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As the major source of energy for colonic mucosal cells and as an important regulator of gene expression, inflammation, differentiation, and apoptosis in host cells, microbiota-derived butyrate can enhance the intestinal mucosal immune barrier, modulate systemic immune response, and prevent infections. Maintaining a certain level of butyrate production in the gut can help balance intestinal microbiota, regulate host immune response, and promote the development and maintenance of the intestinal mucosal barrier. Butyrate-producing bacteria act as probiotics and play important roles in a variety of normal biological functions. Bacteriotherapeutic supplementation by using fecal microbiota transplantation to restore butyrate-producing commensal bacteria in the gut has been very successful in the treatment of recurrent and refractory Clostridium difficile (C. difficile) infection or C. difficile-negative nosocomial diarrhea. Administration of probiotics that include butyrate-producing bacteria may have a role in the treatment of inflammatory bowel diseases and in the prevention of necrotizing enterocolitis and late-onset sepsis in premature infants. Furthermore, modulating gut microbiota with dietary approaches may improve intestinal dysbiosis commonly seen in patients with obesity-associated metabolic disorders. Supplementation with a butyrate-producing bacterial stain might be used to increase energy expenditure, improve insulin sensitivity, and to help control obesity and metabolic syndrome.

Introduction: This paper presents our experience with deep venous stenting in a multi-ethnic Asian cohort of patients with symptomatic Non-Thrombotic Iliac Vein Lesions (NIVL) and Post-Thrombotic Syndrome (PTS). Materials and Methods: This was a multicentre retrospective cohort study of patients who had symptomatic deep venous disease. Stent patency rate was evaluated using Duplex ultrasonography immediately post-intervention and at 3, 6 and 12 months. Clinical outcomes were evaluated using the revised Venous Clinical Severity Score (rVCSS) and Visual Analogue Scale (VAS) pain score at baseline and 3 months post-procedure. Results: 87 patients (males = 47/87 (54.0%)); median age = 62 years (IQR 55 – 70)) and 115 limbs were analysed (left = 76/115 (66.1%)). Median follow-up time was 175 (IQR 57 – 257) days. 97/115 (84.3%) had NIVLs and 55/115 (47.8%) had May-Thurner-Syndrome. 43/115 (37.4%) had Clinical, Etiology, Anatomy and Pathophysiology (CEAP) 6 disease. Primary stent patency rates were 98.2% (112/114), 97.9% (93/95), 95.7% (89/93) and 92.8% (64/69) immediately postintervention, 3, 6 and 12 months, respectively. The 6-month secondary patency rate was 99.1% (114/115). Mean rVCSS and VAS improved from 11.52 (±3.54) to 5.77 (±2.36) (P < 0.01) and 6.62 (±1.93) to 2.92 (±1.50) (P < 0.01) respectively, at 3 months. 41/43 (95.3%) venous ulcers healed over a median time of 169 days (IQR 120 – 253). Conclusions: Short term primary patency rates following deep venous stenting are excellent, with few re-interventions. Patients presented with NIVLs rather than PTS. There was excellent clinical improvement at 3 months, with a high and expedient venous ulcer healing rate. Key words: Deep vein stenting, May-Thurner Syndrome, Non-thrombotic iliac vein lesion, Post-thrombotic syndrome, Vascular patency

Ischaemic diabetic heel ulcers are difficult to treat and prognosis is often guarded. The aim was to document our outcome of treating heel ulcers following revascularization in a predominantly diabetic Asian cohort presenting with chronic limb threatening ischaemia from Singapore. Retrospective cohort study (n = 66, 66 limbs) over a 5‐year period. Data were collected from hospital electronic health records. Outcomes included time to healing, amputation free survival (AFS), and mortality. Minimum follow‐up period was 6 months. Multivariate regression analysis was performed to look for factors associated with poor outcome. Mean age was 67.4 ± 8.8 years. 62/66 (93.9%) were diabetics. Mean wound size at presentation was 3.6 ± 2.3 cm. Mean Wound, Ischaemia, Foot Infection (WIFI) score was 5 ± 1.6. 12/66 (18%) patients had a patent posterior tibial artery pre‐operatively. Straight line flow was restored in only 31/66 (46.9) patients but 47/66 (71.2%) had successful limb salvage. Median time to wound healing was 90.0 (IQR 60‐180) days. A median of 1 (IQR 0‐2) wound debridement was required. Patients who underwent negative pressure dressing (23/66; 34.8%) required a median of 26 (IQR 13‐33) cycles to achieve healing. Amputation free survival (AFS) was 72% and 68% at 6‐ and 12‐months, respectively. Mortality rate was 16.7% and 19.7% at 6‐ and 12‐months, respectively. Low albumin level and initial Rutherford class were independent predictors of worse 6‐month AFS. Outcomes of heel ulcers post revascularisation may not be as poor as previously described. Persistent attention to wound care with multidisciplinary effort is needed for optimal healing.

Iliocaval venous compression syndrome (ICS) is the extrinsic compression of the common iliac vein by the overlying iliac artery against the vertebra. Chronic compression can lead to venous stenosis and stasis, which manifests as chronic venous disease and treatment resistance. Therefore, early recognition of ICS and prompt treatment are essential. Clinical presentations of ICS can be ambiguous and diagnosis requires a high index of suspicion with the relevant imaging studies. The initial imaging test is typically a Duplex ultrasound for vessel assessment and pelvic ultrasound to exclude a compressive mass, which is followed by computed tomography (CT) or magnetic resonance (MR) venography. CT and MRI can identify the anatomical causes for venous compression. In patients with high clinical suspicion for ICS, negative findings on CT and MR venography would still warrant further investigations. Definitive diagnosis can be established using catheter-based venography complemented with intravascular ultrasonography but the nature of their invasiveness limits its utility as a routine imaging modality. In this review paper, we will discuss the evidence, utility and limitations of the existing imaging modalities and endovascular intervention used in the management of ICS.

