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MicroRNAs (miRNAs) are related to the regulation of bone metabolism. Delayed fracture healing (DFH) is a common complication after fracture surgery. The study attempted to examine the role of miR-98-5p and bone morphogenetic protein (BMP)-2 with the onset of DFH. A total of 140 patients with femoral neck fracture were recruited, including 80 cases with normal fracture healing (NFH) and 60 cases with DFH. MC3T3-E1 cells were induced cell differentiation for cell function experiments. Real-time quantitative polymerase chain reaction (RT-qPCR) was carried out to test mRNA levels. Cell proliferation and apoptosis were determined via CCK-8 and flow cytometry assay. Luciferase reporter assay was done to verify the targeted regulatory relationship of miR-98-5p with BMP-2. In comparison with NFH cases, DFH patients owned high levels of serum miR-98-5p and low concentration of BMP-2, and the levels of the two indexes are significantly negatively correlated. Both miR-98-5p and BMP-2 had the ability to predict DFH, while their combined diagnostic value is the highest. BMP-2 was demonstrated to be the target gene of miR-98-5p. Overexpression of BMP-2 reversed the role of miR-98-5p in MC3T3-E1 cell proliferation, apoptosis and differentiation. Increased miR-98-5p and decreased BMP-2 serve as potential biomarkers for the diagnosis of DFH. MiR-98-5p overexpression inhibits osteoblast proliferation and differentiation via targeting BMP-2. [ABSTRACT FROM AUTHOR]

Purpose: According to the National Comprehensive Cancer Network guidelines, segmental ureterectomy (SU) of upper tract urothelial carcinoma (UTUC) is a considerable option for selected mid- and distal ureteral urothelial carcinoma (UC). As a UTUC endemic area, Taiwan lacks treatment outcome analysis of SU. Materials and methods: This study retrospectively reviewed the treatment outcomes of SU for clinically localized UTUCs. Patients with biopsy or washing cytology-confirmed UTUCs who underwent open, laparoscopic, or robot-assisted management with curative intent were retrospectively reviewed for the eligibility of analysis. Cox regression was applied for univariable and multivariable analyses. Results: A total of 161 patients who underwent SU were reviewed and analyzed. The median follow-up period was 44.5 (interquartile range, 21.6-84.9) months. After SU, 56/161 (34.8%) patients were free of UTUCs after the follow-up, 25/161 (15.5%) patients had local recurrence, and 35/161 (21.7%) had lymph node or distant metastasis. Surgical margin involvement was a risk factor associated with worse cancer-specific survival. Higher bladder recurrence and local recurrence rates were observed with concurrent bladder UC. Lymphovascular invasion and previous radical nephroureterectomy (RNU) for UC were related to higher local recurrence rates. Patients with pathological T3/T4 stage and end-stage renal disease tended to have higher metastasis rates. For the management of local recurrence, 19 patients received salvage RNU and 25 patients had adjuvant chemotherapy. However, 26/161 (16.1%) patients died of UTUCs and 2/161 (1.2%) patients died of surgery-related complications. Conclusion: SU provides acceptable oncological outcomes if the surgeons select candidates carefully. SU is not recommended if the patient has T3 or higher stage or comorbidity of end-stage renal disease. Concurrent bladder UC is a risk factor for worse bladder recurrence-free survival and local recurrence-free survival. Lymphovascular invasion and previous RNU for UC were related to higher local recurrence rates. After SU, periodic follow-up is mandatory because the local recurrence rate is higher than radical surgery. [ABSTRACT FROM AUTHOR]

