Objectives:The increasing number of elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR)has prompted concerns regarding their clinical outcomes compared with the y...Objectives:The increasing number of elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR)has prompted concerns regarding their clinical outcomes compared with the younger population.This study evaluated the outcomes of TAVR on the basis of age group(<80 or≥80 years)amongVietnamese patients with severe aortic valve stenosis at intermediate surgical risk.Methods:From March 2017 to December 2022,21 patients≥80 years of age and 69 patients<80 years of age under-went TAVI at a single center.Clinical characteristics,procedures,and outcomes at 30 days and 1 year were compared with the Valve Academic Research Consortium(VARC-2)criteria.Results:Patients≥80 years of age had a higher prevalence of comorbidities but no significant differences in other clinical characteristics and procedures.No statistically significant differences were observed in procedural mortality(4.8%vs.0.0%,P=0.233),30-day mortality(5.0%vs.1.5%,P=0.405),and 1-year mortality(11.8%vs.3.7%,P=0.241)between age groups.Major endpoints at specified time points also showed no significant differences.Conclusions:TAVR in patients with aortic stenosis at intermediate surgical risk has similar clinical outcomes at 30 days and 1 year,according to VARC-2 criteria,with no statistically significant age-associated differences(≥80 vs.<80 years).However,further studies with larger patient populations are needed to better understand the effects of age on TAVI outcomes in patients with similar characteristics.展开更多
The paper introduces gas to liquids (GTL) as a monetising option from a technology, marketing and project perspective. GTL is complementary to LNG and pipelines. At the same time, using natural gas as a source for fue...The paper introduces gas to liquids (GTL) as a monetising option from a technology, marketing and project perspective. GTL is complementary to LNG and pipelines. At the same time, using natural gas as a source for fuels in the form of GTL helps countries around the world to diversify their energy supplies. Furthermore, gas-based products are inherently cleaner than oil products. Shell's proprietary GTL technology or SMDS (Shell Middle Distillates Synthesis), is discussed in some detail. The paper also covers the challenges for successful implementation of GTL projects and why Shell is well positioned to take a lead in the industry on the basis of its long standing and broad experience in GTL research, plant operations, marketing and excellent track record in mega projects in the last thirty years. Shell's commitment to GTL is best demonstrated by the recent signing of a Heads of Agreement with Qatar Petroleum for the construction of the world's largest GTL plant. A key success factor is Shell's experience with marketing quantities of high quality GTL products from its 12,500 barrels per day plant at Bintulu, Malaysia since 1993. Further marketing opportunities will arise when new GTL capacity comes on-stream in the middle east when more quantities will become available to bulk users. Amongst the most interesting market will be automotive transportation, where clean GTL fuels can be positioned as an 'alternative fuel beyond oil' providing energy security to host countries. Shell is actively engaging with a number of regulators, automotive companies and governments worldwide including China, to demonstrate the performance of GTL and its cost effectiveness in reducing local emissions. An added benefit is that GTL can use existing infrastructure and requires no investment. Finally, the paper briefly discusses the coal to liquids (CTL) process as an alternative route to produce high quality GTL products and the key issues relating to the process.展开更多
High-temperature proton exchange membrane fuel cells(HT-PEMFC) possess distinct technical advantages of high output power, simplified water/heat management, increased tolerance to fuel impurities and diverse fuel sour...High-temperature proton exchange membrane fuel cells(HT-PEMFC) possess distinct technical advantages of high output power, simplified water/heat management, increased tolerance to fuel impurities and diverse fuel sources, within the temperature range of 120–200 ℃. However, for practical automobile applications, it was crucial to broaden their low-temperature operating window and enable cold start-up capability. Herein, gel-state phosphoric acid(PA) doped sulfonated polybenzimidazole(PBI) proton exchange membranes(PEMs) were designed and synthesized via PPA sol-gel process and in-situ sultone ring-opening