Bolting steel angles at the bottom ends of columns provides a rapid and efficient method for repairing damaged structures,while also offering a viable approach to restore their potential bearing capacity.To validate t...Bolting steel angles at the bottom ends of columns provides a rapid and efficient method for repairing damaged structures,while also offering a viable approach to restore their potential bearing capacity.To validate the suitability of specific strengthening strategies,particularly the utilization of bolted steel angles,three reinforced concrete frame specimens were subjected to hysteresis testing.These specimens all featured RC columns strengthened with steel angle ends.Additionally,one control specimen without steel angle ends was included in the testing.The hysteresis effects of bolting steel angles were discussed in terms of typical failure mode,hysteresis and skeleton curves,stiffness degradation and energy dissipation.The experimental results revealed that the three specimens that had bolted steel angles exhibited ductile failure behavior.Through analysis of hysteresis and skeleton curves,it was observed that the frame demonstrated distinct plasticity,maintaining sufficient load-bearing capacity even after yielding and exhibiting superior displacement ductility performance.Considering equivalent viscous damping,the energy dissipation capacity of the RC frame increased linearly with drift and remained largely unaffected by structural damage.Therefore,bolting steel angles at specified cross-sections proved to be a viable technique for structural repair and restoration.展开更多
The operation condition of the cold-end system of a steam turbine has a direct impact on the economy and security of the unit as it is an indispensible auxiliary system of the thermal power unit. Many factors influenc...The operation condition of the cold-end system of a steam turbine has a direct impact on the economy and security of the unit as it is an indispensible auxiliary system of the thermal power unit. Many factors influence the cold- end operation of a steam turbine; therefore, the operation mode needs to be optimized. The optimization analysis of a 1000 MW ultra-supercritical （USC） unit, the turbine cold- end system, was performed utilizing the back propagation （BP） neural network method with genetic algorithm （GA） optimization analysis. The optimized condenser pressure under different conditions was obtained, and it turned out that the optimized parameters were of significance to the performance and economic operation of the system.展开更多
The obstacle for idea generation in fuzzy front end （FFE） is difficult to apply knowledge in different fields for designers. Theory of inventive problem solving TRIZ and computer-aided innovation systems （CAIs） wh...The obstacle for idea generation in fuzzy front end （FFE） is difficult to apply knowledge in different fields for designers. Theory of inventive problem solving TRIZ and computer-aided innovation systems （CAIs） which are TRIZ-base software systems with a knowledge base provide a framework for knowledge application in different fields. The major methods in TRIZ are selected, which have four types. The problems to be solved for each method are summarized and mapping from the problems to the methods is given. Systematic method with eight paths to integrate the methods and problems is formed. A case study shows the idea generation in FFE using the integrated method step by step.展开更多
Nonhomologous DNA end joining （NHEJ） is the primary pathway for repair of double-strand DNA breaks in human cells and in multicellular eukaryotes. The causes of double-strand breaks often fragment the DNA at the sit...Nonhomologous DNA end joining （NHEJ） is the primary pathway for repair of double-strand DNA breaks in human cells and in multicellular eukaryotes. The causes of double-strand breaks often fragment the DNA at the site of damage, resulting in the loss of information there. NHEJ does not restore the lost information and may resect additional nucleotides during the repair process. The ability to repair a wide range of overhang and damage configurations reflects the flexibility of the nuclease, polymerases, and ligase of NHEJ. The flexibility of the individual components also explains the large number of ways in which NHEJ can repair any given pair of DNA ends. The loss of information locally at sites of NHEJ repair may contribute to cancer and aging, but the action by NHEJ ensures that entire segments of chromosomes are not lost.