This study aims to compare the diagnostic efficacy of DWI (Diffusion Weighted Imaging) and DCE-MRI (Dynamic Contrast Enhancement-Magnetic Resonance Imaging) in the depth of myometrial invasion, cervical invasion and FIGO (Federation International of Gynecology and Obstetrics) staging in patients with endometrial cancer. 128 patients were selected for preoperative diagnosis with DWI and DCE-MRI techniques. The diagnostic efficacy of the two diagnostic methods on the depth of myometrial invasion, cervical invasion and FIGO staging was compared. Receiver operating characteristic curves were plotted for the two diagnostic methods to further compare the differences between the two diagnostic methods. The accuracy, sensitivity, positive predictive value and negative predictive value of DWI were conspicuously higher than that of DCE-MRI in the diagnosis of depth of myometrial invasion and cervical invasion (p < 0.05). ROC (Receiver Operating Characteristic Curve) analysis demonstrated that the diagnostic effect of DWI was better than that of DCE-MRI in the diagnosis of depth of myometrial invasion and cervical invasion, and the difference in the area under the curve between the two diagnostic methods was statistically significant (p < 0.05). In terms of FIGO staging diagnosis, the accuracy of DWI was 86.72%, which was higher than 65.63% of DCE-MRI (χ² = 15.689, p < 0.001). For patients with endometrial cancer, preoperative depth of myometrial invasion, cervical invasion and FIGO staging have critical guiding significance for clinical diagnosis and treatment. Compared with DCE-MRI, DWI has better diagnostic efficacy for depth of myometrial invasion, cervical invasion and FIGO staging, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Emerging phenomena of ubiquitous multisource data offer promising avenues for making breakthroughs in financial risk prediction. While most existing methods for financial risk prediction are based on a single information source, which may not adequately capture various complex factors that jointly influence financial risks, we propose a hybrid-strategy-based self-adaptive method to effectively leverage heterogeneous soft information drawn from a variety of sources. The method uses a proposed new feature sparsity learning method to adaptively integrate multisource heterogeneous soft features with hard features and a proposed improved evidential reasoning rule to adaptively aggregate base classifier predictions, thereby alleviating both the declarative bias and the procedural bias of the learning process. Evaluation in two cases at the individual level (concerning borrowers at a P2P lending platform) and the company level (concerning listed companies in the Chinese stock market) showed that, compared with relying solely on hard features, effectively incorporating multisource heterogeneous soft features using our proposed method enabled earlier prediction of financial risks with desirable performance. [ABSTRACT FROM AUTHOR]

Fracture healing is a multifaceted process that requires various phases and intercellular interactions. In recent years, investigations have been conducted to assess the feasibility of utilizing exosomes, small extracellular vesicles (EVs), to enhance and accelerate the healing process. Exosomes serve as a cargo transport platform, facilitating intercellular communication, promoting the presentation of antigens to dendritic cells, and stimulating angiogenesis. Exosomes have a special structure that gives them a special function, especially in the healing process of bone injuries. This article provides an overview of cellular and molecular processes associated with bone fracture healing, as well as a survey of existing exosome research in this context. We also discuss the potential use of exosomes in fracture healing, as well as the obstacles that must be overcome to make this a viable clinical practice. [ABSTRACT FROM AUTHOR]

Prior studies of social-norms interventions have focused on nudging behavior in noncompetitive settings. This research evaluates such interventions in competitive environments, for example, a class with a competitive grading policy. Field experiments on a learning management system show that providing descriptive information about peers' behavior has mixed effects in reducing procrastination and improving performance outcomes. Specifically, the effects are moderated by individual characteristics and contextual variables. First, peer information interventions are more effective for males, and the effects are stronger in a male-majority environment than in a female-majority environment. These findings differ from prior studies of social-norms interventions conducted in noncompetitive settings, in which females are found to be more responsive to interventions. Gender differences in our competitive settings can be explained by males' and females' differential preferences for competition: males are more competitive-oriented and thus are more responsive to peer information in competitive environments. Second, we find that individuals who are in great need of interventions, that is, those with poor past behavior and performance, are also more likely to benefit from peer information interventions, suggesting that peer information interventions motivate positive change. This study highlights the heterogeneous effects of peer information interventions and has implications for targeted interventions. [ABSTRACT FROM AUTHOR]

With the development of precision medicine for lung cancer, targeted therapy has greatly improved the survival and prognosis of patients with advanced non-small cell lung cancer (NSCLC), but the occurrence of acquired drug resistance ultimately leads to patients with no targeted drugs available and no standard treatment options for this group of patients afterwards. The emergence of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC. However, due to the unique features of NSCLC with epidermal growth factor receptor (EGFR) mutation, such as immunosuppressive tumor microenvironment (TME), single ICIs treatment has limited clinical benefits in NSCLC patients with EGFR mutation, and the combination of ICIs with chemotherapy and/or targeted therapies is the trend. This review further discusses potential subpopulations with EGFR mutations that may benefit from ICIs treatment, and analyzes how decisions can be made in the era of combined immunotherapy to maximize the efficacy of ICIs treatment in EGFR mutation targeted therapy for NSCLC patients with drug resistance, with the aim of achieving individualized treatment. [ABSTRACT FROM AUTHOR]