reactions with various proton transport pathways based on absorbed PA, flexible alkyl chain connected sulfonic acid groups and imidazole sites. The effects of flexible alkyl sulfonic acid side chain length and content on PA doping level, proton conductivity, and membrane stability under different temperature and relative humidity(RH) were thoroughly investigated. The prepared gel-state membranes contained a self-assembled lamellar and porous structure that facilitated the absorption of a large amount of PA with rapid proton transporting mechanisms. At room temperature, the optimized membrane exhibited a proton conductivity of 0.069 S cm^(-1), which was further increased to 0.162 and 0.358 S cm^(-1)at 80 and 200 ℃, respectively, without additional humidification. The most significant contribution of this work was demonstrating the feasibility of gel-state sulfonated PBI membranes in expanding HT-PEMFC application opportunities over a wider operating range of 25 to 240 ℃.展开更多
AIM： To investigate the anti-cancer mechanisms of Korean mistletoe lectin （Viscum album coloratura agglutinin, VCA） using a human colon cancer cell line （COLO）. METHODS： Cytotoxic effects of VCA on COLO cells we...AIM： To investigate the anti-cancer mechanisms of Korean mistletoe lectin （Viscum album coloratura agglutinin, VCA） using a human colon cancer cell line （COLO）. METHODS： Cytotoxic effects of VCA on COLO cells were determined by 3-（4,5-dimethylthiazol-2-yl）-2,5- diphenyltetrazolium bromide （MTI-） assay in vitro and tumor-killing effects in vivo. To study the mechanisms involved, the expression of various pro-caspases, anti- apoptotic proteins, and death receptors was determined by western blot. To determine which death receptor is involved in VCA-induced apoptosis of COLO cells, cytotoxicity was examined by MTT assay after treatment with agonists or antagonists of death receptors. RESULTS： VCA killed COLO cells in a time- and dosedependent manner and induced complete regression of tumors in nude mice transplanted with COLO cells. Treatment of COLO cells with VCA activated caspase-2, -3, -8, and -9 and decreased expression of anti-apoptotic molecules including receptor interacting protein, nuclear factor-κB, X-linked inhibitor of apoptosis protein, and Akt/protein kinase B. We then examined the involvement of death receptors in VCA-induced apoptosis. Only tumor necrosis factor receptor 1, among the death receptors examined, was involved in apoptosis of COLO cells, evidenced by inhibition of VCA-induced apoptosis and decreased activation of caspases, particularly caspase-8, by tumor necrosis factor receptor 1 antagonizing antibody.CONCLUSION： VCA-induced apoptotic COLO cell death is due to the activation of caspases and inhibition of antiapoptotic proteins, in part through the tumor necrosis factor receptor 1 signaling pathway.展开更多
BACKGROUND Type 1 diabetes originates from gene-environment interactions,with increasing incidence over time.AIM To identify correlates of childhood type 1 diabetes in European countries using an ecological approach.S...BACKGROUND Type 1 diabetes originates from gene-environment interactions,with increasing incidence over time.AIM To identify correlates of childhood type 1 diabetes in European countries using an ecological approach.Several environmental variables potentially influencing the onset of type 1 diabetes have been previously evaluated.However,the relationships between epidemiologic data and exposure to toxic airborne molecules are scarcely studied.METHODS We employed an ecological model to explore,in a wide time period(1990-2018),associations between type 1 diabetes incidence in 19 European countries(systematic literature review)and the nationwide production of five widely diffused air pollutants:particulate matter<10μm(PM10),nitrogen oxides(NO),non-methane volatile organic compounds(VOCs),sulphur oxide(SO2),and ammonia.RESULTS Data confirm a raising incidence of type 1 diabetes in 18 out of 19 explored countries.The average difference(last vs first report,all countries)was+6.9×100000/year,with values ranging from-1.4(Germany)to+16.6(Sweden)per 100000/year.Although the overall production of pollutants decreased progressively from 1990 to 2018,type 1 diabetes incidence was positively associated with the nationwide emissions of PM10,VOCs,and NO but not with those of SO2 and ammonia.Type 1 diabetes incidence was significantly higher in countries with high emissions than in those with low emissions of PM10(27.5±2.4 vs 14.6±2.4×100000 residents,respectively),VOCs(24.5±4.4 vs 13.2±1.7×100000 residents,respectively),and NO(26.6±3 vs 13.4±2.4×100000 residents,respectively),but not of SO2 or ammonia.CONCLUSION Evidence justify further studies to explore better links between long-term air quality and type 1 diabetes onset at the individual level,which should include exposures during pregnancy.In this respect,type 1 diabetes could be,at least in part,a preventable condition.Thus,primary prevention policies acting through a marked abatement of pollutant emissions might attenuate future type 1 diabetes incidence throughout Europe.展开更多