Numerical simulations were conducted to study the effects of the pulverized-coal bias distribution in the primary air on the coal combustion and NOx generation characteristics of a 600-MW down-fired boiler with multiple-injection and multiple-staging combustion technology. The total pulverized-coal in the primary air was kept constant, and the ratio of the pulverized-coal mass flux in the fuel-rich coal/air flow to the total pulverized-coal mass flux (RPR) was set as 60%, 70%, 80%, and 90%. By changing the RPR, the excess air coefficient of the fuel-rich flow was adjusted from 0.700 to 0.467. It was found that numerical simulation results were almost in agreement with cold modeling and in situ experimental results respectively, including the flow fields in the lower furnace at the RPR of 80% and the heating processes for the fuel-rich coal/air flow at the RPR of 90%, which verified the rationality of the numerical model and the grid. The simulation results indicated that the change of RPR has little effect on the symmetry of the flow field in the furnace. With the increase of the RPR from 60 to 90%: (1) the maximum airflow declination angle near the tertiary air slot decreased from 71 to 66°, which indicates that the downward airflow penetration depth gradually decreased; (2) the ignition distance of the fuel-rich coal/air flow decreased from 1.2 to 0.9 m, and the high-temperature area in the furnace hopper decreased and the position gradually moved away from the hopper water walls; (3) the oxygen consumption rate at the initial combustion stage constantly accelerated, and the fuel NOx generation rate under the fuel-rich flow nozzle increased first and then decreased; (4) the NOx emissions at the furnace exit dropped from 778 to 662 mg/m3 at 6% O2, and the carbon in the fly ash decreased from 5.87 to 5.52%. Increasing the RPR reasonably controlled the excess air coefficient of the fuel-rich flow, and realized the high-efficiency combustion in the furnace and the reduction of NOx emissions simultaneously.

Defect segmentation is an important way for defect detection in machine vision. For polycrystalline silicon wafer production, it is difficult to automatically segment defects due to its inhomogeneous background and unpredictable defect shapes. The conventional methods based on handcrafted models or features not only heavily rely on the expertise, but also are not flexible from one application case to another. In this paper, we propose a defect segmentation method for polycrystalline silicon wafer based on the deep convolutional networks. Firstly, we apply Region Proposal Network (RPN) to generate underlying defect regions. Then, these generated image patches are processed to suitable sizes for feeding into a improved segmentation network which is modified based on U-net and a dilation convolution. Real defect images are used to test the proposed method and experimental results show that proposed method achieves better performance compared with the state-of-the-art methods.

In this research, enrichment factor (EF) and pollution load index (PLI) were utilized to estimate the features of enrichment and contamination of PTEs in farmland soil. Furthermore, combining the spatial distribution characteristics of potentially toxic elements (PTEs) and positive matrix factorization (PMF) to distinguish and quantify the sources of PTEs in farmland soil, and then the potential ecological risk (PER) and human health risk (HHR) model based on PMF are applied to quantify the ecological and human health risks from different sources. Taking Puning District as an example, four sources of PTEs in farmland soil were quantitatively allocated. For ecological risk, the study area is at moderate ecological hazard level, and industrial activities were the greatest contributor. The mean E_r^i of Hg were 69.82, reaching medium ecological risk level. For human health risks, both adults and children have no evident non-carcinogenic risk in the study area. And natural source was the largest contributor to non-carcinogenic risk, followed by agricultural activities. With regard to carcinogenic risk, tolerable risks of soil PTEs in the study area were limited not only for adults but also for children. Furthermore, compared with adults, the health risks of children, whether non-carcinogenic or carcinogenic, were higher than those of adults, and the trends in health risks for children and adults were similar. A comprehensive scheme combining source contribution and risk assessment is conducive to quantitatively assess ecological risks, health risks and priority pollution sources, thereupon provide effective suggestions for protecting human health and preventing and controlling pollution.

Background：To investigate the efficacy of venetoclax combined with azacytidine in the treatment of elderly patients with relapsed and refractory (R/R) acute myeloid leukemia（AML). Methods： The clinical data of 9 elderly AML patients over 65 years old, including 5 with R/R AML, using venetoclax and azacytidine were retrospectively analyzed. Results： Six males and 3 females with a median age of 71 years were included in this study, of which four patients had at least one relapse, and one patient did not get go into remission after 4 cycles of azacytidine monotherapy, deeming it refractory. Four patients had AML with myelodysplasia-related changes (AML-MRC). After 1 to 13 cycles of treatment using venetoclax and azacytidine, one of the 9 patients died early due to long duration of neutropenia and severe pulmonary infection caused by drugs. and six of the remaining 8 patients obtained complete response or complete response with incomplete hematologic recovery (CR/ CRi) , including five R/R patients. One patient did not respond to treatment after two cycles. For the side effects of the treatment, granulocytopenia occurred in all patients, and neutropenia occurred in 8 patients, lasting for an average of 10.5 (6-15) days and was most obvious in the second to third week of treatment. Three patients with TP53 gene mutation positive had following different outcomes. One relapsed patient achieved progression free remission (PFS) for 16 months up to date, and a second patient achieved complete remission but relapsed two months thereafter. Another patient had complete remission in myelology for 4months, but the variant allele fraction value (VAF) gradually increased, indicative that the disease was about to progress. Conclusion：Venetoclax combined with azacytidine regimen in elderly patients is an effective and well tolerated rescue scheme for R/R AML.The patients with TP53 mutation with lower VAF may be benifit from Venetoclax and azacytidine. Severe infection caused by neutropenia is an adverse reaction worthy of attention in the treatment process of the regimen.