The damage of regional economic development to ecological environment and ecological management caused by "economic globalization" have gradually aroused people's attention. At the same time, the relationship between the coupling and coordinated development of regional economic development and regional ecological environment as well as their spatial-temporal evolution has become an important research topic under the policy of "carbon neutrality" and "carbon peak". This research guided by the strategy of sustainable development principle, the coupling coordination development model based on constructing a CDO analyzes the regional economic development and the coupling relationship between the coordinated development of ecological environment pollution, and to explore and analyze the between the space-time evolution of the trend, and the sustainable development plan to improve the regional ecological environment protection to provide practical and effective method of governance. The results show that under the background of sustainable development strategy, there is a significant coupling relationship between regional economic development and ecological environmental pollution, with a coupling degree of 0.89 and a dependence degree of 92%. By reforming the region economy development mode, update equipment technology and strengthen the regional environmental quality promoting regional ecological environment protection, after the reform of the coupling between up new mode coupling coordinated development of regional economy and ecological environment, while significantly improve the regional ecological environment quality, which can effectively, reduce the risk of rural ecological environment, feedback the region economy development. [ABSTRACT FROM AUTHOR]

In order to quantitatively characterize the preservation conditions of shale gas of Niuzhitang formation in the Huangling area, the characteristics of formation water (FW) and gas composition of Niutitang formation in wells ZD1, ZD2, CD1, YD2, and YD1 of Huangling area were analyzed based on the analysis of typical structural styles. (1) Under the Xiannushan and Tianyangping faults, the Niutitang formation of wells YD2 and ZD2 located in the north of the Tianyangping syncline is mainly bedding shear fracture, and the ability to communicate surface water and the atmosphere is weak. The type of FW is CaCl2, which has the characteristics of high salinity, high desulfurization coefficient (Cd), high calcium/magnesium coefficient (Cea/Mg), high chlorine/magnesium coefficient (Ca/Mg), and low sodiumchlorine coefficient (CNa/Ci). The contents of nitrogen (N2) and carbon dioxide (CO2) are low, 15N and §13C are mainly -7.3 ‰ ~-1.2 ‰ and-19.2 ‰ ~- 14.8 ‰, respectively, which is the origin of hydrocarbon generation by pyrolysis of OM, indicating that the shale gas is well preserved. (2) The wells XD1 and YD1 located south of the Tianyangping fault and near the Xiannushan normal fault are shallowly buried, mainly large-scale high-angle faults. They have a strong ability to communicate with surface water and the atmosphere. The FW is mainly NaHCO3 type, which has the characteristics of low salinity, low Cd, low CCa/Mg, low Ca/Mg, and high CNa/Cl. The contents of N2 and CO2 are high, with §13C ranging from -12.5 to -3.8 and 15N from - 5.43 to 0 %o, which mainly comes from the atmosphere, indicating that the shale is strongly connected with the atmosphere and surface water, and the preservation condition of shale gas is poor. (3) Based on the analysis of structural elements, the advantages and disadvantages of shale gas preservation conditions can be effectively analyzed using the source of non-hydrocarbon gas and the metamorphic degree of the FW. [ABSTRACT FROM AUTHOR]

Soil heavy metal pollution has become an important environmental pollution problem that plagues most countries and regions in the world today. Black shale is considered as a potential source of heavy metal contamination of soil. In this paper, taking heavy metal mining areas in southern China as an example, the characteristics of heavy metal elements in soil and crops and the degree of heavy metal pollution in soil were systematically studied, and then a strategy for remediation and safe utilization of heavy metal-contaminated farmland soil was formulated. The results showed that the contents of heavy metal elements in different types of soils in the study area were higher than the background values of the corresponding soil elements. The crops grown in the soil of the mining area all exceed the standard, and the heavy metal that exceeds the standard is Ni. The pollution index comparison results showed that the average pollution index of Mo element in dryland soil, paddy soil and forest soil in the study area was the highest, and the pollution degree of Mo element in dryland soil was the highest. The heavy metal content of the soil in the polluted area is seriously polluted, and it is difficult for crops to grow. Therefore, the original planting structure can be adjusted, and the original planting of food crops can be changed to economic crops such as mulberry trees. By planting the mulberry and sericulture industry chain, the heavy metals in farmland can be prevented from being absorbed into the food chain through the roots of plants, so as to achieve the purpose of safe utilization. In addition, in order to prevent heavy metal elements from entering the food chain and endangering human health in heavily polluted areas, a plan should be reasonably formulated to adjust the planting structure of cultivated land or to return farmland to forests and grasslands. [ABSTRACT FROM AUTHOR]

