.Improving the included predictors may help improve the prognosis of patients.
文摘BACKGROUND As a less invasive technique,peroral endoscopic myotomy(POEM)has recently been widely accepted for treating achalasia with an excellent safety profile,durability,and efficacy in adults.In pediatric and geriatric patients,the treatment is more difficult.AIM To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.METHODS We conducted a comprehensive search of PubMed,Embase and Cochrane Library databases from inception to July 2024.The primary outcomes were technical and clinical success.Secondary outcomes of interest included adverse events and gastroesophageal reflux disease(GERD).The pooled event rates were calculated by comprehensive meta-analysis software.RESULTS A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study.The pooled event rates of technical success,clinical success,GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1%[95%confidence interval(CI):95.0%-98.3%;I^(2)=0%;P<0.000],93.2%(95%CI:90.5%-95.2%;I^(2)=0%;P<0.000),22.3%(95%CI:18.4%-26.7%;I^(2)=43.874%;P<0.000)and 20.4%(95%CI:16.6%-24.8%;I^(2)=67.217%;P<0.000),respectively.Furthermore,in geriatric patients,the pooled event rates were 97.7%(95%CI:95.8%-98.7%;I^(2)=15.200%;P<0.000),93.2%(95%CI:90.3%-95.2%;I^(2)=0%;P<0.000),23.9%(95%CI:19.4%-29.1%;I^(2)=75.697%;P<0.000)and 10.8%(95%CI:8.3%-14.0%;I^(2)=62.938%;P<0.000],respectively.CONCLUSION Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.
基金Supported by Science&Technology Department of Sichuan Province,No.2021JDTD0003Scientific Research Cooperation Project of Suining First People’s Hospital and the Affiliated Hospital of Southwest Medical University,No.2021SNXNYD05.
文摘BACKGROUND Mucinous adenocarcinoma(MC)has attracted much attention as a distinct histologic subtype of colorectal cancer in recent years.However,data about its epidemiologic and prognostic characteristics are limited.Therefore,patient data extracted from the National Cancer Institute’s Surveillance,Epidemiology,and End Results Program were collected to analyze the epidemiologic and clinicopathological characteristics of MC.AIM To determine the epidemiologic and clinicopathological characteristics of MC.METHODS The incidence trend of MC was calculated through the Joinpoint Regression Program.Cox regression analyses were performed to identify prognostic factors associated with overall survival(OS).A nomogram was established to predict the survival probability of individual patients with MC.RESULTS We found that rates of MC decreased from 4.50/100000 in 2000 to 1.54/100000 in 2018.Rates of MCs in patients aged≤50 years decreased 2.27%/year during 2000-2018.The incidence of appendiceal MCs increased from 0.14/100000 in 2000 to 0.24/100000 in 2018,while the incidence in other anatomic subsites continued to decrease.On multivariable Cox analyses,age,race,tumor site,T stage,N stage,M stage,surgery,and chemotherapy were associated with OS.A nomogram was developed based on these factors,and the area under the curve for 1-year,3-year,and 5-year OS in the training cohort was 0.778,0.778,and 0.768,respectively.CONCLUSION Our results demonstrated that MC incidence decreased in almost all anatomic subgroups except for the appendix.A nomogram predicting the survival probability of patients with MCs showed good performance.
基金Supported by This study was supported by the Suzhou Municipal Sci-Tech Bureau Program,No.SS202070Scientific and Technological Program of Suzhou,No.SS202069+5 种基金Suzhou clinical Medical Center for mood disorders,No.Szlcyxzx202109Suzhou Clinical Key Disciplines for Geriatric Psychiatry,No.SZXK202116Suzhou Key Technologies Program,No.SKY2021063Jiangsu Province social development project,No.BE2020764Research Project of Jiangsu Commission of Health,No.M2020031Elderly Health Research Project of Jiangsu Commission of Health,No.LR2022015 and No.LKZ2023020.