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at t...BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease,a group of patients known to be particularly susceptible to infectious complications.AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODS We searched PubMed/MEDLINE,EMBASE,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Web of Science databases for relevant terms and imported the results into the Covidence platform.From there,studies were assessed in two stages for relevance and quality,and data from studies that satisfied all the requirements were extracted into a spreadsheet.The data was then analyzed descriptively and statistically.RESULTS Of the 920 studies identified through the initial database search,only 17 were included in the final analysis.The studies included in the analysis were mostly carried out during the first wave.We found that COVID-19 incidence among patients on hemodialysis was significant,over 10%in some studies.Those who developed COVID-19 infection were most likely going to be hospitalized,and over 1 in 5 died from the infection.Intensive care unit admission rate was lower than the infection lethality rate.Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections,and a significant proportion was infected during the first wave.Their prognosis is overall much worse than in the general population,and every effort needs to be made to decrease their exposure.展开更多
BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliativ...BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliative care(PC)is pronounced in patients grappling with ESLD and acute on chronic liver failure(ACLF).Unfortunately,the historical underutilization of PC in ESLD patients,despite their substantial needs and those of their family caregivers,underscores the imperative of seamlessly integrating PC principles into routine healthcare practices across the entire disease spectrum.AIM To comprehensively investigate the evidence surrounding the benefits of incorporating PC into the comprehensive care plan for individuals confronting ESLD and/or ACLF.METHODS A systematic search in the Medline(PubMed)database was performed using a predetermined search command,encompassing studies published in English without any restrictions on the publication date.Subsequently,the retrieved studies were manually examined.Simple descriptive analyses were employed to summarize the results.RESULTS The search strategies yielded 721 references.Following the final analysis,32 fulllength references met the inclusion criteria and were consequently incorporated into the study.Meticulous data extraction from these 32 studies was undertaken,leading to the execution of a comprehensive narrative systematic review.The review found that PC provides significant benefits,reducing symptom burden,depressive symptoms,readmission rates,and hospital stays.Yet,barriers like the appeal of transplants and misconceptions about PC hinder optimal utilization.Integrating PC early,upon the diagnosis of ESLD and ACLF,regardless of transplant eligibility and availability,improves the quality of life for these patients.CONCLUSION Despite the substantial suffering and poor prognosis associated with ESLD and ACLF,where liver transplantation stands as the only curative treatment,albeit largely inaccessible,PC services have been overtly provided too late in the course of the illness.A comprehensive understanding of PC's pivotal role in treating ESLD and ACLF is crucial for overcoming these barriers,involving healthcare providers,patients,and caregivers.展开更多
Non-enzymatic glycation reaction in food can produce diet-derived advanced glycation end products(dAGEs),which have potential health risks.Thus,it is of great significance to find efficient substances to improve the n...Non-enzymatic glycation reaction in food can produce diet-derived advanced glycation end products(dAGEs),which have potential health risks.Thus,it is of great significance to find efficient substances to improve the negative effects induced by dAGEs on human health.This study investigated the intervening effects of peanut skin procyanidins(PSP)on the dAGEs-induced oxidative stress and systemic inflammation in experimental mice model.Results showed that the accumulation of AGEs in serum,liver,and kidney was significantly increased after mice were fed dAGEs(P<0.05).The expression of advanced glycation product receptor(RAGE)was also significantly increased in liver and kidney(P<0.05).PSP could not only effectively reduce the accumulation of AGEs in serum,liver and kidney of mice,but also reduce the expression of RAGE in liver and kidney of mice.And the levels of pro-inflammatory cytokines interleukin-6(IL-6),tumor necrosis factor(TNF-α),and IL-1βin serum of mice were significantly decreased(P<0.05),while the levels of antiinflammatory factor IL-10 were increased,and the inflammatory injury in mice was improved.In addition,the levels of superoxide dismutase(SOD),glutathione(GSH),catalase(CAT)in liver and kidney of mice were increased(P<0.05),and the level of malondialdehyde(MDA)was decreased(P<0.05),which enhanced the antioxidant capacity of mice in vivo,and improved the oxidative damage of liver and kidney.Molecular docking technique was used to confirm that the parent compound of procyanidins and its main metabolites,such as 3-hydroxyphenylacetic acid,could interact with RAGE,which might inhibit the activation of nuclear transcription factor(NF-κB),and ultimately reduce oxidative stress and inflammation in mice.展开更多
