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The muscle is a highly organized tissue, where there are three different moistures including free water, entrapped water, and bound water. These moistures were distributed in intercellular spaces, intracellular spaces, and other solute environments, respectively. Understanding the moisture migration in different environments is crucial to enhance energy efficiency and improve the quality of processed food. Therefore, the tilapia fillets were used to experiment, and the low‐field nuclear magnetic resonance technique is used to measure the change in different moistures during the drying process. The study found that free water is the highest when cell membranes started to rupture. In addition, it also observed that the cell membrane ruptures at different stages of drying. The result of this study provides critical information that could be used to guide the study of the dynamic mechanisms underlying drying and the development of drying technology for tilapia fillets and similar aquatic products., With the progress of drying, the surface and core temperature of the tilapia fillets continues to rise which leads to the decline of free water content, in addition, it was found that the free water is the highest when cell membranes started to rupture by the low‐field nuclear magnetic resonance technique. As the temperature increasing, the free water content appears a peak because the exposed intracellular water is able to readjust rapidly to become free water. The cell membrane ruptures at different stages of drying.

The purpose of this study was to review the literature on the effect of scraping therapy on chronic low back pain (LBP) from randomized controlled trials (RCTs).Three English medical electronic databases (PubMed, Embase, and the Cochrane Library) and 2 Chinese databases (China National Knowledge Infrastructure and Wanfang) were searched. Only randomized controlled trials related to the effects of scraping therapy on chronic LBP were included in this systematic review. Study selection, data extraction, and validation were conducted independently by 2 reviewers. The methodological quality of the studies was evaluated by the Cochrane risk-of-bias tool. RevMan 5.3 software was applied to perform meta-analysis of the data.Ten studies comprising 627 participants were included. Overall, the quality of evidence was moderate owing to a lack of blinding and allocation concealment in some studies and unclear risk of selective reporting. Meta-analysis of 9 RCTs indicated that scraping therapy had a statistically significant effect on pain reduction (standard mean difference = -0.66, 95% confidence interval [CI], -0.83 to -0.49, P.001). However, if only a single scrape treatment was carried out, the results did not show that scraping was superior to the control group regarding pain relief (mean difference = -0.35, 95% CI, -1.23 to 0.53, P = .44). Moreover, the results of 6 RCTs involving 468 participants showed significantly greater improvement in lumbar dysfunction (mean difference = -10.05, 95% CI, -13.52 to -2.32, P.001). In addition, the results of 5 RCTs involving 393 participants showed a favorably significant effect on the overall efficacy (odds ratio = 4.74, 95% CI, 2.34-9.62, P.001). As for follow-up effects, meta-analysis of 3 RCTs involving 241 participants showed a promising effect on pain reduction and lumbar function improvement at 1 month and 3 months after the end of treatment, respectively. Only 1 study reported adverse effects, and none were serious.Scraping therapy may have a therapeutic effect for some individuals with chronic LBP. However, due to the limited amount of research and the low methodological quality of the included studies, additional large-scale, multicenter, high-quality RCTs on relieving pain intensity and improving lumbar dysfunction are still necessary.

Solar steam generation is a prospectively technology that could be used to alleviate the problem of water shortage. Here, we design a 1D/2D W18O49/rGO heterostructure and construct a bilayer structure of light absorber, which contains W18O49 nanofibers and rGO nanosheets composite layer for sunlight harvesting and a pre-treated wood layer for water supply and thermal insulation. With an optimized composition of the 1D/2D W18O49/rGO heterostructure, the constructed interfacial evaporation system demonstrate a quick thermal response and achieve a steady-state evaporation efficiency of 86.5% with the evaporation rate of 1.34 kg∙m−2∙h−1 under one sun illumination, and it exhibits excellent cycle stabilities after 25 cycles. Moreover, the salinity of the sea water is greatly reduced, much less than the World Health Organization (WHO) standards of the drinking water. This novel and facile bilayer structure demonstrates substantial promise for application in the fields of solar evaporation to deal with the problem of water shortage.