AIM： To assess the management and outcome of nonerosive gastro-esophageal reflux disease （NERD） patients who were identified retrospectively, after a 5-year follow-up. METHODS： We included patients with gastro-eso...AIM： To assess the management and outcome of nonerosive gastro-esophageal reflux disease （NERD） patients who were identified retrospectively, after a 5-year follow-up. METHODS： We included patients with gastro-esophageal reflux disease （GERD） symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years （range 3.5-7 years） by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS： 260 patients （137 women） were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 （40%）. 70% received a maintenance treatment, which was proton pump inhibitor （PPI） in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease （ERD） was found in 58/193 （30.0%） of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION： This study to ERD occurs in about 5% shows that progression of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression： smoking and absence of PPI therapy.展开更多
The present article comprehensively reviews the thoracic outlet syndrome (TOS), its etiology and assessment, with reference to the usual conservative treatment and surgical therapy, highlighting new definitions and re...The present article comprehensively reviews the thoracic outlet syndrome (TOS), its etiology and assessment, with reference to the usual conservative treatment and surgical therapy, highlighting new definitions and reporting obsolete tests. The syndrome affects about 8% of the population, with higher prevalence in females, and rarely affects the children. Conservative, non-surgical treatment produces good results, and it becomes important to know which specific areas need to be treated. Currently, there is no rehabilitation scheme, either osteopathic or chiropractic, considered as a valid tool for a precise localization of the pathologic condition, probably due to the lack of a manual assessment process to evaluate bones and muscular components of the thoracic outlet. In this situation, the manual treatment performed is usually generic. The present article proposes a manual evaluation that can be used to identify the anatomical area which needs to be treated. This hypothesis of assessment should be carried out after the clinician has ruled out the necessity of surgery with instrumental examinations.展开更多
Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for ev...Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.展开更多
Flavescence dorée(FD)is a destructive phytoplasma disease of European grapevines.Spontaneous and cultivardependent recovery(REC)may occur in the field in FD-infected vines starting the year following the first sy...Flavescence dorée(FD)is a destructive phytoplasma disease of European grapevines.Spontaneous and cultivardependent recovery(REC)may occur in the field in FD-infected vines starting the year following the first symptoms.However,the biological underpinnings of this process are still largely unexplored.In this study,transcriptome sequencing(RNAseq),whole-genome bisulphite sequencing(WGBS)and metabolite analysis were combined to dissect molecular and metabolic changes associated to FD and REC in leaf veins collected in the field from healthy(H),FD and REC plants of the highly susceptible Vitis vinifera‘Barbera’.Genes involved in flavonoid biosynthesis,carbohydrate metabolism and stress responses were overexpressed in FD conditions,whereas transcripts linked to hormone and stilbene metabolisms were upregulated in REC vines.Accumulation patterns of abscisic acid and stilbenoid compounds analysed in the same samples confirmed the RNAseq data.In recovery conditions,we also observed the persistence of some FD-induced expression changes concerning inhibition of photosynthetic processes and stress responses.Several differentially expressed genes tied to those pathways also underwent post-transcriptional regulation by microRNAs,as outlined by merging our transcriptomic data set with a previously conducted smallRNAseq analysis.Investigations by WGBS analysis also revealed different DNA methylation marks between REC and H leaves,occurring within the promoters of genes tied to photosynthesis and secondary metabolism.The results allowed us to advance the existence of a“molecular memory”of FDp infection,involving alterations in the DNA methylation status of REC plants potentially related to transcriptional reprogramming events,in turn triggering changes in hormonal and secondary metabolite profiles.展开更多