Uncontrolled hypertension is a significant problem in children with end stage kidney disease. We studied 10 children on chronic hemodialysis who received the endothelin-1 receptor antagonist, bosentan as adjunctive th...Uncontrolled hypertension is a significant problem in children with end stage kidney disease. We studied 10 children on chronic hemodialysis who received the endothelin-1 receptor antagonist, bosentan as adjunctive therapy in refractory systemic hypertension. Data were retrospectively analyzed on systolic (SBP) and diastolic blood pressure (DBP), antihypertensive medications and hospitalization days per patient per year, at baseline and 3 months after initiation of bosentan. The standard deviation (Z) score of BP for age, height and gender was calculated. Mean age and weight of these children were 11.4 ± 4.8 years (range 1 - 17.5 years) and 32.9 ± 14.4 kg (range 7.4 - 57 kg) respectively and 90% were African American. Seven were on hemodialysis ≥4 times weekly. The average inter-dialytic weight gain was 4.7% ± 1.8%. The pre-dialysis SBP and DBP Z scores were 4.9 ± 1.8 and 4.0 ± 1.0 at baseline and decreased to 1.3 ± 0.4 and 1.3 ± 0.8, 3 months after initiation of bosentan (p < 0.0001). Similarly, anti-hypertensive medications were decreased from 5 ± 1.5 to 2.1 ± 2.6 (p < 0.01). Hospitalization days decreased from 35.6 ± 52.4 days to 1.5 ± 3.3 days (p < 0.0001). This preliminary report indicates bosentan may be beneficial in the management of children with severe refractory hypertension.展开更多
AIM： To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS： A literature search was undertaken...AIM： To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS： A literature search was undertaken on PubMed database to identify studies meeting estab-lished criteria, with the aim of selecting randomized clinical trials and study definition and performance of their end points. The end points were grouped into three categories： overall survival （OS）, time-to-event end points, and response end points. A special analysis was performed for secondary end points of the studies which documented a beneft in OS in the experimental arm. Finally, publishes analyses for surrogacy of the in-cluded end points were also reported. RESULTS： OS, time-to-event and response end points in 31 selected trials were analyzed. OS was the pri-mary end point in 14 trials, and the secondary end point in 17. A time-to-event end point was the primaryend point in 8 studies, and the secondary end point in 22; the most reported time-to-event end points were composite end points, and the events changed among trials. A response end point was the primary end point in 9 studies, in 3 it was prostate-specifc antigen （PSA）-related, in 3 pain-related and in 3 mixed. A response end point was the secondary end point in 19 studies： PSA response and radiologic response were the most frequently used secondary end points in 19 and 11 tri-als, respectively, while pain response was used in 5 studies.CONCLUSION： A homogeneous defnition of progres-sion in future trials is mandatory. Among response end points, pain-response and PSA-response appear to be the most reliable.展开更多
Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of t...Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review;examined patient involvement in end-of-life discussions;full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review;there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end-of-life decision making through;describing current practices;understanding perspectives of end of life discussions;investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end-of-life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in end-of-life decisions were recognized;lack of awareness;lack of education, training and experience;concerns about ethical and legal issues;and personal preferences of doctors or nurses were among the most commonly identified barriers.展开更多