Purpose: To evaluate the effects of dezocine on the prevention of postoperative catheter-related bladder discomfort (CRBD). Patients and methods: Ninety-six adult patients undergoing abdominal surgery with urinary catheterization under general anesthesia were randomized into dezocine and control (flurbiprofen) groups. The postoperative CRBD, pain score, sedation score and adverse effects were evaluated at 0, 1, 2 and 6 hrs after tracheal extubation. Results: The primary outcome showed a lower incidence of CRBD at 1 hr post-extubation in the dezocine group (29.17%) than the control group (58.33%, P 0.05); however, the overall severity of CRBD was decreased in the dezocine group compared with the control group (P

Background: Patients’ capacity to manage their own health can be graded by levels of activation. Highly activated patients tend to have better health outcomes. However, little is known about the activation levels of chronic pain patients in China. This study aimed to identify: (1) the activation levels within this population; and (2) demographic and pain factors associated with the level of activation. Methods: In this cross-sectional survey, patients completed a sociodemographic questionnaire, Brief Pain Inventory and Patient Activation Measure (PAM) 13. Patient activation was measured and categorized into Levels 1–4. Its associations with sociodemographic, patient-reported diseases and pain variables were explored using Wilcoxon rank sum test and Kruskal-Wallis H test. Results: Of 338 patients, 84 were excluded. Of the 254 remaining, 51.6% of patients were at lower activation levels (PAM Levels 1 and 2). Higher activation levels (PAM Levels 3 and 4) were recorded in patients with younger age (P = .00005), higher education (P = .0018), non-laboring occupations (P = .0239), and fewer co-morbidities (P = .00615). Intensities of the worst pain (P = .000627), average pain (P = .0213), and current pain (P = .0353), as well as the impact of pain on relationships with others (P = 0.00529), mood (P = .00391), sleep (P = .0132), and interest in life (P = .0248), were negatively correlated with activation levels. Conclusion: Half of the chronic pain patients in this population displayed lower activation levels. Older age, less education, manual labor, more co-morbidities, more intense pain and greater impact of pain on life were associated with lower activation levels. Pain education programs need to target the individual's PAM level. Registration: This trial was registered in Chinese Clinical Trial Registry. Number: ChiECRCT-20180170

A series of significant breakthroughs in exploring conventional and unconventional natural gas resources have been achieved in new strata and new domains. However, the quality of the increased reserves has declined with the entry of unconventional resources into the reserves sequence. Therefore, the potential of conventional and unconventional natural gas resources as well as important exploration regions of the remaining natural gas resources need to be clarified, and favorable directions need to be established. On the basis of oil and gas exploration results, discoveries in petroleum geology, and exploration data of the past 10 years acquired by PetroChina, an entire system of resource assessment for conventional and unconventional oil and gas resources has been established. The fourth round of resource assessment has been systematically executed. The results indicate that the total conventional natural gas resources of China are 78 × 1012 m3, which shows an increase of 8 × 1012 m3 over the results of the third round of resource assessment. Unconventional resources include four types of resources: tight gas, shale gas, coalbed methane, and natural gas hydrates. Among them, tight gas reservoirs make up 21.86 × 1012 m3 (Jiyang, Dongpu, Nanxiang, Subei, and others were excluded from the assessed regions). In addition, shale gas, coalbed methane, and natural gas hydrate reservoirs make up 80.21 × 1012 m3, 29.82 × 1012 m3, and 153.06 × 1012 m3, respectively. The remaining resources for onshore conventional natural gas are distributed mainly in four significant domains, which are lithology–strata (clastic rock), marine carbonatites, foreland thrust belts, and complex tectonic belts. Of these, marine carbonatites and foreland thrust belts are the dominant domains. The resources for offshore natural gas are concentrated mainly in three domains, which are offshore structures, organic reefs, and lithology in deep water. The total remaining natural gas resources in marine carbonatites, foreland, lithology–strata, complex tectonic belts, and the South China Sea amount to 59.83 × 1012 m3, which is 94% of the remaining natural gas resources in China. Based on this assessment, favorable targets are selected including 10 targets for conventional resources, 4 for tight gas, 4 for coalbed methane, and 6 for shale gas. Keywords: Resources assessment, Resources potential of natural gas, Remaining resources potential of natural gas, Resources distribution, Major exploration region, Favorable target zone

