BACKGROUND Pancreatic fluid leakage is a rare complication of pancreatic cancer and often requires drainage when conservative therapy fails.Endoscopic,percutaneous,and surgical drainage are options.Minimally invasive ...BACKGROUND Pancreatic fluid leakage is a rare complication of pancreatic cancer and often requires drainage when conservative therapy fails.Endoscopic,percutaneous,and surgical drainage are options.Minimally invasive endoscopic procedures are generally considered the first-line treatment,with either a transpapillary approach or an endoscopic ultrasound-guided transmural approach selected depending on the case.Various dilators are used to dilate tracts to the leakage site.However,reports of dilation through a rigid trans-tumoral tract using a drill dilator remain extremely rare.CASE SUMMARY A 74-year-old woman with pancreatic body and tail cancer developed fever and left-sided chest pain after multiple courses of chemotherapy.Computed tomography revealed fluid accumulation around the pancreatic tail and spleen along with a left pleural effusion.The effusion was diagnosed as reactive secondary to pancreatic fluid leakage.Endoscopic retrograde cholangiopancreatography identified irregular stenosis of the main pancreatic duct in the pancreatic body.Distal to the stenosis,the main ductal structure was nearly obliterated by the tumor.The contrast medium had leaked into the pancreatic fluid leakage area through several fine,disrupted ductal structures.The guidewire was successfully advanced through an extremely fine tract that was not the main contrast-filling route.Standard dilators failed to expand the rigid trans-tumoral tract.A second endoscopic retrograde cholangiopancreatography using a drill dilator successfully expanded the trans-tumoral tract,enabling endoscopic nasopancreatic drainage tube placement.Subsequently,the pancreatic fluid leakage and pleural effusion resolved.CONCLUSION Even in rigid trans-tumoral tracts,the use of a drill dilator can facilitate successful tract expansion,enabling effective drainage.展开更多
To evaluate the efficacy of a newly developed dilator for endoscopic ultrasound (EUS)-guided drainage (ES Dilator). METHODSFourteen consecutive patients who had undergone EUS-guided choledochoduodenostomy (EUS-CDS) wi...To evaluate the efficacy of a newly developed dilator for endoscopic ultrasound (EUS)-guided drainage (ES Dilator). METHODSFourteen consecutive patients who had undergone EUS-guided choledochoduodenostomy (EUS-CDS) with the ES Dilator were identified from a prospectively maintained database and enrolled in the study group. Fourteen other patients who had undergone EUS-CDS without the dilator just prior to its introduction were analyzed as the control group. A historical cohort study was carried out comparing the two groups. The main outcome measurement was the procedure time. The technical success rate and early AE rate were also compared between the two groups. RESULTSThere were no significant differences in age, sex and etiology of biliary obstruction. The utilization rate of a plastic stent was higher in the control group (36% vs 0%). The technical success rate was 100% in both groups. The mean procedure time was significantly shorter in the study group than in the control group (27 ± 7 min vs 44 ± 26 min, P = 0.026). Additionally, there were no patients who required more than 40 min for the procedure in the study group. Early adverse events occurred in 29% (4/14) of the control group whereas none in the study group. The adverse events in all 4 patients was bile peritonitis, including pan-peritonitis in one patient. All patients recovered with conservative treatment by medication. CONCLUSIONThe newly developed dilator was found to be useful for shortening procedure time and would prevent adverse events related to bile leakage in EUS-CDS.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>展开更多
Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Am...Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Amplatz dilator can cause injury to the opposite side of the renal-pelvic mucosa.In this study,we report the experimental and initial clinical performance of a spherical-headed fascial dilator developed specifically for second-stage PCNL.Methods:The novel spherical-headed dilator was compared with existing tapered-headed dilators in configuration and in puncture resistance utilizing a static puncture test.Subsequently,a pilot clinical study was conducted during which patients scheduled to undergo second-stage PCNL from June 2019 to October 2019 in our center were enrolled.A typical ultrasound guided PCNL procedure was performed with the exception that the new spherical-headed fascial dilator was substituted for a tapered-headed one.Results:Experimentally,stab resistance against polyethylene film was significantly increased using the novel spherical-headed dilator compared to the traditional tapered-headed dilators(p<0.005).In the clinical study,the novel dilators were successfully introduced into the renal pelvis and passed down the collecting system in all eight second-stage PCNL cases.There were no cases of renal pelvic perforation or brisk hemorrhage nor need for transfusion.展开更多