The recent growth of the World Wide Web has sparked new research into using the Internet for novel types of group communication, like multiparty videoconferencing and real-time streaming. Multicast has the potential t...The recent growth of the World Wide Web has sparked new research into using the Internet for novel types of group communication, like multiparty videoconferencing and real-time streaming. Multicast has the potential to be very useful, but it suffers from many problems like security. To achieve secure multicast communications with the dynamic aspect of group applications due to free membership joins and leaves in addition to member's mobility, key management is one of the most critical problems. So far, a lot of multicast key management schemes have been proposed and most of them are centralized, which have the problem of 'one point failure' and that the group controller is the bottleneck of the group. In order to solve these two problems, we propose a Key Management Scheme, using cluster-based End-System Multicast (ESM). The group management is between both 1) the main controller (MRP, Main Rendezvous Point) and the second controllers (CRP, Cluster RP), and 2) the second controllers (CRPs) and its members. So, ESM simplifies the implementation of group communication and is efficient ways to deliver a secure message to a group of recipients in a network as a practical alternative to overcome the difficulty of large scale deployment of traditional IP multicast. In this paper, we analyze different key management schemes and propose a new scheme, namely Advanced Transition/Cluster Key management Scheme (ATCKS) and find it has appropriate performance in security.展开更多
The SRS TM Endoscopic Stapling System(Medigus,Tel Aviv,Israel) is a new tool capable of creating a totally endoscopic fundoplication,combined with an endoscope,endoscopic ultrasound and a surgical stapler.SRS TM endos...The SRS TM Endoscopic Stapling System(Medigus,Tel Aviv,Israel) is a new tool capable of creating a totally endoscopic fundoplication,combined with an endoscope,endoscopic ultrasound and a surgical stapler.SRS TM endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive,outpatient procedure,which requires general anesthesia with positive-pressure ventilation.Keeping the patient on positive endexpiratory pressure(PEEP) may minimize the pressure gradient between the esophagus and the mediastinum,as well as help to prevent air from leaking around the screws and causing pneumomediastinum.In addition,in patients with hiatal hernia,higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy.We advise smoother emergence from anesthesia,taking precautions for retching,postoperative nausea and vomiting(PONV),while coughing and gagging during extubation and PONV may affect the success of the procedure.Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.展开更多
OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-perf...OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.展开更多
To improve the accuracy of thermal response estimation and overcome the limitations of the linear regression model and Artificial Neural Network(ANN)model,this study introduces a deep learning estimation method specif...To improve the accuracy of thermal response estimation and overcome the limitations of the linear regression model and Artificial Neural Network(ANN)model,this study introduces a deep learning estimation method specifically based on the Long Short-Term Memory(LSTM)network,to predict temperature-induced girder end displacements of the Dasha Waterway Bridge,a suspension bridge in China.First,to enhance data quality and select target sensors,preprocessing based on the sigma rule and nearest neighbor interpolation is applied to the raw data.Furthermore,to eliminate the high-frequency components from the displacement signal,the wavelet transform is conducted.Subsequently,the linear regression model and ANN model are established,whose results do not meet the requirements and fail to address the time lag effect between temperature and displacements.The study proceeds to develop the LSTM network model and determine the optimal parameters through hyperparameter sensitivity analysis.Finally,the results of the LSTM network model are discussed by a comparative analysis against the linear regression model and ANN model,which indicates a higher accuracy in predicting temperatureinduced girder end displacements and the ability to mitigate the time-lag effect.To be more specific,in comparison between the linear regression model and LSTM network,the mean square error decreases from 6.5937 to 1.6808 and R^(2) increases from 0.683 to 0.930,which corresponds to a 74.51%decrease in MSE and a 36.14%improvement in R^(2).Compared to ANN,with an MSE of 4.6371 and an R^(2) of 0.807,LSTM shows a decrease in MSE of 63.75%and an increase in R^(2) of 13.23%,demonstrating a significant enhancement in predictive performance.展开更多
Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patient...Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].展开更多
On December 27,2011,Ran Chengqi,director of the China Satellite Navigation Office announced that,the BeiDou Navigation Satellite System (BeiDou system) had that day begun to provide initial operational service.