Digital literacy is a multidimensional concept that encompasses a complex integration of knowledge, skills, attitudes, and cognition dimensions, which gains increased attention in the context of higher education. The objective of this study is to analyze the scientific production of digital literacy in higher education from 2012 to 2021 based on the Scopus database, and reveal the current research trends on this subject. To this end, a bibliometric study was carried out, which first investigated some variables that addressed different features, from the distribution of publications to the most productive countries/regions and the prolific publication venues, and continued with the analysis of the authors and the keywords co-occurrence through VOSviewer software. The results show that the most frequently explored themes in the area of digital literacy can be detected, which focused on the integration of digital technology, ontology research and the educational practices of digital literacy, and the effectiveness evaluation of digital literacy in the time of the COVID-19 pandemic. The findings of this study are beneficial for researchers to gain a comprehensive understanding of digital literacy in the domain of higher education, and provide new directions for future research. [ABSTRACT FROM AUTHOR]

Background: Cough is often the most prominent and intractable symptom reported by patients with asthma, but few studies have explored the characteristics of patients with asthma and with chronic cough (CC) in a real-world setting. Methods: In a prospective cohort study, patients ages ≥ 18 years with stable asthma were consecutively recruited at the West China Hospital, Sichuan University. The patients were classified as having asthma with CC (the CC group) or asthma with non-CC (the non-CC group) after 3 months of optimized asthma therapy according to standard guidelines. Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to assess asthma exacerbations. Results: Of 323 patients with asthma, 127 patients were assigned to the CC group and 196 patients were assigned to the non-CC group. The participants with CC were older and had more airflow obstruction; worse asthma control and quality of life; increased airway inflammation; upper respiratory tract infection as a trigger; and more comorbidities, such as psychological dysfunction, rhinitis, chronic obstructive pulmonary disease, and bronchiectasis. They reported greater work productivity loss and daily activity impairment, and increased moderate-to-severe exacerbations. Conclusion: The participants with asthma and with CC had a significant disease burden, with increased exacerbations, health-care utilization, and impaired work productivity and daily activity. These observations indicated potential clinical implications in patients with asthma and with CC, and call for more attention to this aspect of asthma. [ABSTRACT FROM AUTHOR]

Since the sharp decline of oil price, chemical sand control technology has become an important technical support for sand control under low oil price because of its low-cost technical advantages. However, the traditional chemical sand control technology cannot pass through the obstruction of crude oil on the sand surface, resulting in poor sand consolidation effect. Therefore, through the combination of molecular simulation technology and indoor experiments, the active sand consolidation agent for heterogeneous loose sandstone is synthesized, the influence law of the composition is analyzed, and its sand consolidation performance is evaluated. It is found that: (1) Molecular simulation shows that the active sand consolidation agent synthesized by active sand consolidation agent molecular design can contact with sand particle surface through oil film to realize strong bottom hole sand consolidation; (2) With the increase of molecular weight of epoxy resin, the water dispersion stability is improved, and the dispersion stability of epoxy resin E-44 is better than that of other resins; There is an optimal amount of initiator to minimize the particle size, and the optimal amount is 1.9%; There is an optimal amount of monomer to make the grafting rate the highest, and the amount is 1.5%; (3) With the increase of aging time, the compressive strength of solidified rock samples decreases firstly and then stabilizes, and the permeability is just the opposite; With the increase of polymer concentration, the consolidation strength of other types of sand consolidation agents decreases rapidly, and the consolidation strength of active sand consolidation agents remains basically unchanged; With the increase of formation sand particle size, the consolidation strength of sand consolidation agent decreases, but the decrease range of active sand consolidation agent is the smallest; The higher the mud content, the lower the consolidation strength of sand consolidation agent, but the influence is limited when the mud content exceeds 20%; Experiments show that the sand filtering effect is good. [ABSTRACT FROM AUTHOR]