文摘BACKGROUND There are systematic differences in clinical features between women and men with schizophrenia(SCZ).The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ.Brain-derived neurotrophic factor(BDNF)and sex hormones have complex interacting actions that contribute to the etiology of SCZ.AIM To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.METHODS The serum levels of follicle-stimulating hormone,luteinizing hormone(LH),estradiol(E2),progesterone,testosterone(T),prolactin(PRL)and BDNF were compared between chronic antipsychotic-treated male(CATM)patients with SCZ(n=120)and healthy controls(n=120).The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms,while neuropsychological tests were used to assess cognition.Neuropsychological tests,such as the Digit Cancellation Test(DCT),Semantic Verbal Fluency(SVF),Spatial Span Test(SS),Paced Auditory Serial Addition Test(PASAT),Trail Making Task(TMT-A),and Block Design Test(BDT),were used to assess executive functions(BDT),attention(DCT,TMT-A),memory(SS,PASAT),and verbal proficiency(SVF).RESULTS Although E2 levels were significantly lower in the patient group compared to the healthy controls,T,PRL,and LH levels were all significantly higher.Additionally,the analysis revealed that across the entire sample,there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time.In CATM patients with SCZ,a significant correlation between the negative symptoms score and PRL levels was observed.CONCLUSION Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.
文摘Heterotopic pancreas(HP) is a relatively uncommon entity that is defined as pancreatic tissue without a true anatomical or vascular connection to the pancreas. HP does not cause symptoms in most cases but can occasionally produce various manifestations, including nausea, vomiting, abdominal pain, and even heterotopic pancreatitis. Here, we report an unusual case in which heterotopic pancreatitis complicated by the formation of a pseudocyst that caused gastric outlet obstruction was diagnosed based on serum hyperamylasemia and findings from endoscopic ultrasonography(EUS)-guided fine needle aspiration(EUS-FNA) cytology. EUS-guided single pigtail stent insertion was successfully performed for recurrent gastric outlet obstruction. The patient has remained healthy and symptom-free during 4 years of surveillance. In the context of the relevant literature, the described case is a rare case of HP complicated by a pseudocyst treated via EUS-FNA and stent insertion.
基金partially supported by grants from the Jiangsu Province Social Development Program(BL2012031)the National Natural Science Foundation of China(81172266)+1 种基金the Natural Science Foundation of Jiangsu Province(BK2011859)Jiangsu Innovation of Medical Team and Leading Talents Cultivation(LJ201127)
文摘BACKGROUND： One of the major limitations of biliary stents is the stent occlusion, which is closely related to the over- growth of bacteria. This study aimed to evaluate the feasibility of a novel silver=nanoparticle-coated polyurethane （Ag/PU） stent in bacterial cholangitis model in swine. METHODS： Ag/PU was designed by coating silver nanopar- tides on polyurethane （PU） stent. Twenty-four healthy pigs with bacterial cholangitis using Ag/PU and PU stents were ran- domly divided into an Ag/PU stent group （n=12） and a PU stem group （n=12）, respectively. The stents were inserted by standard endoscopic retrograde cholangiopancreatography. Laboratory assay was performed for white blood cell （WBC） count, alanine aminotransferase （ALT）, interleukin-1 [l （IL- 1 p）, tumor necrosis factor-a （TNF-~） at baseline time, 8 hours, 1, 2, 3, and 7 days after stent placements. The segment of bile duct containing the stent was examined histologically ex vivo. Implanted bili- ary stents were examined by a scan electron microscope. The amount of silver release was also measured in vitro. RESULTS： The number of inflammatory cells and level of ALT, IL-1β and TNF-α were significantly lower in the Ag/PU stent group than in the PU stent group. Hyperplasia of the mucosa was more severe in the PU stent group than in the Ag/PU stent group. In contrast to the biofilm of bacteria on the PU stent, fewer bacteria adhered to the Ag/PU stent. CONCLUSIONS： PU biliary stents modified with silver nanoparticles are able to alleviate the inflammation of pigs with bacterial cholangitis. Silver-nanoparticle-coated stents are resistant to bacterial adhesion.