This paper considered the optimal control problem for distributed parameter systems with mixed phase-control constraints and end-point constraints. Pontryagin's maximum principle for optimal control are derived vi...This paper considered the optimal control problem for distributed parameter systems with mixed phase-control constraints and end-point constraints. Pontryagin's maximum principle for optimal control are derived via Duboviskij-Milujin theorem.展开更多
BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram ...BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.展开更多
基金National Key R&D Program of China under Grant No.2023YFC3805100Technologies R&D Project of China Construction First Group Corporation Limited under Grant No.PT-2022-09National Natural Science Foundation of China under Grant No.52178126。
文摘Bolting steel angles at the bottom ends of columns provides a rapid and efficient method for repairing damaged structures,while also offering a viable approach to restore their potential bearing capacity.To validate the suitability of specific strengthening strategies,particularly the utilization of bolted steel angles,three reinforced concrete frame specimens were subjected to hysteresis testing.These specimens all featured RC columns strengthened with steel angle ends.Additionally,one control specimen without steel angle ends was included in the testing.The hysteresis effects of bolting steel angles were discussed in terms of typical failure mode,hysteresis and skeleton curves,stiffness degradation and energy dissipation.The experimental results revealed that the three specimens that had bolted steel angles exhibited ductile failure behavior.Through analysis of hysteresis and skeleton curves,it was observed that the frame demonstrated distinct plasticity,maintaining sufficient load-bearing capacity even after yielding and exhibiting superior displacement ductility performance.Considering equivalent viscous damping,the energy dissipation capacity of the RC frame increased linearly with drift and remained largely unaffected by structural damage.Therefore,bolting steel angles at specified cross-sections proved to be a viable technique for structural repair and restoration.
文摘The operation condition of the cold-end system of a steam turbine has a direct impact on the economy and security of the unit as it is an indispensible auxiliary system of the thermal power unit. Many factors influence the cold- end operation of a steam turbine; therefore, the operation mode needs to be optimized. The optimization analysis of a 1000 MW ultra-supercritical （USC） unit, the turbine cold- end system, was performed utilizing the back propagation （BP） neural network method with genetic algorithm （GA） optimization analysis. The optimized condenser pressure under different conditions was obtained, and it turned out that the optimized parameters were of significance to the performance and economic operation of the system.
基金National Natural Science Foundation of China (No.50675059)National Hi-tech Research and Development Program of China (863 Program,No.2006AA04Z109)
文摘The obstacle for idea generation in fuzzy front end （FFE） is difficult to apply knowledge in different fields for designers. Theory of inventive problem solving TRIZ and computer-aided innovation systems （CAIs） which are TRIZ-base software systems with a knowledge base provide a framework for knowledge application in different fields. The major methods in TRIZ are selected, which have four types. The problems to be solved for each method are summarized and mapping from the problems to the methods is given. Systematic method with eight paths to integrate the methods and problems is formed. A case study shows the idea generation in FFE using the integrated method step by step.
文摘Nonhomologous DNA end joining （NHEJ） is the primary pathway for repair of double-strand DNA breaks in human cells and in multicellular eukaryotes. The causes of double-strand breaks often fragment the DNA at the site of damage, resulting in the loss of information there. NHEJ does not restore the lost information and may resect additional nucleotides during the repair process. The ability to repair a wide range of overhang and damage configurations reflects the flexibility of the nuclease, polymerases, and ligase of NHEJ. The flexibility of the individual components also explains the large number of ways in which NHEJ can repair any given pair of DNA ends. The loss of information locally at sites of NHEJ repair may contribute to cancer and aging, but the action by NHEJ ensures that entire segments of chromosomes are not lost.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease,a group of patients known to be particularly susceptible to infectious complications.AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODS We searched PubMed/MEDLINE,EMBASE,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Web of Science databases for relevant terms and imported the results into the Covidence platform.From there,studies were assessed in two stages for relevance and quality,and data from studies that satisfied all the requirements were extracted into a spreadsheet.The data was then analyzed descriptively and statistically.RESULTS Of the 920 studies identified through the initial database search,only 17 were included in the final analysis.The studies included in the analysis were mostly carried out during the first wave.We found that COVID-19 incidence among patients on hemodialysis was significant,over 10%in some studies.Those who developed COVID-19 infection were most likely going to be hospitalized,and over 1 in 5 died from the infection.Intensive care unit admission rate was lower than the infection lethality rate.Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections,and a significant proportion was infected during the first wave.Their prognosis is overall much worse than in the general population,and every effort needs to be made to decrease their exposure.