The data series of monthly clouldiness over global ocean from COADS was compared with that of from satellite Nimbus-7 during April 1979 to March 1985. The correspondence between them is good. Both the two methods of o...The data series of monthly clouldiness over global ocean from COADS was compared with that of from satellite Nimbus-7 during April 1979 to March 1985. The correspondence between them is good. Both the two methods of observation can provide useful information of the distribution of cloudiness and the two data sets can be mutually complementary.展开更多
In offshore tubular structures, a typical tubular joint may be subjected to three different types of basic loadings: axial, in-plane bending and out-of-plane bending, through its brace members. Each type will cause a ...In offshore tubular structures, a typical tubular joint may be subjected to three different types of basic loadings: axial, in-plane bending and out-of-plane bending, through its brace members. Each type will cause a different stress distribution at the joint intersection of structures. Moreover, the actual load condition of a tubular joint can be any combination of the above three basic load cases, for this reason, a combined loading was investigated in addition to these three basic loadings. This load is composed of an axial loading combined with a continuation of rotational bending loading obtained while rotate center of the brace around a circle. Different types of planar joints such as T, Y, X, K, DT, DY, DX, TY, TK, DTX, DTDY, and DTDK, with braces subjected to combined loading, were numerically analyzed to study the effect of those different cases of loading and different types of joints, on the stress concentration zone and values.展开更多
The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dr...The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dry and cryogenic cold air jet cuttings carried out for grade 45 steel, the effects of cryogenic cold air jet on the breaking of chips were discussed. The experimental results reveal that in the valid ranges of pressure and temperature, the cryogenic cold air jet widens the chip breaking areas effectively. When the cutting depth is not greater than 1 mm, the influence of chip breaking is much more significant. But different injecting angle of cold air has different influence on the chip-break. From the experiment, the optimized jet injecting angle, temperature effecting range and pressure working range of cold air are obtained. These results can offer a foundation for industrial manufacturing.展开更多
By using the monthly data from 1951 through 1984, empirical orthogonal expansion is performed for the 500 hPa geopotential height north of 65°N and the canonical fields are clustered by fuzzy classification. It i...By using the monthly data from 1951 through 1984, empirical orthogonal expansion is performed for the 500 hPa geopotential height north of 65°N and the canonical fields are clustered by fuzzy classification. It is noted that both the mean monthly polar vortex fields and the large-scale anomaly fields fall into three regimes, with those of the January mean field and th April anomaly field having characteristic features. In addition, the relationship between the time weigthing coefficients of the canonical fields and El Nino / SO is examined, showing significant anomalies in the large-scale polar anomaly fields during April and October of the year when El Nino occurs. These polar circulation anomalies have considerably influenced the temperature fields in China during April and October. Thus, we may conclude that this is one of the most important reasons for a relatively cool April and a warm October in China during the El Nino year.展开更多
A new type of linear rotary magnetorheological damper (MRD) is proposed, which consists of a cylinder-type MRD and a screw mechanism to transform a linear motion into revolving motion. It is found that the structure p...A new type of linear rotary magnetorheological damper (MRD) is proposed, which consists of a cylinder-type MRD and a screw mechanism to transform a linear motion into revolving motion. It is found that the structure parameters of MRD have complex relationship with the force of the damper, especially the lead angle, width and radius of the inner rotor. The analyses and simulation calculation of the static magnetic field give some usable data, and experiments of the damping component indicate that the proposed methods is feasible for developing linear rotary MRD.展开更多