Myocardial fibrosis plays a central role in the development of heart failure. It has been shown that recurrent exposure to subclinical lipopolysaccharide (LPS) increases mortality and induces cardiac fibrosis in mice, which is not mediated by the common renin-angiotensin system. LPS increased NADPH oxidase2 (NOX2) in isolated adult mouse cardiac fibroblasts and NOX2 may mediate LPS-induced cardiac fibrosis. Therefore, the current study was designed to delineate the role of NOX2 in LPS-induced fibrosis model and to investigate the preventive role of Tanshinone IIA (TIIA) on the development of cardiac fibrosis. The protective mechanism of TIIA was determined to be associated with the inhibition of NOX2, by comparing its effects with the NADPH oxidase inhibitor, apocynin. The results revealed remarkable effects of apocynin and TIIA on attenuating the development of myocardial fibrosis and fibrosis-related genes and mediators. Furthermore, TIIA and apocynin decreased the expression of NADPH oxidase subunits (NOX2 and P67phox) expression and the ROS levels. The anti-fibrotic effect of apocynin suggested that NOX2 inhibition may be a potential preventive strategy for attenuating the progression of LPS-induced cardiac fibrosis. Our results demonstrate that TIIA may be a potent agent against subclinical LPS-induced cardiac fibrosis in mice partially via inhibition of NADPH oxidase 2.

Introduction The primary purpose of this survey was to investigate the attitudes of patients undergoing elective surgery, towards the application of acupuncture to reduce perioperative complications, and to identify the possible factors that influenced their attitudes. Methods The survey was conducted in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine in China. A 20-item questionnaire was developed and piloted over a period of eight weeks. Results 176 adult surgical inpatients completed the survey with a response rate of 98.9%. Only about one quarter of the participants had past experience of acupuncture treatment (n = 46, 26.1%) and one third thought acupuncture was effective (n = 61, 34.7%). Less than half of them were willing to use acupuncture for postoperative nausea and vomiting (PONV) (n = 70, 39.8%), postoperative pain (n = 79, 44.9%), preoperative anxiety and insomnia (n = 65, 36.9%), postoperative gastrointestinal dysfunction (n = 76, 43.2%), postoperative urinary retention (n = 81, 46.0%). Patients who were professionals or office workers (chi square = 26.181, p = 0.001) or with better education (chi square = 14.583, p = 0.024) were more willing to use acupuncture, while age or gender did not affect their attitudes. A majority of patients would follow the doctor’s advice about acupuncture (n = 111, 63.1%). Those who had history of PONV were less likely to receive acupuncture (chi square = 10.664, p = 0.005). Conclusions Overall, the surveyed Chinese patients had limited experience and knowledge of acupuncture, and less than half had positive attitudes towards using acupuncture for reducing perioperative complications. Education of patients and their doctors may be promising strategies for improving patients’ willingness to use acupuncture.

Small artery occlusion (SAO) is responsible for 31.3% of all ischemic strokes in China. However, reports regarding the recurrence rate of SAO in China are rare. We aimed to assess the recurrence rate and factors associated with SAO in China. All consecutive patients with SAO hospitalized at Tianjin Huanhu Hospital from 2005 to 2014 were recruited. We assessed the association between stroke subtype, severity, and disease history with recurrence at 3, 12, and 36 months of onset using multivariate logistic regression analysis. A total of 2,524 SAO patients were included in this study, including 1696 (67.2%) men and 828 (32.8%) women. The recurrence rates were 3.1% at 3 months, 12.7% at 12 months, and 36.5% at 36 months. Compared with women, men had a higher risk of recurrence at 3 months after SAO (P = 0.003). Old age and severity of stroke were also associated with a higher risk of recurrence (P