Real time operating system (RTOS) is an operating system which is designed to execute tasks in a guaranteed time. In this paper, we introduce SylixOS - a powerful and open source RTOS. As an industrial RTOS, SylixOS has been used in aerospace, military and many more embedded devices. We introduce the development path and some advanced features of SylixOS. In addition, SylixOS also supports the multiprocess. We discuss how SMP scheduling algorithms can be applied in SylixOS. Performance evaluations of SylixOS are presented to assess the real-time efficiency of SylixOS.

The eccentric-swirl-secondary-air combustion technology has been confirmed to comprehensively solve high NOx emission and poor coal burnout for down-fired boilers with swirl burners. The influence of vent-air inclination angle (βv), a critical factor that affects coal burnout, on gas/particle flow characteristics is investigated to further decrease unburned combustible in fly ash. Gas/particle two-phase flow experiments under different βv (i.e., 10°, 20°, 28°, 40° and 50°) are performed by using a particle dynamic analyser in a 1:10-scale model of the full-scale improved boiler. With increasing βv, the under-arch recirculation zone and the recirculation velocities of gas/particle flows continuously increase. In the staged air region, the vertical velocities of gas/particle flows near water-cooled wall for βv of 40° and 50° are still as high as 2–4 m/s, however, the vertical velocities of gas/particle flows basically decay to negative values for smaller βv of 10° and 20°. At furnace section Y/Y0 from 0.220 to 0.369, the vertical fluctuation velocities of gas/particle flows near water-cooled wall for βv of 40° and 50° are significantly higher than those with βv of 10°, 20° and 28°, and the particle volume flux at the same horizontal position X/X0 constantly increases with increasing βv. Furthermore, the downward ejection ability of vent air to gas/particle flows from burners continuously improves, and the downward depth of gas/particle flows and the space utilization ratio of lower furnace both increase with increasing βv. The appropriate inclination angle of vent air for the improved boiler varies from 40° to 50°.

A comprehensive study of thermo-economic analysis and practical conceptual design of miniaturized lead-cooled fast reactor (LFR) composing supercritical CO2 power cycle is proposed in order to promote the real application in the market. The thermodynamic model and economic model are established based on the following five supercritical CO2 (S-CO2) Brayton cycles integrating with the miniaturized LFR, separately. Moreover, the optimization algorithm is adopted to optimize the key parameters of five power cycles with the objectives of maximizing the system thermoelectric conversion efficiency and electricity production costs (EPC) simultaneously. The optimal cycle and optimum parameters are obtained for the integrated system. Furthermore, the structural parameters of key components are confirmed based on the above results. The main subsidiary systems are designed. Finally, the practical design of LFR composing S-CO2 power cycle is carried out. The results shown that various parameters have different effects on the thermodynamic-economic performance of the system. The higher inlet temperature of turbine is beneficial to improve both thermodynamic and economic performance of the system. With the ƞt,sys-EPC analyzed simultaneously, the recompression cycle is the optimal to operate with more working conditions. Its ƞt,sys is from 36.68% to 44.46%, and EPC is from 0.050 $·kW−1·h−1 to 0.055 $·kW−1·h−1).

To further reduce unburned combustible in fly ash of the improved down-fired boiler with the eccentric-swirl-secondary-air combustion technology, a breakthrough idea is proposed to significantly increase the primary air velocity by reducing the damper opening of vent air. In this study, the effects of the high primary air velocity on anthracite burnout and NOx formation are investigated via industrial experiments. With increasing primary air velocity, there is a significant change in the dominant role between the inhibition effect of pulverized coal concentration reduction and the promotion effect of the recirculation zone enlargement on the pulverized coal ignition. With increasing primary air velocity from 23.9 to 32.6 m/s, the flue gas temperature in the furnace hopper increases by approximately 75 °C. Besides, the increase of coal char burnout rate at the initial combustion stage is larger than that at the intense combustion stage, and the sum of NOx reduction rates at the initial and intense combustion stages varies from 57 to 61%. The boiler thermal efficiency basically rises linearly from 91 to 92.34% with increasing primary air velocity from 23.9 to 32.6 m/s, and the change of primary air velocity has little influence on the NOx emission at the furnace outlet. Compared with the original boiler, unburned combustible in fly ash decreases by approximately four percentage points, boiler thermal efficiency increases by 3.3%, and NOx emission decreases by 43.3% under the primary air velocity of 32.6 m/s for the improved boiler.

The brewing by-product brewer’s yeast biomass (BYB) was evaluated as a bioadsorbent for removal of basic dyes and lead from aqueous solutions. The functional groups including the hydroxyl group and...

Summary: Background: Iliofemoral vein stenosis can cause debilitating chronic venous disease. Diagnostic tools include both computed tomography venography (CTV) and intravascular ultrasonography (IVUS). We aim to compare the diagnostic performance of CTV and IVUS. Patients and methods: We performed a retrospective study of patients with chronic venous disease presenting with iliac vein compression or post-thrombotic limb symptoms, excluding those with acute deep vein thrombosis, high anaesthesia risk, or who had contrast allergy. All patients received CTV before IVUS, as part of the diagnostic work-up and intervention. The cross-sectional area (CSA) of iliofemoral vein segments obtained from both studies were compared against reference CSAs to derive percentage stenosis. A 50% reduction in CSA was considered significant. Results: We studied 50 patients between May 2018 and April 2019. 58% of patients had severe disease CEAP C5-6. 48% of patients had at least one vein segment with significant stenosis. The left proximal common iliac vein was the most commonly stenosed vein segment (n = 12, 24% on IVUS). CSA measurements from CTV were greater than those of IVUS, with a correlation coefficient of 0.57 (p