The spontaneous combustion of low-rank anthracite coal not only causes environmental pollution, but also seriously affects the progress and efficiency of coal mining operations. At present, the research on the spontaneous combustion process of anthracite only stays in the influence of external conditions on the natural process, while its internal mechanism and design of related engineering measures have been ignored. In order to solve these problems, in this paper, a self-built experimental device was used to study the influence of water immersion effect on the spontaneous combustion process of anthracite, and then, engineering measures to prevent uncontrollable spontaneous combustion of coal were proposed. Research results showed that spontaneous combustion of anthracite under the action of water immersion produced more CO, but the difference in CO2 output was small. The final CO generation rate of the waterleached coal sample was 532.15 ml/s, while the final CO generation rate of the raw coal sample was only 176.34 ml/min. Water immersion has little effect on the amount of oxygen consumed by spontaneous combustion of anthracite. When the temperature was 180°C, the oxygen consumption of anthracite when affected by the water immersion was 5 434.25 ml/min, and when the anthracite is not affected by the water immersion, the oxygen consumption was 5 451.67 ml/min. Water immersion will cause anthracite to produce more C2 products during the spontaneous combustion process. This was mainly because the water immersion effect destroyed the surface microstructures of anthracite, resulting in more fractured surfaces being produced and exposed, so that the surface of anthracite has stronger polarity and activity. This research can provide theoretical support for the reduction of spontaneous combustion risk of anthracite and the improvement of mining efficiency. [ABSTRACT FROM AUTHOR]

This qualitative study describes the psychological experience of patients hospitalized with COVID-19. These patients went through 3 psychological stages: extremely uncertainties during the initial diagnostic stage, complicated feelings of negativity during the treatment stage, and positive growth in the recovery stage. It is important for nurses to provide holistic care. [ABSTRACT FROM AUTHOR]

Objective: VEGF-D is a potential biomarker for lymphangioleiomyomatosis (LAM); however, its diagnostic performance has yet to be systematically studied. Methods: We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library to identify primary studies on VEGF-D in relation to the diagnosis of LAM. The quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Summary estimates of diagnostic accuracy were pooled using a bivariate random effects model. Subgroup and sensitivity analyses were performed to explore possible heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to rate the quality of evidence and indicate the strength of recommendations. Results: Ten studies involving 945 patients were of high risk in quality, as assessed using the QUADAS-2. The pooled diagnostic parameters were indicated as follows: sensitivity = 0.82 (95% CI, 0.71-0.90); specificity = 0.98 (95% CI, 0.94-0.99); and diagnostic OR = 197 (95% CI, 66-587). The AUC of summary ROC analysis was 0.98. The subgroup and sensitivity analyses revealed that the overall performance was not substantially affected by the composition of the control group, prespecified cutoff value, the country of origin, or different cutoff values (p > 0.05 for all). A strong recommendation for serum VEGF-D determination to aid in the diagnosis of LAM was made according to the GRADE. Conclusions: VEGF-D seems to have great potential implications for the diagnosis of LAM in clinical practice due to its excellent specificity and suboptimal sensitivity. [ABSTRACT FROM AUTHOR]

Existing methods for blind identification of linear block codes without a candidate set are mainly built on the Gauss elimination process. However, the fault tolerance will fall short when the intercepted bit error rate (BER) is too high. To address this issue, we apply the reverse algebra approach and propose a novel "two-step-screening" algorithm by solving the linear error equations on the binary Galois field, or GF(2). In the first step, a recursive matrix partition is implemented to solve the system linear error equations where the coefficient matrix is constructed by the full codewords which come from the intercepted noisy bitstream. This process is repeated to derive all those possible parity-checks. In the second step, a check matrix constructed by the intercepted codewords is applied to find the correct parity-checks out of all possible parity-checks solutions. This novel "two-step-screening" algorithm can be used in different codes like Hamming codes, BCH codes, LDPC codes, and quasi-cyclic LDPC codes. The simulation results have shown that it can highly improve the fault tolerance ability compared to the existing Gauss elimination process-based algorithms. [ABSTRACT FROM AUTHOR]