文摘AIM to compare the efficacy and safety of a hook knife(HO) with a hybrid knife(HK) during endoscopic submucosal tunnel dissection(EStD) procedure.METHODS Between August 2012 and December 2015, the ESt D procedure was performed for 83 upper GI submucosal lesions, which originated from the muscularis propria layer identified by upper endoscopy and endoscopic ultrasonography. Of these, 34 lesions were treated by a HO, whereas 49 lesions were treated by a HK. Data regarding age, gender, presenting symptoms, tumor location and size, procedure time, complications, en bloc resection rate and others were analyzed and compared between the two groups.RESULTS there were no significant differences in the age, gender, presenting symptoms and tumor location between the two groups. EStD was successfully completed in all the patients, and no case was converted to laparoscopy. the mean procedure time was significantly shorter in the HK group than in the HO group(41.3 ± 20.3 min vs 57.2 ± 28.0 min, p = 0.004). the mean frequency of device exchange was 1.4 ± 0.6 in the HK group and significantly less than 3.3 ± 0.6 in the HO group(p < 0.001). the differences in tumor size and histopathological diagnoses were not significant between the two groups(p = 0.813, p = 0.363, respectively). Both groups had an equal en bloc resection rate and complete resection rate. Additionally, the complication rate was similar between the two groups(p = 0.901). During the follow-up, no recurrence occurred in either group.CONCLUSION We demonstrate for the first time that HO and HK do not differ in efficacy or safety, but HK reduces the frequency of device exchange and procedure time.
文摘BACKGROUND Liver cirrhosis is the leading cause of liver-related mortality worldwide. It is currently a global health challenge.AIM This research intended to explore and analyse research trends and frontiers in this field during the last 10 years, providing new inspiration for clinical decisionmaking and scientific research.METHODS Publications on hepatic cirrhosis research were retrieved from the Web of Science Core Collection on April 4, 2021. Bibliometric visualisation was conducted through VOSviewer and CiteSpace.RESULTS The analytic research was based on original articles and reviews. A total of 7775records of hepatic cirrhosis published from 2011 to 2020 were retrieved. In the past ten years, the number of related annual publications has increased significantly, especially in the United States and China. All publications were distributed among 109 countries. The United States contributed the most(21.95%)and was consistently the leading driving force, with a solid academic reputation in this area. The University of Barcelona distributed the most related articles(177articles) and was cited the most frequently. The Journal of Hepatology ranked third in the top 10journals, which has the highest impact factor(impact factor 2019 = 20.582). Jasmohan S. Bajaj was the most productive author(72 articles). Burst keywords(e.g., sofosbuvir, burden, care, sarcopenia,chronic liver failure, human gut microbiome, and nonalcoholic fatty liver disease) and a succession of reference citation bursts have provided clues about research frontiers in recent years.CONCLUSION This study identified developing trends in the evolution of liver cirrhosis to provide new inspiration for researchers.
基金Supported by National Key R&D Program of China,No.2016YFC1303601
文摘BACKGROUND The use of radiofrequency ablation(RFA)has been reported in the treatment of gastric low-grade intraepithelial neoplasia(LGIN).However,its efficacy and prognostic risk factors have not been well analyzed.AIM To explore the efficacy and prognostic risk factors of RFA for gastric LGIN in a large,long-term follow-up clinical study.METHODS The clinical data of 271 consecutive cases from 198 patients who received RFA for treatment of gastric LGIN at the Chinese PLA General Hospital from October 2014 to October 2020 were reviewed in this retrospective study.Data on operative parameters,complications,and follow-up outcomes including curative rates were recorded and analyzed.RESULTS The curative rates of endoscopic RFA for gastric LGIN at 3 mo,6 mo,and 1-5 years after the operation were 93.3%,92.8%,91.5%,90.3%,88.5%,85.7%,and 83.3%,respectively.Multivariate analyses revealed that Helicobacter pylori(H.pylori)infection and disease duration>1 year had a significant effect on the curative rate(P<0.001 and P=0.013,respectively).None of patients had bleeding,perforation,infection,or other serious complications after RFA,and the main discomfort was postoperative abdominal pain.CONCLUSION RFA was safe and effective for gastric LGIN during long-term follow-up.H.pylori infection and disease course>1 year may be the main risk factors for relapse of LGIN after RFA.