Objective:To determine the effect of different cervical dilators on cervical dilation and reproductive performance of fat-tailed ewes.Methods: In experiment 1140 ewes were divided into seven groups with seven differen...Objective:To determine the effect of different cervical dilators on cervical dilation and reproductive performance of fat-tailed ewes.Methods: In experiment 1140 ewes were divided into seven groups with seven different treatments as following: 10 mL normal saline (control group), 100 IU oxytocin (OT group), 100 μg estradiol and 100 IU oxytocin (E2+OT group), 5 mL relaxin (R group), 2 mL sensiblex (SEN group), 200 μg misoprostol (MIS group) or 200 μg dinoprostone (DIN group). In experiment 2, artificial insemination was applied for evaluation of reproductive performance in experimental groups.Results: In experiment 1, the highest cervical dilation was observed in OT (90%) and E2+OT (100%) groups (P<0.05), while no significant differences was found among DIN, MIS, SEN and R groups (80%, 75%, 70% and 65%, respectively). In addition, the lowest cervical dilation was observed in control group. Experiment 2 found no significant differences among control, OT and E2+OT groups. The highest pregnancy rate, parturition rate and lambing rate were observed in OT groups (60%, 60% and 70%, respectively) and E2+OT groups (65%, 60% and 70%, respectively) compared to SEN, R, MIS and DIN groups (P<0.05).Conclusions:Oxytocin treatment alone or with estradiol could be used as a suitable dilator for improving reproductive efficiency during artificial insemination in fat-tailed ewes.展开更多
Introduction: Percutaneous approach to the kidney is a very useful alternative in renal surgery which minimizes the morbidity of a variety of procedures. Objectives: To evaluate the efficacy, practicity of a reusable ...Introduction: Percutaneous approach to the kidney is a very useful alternative in renal surgery which minimizes the morbidity of a variety of procedures. Objectives: To evaluate the efficacy, practicity of a reusable system of metallic coaxial dilator coupled to a special puncture needle to perform lumbar puncture and dilation of the percutaneous tract. Methods: A randomized experimental study was carried out involving 50 individuals. These patients were randomized as follows: Group 1 had the procedure performed with the conventional disposable Amplatz set traditionally used for this procedure. Patients in Group 2 were operated utilizing the new reusable coaxial set specially designed for this purpose. The following parameters were measured to compare the 2 groups: sex Corporeal Mass Index (CMI), Pre and postoperative hematocrit and hemoglobin. Time interval between the puncture, dilation and access to the renal pelvis and insertion of the nephroscope were also analyzed. Results: There was no statistical difference between the 2 groups concerning hematocrit and hemoglobin changes when comparing prewith postoperative period. Patients in Group 2 required a significant lower time between puncture and final access to the upper collecting system. Conclusion: The new coaxial dilator set showed to be as safe as the conventional Amplatz set with the advantage of reusability and decrease of tract dilation time.展开更多
AIM:To compare the mydriatic efficacy of an ophthalmic insert(Mydriasert,MY)versus phenylephrine and tropicamide(PT)eye drops.METHODS:Two controlled,prospective,randomized,single-blind studies were performed.In the fi...AIM:To compare the mydriatic efficacy of an ophthalmic insert(Mydriasert,MY)versus phenylephrine and tropicamide(PT)eye drops.METHODS:Two controlled,prospective,randomized,single-blind studies were performed.In the first study,a total of 80 eyes from 40 outpatient-clinic patients were analyzed.PT drops were applied to the right eye,and a MY device was inserted in the left eye for 30min.Time until maximal pupil dilation for each eye was then assessed.In the second study,80 eyes from 80 patients undergoing cataract surgery were analyzed.Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery(40 patients),or a MY device was inserted one hour prior to surgery(40 patients).RESULTS:In the first study,MY achieved superior mydriasis compared to PT eye drops at 90min(9.04±1.33mm vs 8.78±1.37mm,P=0.012).However MY took longer than PT drops to achieve maximal dilation,and mydriasis was inferior in eyes with MY compared to PT drops at 30min(7.21±1.73mm vs 8.22±1.43mm,P【0.001),the two groups only becoming similar by 60min(8.85±1.44mm vs 8.71±1.27mm,P=0.236).In the second study,both MY and PT achieved similar levels of mydriasis at the beginning of surgery(8.75±0.76mm with MY vs 8.77±0.63mm with PT),and also at the end of surgery(7.96±1.06mm with MY vs 8.32±0.72mm with PT),with no significant difference between groups(P=0.08).MY was well tolerated and cardiovascular effects were not influenced by dilation method.CONLUSION:MY could be a safe and efficacious alternative for mydriasis.The mydriatic effect of MY is as good as conventional PT eye drops after 60min,and is superior after 90min.MY also maintains good pupil dilation during cataract surgery.展开更多
Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This st...Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.展开更多
The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future car...The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.展开更多
A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly und...A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.展开更多
BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and ...BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.展开更多
Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts f...Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].展开更多
The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacen...The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.展开更多
AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study wa...AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.展开更多
This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang defic...This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.展开更多
Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mi...Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mitigation. Key controls on seismicity are defined in terms of fault and fracture strength, second-order frictional response and stability, and competing fluid-driven mechanisms for arrest. We desire to constrain maximum event magnitudes in triggered earthquakes by relating pre-existing critical stresses to fluid injection volume to explain why some recorded events are significantly larger than anticipated seismic moment thresholds. This formalism is consistent with several uncharacteristically large fluid injection-triggered earthquakes. Such methods of reactivating fractures and faults by hydraulic stimulation in shear or tensile fracturing are routinely used to create permeability in the subsurface. Microearthquakes (MEQs) generated by such stimulations can be used to diagnose permeability evolution. Although high-fidelity data sets are scarce, the EGS-Collab and Utah FORGE hydraulic stimulation field demonstration projects provide high-fidelity data sets that concurrently track permeability evolution and triggered seismicity. Machine learning deciphers the principal features of MEQs and the resulting permeability evolution that best track permeability changes – with transfer learning methods allowing robust predictions across multiple eological settings. Changes in permeability at reactivated fractures in both shear and extensional modes suggest that permeability change (Δk) scales with the seismic moment (M) of individual MEQs as Δk∝M. This scaling relation is exact at early times but degrades with successive MEQs, but provides a method for characterizing crustal permeability evolution using MEQs, alone. Importantly, we quantify for the first time the role of prestress in defining the elevated magnitude and seismic moment of fluid injection-triggered events, and demonstrate that such MEQs can also be used as diagnostic in quantifying permeability evolution in the crust.展开更多
A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled usin...A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled using a vapour equilibrium technique,with four suction levels ranging from 3.29 MPa to 198.14 MPa,where water retention is dominated by adsorption.The experimental results show that the tested soil exhibits a brittle failure mode under high suction,significantly distinguishing the hydro-mechanical behaviour of the soil at high suction from that observed at low suction.This brittle failure mode significantly increases the contribution of suction to peak strength compared to residual strength,causes the soil to fail before reaching the critical state,a phenomenon not observed in soils under high suction,and results in dilatancy caused by damage to the soil particle aggregates rather than particle rearrangement.The dilatancy data obtained from the triaxial tests reveal that significant soil dilatancy occurs during shear after reaching peak strength,with the maximum dilatancy angle increasing with suction and decreasing with confining pressure.However,the initial dry density has a negligible impact on the soil's dilatancy under high suction levels.This observation further supports that,for unsaturated soils under high suction levels,dilatancy is attributed to damage to soil particle aggregates rather than the rearrangement of soil particles.展开更多
We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function ...We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function converge to the same function in norm;in particular,we seek conditions on the weights to ensure that the analytic polynomials are dense in the space.展开更多