Background: Symptomatic asthma and rhinitis negatively impact patients' work productivity and activity. However, little is known about the potential interaction effect of both asthma and rhinitis control on work productivity and activity impairment. Objective: This study aimed to explore whether there are interaction effects of asthma and rhinitis control on work productivity and activity impairment in patients with asthma and with rhinitis. Methods: A total of 206 adult patients were prospectively recruited and were divided into four groups: both poorly controlled (BPC) n = 53), poorly controlled asthma (PCA) with controlled rhinitis (CR) (n = 38), well controlled asthma with uncontrolled rhinitis (n = 43), and both well controlled (BWC) (n = 72) based on the symptom control status of asthma and rhinitis. Work productivity loss and activity impairment, asthma control, and rhinitis control were assessed by using work productivity and activity impairment questionnaire: general health, the asthma control test, and the rhinitis control assessment test, respectively. General linear regression models were used to study the contribution of asthma control, rhinitis control, and the interaction effect on work productivity and activity impairment. Results: Work productivity loss was most frequently reported in patients in the BPC group. Compared with the patients in the BWC group, the patients in the PCA-CR group had significantly higher activity impairment and worse asthma-related quality of life (both p< 0.001). There were significant interaction effects of asthma and rhinitis control, which accounted for the increase in presenteeism, work productivity loss, and activity impairment (all p< 0.001). Although differences in absenteeism were not significant among the groups, there was a significant interaction effect of control levels accounted for absenteeism (p=0.035). Conclusion: Distinct interaction effects of asthma and rhinitis control reflected a link between upper and lower airways, which indicated that rhinitis control and the interaction effects of asthma and rhinitis control cannot be neglected during asthma management. [ABSTRACT FROM AUTHOR]

A functionally fluorinated emulsion and starch particles co-doped electrospun poly-m-phenyleneisophthalamide (PMIA) nanofiber membrane-based gel polymer electrolyte was produced to inhibit the "shuttle effect" of lithium polysulfides (LiPSs) and promote the transport of lithium ions for lithium-sulfur (Li-S) batteries. The high mechanical property, high thermal stability, and significant preserving liquid electrolyte of the prepared membrane are derived from the addition of functionally fluorinated emulsion and starch particles. Specially, with the chemical adsorption of -OH in starch particles and physical prevention of a gel state deriving from the prepared membrane, the lithium polysulfides are effectively controlled in the side of the cathode. In addition, the polar group and stable helix structure existing in starch particles are beneficial to the fast migration of Li+. Therefore, the battery with the Starch-F PMIA separator possesses a first-discharge capacity of 1117.8 mAh g-1 at 0.5 C. Moreover, an Li-S battery assembled with the prepared membrane also reflects preeminent rate performance, low interface impedance, and admirable cycling stability. In consequence, the Starch-F PMIA separator is a promising candidate for the progressive lithium sulfur batteries. [ABSTRACT FROM AUTHOR]

Recently, performance improvement in facade parsing from 3D point clouds has been brought about by designing more complex network structures, which cost huge computing resources and do not take full advantage of prior knowledge of facade structure. Instead, from the perspective of data distribution, we construct a new hierarchical mesh multi-view data domain based on the characteristics of facade objects to achieve fusion of deep-learning models and prior knowledge, thereby significantly improving segmentation accuracy. We comprehensively evaluate the current mainstream method on the RueMonge 2014 data set and demonstrate the superiority of our method. The mean intersection-over-union index on the facade-parsing task reached 76.41%, which is 2.75% higher than the current best result. In addition, through comparative experiments, the reasons for the performance improvement of the proposed method are further analyzed. [ABSTRACT FROM AUTHOR]

Rationale: Emphysematous pyelonephritis is a life-threatening infectious disease that requires early diagnosis and treatment. The disease is often misdiagnosed due to its diversity of clinical manifestations. Patient's concern: A 62-year-old woman was admitted to the emergency department following a 12-hour history of abdominal pain and dyspnea. Physical examination showed percussion pain on the right costovertebral angle. Besides, she had a history of diabetes mellitus and urinary calculus. Diagnosis: Emphysematous pyelonephritis. Intervention: The patient accepted antishock therapy, tight glucose control, and broad-spectrum anti-infective therapy. After stabilization of the general condition, an ultrasound-guided percutaneous nephrostomy was performed. Outcome: Her conditions became stable over the following days. She presented a favorable clinical course, with normalization of renal function and positive improvements in imaging findings in a month. Lessons: Early diagnosis and rapid medical management are the keys to successful treatment. CT is an important method for the diagnosis of emphysematous pyelonephritis. For patients with severe lesions, percutaneous renal drainage combined with active anti-infection should be given in time. [ABSTRACT FROM AUTHOR]