文摘BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliative care(PC)is pronounced in patients grappling with ESLD and acute on chronic liver failure(ACLF).Unfortunately,the historical underutilization of PC in ESLD patients,despite their substantial needs and those of their family caregivers,underscores the imperative of seamlessly integrating PC principles into routine healthcare practices across the entire disease spectrum.AIM To comprehensively investigate the evidence surrounding the benefits of incorporating PC into the comprehensive care plan for individuals confronting ESLD and/or ACLF.METHODS A systematic search in the Medline(PubMed)database was performed using a predetermined search command,encompassing studies published in English without any restrictions on the publication date.Subsequently,the retrieved studies were manually examined.Simple descriptive analyses were employed to summarize the results.RESULTS The search strategies yielded 721 references.Following the final analysis,32 fulllength references met the inclusion criteria and were consequently incorporated into the study.Meticulous data extraction from these 32 studies was undertaken,leading to the execution of a comprehensive narrative systematic review.The review found that PC provides significant benefits,reducing symptom burden,depressive symptoms,readmission rates,and hospital stays.Yet,barriers like the appeal of transplants and misconceptions about PC hinder optimal utilization.Integrating PC early,upon the diagnosis of ESLD and ACLF,regardless of transplant eligibility and availability,improves the quality of life for these patients.CONCLUSION Despite the substantial suffering and poor prognosis associated with ESLD and ACLF,where liver transplantation stands as the only curative treatment,albeit largely inaccessible,PC services have been overtly provided too late in the course of the illness.A comprehensive understanding of PC's pivotal role in treating ESLD and ACLF is crucial for overcoming these barriers,involving healthcare providers,patients,and caregivers.
基金supported by the Doctoral Science Foundation of Shanxi Agricultural University(2023BQ34)Shanxi Province Work Award Fund Research Project(SXBYKY2022116).
文摘Non-enzymatic glycation reaction in food can produce diet-derived advanced glycation end products(dAGEs),which have potential health risks.Thus,it is of great significance to find efficient substances to improve the negative effects induced by dAGEs on human health.This study investigated the intervening effects of peanut skin procyanidins(PSP)on the dAGEs-induced oxidative stress and systemic inflammation in experimental mice model.Results showed that the accumulation of AGEs in serum,liver,and kidney was significantly increased after mice were fed dAGEs(P<0.05).The expression of advanced glycation product receptor(RAGE)was also significantly increased in liver and kidney(P<0.05).PSP could not only effectively reduce the accumulation of AGEs in serum,liver and kidney of mice,but also reduce the expression of RAGE in liver and kidney of mice.And the levels of pro-inflammatory cytokines interleukin-6(IL-6),tumor necrosis factor(TNF-α),and IL-1βin serum of mice were significantly decreased(P<0.05),while the levels of antiinflammatory factor IL-10 were increased,and the inflammatory injury in mice was improved.In addition,the levels of superoxide dismutase(SOD),glutathione(GSH),catalase(CAT)in liver and kidney of mice were increased(P<0.05),and the level of malondialdehyde(MDA)was decreased(P<0.05),which enhanced the antioxidant capacity of mice in vivo,and improved the oxidative damage of liver and kidney.Molecular docking technique was used to confirm that the parent compound of procyanidins and its main metabolites,such as 3-hydroxyphenylacetic acid,could interact with RAGE,which might inhibit the activation of nuclear transcription factor(NF-κB),and ultimately reduce oxidative stress and inflammation in mice.