The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitate...The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitates the optimization of the combustion process and enhances combustion efficiency.Among existing deep convolutional models,InceptionNeXt is a deep learning architecture that integrates the ideas of the Inception series and ConvNeXt.It has garnered significant attention for its computational efficiency,remarkable model accuracy,and exceptional feature extraction capabilities.However,since this model still has limitations in the combustion state recognition task,we propose a Triple-Scale Multi-Stage InceptionNeXt(TSMS-InceptionNeXt)combustion state recognitionmethod based on feature extraction optimization.First,to address the InceptionNeXt model’s limited ability to capture dynamic features in flame images,we introduce Triplet Attention,which applies attention to the width,height,and Red Green Blue(RGB)dimensions of the flame images to enhance its ability to model dynamic features.Secondly,to address the issue of key information loss in the Inception deep convolution layers,we propose a Similarity-based Feature Concentration(SimC)mechanism to enhance the model’s capability to concentrate on critical features.Next,to address the insufficient receptive field of the model,we propose a Multi-Scale Dilated Channel Parallel Integration(MDCPI)mechanism to enhance the model’s ability to extract multi-scale contextual information.Finally,to address the issue of the model’s Multi-Layer Perceptron Head(MlpHead)neglecting channel interactions,we propose a Channel Shuffle-Guided Channel-Spatial Attention(ShuffleCS)mechanism,which integrates information from different channels to further enhance the representational power of the input features.To validate the effectiveness of the method,experiments are conducted on the counterflow burner flame visible light image dataset.The experimental results show that the TSMS-InceptionNeXt model achieved an accuracy of 85.71%on the dataset,improving by 2.38%over the baseline model and outperforming the baseline model’s performance.It achieved accuracy improvements of 10.47%,4.76%,11.19%,and 9.28%compared to the Reparameterized Visual Geometry Group(RepVGG),Squeeze-erunhanced Axial Transoformer(SeaFormer),Simplified Graph Transformers(SGFormer),and VanillaNet models,respectively,effectively enhancing the recognition performance for combustion states in counterflow burners.展开更多
In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering envi...In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering environments,so that most existing compressed sensing(CS)based techniques can harvest a very limited gain(if any)in reducing the channel estimation overhead.To address the problem,we propose the learning-based turbo message passing(LTMP)algorithm.Instead of exploiting the channel sparsity,LTMP is able to efficiently extract the channel feature via deep learning as well as to exploit the channel continuity in the frequency domain via block-wise linear modelling.More specifically,as a component of LTMP,we develop a multi-scale parallel dilated convolutional neural network(MPDCNN),which leverages frequency-space channel correlation in different scales for channel denoising.We evaluate the LTMP’s performance in MIMO-OFDM channels using the 3rd generation partnership project(3GPP)clustered delay line(CDL)channel models.Simulation results show that the proposed channel estimation method has more than 5 dB power gain than the existing algorithms when the normalized mean-square error of the channel estimation is-20 dB.The proposed algorithm also exhibits strong robustness in various environments.展开更多
文摘BACKGROUND Pancreatic fluid leakage is a rare complication of pancreatic cancer and often requires drainage when conservative therapy fails.Endoscopic,percutaneous,and surgical drainage are options.Minimally invasive endoscopic procedures are generally considered the first-line treatment,with either a transpapillary approach or an endoscopic ultrasound-guided transmural approach selected depending on the case.Various dilators are used to dilate tracts to the leakage site.However,reports of dilation through a rigid trans-tumoral tract using a drill dilator remain extremely rare.CASE SUMMARY A 74-year-old woman with pancreatic body and tail cancer developed fever and left-sided chest pain after multiple courses of chemotherapy.Computed tomography revealed fluid accumulation around the pancreatic tail and spleen along with a left pleural effusion.The effusion was diagnosed as reactive secondary to pancreatic fluid leakage.Endoscopic retrograde cholangiopancreatography identified irregular stenosis of the main pancreatic duct in the pancreatic body.Distal to the stenosis,the main ductal structure was nearly obliterated by the tumor.The contrast medium had leaked into the pancreatic fluid leakage area through several fine,disrupted ductal structures.The guidewire was successfully advanced through an extremely fine tract that was not the main contrast-filling route.Standard dilators failed to expand the rigid trans-tumoral tract.A second endoscopic retrograde cholangiopancreatography using a drill dilator successfully expanded the trans-tumoral tract,enabling endoscopic nasopancreatic drainage tube placement.Subsequently,the pancreatic fluid leakage and pleural effusion resolved.CONCLUSION Even in rigid trans-tumoral tracts,the use of a drill dilator can facilitate successful tract expansion,enabling effective drainage.