Floating wind turbine is the core of offshore floating power generation and an important way to develop offshore wind resources. In recent years, artificial intelligence technology has made great achievements in many fields, and equipment fault diagnosis is also very prominent. As the working environment of the floating fan unit is bad and far away from the land, once the floating fan unit generator fails, it may have very serious consequences. Based on the research results of artificial intelligence technology, this paper focuses on the application of artificial intelligence technology in the fault diagnosis of floating wind turbine generator, and proposes an intelligent fault diagnosis system framework. According to the research of expert system and artificial neural network, the fault diagnosis technology of floating fan generator is put forward, and the artificial neural network model and reasonable fault diagnosis reasoning flow are given.

OBJECTIVE To evaluate the efficacy and safety of gandouling plus sodium dimercaptosulphonate (DMPS) on neurological Wilson's disease (WD) in patients. METHODS We retrospectively evaluated the clinical records of 125 WD patients with neurological syndromes who were treated with gandouling plus sodium DMPS or DMPS used alone. All patients had a history of neurological deterioration during their diseases courses. The clinical efficacies, adverse reactions, and results of the various hematological and biochemical investigations were recorded for statistical analysis. RESULTS 92.30% (60 patients) of the WD patients treated with the combined therapy experienced an improved or stable neurological condition paralleled by a significantly improved GAS score. Meanwhile, the WBC and PLT counts stabilized, liver function and renal function were improved or remained stable. The combined therapy also obviously promoted the 24-h urinary copper excretion. In particular, only 30.76% of the WD patients experienced mild adverse reactions, including neurological deterioration in 5 patients (7.69%), hepatic worsening in 1 subject (1.89%), which was less frequently than those in the control group treated with DMPS only. CONCLUSION Our findings indicate that the safety and efficacy of gandou-ling plus DMPS is superior to those of DMPS used alone in the WD patients with neurological symptoms.

To make pollution evaluation of potentially hazardous elements in the soil more accurately, the regional geochemical baseline concentrations of eight potentially hazardous elements (Cr, Ni, Cu, Zn, As, Cd, Hg, and Pb) were established in Huilai County using cumulative frequency distribution curves. Then, the pollution load index and enrichment factor were applied to estimate the contamination levels, based on these geochemical baseline concentrations. The results suggested that topsoil was moderately polluted by potentially hazardous elements, while Cd pollution in the construction land and As pollution in the farmland was relatively severe. The possible sources of eight potentially hazardous elements were analyzed by correlation analysis, geostatistics and positive matrix factorization. Four sources have been determined and apportioned, namely industrial activities, natural sources, agricultural practices, and traffic emissions. Combining the health risk assessment with the source profiles, the health risks quantified from four sources were estimated under farmland, construction land, and woodland. The results showed that agricultural practices were the most main source of non-cancer and cancer risks under woodland and farmland for adults; industrial activities were the most main source of non-cancer and cancer risks under construction land for adults. Children's health risks, both carcinogenic risk and non-carcinogenic risk, were greater than adults, and the health risk trends of adults and children showed similarities. Therefore, agricultural practices under woodland and farmland should be controlled and managed as a priority, while industrial activities should be given priority to control and management under construction land.

The lead is considered as a more attractive material of coolant than lead/bismuth because of higher availability, lower price and fast neutron spectrum in recent years. In this paper, the thermodynamic analysis and cost-benefit-analysis of miniaturized lead-cooled fast reactor (LFR) composing different power cycles have been investigated to examine the optimization result of the miniaturized system in the commercial market. The study proposes a design of such the miniaturized LFR system for a first step implementation of the technology. First, the typical cycles include the reheating recompression supercritical CO2 Brayton cycle (hereinafter referred to as S-CO2 cycle), the traditional steam Rankine cycle and the helium (He) Brayton cycle. Second, main parameters of thermodynamic analysis and economic analysis are based on the National Standards of Chinese Industry and the realistic financial and cost estimating assumptions in China. Third, the reheating recompression S-CO2 Brayton cycle is the optimal option to the LFR. The main results demonstrate that the thermal efficiency of the reheating recompression S-CO2 Brayton cycle is 43.72%. The efficiency of the LFR generation system comprising reheating recompression S-CO2 Brayton cycle is 41.53%. Both of them are greater than the efficiencies of steam Rankine cycle (38.62%, 36.69%) and He cycle (37%, 35.41%). Finally, the electricity production costs (EPC) of LFR generation system is obtained as $0.0536/(kW·h), which is lower than the average electricity price in China ($0.0632/kW·h). The payback period of the investment is 31.4 years while the lifespan is 40 years. The profit of company undertaking the LFR generation system is $6.3 million. Therefore, it can be found that the reheating recompression S-CO2 Brayton cycle is the primary choice of the LFR system, and its profit for commercialization of the system is beneficial.