Multivariate normality of logarithmic intensity measures (IMs) is conventionally assumed in earthquake engineering applications. This article introduces a vine copula approach as a useful tool for multivariate modeling of IMs. This approach provides a flexible way to decompose a joint distribution into individual marginal distributions and multiple dependences characterized by a cascade of bivariate copulas (pair-copulas), whereas the conventional multivariate normality can be considered as a special case of the vine copula model. Based on the Next Generation Attenuation-West1 database and various combinations of ground-motion prediction equations (GMPEs), the optimal dependence structures among peak ground acceleration, peak ground velocity, and Arias intensity, as well as that for spectral accelerations at four periods, are identified. The joint normality assumption for the two vector sets of logarithmic IMs is examined from the perspective of copula theory. The results illustrate that the normality assumption is generally adequate for bivariate IMs but may not be optimal for multivariate IMs. Using the same set of GMPEs (developed by the same researchers) may improve the joint normality for logarithmic IMs. Furthermore, the impact of dependence structures among IMs on probabilistic seismic slope displacement hazard analysis is explored. The results indicate that using the same Pearson correlation coefficients but different dependence structures for IMs produces different hazard results and this difference is generally enlarged with increasing hazard levels. As hazard difference from different dependence structures is generally not significant, the multivariate normality distribution for logarithmic IMs is judged to be an acceptable assumption in engineering practice. Alternatively, engineers may make a choice between the joint normal distribution and the vine copula tool depending on the specific situation because of the better generality of the latter. [ABSTRACT FROM AUTHOR]

Background: Although studies have consistently linked obesity and asthma, the potential influence of visceral obesity on asthma has not been well investigated. Objective: To study the associations of visceral fat area (VFA) and clinical and inflammatory features of asthma and to further explore the effects of VFA on the future risk of asthma exacerbation. Methods: A 12-month prospective cohort study based on the Australasian Severe Asthma Network was designed to observe patients with stable asthma grouped by the median value of VFA. The clinical and inflammatory features of asthma were compared between the low VFA (VFAlow) and high VFA (VFAhigh) groups. Relationships between VFA and clinical and inflammatory features of asthma were analyzed by using correlation analysis. Univariate and multivariable negative binomial regression analyses were performed to investigate the association of VFA with exacerbations within a 12-month follow-up period. Results: The patients in the VFAhigh group were older and had a longer asthma duration. Interleukin (IL) 6 and IL-8 in sputum were higher, whereas fractional exhaled nitric oxide (FeNO) and blood eosinophils were lower in the VFAhigh group. Gender-differentiated correlations of VFA with clinical and inflammatory variables were observed in age, FeNO, immunoglobulin E, blood total white cells and neutrophils, and sputum IL-1b and IL-8. Furthermore, compared with the VFAlow group, the VFAhigh group was at significantly increased risk of moderate-to-severe exacerbations (adjusted incidence rate ratio [IRR] 1.55 [95% confidence interval {CI}, 1.06-2.28; p = 0.025), severe exacerbations (adjusted IRR 2.25 [95% CI, 1.26-4.04]; p = 0.007), and emergency visits (adjusted IRR 5.33 [95% CI, 1.78-17.16]; p = 0.003). Conclusion: The level of VFA was associated with specific clinical and inflammatory characteristics of asthma. Furthermore, VFA, as an independent risk factor, was associated with an increased risk of exacerbations. It indicated that VFA would provide more potential clinical implications for asthma management. [ABSTRACT FROM AUTHOR]

Fracturing technology is one of the main methods for the development of low-permeability and low-pressure oil and gas reservoirs. Thickener is the key treatment agent in the fracturing fluid to improve the fracturing effect. The guar film is reacted with chloroacetic acid and propylene oxide under the action of sodium hydroxide to form carboxymethylhy-droxypropyl guar. By detailed and precise observation and analysis of the performance of the modified product affected by factors such as the amount of propylene oxide, the material ratio, and the reaction temperature, the most suitable synthetic process conditions were determined. The volume ratio of the guar film, sodium hydroxide, ring oxypropane, and chloroacetic acid is 1: 0.2: 0.15: 0.2. The components were alkalized at 25℃ for 40min, and etheri-fied at 85℃ for 3h. The insoluble content of carbox-ymethylhydroxypropyl guar gum reduced to about 3 %. The viscosity of the product is 110mPa s, which is higher than industry indicators. [ABSTRACT FROM AUTHOR]