文摘To evaluate the efficacy of a newly developed dilator for endoscopic ultrasound (EUS)-guided drainage (ES Dilator). METHODSFourteen consecutive patients who had undergone EUS-guided choledochoduodenostomy (EUS-CDS) with the ES Dilator were identified from a prospectively maintained database and enrolled in the study group. Fourteen other patients who had undergone EUS-CDS without the dilator just prior to its introduction were analyzed as the control group. A historical cohort study was carried out comparing the two groups. The main outcome measurement was the procedure time. The technical success rate and early AE rate were also compared between the two groups. RESULTSThere were no significant differences in age, sex and etiology of biliary obstruction. The utilization rate of a plastic stent was higher in the control group (36% vs 0%). The technical success rate was 100% in both groups. The mean procedure time was significantly shorter in the study group than in the control group (27 ± 7 min vs 44 ± 26 min, P = 0.026). Additionally, there were no patients who required more than 40 min for the procedure in the study group. Early adverse events occurred in 29% (4/14) of the control group whereas none in the study group. The adverse events in all 4 patients was bile peritonitis, including pan-peritonitis in one patient. All patients recovered with conservative treatment by medication. CONCLUSIONThe newly developed dilator was found to be useful for shortening procedure time and would prevent adverse events related to bile leakage in EUS-CDS.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>
基金This study was funded by grants from Shanghai Sailing Program(19YF1427200)National Natural Science Foundation of China(81902556)+2 种基金Shanghai Municipal Commission of Health and Family Planning Program(20184Y0151)Shanghai Association of Chinese Integrative Medicine Program(ZHYY-ZXYJHZX-1-03)Shanghai Ninth People’s Hospital Chuangke Projects(CK2018009).
文摘Objective:In second-stage percutaneous nephrolithotomy(PCNL),because the hydronephrosis has been decompressed,the dilated renal pelvis has resolved and the space is small.Consequently,introduction of the tip of the Amplatz dilator can cause injury to the opposite side of the renal-pelvic mucosa.In this study,we report the experimental and initial clinical performance of a spherical-headed fascial dilator developed specifically for second-stage PCNL.Methods:The novel spherical-headed dilator was compared with existing tapered-headed dilators in configuration and in puncture resistance utilizing a static puncture test.Subsequently,a pilot clinical study was conducted during which patients scheduled to undergo second-stage PCNL from June 2019 to October 2019 in our center were enrolled.A typical ultrasound guided PCNL procedure was performed with the exception that the new spherical-headed fascial dilator was substituted for a tapered-headed one.Results:Experimentally,stab resistance against polyethylene film was significantly increased using the novel spherical-headed dilator compared to the traditional tapered-headed dilators(p<0.005).In the clinical study,the novel dilators were successfully introduced into the renal pelvis and passed down the collecting system in all eight second-stage PCNL cases.There were no cases of renal pelvic perforation or brisk hemorrhage nor need for transfusion.