Multi-pass slab vertical-horizontal （V-H） rolling process with variable edging roll shape have been simulated with explicit dynamic finite element method and updating geometric method. The distributions of plastic s...Multi-pass slab vertical-horizontal （V-H） rolling process with variable edging roll shape have been simulated with explicit dynamic finite element method and updating geometric method. The distributions of plastic strain contour in slab daring rolling process with different edging roll and under different rolling stage have been obtained. The results show that there exist two thin strain assembling zones in slab when the flat edging roll is used, and there just exist one strain assembling zone in slab when the edging roll with groove is used. And compared the deformation equality between flat edging roll and edging roll with groove, the lateris better than the former, which supplies the theory prove to the slab deformation distribution during V-H rolling process and is helpful for predicting the slab texture.展开更多
文摘Objectives:The increasing number of elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR)has prompted concerns regarding their clinical outcomes compared with the younger population.This study evaluated the outcomes of TAVR on the basis of age group(<80 or≥80 years)amongVietnamese patients with severe aortic valve stenosis at intermediate surgical risk.Methods:From March 2017 to December 2022,21 patients≥80 years of age and 69 patients<80 years of age under-went TAVI at a single center.Clinical characteristics,procedures,and outcomes at 30 days and 1 year were compared with the Valve Academic Research Consortium(VARC-2)criteria.Results:Patients≥80 years of age had a higher prevalence of comorbidities but no significant differences in other clinical characteristics and procedures.No statistically significant differences were observed in procedural mortality(4.8%vs.0.0%,P=0.233),30-day mortality(5.0%vs.1.5%,P=0.405),and 1-year mortality(11.8%vs.3.7%,P=0.241)between age groups.Major endpoints at specified time points also showed no significant differences.Conclusions:TAVR in patients with aortic stenosis at intermediate surgical risk has similar clinical outcomes at 30 days and 1 year,according to VARC-2 criteria,with no statistically significant age-associated differences(≥80 vs.<80 years).However,further studies with larger patient populations are needed to better understand the effects of age on TAVI outcomes in patients with similar characteristics.
文摘The paper introduces gas to liquids (GTL) as a monetising option from a technology, marketing and project perspective. GTL is complementary to LNG and pipelines. At the same time, using natural gas as a source for fuels in the form of GTL helps countries around the world to diversify their energy supplies. Furthermore, gas-based products are inherently cleaner than oil products. Shell's proprietary GTL technology or SMDS (Shell Middle Distillates Synthesis), is discussed in some detail. The paper also covers the challenges for successful implementation of GTL projects and why Shell is well positioned to take a lead in the industry on the basis of its long standing and broad experience in GTL research, plant operations, marketing and excellent track record in mega projects in the last thirty years. Shell's commitment to GTL is best demonstrated by the recent signing of a Heads of Agreement with Qatar Petroleum for the construction of the world's largest GTL plant. A key success factor is Shell's experience with marketing quantities of high quality GTL products from its 12,500 barrels per day plant at Bintulu, Malaysia since 1993. Further marketing opportunities will arise when new GTL capacity comes on-stream in the middle east when more quantities will become available to bulk users. Amongst the most interesting market will be automotive transportation, where clean GTL fuels can be positioned as an 'alternative fuel beyond oil' providing energy security to host countries. Shell is actively engaging with a number of regulators, automotive companies and governments worldwide including China, to demonstrate the performance of GTL and its cost effectiveness in reducing local emissions. An added benefit is that GTL can use existing infrastructure and requires no investment. Finally, the paper briefly discusses the coal to liquids (CTL) process as an alternative route to produce high quality GTL products and the key issues relating to the process.