BACKGROUND The aim of this study was to investigate the expression level of martrilin-3 (MATN3) in patients with gastric adenocarcinoma (GAC) and to investigate the prognostic significance of MATN3. MATERIAL AND METHODS Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) data were used to predict the expression and prognostic value of MATN3 mRNA in GAC patients. Seventy-six GAC patients had GAC tissue samples and paired adjacent normal tissue samples collected retrospectively to examine the MATN3 protein expression level by immunohistochemical staining. Furthermore, Kaplan-Meier univariate and Cox multivariate analyses were used to verify the correlation between MATN3 expression and clinicopathological parameters of GAC patients and the prognostic significance of MATN3. RESULTS The GEO and TCGA data predicted that MATN3 mRNA levels were significantly higher in GAC tissue compared to normal tissue (all p

In this paper, a complete mathematical model is developed to carry out the thermodynamic analysis and comparison for different direct-heated S-CO 2 Brayton cycles (simple, pre-compression, recompression, partial-cooling, and intercooling) integrated into a solar power tower (SPT) system. Based on the model, the effect of turbine inlet temperature (TIT) on the thermodynamic performances of the receiver, the thermal energy storage unit, the S-CO 2 power cycle blocks and the integrated SPT systems is investigated respectively for these cycles. Additionally, a comparison of cycle efficiencies and overall integrated SPT system efficiencies is performed for five S-CO 2 cycles at a series of total recuperator conductance ( UA total ) values. The results reveal that the TIT exhibits a parabolic effect on the overall efficiencies for each S-CO 2 cycle, and the intercooling S-CO 2 cycle achieves the highest overall efficiencies followed by the recompression, the partial-cooling, the pre-compression, and the simple cycles at different TIT values. Furthermore, the partial-cooling cycle possesses the highest overall specific work at each TIT and offers higher overall efficiencies than the recompression cycle at a constant TIT (650 °C) as the UA total is rather low, having the potential to reduce the costs of integrated SPT systems with limited UA total values.

The development technology and applications of supercritical CO2 power cycle have recently been gaining a lot of attention for applications to different energy industries. The advantage of the S-CO2 cycle is high-efficiency within an economic and convenient structure. The stable chemical properties make it be proper to a range of metal material applications. This study provides a detailed comprehensive study of the recent development trends of the S-CO2 power cycle and the different applications of S-CO2 power cycle in various energy industries, especially nuclear energy and solar energy. The theoretical analysis, experimental analysis and the classification of different approaches are summarized for energy sources. The comparison of working fluids, component designs are presented in the article as well. The challenges for improving the efficiency of S-CO2 power cycle applications are analyzed. The study will be a beneficial complement to understanding the recent progress.

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life- sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge., The authors received no funding for this study. However, the LUNG SAFE study was funded and supported by the European Society of Intensive Care Medicine (ESICM; Brussels, Belgium), St. Michael's Hospital (Toronto, ON, Canada), and the University of Milano-Bicocca (Monza, Italy).

In the present study, several current S-CO 2 Brayton cycle layouts are reviewed, and considered to be integrated into the existing mature molten salt solar power tower (SPT) systems. The SPT systems integrated with S-CO 2 Brayton cycles are completely modeled by an integrative approach. The performances of these different cycles are compared comprehensively for applications in molten salt SPT systems from the aspects of the efficiency, the specific work, and the incorporation ability with the thermal energy storage indicated by the molten salt temperature difference across the solar receiver. The results indicate: (1) The intercooling cycle can generally offer the highest efficiency, followed by the partial-cooling cycle, and the recompression cycle; The precompression cycle can yield higher efficiency than the recompression cycle when the compressor inlet temperature is high; The increase in the hot salt temperature cannot always result in the efficiency improvement of the SPT systems. (2) The partial-cooling cycle can offer the largest specific work, while the recompression cycle and the split expansion cycle yield the lowest specific work. (3) The molten salt temperature differences of SPT systems with the simple recuperation cycle, the partial-cooling cycle, and the precompression cycle are slightly larger than those of SPT systems with the recompression cycle, the split expansion cycle, and the intercooling cycle. (4) As a classical approach to improve efficiency, reheating can decrease the system efficiency in the cases with high hot molten salt temperature; SPT systems without reheating can yield larger molten salt temperature difference than those with reheating. (5) Although the current S-CO 2 Brayton cycle layouts can offer high efficiency, there are still several challenges for integrating them into the SPT systems: the specific work is relatively small, and the temperature difference across the solar receiver is narrow. Further work remains to build novel S-CO 2 cycle layouts with high efficiency, large specific work, and wide temperature difference.

BACKGROUND Angiogenic factor with G-patch and FHA domain1 (AGGF1 or VG5Q) is a newly identified human angiogenic factor. The aim of this study was to explore AGGF1 expression level in gastric cancer and detect its correlation with the prognosis. MATERIAL AND METHODS Immunohistochemistry was performed to detect AGGF1 level in gastric cancer and its adjacent noncancerous samples of 198 cases, and the relationships among the expression levels of AGGF1, vascular endothelial growth factor (VEGF), and prognosis were analyzed. RESULTS Expression of AGGF1 in gastric cancer samples was significantly higher than that in adjacent noncancerous samples (P

Osteoarthritis is associated with intrauterine growth retardation (IUGR) and abnormal glucose metabolism. Our laboratory previously reported that prenatal caffeine exposure (PCE) can induce intrauterine maternal glucocorticoid (GC) overexposure in IUGR offspring and increase susceptibility to osteoarthritis after birth. In the present study, we demonstrated the essential role of glucose transporter 1 (GLUT1) programming changes in the increased matrix degradation of articular cartilage and susceptibility to osteoarthritis in female PCE adult offspring. In vivo, we found that PCE decreased the matrix content but did not significantly change the expression of matrix degradation-related genes in the articular cartilage of female fetal rats. The decreased expression of IGF1 and GLUT1 and the content of advanced-glycation-end-products (AGEs) were also detected. At different postnatal stages (2, 6, and 12 weeks), the cartilage matrix content decreased while the degradation-related genes expression increased in the PCE group. Meanwhile, the expression of IGF1 and GLUT1 and AGEs content in the local cartilage increased. In vitro, the expression levels of IGF1 and GLUT1 were inhibited by corticosterone but remained unchanged under caffeine treatment. Exogenous IGF1 can reverse the corticosterone-induced decrease in GLUT1 expression and promote AGEs production, while mifepristone (a glucocorticoid receptor inhibitor) reversed the corticosterone-induced low expression of IGF1 and GLUT1. Exogenous AGEs can increase the expression of inflammatory factors (IL-6 and TNF-α) and degradation-related genes, and decrease the matrix synthesis-related genes expression in chondrocyte. In conclusion, the GC-IGF1-GLUT1 axis mediated intrauterine dysplasia of articular cartilage, increased accumulation of AGEs and matrix degradation after birth in PCE female offspring, thereby increasing their susceptibility to osteoarthritis in adulthood.