文摘Objective:To study the effect of berberine combined with risperidone therapy on endocrine hormones and oxidative stress in patients with schizophrenia.Methods: A total of 90 patients with schizophrenia who were treated in our hospital between May 2014 and May 2016 were collected, reviewed and then divided into the control group (n=47) who received risperidone therapy and the observation group (n=47) who received berberine combined with risperidone therapy. Serum insulin resistance index levels, thyroid hormone and prolactin contents as well as oxidative stress index contents before and after treatment were compared between two groups of patients.Results: Before treatment, differences in serum insulin resistance index levels, thyroid hormone and prolactin contents as well as oxidative stress index contents were not statistically significant between two groups of patients. After treatment, serum FINS and HOMA-IR levels in observation group were lower than those in control group;serum T3 content was higher than that in control group while PRL content was lower than that in control group;serum MDA content was lower than that in control group while SOD, GSH-Px and CAT contents were higher than those in control group.Conclusion: Berberine combined with risperidone therapy for patients with schizophrenia won't cause severe endocrine hormone level disorder, and helps to reduce the systemic oxidative stress response.
基金The National Key Basic Research and Development Program(2014CB744100)and the National Natural Science Foundation of China(91530319 and 11325212)support the present researches in the design of the study and collection,analysis,and interpretation of data and in writing the manuscript.
文摘How to solve the hypersonic aerothermodynamics around large-scale uncontrolled spacecraft during falling disintegrated process from outer space to earth,is the key to resolve the problems of the uncontrolled Tiangong-No.1 spacecraft reentry crash.To study aerodynamics of spacecraft reentry covering various flow regimes,a Gas-Kinetic Unified Algorithm(GKUA)has been presented by computable modeling of the collision integral of the Boltzmann equation over tens of years.On this basis,the rotational and vibrational energy modes are considered as the independent variables of the gas molecular velocity distribution function,a kind of Boltzmann model equation involving in internal energy excitation is presented by decomposing the collision term of the Boltzmann equation into elastic and inelastic collision terms.Then,the gas-kinetic numerical scheme is constructed to capture the time evolution of the discretized velocity distribution functions by developing the discrete velocity ordinate method and numerical quadrature technique.The unified algorithm of the Boltzmann model equation involving thermodynamics non-equilibrium effect is presented for the whole range of flow regimes.The gas-kinetic massive parallel computing strategy is developed to solve the hypersonic aerothermodynamics with the processor cores 500~45,000 at least 80%parallel efficiency.To validate the accuracy of the GKUA,the hypersonic flows are simulated including the reentry Tiangong-1 spacecraft shape with the wide range of Knudsen numbers of 220~0.00005 by the comparison of the related results from the DSMC and N-S coupled methods,and the low-density tunnel experiment etc.For uncontrolling spacecraft falling problem,the finite-element algorithm for dynamic thermalforce coupling response is presented,and the unified simulation of the thermal structural response and the hypersonic flow field is tested on the Tiangong-1 shape under reentry aerodynamic environment.Then,the forecasting analysis platform of end-of-life largescale spacecraft flying track is established on the basis of ballistic computation combined with reentry aerothermodynamics and deformation failure/disintegration.
文摘Background:With the wide application of endoscopic submucosal dissection(ESD)for early gastric neoplasms,metachronous gastric neoplasms(MGN)have gradually become a concern.This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients.Methods:A total of 814 patients were retrospectively enrolled.All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People’s Liberation Army General Hospital.The risk factors for MGN were analyzed using Cox hazard proportional model.Moreover,the cumulative incidence,the correlation of initial lesions and MGN lesions,and the treatment and follow-up outcomes of MGN patients were analyzed.Results:A total of 4.5%(37/814)of patients had MGN after curative ESD.The 3-,5-,and 7-year cumulative incidences of MGN were 3.5%,5.1%,and 6.9%,respectively,and ultimately reaching a plateau of 11.3%at 99 months after ESD.There was no significant correlation between initial lesions and MGN lesions in terms of gross type(P=0.178),location(long axis:P=0.470;short axis:P=0.125),and histological type(P=0.832).Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN(hazard ratio:4.3,95%confidence interval:2.0-9.4,P<0.001).Seventy-three percent of patients with MGN were treated by endoscopic resection.During follow-up,two patients with MGN died of gastric cancer with lymph node metastasis.The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN(94.6%vs.99.6%,P=0.006).Conclusions:The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD.Thus,regular and long-term surveillance endoscopy may be helpful,especially for patients with initial multiple neoplasms.