基金supported by the National Natural Science Foundation of China (NSFC-22209147)。
文摘High-temperature proton exchange membrane fuel cells(HT-PEMFC) possess distinct technical advantages of high output power, simplified water/heat management, increased tolerance to fuel impurities and diverse fuel sources, within the temperature range of 120–200 ℃. However, for practical automobile applications, it was crucial to broaden their low-temperature operating window and enable cold start-up capability. Herein, gel-state phosphoric acid(PA) doped sulfonated polybenzimidazole(PBI) proton exchange membranes(PEMs) were designed and synthesized via PPA sol-gel process and in-situ sultone ring-opening reactions with various proton transport pathways based on absorbed PA, flexible alkyl chain connected sulfonic acid groups and imidazole sites. The effects of flexible alkyl sulfonic acid side chain length and content on PA doping level, proton conductivity, and membrane stability under different temperature and relative humidity(RH) were thoroughly investigated. The prepared gel-state membranes contained a self-assembled lamellar and porous structure that facilitated the absorption of a large amount of PA with rapid proton transporting mechanisms. At room temperature, the optimized membrane exhibited a proton conductivity of 0.069 S cm^(-1), which was further increased to 0.162 and 0.358 S cm^(-1)at 80 and 200 ℃, respectively, without additional humidification. The most significant contribution of this work was demonstrating the feasibility of gel-state sulfonated PBI membranes in expanding HT-PEMFC application opportunities over a wider operating range of 25 to 240 ℃.
基金Supported by the International Innovative Biotechnology Institute
文摘AIM： To investigate the anti-cancer mechanisms of Korean mistletoe lectin （Viscum album coloratura agglutinin, VCA） using a human colon cancer cell line （COLO）. METHODS： Cytotoxic effects of VCA on COLO cells were determined by 3-（4,5-dimethylthiazol-2-yl）-2,5- diphenyltetrazolium bromide （MTI-） assay in vitro and tumor-killing effects in vivo. To study the mechanisms involved, the expression of various pro-caspases, anti- apoptotic proteins, and death receptors was determined by western blot. To determine which death receptor is involved in VCA-induced apoptosis of COLO cells, cytotoxicity was examined by MTT assay after treatment with agonists or antagonists of death receptors. RESULTS： VCA killed COLO cells in a time- and dosedependent manner and induced complete regression of tumors in nude mice transplanted with COLO cells. Treatment of COLO cells with VCA activated caspase-2, -3, -8, and -9 and decreased expression of anti-apoptotic molecules including receptor interacting protein, nuclear factor-κB, X-linked inhibitor of apoptosis protein, and Akt/protein kinase B. We then examined the involvement of death receptors in VCA-induced apoptosis. Only tumor necrosis factor receptor 1, among the death receptors examined, was involved in apoptosis of COLO cells, evidenced by inhibition of VCA-induced apoptosis and decreased activation of caspases, particularly caspase-8, by tumor necrosis factor receptor 1 antagonizing antibody.CONCLUSION： VCA-induced apoptotic COLO cell death is due to the activation of caspases and inhibition of antiapoptotic proteins, in part through the tumor necrosis factor receptor 1 signaling pathway.