Heavy metals (HMs) in soil cause adverse effects on ecosystem and human health. Quantifying ecological risk and human health risk (HHR) from sources can determine priority sources and help to mitigate the risks. In this research, geostatistics and positive matrix factorization (PMF) were used to identify and quantify the sources of soil HMs; and then ecological risk and HHR from different sources under woodland, construction land and farmland were quantitatively calculated by combining the potential ecological risk index (RI) and HHR assessment models with PMF model. Taking Jiedong District as an example, four sources were quantitatively apportioned, which were agricultural practices (23.08%), industrial activities (29.10%), natural source (22.87%) and traffic emissions (24.95%). For ecological risk, industrial activities were the greatest contributor, accounting for about 49.71%, 48.11% and 47.15% under construction land, woodland and farmland, respectively. For non-carcinogenic risk, agricultural practices were the largest source under woodland and farmland, while industrial activities were the largest source under construction land. As for carcinogenic risk, no matter which kind of land use, agricultural practices were the largest source. In addition, the health risks of children, including non-carcinogenic and carcinogenic risks, were higher than those of adults, and the trends in health risks for children and adults were similar. The integrated approach was useful to evaluate ecological risk and HHR quantification from sources under different land use, thereby providing valuable suggestions for reducing pollution and protecting human health from the sources.

INTRODUCTION AND OBJECTIVES:The 8th American Joint Committee on Cancer tumor-node-metastasis (AJCC-TNM) staging systemis based on a few retrospective single-center studies. We aimed to test the pro...

We analyzed the spontaneous adverse event database in Singapore to determine the types of cutaneous adverse drug reactions (CADRs) and causative drugs reported. We selected 10 CADRs‐of‐interest, and identified the suspected drugs and the characteristics of the at‐risk population. ADR reports received from 2006 to 2015 of the system organ class “Skin and Appendages Disorders” were analyzed based on patient demographics, the types of CADRs, suspected drugs, outcome, and latency period. Of the 104 372 reports analyzed, 56.2% involved females and 72.5% involved Chinese patients. The mean age was 41.1 years old. The top CADRs reported were rash (including nonspecified rash, follicular rash, maculopapular rash, and vesicular rash) (67.2%) and angioedema (13.9%). The drugs frequently associated with the CADRs‐of‐interest include nonsteroidal antiinflammatory drugs and antibiotics with angioedema, iohexol with urticaria, and antiepileptics and allopurinol with Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). A subgroup analysis based on age, sex, and race on the 10 CADRs‐of‐interest showed the following trends in reporting: Alopecia (reported more in females), drug hypersensitivity syndrome (more in males), angioedema (more in younger patients), and photosensitivity (more in older patients). In general, the racial distribution across each CADR‐of‐interest was consistent with that of Singapore's population, with slight deviations observed for SJS/TEN, photosensitivity and skin discoloration. We analyzed CADR reports from Singapore over 10 years, and identified the types of CADRs reported, and their associated drugs, latency periods and patient characteristics. Such information could add value to healthcare professionals as they assess CADR cases and evaluate suspected drugs.

A kind of off-axis meta-lens with large focal depth based on a single-layer metasurface is designed and fabricated. Our proposed off-axis focus is realized by combining the two functions of deflection and focus through phase superposition method, and the focal depth can be increased by optimizing the input aperture and off-axis deflection angle. Three-dimensional finite difference time domain (FDTD) method is used for numerical simulation to construct the off-axis meta-lens, then the off-axis meta-lens is fabricated and its focus performance is tested in a microwave anechoic chamber.Experimental results indicate that at the designed electromagnetic wave frequency (9 GHz), the measured off-axis deflection angle is 27.5° and the focal length is 335.4 mm, which agree with the designed values of 30° and 350 mm. The measured full-wave half-maximum (FWHM) at the focal point is 48.2 mm, however, the simulated FWHM is 40.2 mm, which means that the imaging quality of the measured focus spot is slightly worse than the simulated one. This is mainly due to the fact that the actual parameters of the fabricated meta-lens are inconsistent with simulated parameters. In addition, during the measurement, the large sampling interval in the x- direction also leads to experimental errors.The focusing efficiency of the off-axis meta-lens at the working frequency of 9 GHz is calculated to be 16.9%. The main reason for the low focusing efficiency is that the plasmonic metasurface works in the transmission mode, which can manipulate only the cross-polarized component of the incident wave, and the maximum efficiency will not exceed 25%. Moreover, the focal depths at 8 GHz, 9 GHz and 10 GHz are 263.2 mm, 278.5 mm and 298.2 mm, respectively, which are 7.02 times, 8.36 times and 9.98 times the corresponding wavelengths, indicating that a larger focal depth off-focus meta-lens is achieved. This kind of off-axis meta-lens has a simple structure, good off-axis focus ability and large focal depth, which has potential applications in a compact and planar off-axis optical system and large focal depth imaging system. Although the working waveband in this article is the microwave band, according to the size scaling effect of the metasurface, it is also possible to design a large focal depth off-axis meta-lens in other bands such as visible light and terahertz bands by using the same method.