文摘Uncontrolled hypertension is a significant problem in children with end stage kidney disease. We studied 10 children on chronic hemodialysis who received the endothelin-1 receptor antagonist, bosentan as adjunctive therapy in refractory systemic hypertension. Data were retrospectively analyzed on systolic (SBP) and diastolic blood pressure (DBP), antihypertensive medications and hospitalization days per patient per year, at baseline and 3 months after initiation of bosentan. The standard deviation (Z) score of BP for age, height and gender was calculated. Mean age and weight of these children were 11.4 ± 4.8 years (range 1 - 17.5 years) and 32.9 ± 14.4 kg (range 7.4 - 57 kg) respectively and 90% were African American. Seven were on hemodialysis ≥4 times weekly. The average inter-dialytic weight gain was 4.7% ± 1.8%. The pre-dialysis SBP and DBP Z scores were 4.9 ± 1.8 and 4.0 ± 1.0 at baseline and decreased to 1.3 ± 0.4 and 1.3 ± 0.8, 3 months after initiation of bosentan (p < 0.0001). Similarly, anti-hypertensive medications were decreased from 5 ± 1.5 to 2.1 ± 2.6 (p < 0.01). Hospitalization days decreased from 35.6 ± 52.4 days to 1.5 ± 3.3 days (p < 0.0001). This preliminary report indicates bosentan may be beneficial in the management of children with severe refractory hypertension.
文摘AIM： To review the defnition and performance of the commonly used end points in trials of systemic thera-pies in metastatic castration-resistant prostate cancer patients. METHODS： A literature search was undertaken on PubMed database to identify studies meeting estab-lished criteria, with the aim of selecting randomized clinical trials and study definition and performance of their end points. The end points were grouped into three categories： overall survival （OS）, time-to-event end points, and response end points. A special analysis was performed for secondary end points of the studies which documented a beneft in OS in the experimental arm. Finally, publishes analyses for surrogacy of the in-cluded end points were also reported. RESULTS： OS, time-to-event and response end points in 31 selected trials were analyzed. OS was the pri-mary end point in 14 trials, and the secondary end point in 17. A time-to-event end point was the primaryend point in 8 studies, and the secondary end point in 22; the most reported time-to-event end points were composite end points, and the events changed among trials. A response end point was the primary end point in 9 studies, in 3 it was prostate-specifc antigen （PSA）-related, in 3 pain-related and in 3 mixed. A response end point was the secondary end point in 19 studies： PSA response and radiologic response were the most frequently used secondary end points in 19 and 11 tri-als, respectively, while pain response was used in 5 studies.CONCLUSION： A homogeneous defnition of progres-sion in future trials is mandatory. Among response end points, pain-response and PSA-response appear to be the most reliable.
文摘Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review;examined patient involvement in end-of-life discussions;full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review;there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end-of-life decision making through;describing current practices;understanding perspectives of end of life discussions;investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end-of-life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in end-of-life decisions were recognized;lack of awareness;lack of education, training and experience;concerns about ethical and legal issues;and personal preferences of doctors or nurses were among the most commonly identified barriers.
文摘The recent growth of the World Wide Web has sparked new research into using the Internet for novel types of group communication, like multiparty videoconferencing and real-time streaming. Multicast has the potential to be very useful, but it suffers from many problems like security. To achieve secure multicast communications with the dynamic aspect of group applications due to free membership joins and leaves in addition to member's mobility, key management is one of the most critical problems. So far, a lot of multicast key management schemes have been proposed and most of them are centralized, which have the problem of 'one point failure' and that the group controller is the bottleneck of the group. In order to solve these two problems, we propose a Key Management Scheme, using cluster-based End-System Multicast (ESM). The group management is between both 1) the main controller (MRP, Main Rendezvous Point) and the second controllers (CRP, Cluster RP), and 2) the second controllers (CRPs) and its members. So, ESM simplifies the implementation of group communication and is efficient ways to deliver a secure message to a group of recipients in a network as a practical alternative to overcome the difficulty of large scale deployment of traditional IP multicast. In this paper, we analyze different key management schemes and propose a new scheme, namely Advanced Transition/Cluster Key management Scheme (ATCKS) and find it has appropriate performance in security.