文摘BACKGROUND Type 1 diabetes originates from gene-environment interactions,with increasing incidence over time.AIM To identify correlates of childhood type 1 diabetes in European countries using an ecological approach.Several environmental variables potentially influencing the onset of type 1 diabetes have been previously evaluated.However,the relationships between epidemiologic data and exposure to toxic airborne molecules are scarcely studied.METHODS We employed an ecological model to explore,in a wide time period(1990-2018),associations between type 1 diabetes incidence in 19 European countries(systematic literature review)and the nationwide production of five widely diffused air pollutants:particulate matter<10μm(PM10),nitrogen oxides(NO),non-methane volatile organic compounds(VOCs),sulphur oxide(SO2),and ammonia.RESULTS Data confirm a raising incidence of type 1 diabetes in 18 out of 19 explored countries.The average difference(last vs first report,all countries)was+6.9×100000/year,with values ranging from-1.4(Germany)to+16.6(Sweden)per 100000/year.Although the overall production of pollutants decreased progressively from 1990 to 2018,type 1 diabetes incidence was positively associated with the nationwide emissions of PM10,VOCs,and NO but not with those of SO2 and ammonia.Type 1 diabetes incidence was significantly higher in countries with high emissions than in those with low emissions of PM10(27.5±2.4 vs 14.6±2.4×100000 residents,respectively),VOCs(24.5±4.4 vs 13.2±1.7×100000 residents,respectively),and NO(26.6±3 vs 13.4±2.4×100000 residents,respectively),but not of SO2 or ammonia.CONCLUSION Evidence justify further studies to explore better links between long-term air quality and type 1 diabetes onset at the individual level,which should include exposures during pregnancy.In this respect,type 1 diabetes could be,at least in part,a preventable condition.Thus,primary prevention policies acting through a marked abatement of pollutant emissions might attenuate future type 1 diabetes incidence throughout Europe.
文摘AIM： To assess the management and outcome of nonerosive gastro-esophageal reflux disease （NERD） patients who were identified retrospectively, after a 5-year follow-up. METHODS： We included patients with gastro-esophageal reflux disease （GERD） symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years （range 3.5-7 years） by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS： 260 patients （137 women） were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 （40%）. 70% received a maintenance treatment, which was proton pump inhibitor （PPI） in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease （ERD） was found in 58/193 （30.0%） of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION： This study to ERD occurs in about 5% shows that progression of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression： smoking and absence of PPI therapy.
文摘The present article comprehensively reviews the thoracic outlet syndrome (TOS), its etiology and assessment, with reference to the usual conservative treatment and surgical therapy, highlighting new definitions and reporting obsolete tests. The syndrome affects about 8% of the population, with higher prevalence in females, and rarely affects the children. Conservative, non-surgical treatment produces good results, and it becomes important to know which specific areas need to be treated. Currently, there is no rehabilitation scheme, either osteopathic or chiropractic, considered as a valid tool for a precise localization of the pathologic condition, probably due to the lack of a manual assessment process to evaluate bones and muscular components of the thoracic outlet. In this situation, the manual treatment performed is usually generic. The present article proposes a manual evaluation that can be used to identify the anatomical area which needs to be treated. This hypothesis of assessment should be carried out after the clinician has ruled out the necessity of surgery with instrumental examinations.
文摘Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.
基金support by the“INTEFLAVI project:un approccio integrato alla lotta contro la Flavescenza dorata della vite”,jointly funded by Fondazione Cassa di Risparmio di Cuneo(CRC),Fondazione Cassa di Risparmio di Asti(CRA)and Fondazione Cassa di Risparmio di Torino(CRT).
文摘Flavescence dorée(FD)is a destructive phytoplasma disease of European grapevines.Spontaneous and cultivardependent recovery(REC)may occur in the field in FD-infected vines starting the year following the first symptoms.However,the biological underpinnings of this process are still largely unexplored.In this study,transcriptome sequencing(RNAseq),whole-genome bisulphite sequencing(WGBS)and metabolite analysis were combined to dissect molecular and metabolic changes associated to FD and REC in leaf veins collected in the field from healthy(H),FD and REC plants of the highly susceptible Vitis vinifera‘Barbera’.Genes involved in flavonoid biosynthesis,carbohydrate metabolism and stress responses were overexpressed in FD conditions,whereas transcripts linked to hormone and stilbene metabolisms were upregulated in REC vines.Accumulation patterns of abscisic acid and stilbenoid compounds analysed in the same samples confirmed the RNAseq data.In recovery conditions,we also observed the persistence of some FD-induced expression changes concerning inhibition of photosynthetic processes and stress responses.Several differentially expressed genes tied to those pathways also underwent post-transcriptional regulation by microRNAs,as outlined by merging our transcriptomic data set with a previously conducted smallRNAseq analysis.Investigations by WGBS analysis also revealed different DNA methylation marks between REC and H leaves,occurring within the promoters of genes tied to photosynthesis and secondary metabolism.The results allowed us to advance the existence of a“molecular memory”of FDp infection,involving alterations in the DNA methylation status of REC plants potentially related to transcriptional reprogramming events,in turn triggering changes in hormonal and secondary metabolite profiles.