Optimisation design of gas-liquid packed column filled with structured packing during the absorption process requires an accurate prediction of the liquid distribution. A two-dimensional computational fluid dynamics (CFD) model is developed for the structured packed column which is applied in floating liquefied natural gas (FLNG) in offshore platforms. And several user-defined functions (UDFs) based on the dynamic mesh technology are incorporated in Fluent to quantitatively evaluate how the pressure drops, the liquid volume fraction, and liquid radial and axial velocities are affected by sloshing angles, periods, and displacements. The results show that the sloshing angle has significant effects on the liquid volume fraction in the central region of the column as its value increases by 145% for a sloshing angle of 9°. And the turning points of the liquid volume fraction and liquid radial velocity appear at the same time. Furthermore, the liquid volume fraction, the liquid radial and axial velocities of the packed column fluctuate periodically around the values of the vertical steady state under different sloshing periods and displacements. The critical value of the sloshing displacement is determined as 150 mm based on the minimum range of liquid radial dispersion in the packed column.

The terms global warming and climate change are often used interchangeably, but recent research finds “global warming” has become more emotive and more polarizing, resulting in less advocacy by some subpopulations. We explore the robustness of this framing effect based on the expectation that people with stronger partisan identities tend to have more deep-seated climate change beliefs. We use multiple methods and measures to study framing across a range of attitude scales designed to measure climate change beliefs, degree of knowledge about climate change, and intentions to take corrective actions. We find stronger framing effects for political Independents and those who are disengaged from climate change issues, indicating that polarization overrides framing at the extremes, and those with moderate beliefs are more susceptible to labeling and framing effects, especially when beliefs are inconsistent with one’s political identity. We conclude by urging communicators to appreciate the heterogeneity of their target audience.

According to the nonlinearity, nonstationarity and multi-component coupling characteristics of reciprocating compressor vibration signal, a feature extraction method based on hermite local mean decomposition (HLMD) and multiscale fuzzy entropy (MFE) is proposed for the diagnosis of reciprocating compressor oversized bearing clearance faults. Firstly, aiming at the strong nonstationary characteristic of vibration signal, a novel HLMD algorithm was given by using the monotone piecewise cubic hermite interpolation (MPCHI) instead of cubic spline interpolation (CSI) to construct the envelopes. Secondly, HLMD was performed on the vibration signals in each state and a series of PF components are produced, and the highlighted PF components which contain the main information of fault state were chosen with the correlation coefficient. Thirdly, MFE of the selected PF components were calculated to form the eigenvectors matrix, and the eigenvectors which have the best divisibility were extracted based on the average euclidean distances of each scale factor. Finally, four bearing clearance fault states were extracted by the proposed method, and taken SVM as a pattern classifier, the faults were diagnosed accurately. Furthermore, the comparison of recognition results with other three feature extraction methods demonstrates the superiority of this method.

Air pollution is continuously increasing severe health problems in all over the world conscientious for copious diseases and deaths. Extensive economic growth, especially in urban areas of China, has led to escalating episodes of severe air pollution. In the past few decades, continuous industrialization and urbanization in China improved the living standards of their people but also increase the air pollution, which badly affected on health. In early 2002, China has carried out certain steps for the management and control of air pollution, but unfortunately there approaches towards implementation and governance is unsatisfied, after passing the so many years still have haze and other serious air pollution issues, which not only damage the environment but also destroy the people health. Recent, development, industrialization, and urbanization, air pollution has become one of the major and critical problems. Thus, it is very important to examine the cause and source of air pollution, treatment and effectively resolve the problems. Based on the causes and treatment of urban air pollution, this short communication would be a guideline for further control measures and technology development.

As a class of cholesterol-lowering drugs, statins have been reported to cause unexpected decrease in blood pressure (BP). However, most studies in this issue were subject to inadequate study design or very small sample size. The present study was designed to examine the BP-lowering effect of various statins.Here we retrieved 5.9 million clinical reports submitted to FDA Adverse Event Reporting System (FAERS) from 2004 to 2015. Meta-analysis was performed to estimate the overall reporting odds ratio (ROR) of hypotension adverse events concurrent with various statins (i.e., atorvastatin, simvastatin, and rosuvastatin).Comparing the reporting rate of hypotension event between statins and other drugs found that atorvastatin (pooled ROR = 1.26, adjusted p-value = 8.60 × 10To our knowledge, this is the first pooled analysis on large-scale data of adverse events to identify the BP-lowering effect of statins. The results will contribute to the development of novel statin-based antihypertensive therapies. In addition, the differential effects of individual statins can warrant subsequent research on the underlying mechanisms of BP control.

Aimed at the structure limitation of tandem following warhead, a variable-structure following warhead which can be transformed from series to parallel was proposed. The following process of the variable-structure was simulated by numerical simulation method, and the advantages in reaming and aftereffect was proved, which provided new ideas for the design of the following warhead.

Bile duct injury (BDI) after laparoscopic cholecystectomy (LC-BDI) is still a major problem. However, despite the many improvements in clinical management of patients undergoing repair, postoperative complications remain frequent and factors that increase the susceptibility to such adverse events remain unknown. To report on a large experience with laparoscopic cholecystectomy-associated bile duct injuries (LC-BDIs) and define predictive factors associated with postoperative complication. A retrospective medical record review of 94 patients referred for the surgical management of major BDIs to our center during a 12-year period between January 1, 1998, and December 31, 2010, was performed. Univariate statistical analysis and multivariate analysis were used to identify risk factors for postoperative complications. A nomogram was developed to predict postoperative complication, given associated risk factors, and bootstrap validation was performed. In univariate analysis, there is no factor significantly associated with short-term complication. There was a statistically significant relationship between type of repair and the risk of biliary strictures (p = 0.012). Other factors significantly associated with late biliary strictures were sepsis (p = 0.007) and bile leak (p = 0.003). In multivariate analysis, bile leak (p = 0.005), sepsis (p = 0.03), and type of repair (p = 0.028) were independently and significantly associated with long-term complication. The resulting nomogram demonstrated good accuracy in predicting long-term complication, with a bootstrap-corrected concordance index 0.7905. Our results suggest that missed injuries that result in sepsis or bile leak as well as high injuries that require hepaticojejunostomy will result in a higher stricture rate after repair.