文摘Objective:To determine the effect of different cervical dilators on cervical dilation and reproductive performance of fat-tailed ewes.Methods: In experiment 1140 ewes were divided into seven groups with seven different treatments as following: 10 mL normal saline (control group), 100 IU oxytocin (OT group), 100 μg estradiol and 100 IU oxytocin (E2+OT group), 5 mL relaxin (R group), 2 mL sensiblex (SEN group), 200 μg misoprostol (MIS group) or 200 μg dinoprostone (DIN group). In experiment 2, artificial insemination was applied for evaluation of reproductive performance in experimental groups.Results: In experiment 1, the highest cervical dilation was observed in OT (90%) and E2+OT (100%) groups (P<0.05), while no significant differences was found among DIN, MIS, SEN and R groups (80%, 75%, 70% and 65%, respectively). In addition, the lowest cervical dilation was observed in control group. Experiment 2 found no significant differences among control, OT and E2+OT groups. The highest pregnancy rate, parturition rate and lambing rate were observed in OT groups (60%, 60% and 70%, respectively) and E2+OT groups (65%, 60% and 70%, respectively) compared to SEN, R, MIS and DIN groups (P<0.05).Conclusions:Oxytocin treatment alone or with estradiol could be used as a suitable dilator for improving reproductive efficiency during artificial insemination in fat-tailed ewes.
文摘Introduction: Percutaneous approach to the kidney is a very useful alternative in renal surgery which minimizes the morbidity of a variety of procedures. Objectives: To evaluate the efficacy, practicity of a reusable system of metallic coaxial dilator coupled to a special puncture needle to perform lumbar puncture and dilation of the percutaneous tract. Methods: A randomized experimental study was carried out involving 50 individuals. These patients were randomized as follows: Group 1 had the procedure performed with the conventional disposable Amplatz set traditionally used for this procedure. Patients in Group 2 were operated utilizing the new reusable coaxial set specially designed for this purpose. The following parameters were measured to compare the 2 groups: sex Corporeal Mass Index (CMI), Pre and postoperative hematocrit and hemoglobin. Time interval between the puncture, dilation and access to the renal pelvis and insertion of the nephroscope were also analyzed. Results: There was no statistical difference between the 2 groups concerning hematocrit and hemoglobin changes when comparing prewith postoperative period. Patients in Group 2 required a significant lower time between puncture and final access to the upper collecting system. Conclusion: The new coaxial dilator set showed to be as safe as the conventional Amplatz set with the advantage of reusability and decrease of tract dilation time.
文摘AIM:To compare the mydriatic efficacy of an ophthalmic insert(Mydriasert,MY)versus phenylephrine and tropicamide(PT)eye drops.METHODS:Two controlled,prospective,randomized,single-blind studies were performed.In the first study,a total of 80 eyes from 40 outpatient-clinic patients were analyzed.PT drops were applied to the right eye,and a MY device was inserted in the left eye for 30min.Time until maximal pupil dilation for each eye was then assessed.In the second study,80 eyes from 80 patients undergoing cataract surgery were analyzed.Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery(40 patients),or a MY device was inserted one hour prior to surgery(40 patients).RESULTS:In the first study,MY achieved superior mydriasis compared to PT eye drops at 90min(9.04±1.33mm vs 8.78±1.37mm,P=0.012).However MY took longer than PT drops to achieve maximal dilation,and mydriasis was inferior in eyes with MY compared to PT drops at 30min(7.21±1.73mm vs 8.22±1.43mm,P【0.001),the two groups only becoming similar by 60min(8.85±1.44mm vs 8.71±1.27mm,P=0.236).In the second study,both MY and PT achieved similar levels of mydriasis at the beginning of surgery(8.75±0.76mm with MY vs 8.77±0.63mm with PT),and also at the end of surgery(7.96±1.06mm with MY vs 8.32±0.72mm with PT),with no significant difference between groups(P=0.08).MY was well tolerated and cardiovascular effects were not influenced by dilation method.CONLUSION:MY could be a safe and efficacious alternative for mydriasis.The mydriatic effect of MY is as good as conventional PT eye drops after 60min,and is superior after 90min.MY also maintains good pupil dilation during cataract surgery.