文摘The data series of monthly clouldiness over global ocean from COADS was compared with that of from satellite Nimbus-7 during April 1979 to March 1985. The correspondence between them is good. Both the two methods of observation can provide useful information of the distribution of cloudiness and the two data sets can be mutually complementary.
文摘In offshore tubular structures, a typical tubular joint may be subjected to three different types of basic loadings: axial, in-plane bending and out-of-plane bending, through its brace members. Each type will cause a different stress distribution at the joint intersection of structures. Moreover, the actual load condition of a tubular joint can be any combination of the above three basic load cases, for this reason, a combined loading was investigated in addition to these three basic loadings. This load is composed of an axial loading combined with a continuation of rotational bending loading obtained while rotate center of the brace around a circle. Different types of planar joints such as T, Y, X, K, DT, DY, DX, TY, TK, DTX, DTDY, and DTDK, with braces subjected to combined loading, were numerically analyzed to study the effect of those different cases of loading and different types of joints, on the stress concentration zone and values.
文摘The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dry and cryogenic cold air jet cuttings carried out for grade 45 steel, the effects of cryogenic cold air jet on the breaking of chips were discussed. The experimental results reveal that in the valid ranges of pressure and temperature, the cryogenic cold air jet widens the chip breaking areas effectively. When the cutting depth is not greater than 1 mm, the influence of chip breaking is much more significant. But different injecting angle of cold air has different influence on the chip-break. From the experiment, the optimized jet injecting angle, temperature effecting range and pressure working range of cold air are obtained. These results can offer a foundation for industrial manufacturing.
文摘By using the monthly data from 1951 through 1984, empirical orthogonal expansion is performed for the 500 hPa geopotential height north of 65°N and the canonical fields are clustered by fuzzy classification. It is noted that both the mean monthly polar vortex fields and the large-scale anomaly fields fall into three regimes, with those of the January mean field and th April anomaly field having characteristic features. In addition, the relationship between the time weigthing coefficients of the canonical fields and El Nino / SO is examined, showing significant anomalies in the large-scale polar anomaly fields during April and October of the year when El Nino occurs. These polar circulation anomalies have considerably influenced the temperature fields in China during April and October. Thus, we may conclude that this is one of the most important reasons for a relatively cool April and a warm October in China during the El Nino year.
文摘A new type of linear rotary magnetorheological damper (MRD) is proposed, which consists of a cylinder-type MRD and a screw mechanism to transform a linear motion into revolving motion. It is found that the structure parameters of MRD have complex relationship with the force of the damper, especially the lead angle, width and radius of the inner rotor. The analyses and simulation calculation of the static magnetic field give some usable data, and experiments of the damping component indicate that the proposed methods is feasible for developing linear rotary MRD.
文摘Multi-pass slab vertical-horizontal （V-H） rolling process with variable edging roll shape have been simulated with explicit dynamic finite element method and updating geometric method. The distributions of plastic strain contour in slab daring rolling process with different edging roll and under different rolling stage have been obtained. The results show that there exist two thin strain assembling zones in slab when the flat edging roll is used, and there just exist one strain assembling zone in slab when the edging roll with groove is used. And compared the deformation equality between flat edging roll and edging roll with groove, the lateris better than the former, which supplies the theory prove to the slab deformation distribution during V-H rolling process and is helpful for predicting the slab texture.