基金The work presented in this paper was part of research sponsored by the National Key Research&Development Plan of China(Nos.2018YFC1505305 and 2016YFE0200100)the Key Program of the National Natural Science Foundation of China(No.51639002).
文摘This study investigates the performance of four machine learning(ML)algorithms to evaluate the earthquake-induced liquefaction potential of soil based on the cone penetration test field case history records using the Bayesian belief network(BBN)learning software Netica.The BBN structures that were developed by ML algorithms-K2,hill climbing(HC),tree augmented naive(TAN)Bayes,and Tabu search were adopted to perform parameter learning in Netica,thereby fixing the BBN models.The performance measure indexes,namely,overall accuracy(OA),precision,recall,F-measure,and area under the receiver operating characteristic curve,were used to evaluate the training and testing BBN models’performance and highlight the capability of the K2 and TAN Bayes models over the Tabu search and HC models.The sensitivity analysis results showed that the cone tip resistance and vertical effective stress are the most sensitive factors,whereas the mean grain size is the least sensitive factor in the prediction of seismic soil liquefaction potential.The results of this study can provide theoretical support for researchers in selecting appropriate ML algorithms and improving the predictive performance of seismic soil liquefaction potential models.
基金The research presented in this paper was part of the research sponsored by the National Key Research&Development Plan of China(Nos.2018YFC1505305 and 2016YFE0200100)Key Program of the National Natural Science Foundation of China(Grant No.51639002)Much gratitude is extended to the experts for their opinions on the BBN model building.
文摘The unprecedented liquefaction-related land damage during earthquakes has highlighted the need to develop a model that better interprets the liquefaction land damage vulnerability(LLDV)when determining whether liquefaction is likely to cause damage at the ground's surface.This paper presents the development of a novel comprehensive framework based on select case history records of cone penetration tests using a Bayesian belief network(BBN)methodology to assess seismic soil liquefaction and liquefaction land damage potentials in one model.The BBN-based LLDV model is developed by integrating multi-related factors of seismic soil liquefaction and its induced hazards using a machine learming(ML)algorithm-K2 and domain knowledge(DK)data fusion methodology.Compared with the C4.5 decision tree-J48 model,naive Bayesian(NB)classifier,and BBN-K2 ML prediction methods in terms of overall accuracy and the Cohen's kappa coefficient,the proposed BBN K2 and DK model has a better performance and provides a substitutive novel LLDV framework for characterizing the vulnerability of land to liquefaction-induced damage.The proposed model not only predicts quantitatively the seismic soil liquefaction potential and its ground damage potential probability but can also identify the main reasons and fault-finding state combinations,and the results are likely to assist in decisions on seismic risk mitigation measures for sustainable development.The proposed model is simple to perform in practice and provides a step toward a more sophisticated liquefaction risk assessment modeling.This study also interprets the BBN model sensitivity analysis and most probable explanation of seismic soil liquefed sites based on an engineering point of view.
基金This study was part of research work sponsored by the National Key Research&Development Plan of China(Nos.2018YFC 1505300-5.3 and 2016YFE0200100)the Key Program of the National Natural Science Foundation of China(Grant No.51639002).
文摘Liquefaction-induced lateral displacement is responsible for considerable damage to engineered structures during major earthquakes.Therefore,an accurate estimation of lateral displacement in liquefaction-prone regions is an essential task for geotechnical experts for sustainable development.This paper presents a novel probabilistic framework for evaluating liquefaction-induced lateral displacement using the Bayesian belief network(BBN)approach based on an interpretive structural modeling technique.The BBN models are trained and tested using a wide-range casehistory records database.The two BBN models are proposed to predict lateral displacements for free-face and sloping ground conditions.The predictive performance results of the proposed BBN models are compared with those of frequently used multiple linear regression and genetic programming models.The results reveal that the BBN models are able to learn complex relationships between lateral displacement and its influencing factors as cause-effect relationships,with reasonable precision.This study also presents a sensitivity analysis to evaluate the impacts of input factors on the lateral displacement.