基金Supported by Sichuan Science and Technology Program(2023YFSY0026,2023YFH0004)Supported by the Institute of Information&Communications Technology Planning&Evaluation(IITP)grant funded by the Korean government(MSIT)(No.RS-2022-00155885,Artificial Intelligence Convergence Innovation Human Resources Development(Hanyang University ERICA)).
文摘Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.
文摘The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.
基金supported by grants from National Natural Science Foundation of China(No.82370392)Shenzhen Medical Research Fund(No.B2302026)+4 种基金Science,Technology and Innovation Commission of Shenzhen Municipality(No.RCJC20210706091947009)National Key R&D Program of China(No.2022YFA1104500)CAMS Innovation Fund for Medical Sciences(No.2023-I2M-1-003 and 2022-I2M-2-001)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320026)National High Level Hospital Clinical Research Funding(No.2022-GSP-GG-7)。
文摘A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.
文摘BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.
文摘Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].
基金supported by Universitas Gadjah Mada through the 2022 Indonesian Collaborative Research Program.
文摘The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.
基金Supported by the National Natural Science Foundation of China(No.82371093,No.72342015)R&D Program of Beijing Municipal Education Commission(No.KZ202110025039).
文摘AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.
文摘This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.
基金Derek Elsworth acknowledges the support from a Gledden Visiting Fellowship from the Institute of Advanced Studies at the University of Western Australia,Australia,and the G.Albert Shoemaker Endowment at Pennsylvania State University,USA.
文摘Triggered seismicity is a key hazard where fluids are injected or withdrawn from the subsurface and may impact permeability. Understanding the mechanisms that control fluid injection-triggered seismicity allows its mitigation. Key controls on seismicity are defined in terms of fault and fracture strength, second-order frictional response and stability, and competing fluid-driven mechanisms for arrest. We desire to constrain maximum event magnitudes in triggered earthquakes by relating pre-existing critical stresses to fluid injection volume to explain why some recorded events are significantly larger than anticipated seismic moment thresholds. This formalism is consistent with several uncharacteristically large fluid injection-triggered earthquakes. Such methods of reactivating fractures and faults by hydraulic stimulation in shear or tensile fracturing are routinely used to create permeability in the subsurface. Microearthquakes (MEQs) generated by such stimulations can be used to diagnose permeability evolution. Although high-fidelity data sets are scarce, the EGS-Collab and Utah FORGE hydraulic stimulation field demonstration projects provide high-fidelity data sets that concurrently track permeability evolution and triggered seismicity. Machine learning deciphers the principal features of MEQs and the resulting permeability evolution that best track permeability changes – with transfer learning methods allowing robust predictions across multiple eological settings. Changes in permeability at reactivated fractures in both shear and extensional modes suggest that permeability change (Δk) scales with the seismic moment (M) of individual MEQs as Δk∝M. This scaling relation is exact at early times but degrades with successive MEQs, but provides a method for characterizing crustal permeability evolution using MEQs, alone. Importantly, we quantify for the first time the role of prestress in defining the elevated magnitude and seismic moment of fluid injection-triggered events, and demonstrate that such MEQs can also be used as diagnostic in quantifying permeability evolution in the crust.
基金support from the China Scholarship Council(CSC)-University of Technology Sydney joint scholarship and the National Key R&D Program of China(Grant No.2016YFC0800200)is gratefully acknowledged.
文摘A series of suction-controlled triaxial tests was conducted on Nanyang expansive clay to investigate the effects of dry density and suction on dilatancy and strength.The suction of the soil samples was controlled using a vapour equilibrium technique,with four suction levels ranging from 3.29 MPa to 198.14 MPa,where water retention is dominated by adsorption.The experimental results show that the tested soil exhibits a brittle failure mode under high suction,significantly distinguishing the hydro-mechanical behaviour of the soil at high suction from that observed at low suction.This brittle failure mode significantly increases the contribution of suction to peak strength compared to residual strength,causes the soil to fail before reaching the critical state,a phenomenon not observed in soils under high suction,and results in dilatancy caused by damage to the soil particle aggregates rather than particle rearrangement.The dilatancy data obtained from the triaxial tests reveal that significant soil dilatancy occurs during shear after reaching peak strength,with the maximum dilatancy angle increasing with suction and decreasing with confining pressure.However,the initial dry density has a negligible impact on the soil's dilatancy under high suction levels.This observation further supports that,for unsaturated soils under high suction levels,dilatancy is attributed to damage to soil particle aggregates rather than the rearrangement of soil particles.