This paper aims to design a golf wood club to provide the golf players with very useful information. First, the new golf wood club is designed, including the golf head and shaft. Second, this study bases on the design rules of golf for wood material, choose the appropriate design parameters. This study obtains the results as follows. First, Pinaceae is the best material for golf head. Second, Carbon fiber is the best material for golf club.

In this study, a spatiotemporal saliency detection and salient region determination approach for H.264 videos is proposed. After Gaussian filtering in Lab color space, the phase spectrum of Fourier transform is used to generate the spatial saliency map of each video frame. On the other hand, the motion vector fields from each H.264 compressed video bitstream are backward accumulated. After normalization and global motion compensation, the phase spectrum of Fourier transform for the moving parts is used to generate the temporal saliency map of each video frame. Then, the spatial and temporal saliency maps of each video frame are combined to obtain its spatiotemporal saliency map using adaptive fusion. Finally, a modified salient region determination scheme is used to determine salient regions (SRs) of each video frame. Based on the experimental results obtained in this study, the performance of the proposed approach is better than those of two comparison approaches.

A 5-DOF strengthen upper limb exoskeleton robot has been designed, which is driven by hydraulic pressure and steel wirerope. Simplified the degree of freedom, designed the mechanical structure and optimized structural parameters. The research ensured the structural strength and safety when the robot working. A virtual prototype has been established in RecurDyn. Kinematics simulation is carried out for three kinds of typical weightlifting mode. The research results verified the correctness of the structure design and provided reference for enhancing the lifting capacity of the exoskeleton robot.

In this paper, we investigate the features of energy detection and cyclostationary feature detection for spectrum sensing. In order to combine their advantages, we propose an adaptive two-stage sensing scheme which performs spectrum sensing using an energy detector first in cognitive radio networks. Then in the second stage, this scheme decides whether or not to implement cyclostationary feature detection based on the sensing results of the first stage. On the premise of meeting a given constraint on the probability of false alarm, the goal of our proposed scheme is to optimize the probability of detection and sensing speed at the same time. In order to obtain the optimal detection thresholds, we can formulate the detection model as a nonlinear optimization problem. Furthermore, the simulation results show that the proposed scheme improves the performance of spectrum sensing compared with the ones where only energy detection or cyclostationary feature detection is performed.

The curved structural plate components have been widely used in petroleum, natural gas, chemical industry, and other industries fields, monitoring and detecting the curved structural plate components flaw has a great significance for improving the components integrity, reliability and lifespan in service. Based on the elastic wave fundamental theory, elastic wave equations, and phase velocity dispersion characteristic curves in curved plate component, the article gives the phase velocity practical detecting method. By using thecomsolfinite element software, the author proposed a wave propagating forward modeling analytical method, which gives a guidance to study the relationship between the wave and the flaw. By adopting the ellipse algorithm, the article proposed a positioning and imaging method which was used to locate the flaws position and distinguish the flaws direction. Based on the theoretical and technical analysis above, a number of experiments has been done, and the results shows that the detecting and imaging method can locate and image the flaws position and its geometrical morphology precisely for the curved plates flaw detecting.

Studies of recurrent dysembryoplastic neuroepithelial tumors (DNTs) are distinctly rare. The present study reports the case of a 15-year-old female with a temporal lobe DNT, which recurred and transformed into an astrocytoma (WHO grade II) five years after an initial gross total resection (GTR). Furthermore, all the previous studies on recurrent DNT are reviewed. Although the majority of DNT cases demonstrate benign behavior, recurrent DNTs have been observed following a GTR of the tumor. Patients do not appear to benefit from post-operative adjuvant therapy, and inappropriate radiotherapy or chemotherapy may result in tumor recurrence or malignant transformation. The prognosis is favorable if a GTR of the recurrent tumor is achieved. The use of regular imaging examinations and the maintenance of a long-term follow-up is of importance following a tumor resection.

To explore the effectiveness of exercise program for banking and insurance workers and clarify the association between exercise, burnout, and metabolic syndrome components. In the process of the study, a practicable worksite exercise program was developed for bank and insurance enterprises. A three-month (12-wk) exercise course was conducted, and its benefits evaluated. Levels of burnout and metabolic syndrome components were analyzed after exercise intervention. After intervention, the indicators of burnout and metabolic syndrome components were significantly improved in both low and high intensity groups, and the improvement were expressed in reduction of waist circumference, systolic blood pressure, person burnout and work-related burnout. A dose-response of burnouts and metabolic syndrome components with exercise intensity are shown (p

We aimed to investigate the changes in adiposity and other cardiometabolic risk factors in the year following Roux-en-Y gastric bypass (RYGB) in patients of Chinese ethnicity. The study recruited 209 patients who met the indications for bariatric surgery. Adiposity and cardiometabolic risk factors were assessed at baseline and over the 12 months following surgery in all participants. SPSS® software was used for statistical analysis. The mean body mass index (BMI) was 29.98 kg/m2 at baseline and steadily decreased to 25.32 kg/m2 at 12 months, giving a relative change of −15.5% (p