文摘The SRS TM Endoscopic Stapling System(Medigus,Tel Aviv,Israel) is a new tool capable of creating a totally endoscopic fundoplication,combined with an endoscope,endoscopic ultrasound and a surgical stapler.SRS TM endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive,outpatient procedure,which requires general anesthesia with positive-pressure ventilation.Keeping the patient on positive endexpiratory pressure(PEEP) may minimize the pressure gradient between the esophagus and the mediastinum,as well as help to prevent air from leaking around the screws and causing pneumomediastinum.In addition,in patients with hiatal hernia,higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy.We advise smoother emergence from anesthesia,taking precautions for retching,postoperative nausea and vomiting(PONV),while coughing and gagging during extubation and PONV may affect the success of the procedure.Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.
基金the Guangdong Provincial Basic and Applied Basic Research Project:Mechanistic Study on the Regulation of Inflammatory Microenvironment and Improvement of Ulcerative Colitis by Lingnan Traditional Medicine Ficus Pandurata Hance through Wilms'Tumor 1-associating Protein-Mediated RNA Methyltransferase Promoting Toll Like Receptor 4 m6A Modification(2023A1515011699)the Zhongshan Medical Research Project:Mechanistic Study on the Action of Xiahuo Pingwei San in the Treatment of Ulcerative Colitis(2022A020446)。
文摘OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.
基金The National Key Research and Development Program of China grant No.2022YFB3706704 received by Yuan Renthe National Natural and Science Foundation of China grant No.52308150 received by Xiang Xu.
文摘To improve the accuracy of thermal response estimation and overcome the limitations of the linear regression model and Artificial Neural Network(ANN)model,this study introduces a deep learning estimation method specifically based on the Long Short-Term Memory(LSTM)network,to predict temperature-induced girder end displacements of the Dasha Waterway Bridge,a suspension bridge in China.First,to enhance data quality and select target sensors,preprocessing based on the sigma rule and nearest neighbor interpolation is applied to the raw data.Furthermore,to eliminate the high-frequency components from the displacement signal,the wavelet transform is conducted.Subsequently,the linear regression model and ANN model are established,whose results do not meet the requirements and fail to address the time lag effect between temperature and displacements.The study proceeds to develop the LSTM network model and determine the optimal parameters through hyperparameter sensitivity analysis.Finally,the results of the LSTM network model are discussed by a comparative analysis against the linear regression model and ANN model,which indicates a higher accuracy in predicting temperatureinduced girder end displacements and the ability to mitigate the time-lag effect.To be more specific,in comparison between the linear regression model and LSTM network,the mean square error decreases from 6.5937 to 1.6808 and R^(2) increases from 0.683 to 0.930,which corresponds to a 74.51%decrease in MSE and a 36.14%improvement in R^(2).Compared to ANN,with an MSE of 4.6371 and an R^(2) of 0.807,LSTM shows a decrease in MSE of 63.75%and an increase in R^(2) of 13.23%,demonstrating a significant enhancement in predictive performance.
文摘Liver transplantation(LT)has made significant progress in the treatment of end stage liver disease(ESLD).However,many patients still die from disease progression while awaiting transplantation.As the number of patients on LT waiting lists is increasing,and the organ shortage crisis is obvious,various efforts have been made to increase the pool of available liver grafts[1].In addition to living donor liver transplantation(LDLT),improving the utilization rate of extended criteria donor(ECD)livers is an important way.However,under traditional cold storage,ECD livers are usually associated with a higher risk of ischemic biliary disease,early allograft dysfunction(EAD)or even primary nonfunction(PNF).The frequently described definition in the literature for ECD grafts generally includes elderly,steatotic,long cold ischemia time(CIT),grafts obtained from donation after circulatory death(DCD),split liver grafts,donors with increased risk of infectious disease transmission and prolonged donor intensive care unit stay[2].
文摘On December 27,2011,Ran Chengqi,director of the China Satellite Navigation Office announced that,the BeiDou Navigation Satellite System (BeiDou system) had that day begun to provide initial operational service.
文摘This paper considered the optimal control problem for distributed parameter systems with mixed phase-control constraints and end-point constraints. Pontryagin's maximum principle for optimal control are derived via Duboviskij-Milujin theorem.
基金Supported by the Appropriate Technology Promotion Program in Chongqing,No.2023jstg005.
文摘BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.