文摘We study certain weighted Bergman and weighted Besov spaces of holomorphic functions in the polydisk and in the unit ball.We seek conditions on the weight functions to guarantee that the dilations of a given function converge to the same function in norm;in particular,we seek conditions on the weights to ensure that the analytic polynomials are dense in the space.
文摘The counterflow burner is a combustion device used for research on combustion.By utilizing deep convolutional models to identify the combustion state of a counter flow burner through visible flame images,it facilitates the optimization of the combustion process and enhances combustion efficiency.Among existing deep convolutional models,InceptionNeXt is a deep learning architecture that integrates the ideas of the Inception series and ConvNeXt.It has garnered significant attention for its computational efficiency,remarkable model accuracy,and exceptional feature extraction capabilities.However,since this model still has limitations in the combustion state recognition task,we propose a Triple-Scale Multi-Stage InceptionNeXt(TSMS-InceptionNeXt)combustion state recognitionmethod based on feature extraction optimization.First,to address the InceptionNeXt model’s limited ability to capture dynamic features in flame images,we introduce Triplet Attention,which applies attention to the width,height,and Red Green Blue(RGB)dimensions of the flame images to enhance its ability to model dynamic features.Secondly,to address the issue of key information loss in the Inception deep convolution layers,we propose a Similarity-based Feature Concentration(SimC)mechanism to enhance the model’s capability to concentrate on critical features.Next,to address the insufficient receptive field of the model,we propose a Multi-Scale Dilated Channel Parallel Integration(MDCPI)mechanism to enhance the model’s ability to extract multi-scale contextual information.Finally,to address the issue of the model’s Multi-Layer Perceptron Head(MlpHead)neglecting channel interactions,we propose a Channel Shuffle-Guided Channel-Spatial Attention(ShuffleCS)mechanism,which integrates information from different channels to further enhance the representational power of the input features.To validate the effectiveness of the method,experiments are conducted on the counterflow burner flame visible light image dataset.The experimental results show that the TSMS-InceptionNeXt model achieved an accuracy of 85.71%on the dataset,improving by 2.38%over the baseline model and outperforming the baseline model’s performance.It achieved accuracy improvements of 10.47%,4.76%,11.19%,and 9.28%compared to the Reparameterized Visual Geometry Group(RepVGG),Squeeze-erunhanced Axial Transoformer(SeaFormer),Simplified Graph Transformers(SGFormer),and VanillaNet models,respectively,effectively enhancing the recognition performance for combustion states in counterflow burners.
基金supported in part by the National Key Research and Development Program of China under Grant 2020YFB1804800.
文摘In this paper,we focus on the channel estimation for multi-user MIMO-OFDM systems in rich scattering environments.We find that channel sparsity in the delay-angle domain is severely compromised in rich scattering environments,so that most existing compressed sensing(CS)based techniques can harvest a very limited gain(if any)in reducing the channel estimation overhead.To address the problem,we propose the learning-based turbo message passing(LTMP)algorithm.Instead of exploiting the channel sparsity,LTMP is able to efficiently extract the channel feature via deep learning as well as to exploit the channel continuity in the frequency domain via block-wise linear modelling.More specifically,as a component of LTMP,we develop a multi-scale parallel dilated convolutional neural network(MPDCNN),which leverages frequency-space channel correlation in different scales for channel denoising.We evaluate the LTMP’s performance in MIMO-OFDM channels using the 3rd generation partnership project(3GPP)clustered delay line(CDL)channel models.Simulation results show that the proposed channel estimation method has more than 5 dB power gain than the existing algorithms when the normalized mean-square error of the channel estimation is-20 dB.The proposed algorithm also exhibits strong robustness in various environments.