BACKGROUND The aim of this study was to study the feasibility and acceptability of electroacupuncture (EA) for preventing postoperative gastrointestinal complications in patients undergoing thoracoscopic segmentectomy/lobectomy. MATERIAL AND METHODS Sixty patients who underwent video-assisted thoracoscopic (VATS) segmentectomy/lobectomy received either EA treatments plus usual care (EA group) or usual care alone (UC group). Patients in the EA group were given 30 minutes of bilateral electroacupuncture on 3 acupoints [Neiguan (PC6), Zusanli (ST36), and Shangjuxu (ST37)] at 3 time points (24 hours before surgery, and 4 hours and 24 hours after surgery). The primary outcomes were recruitment, retention, acceptability of the EA intervention, incidence and severity of abdominal distension (AD), and time to first flatus and defecation. Secondary outcomes included postoperative nausea and vomiting (PONV), pain intensity, and duration of hospital stay. RESULTS We recruited 60 participants and 59 were randomized into 2 groups for this study: 30 in the EA group and 29 in the UC group. In total, 57 participants completed the study. With the exception of one participant in the EA group, all participants completed all three sessions of EA. The one exclusion was a case where a paravertebral block was not used during the surgery. Qualitative findings from the acceptability questionnaire indicated that participants viewed the EA treatment as acceptable. After EA treatment, there was a small but statistically significant improvement in participants' acceptance of EA for alleviating postoperative gastrointestinal discomfort (P=0.001). The EA group showed improved outcomes compared to the UC group in terms of time to first flatus (20.8±4.6 versus 24.1±6.2 hours, P=0.026) and defecation (53.9±6.0 versus 57.5±7.2 hours, P=0.046). No significant differences appeared regarding AD, rescue medication, or duration of hospitalization. PONV and pain intensity were similar in both groups at the recorded time periods. CONCLUSIONS EA is feasible and acceptable to patients undergoing VATS surgery. Our preliminary findings of EA promoting postoperative recovery of gastrointestinal function warrants large randomized controlled trials.

Cardiac dysfunction is a critical event during sepsis/septic shock. Tanshinone IIA (TIIA), a compound extracted from herb medicine Danshen, has been shown possessing anti-inflammatory and anti-oxidative properties. It is possible, therefore, that treatment with TIIA may attenuate cardiac dysfunction during sepsis/septic shock through inhibition of inflammation. To test this possibility, we preadministrated C57BL/6 mice with TIIA prior to lipopolysaccharide (LPS) challenge. LPS significantly suppressed left ventricular function as evidenced by decreases in EF% and FS% in mice. However, TIIA pretreatment significantly attenuated cardiac dysfunction following LPS challenge. Furthermore, TIIA markedly attenuated the LPS-induced upregulation of circulating tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels. Meanwhile, LPS challenge significantly increased myocardial reactive oxygen species (ROS) production, which was attenuated by TIIA. Moreover, TIIA treatment dramatically decreased the level of the Nox2, reduced phosphorylation levels of extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 mitogen-activated protein kinase (p38 MAPK) expression. In conclusion, TIIA effectively improves cardiac function during endotoxemia in mice. This is attributed to TIIA reducing inflammatory cytokines release and inhibiting the Nox2 signaling during endotoxemia.

Background Acute postoperative pain remains a major clinical problem that affects patient recovery. Distal acupoint and peri-incisional stimulation are both used for relieving acute postoperative pain in hospital. Our objective was to assess and compare the effects of distal and peri-incisional stimulation on postoperative pain in open abdominal surgery. Methods MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese databases CNKI and Wanfangdata were searched to identify eligible randomized controlled trials. Intensity of postoperative pain, opioid consumption and related data were extracted and analyzed using a random effects model. Risk of bias was assessed. Subgroup analyses were conducted when data were enough. Results Thirty-five trials were included, in which 17 trials studied distal stimulation, another 17 trials studied peri-incisional stimulation and one studied the combination of the two approaches. No studies that directly compared the two approaches were identified. Subgroup analysis showed that both distal and peri-incisional stimulation significantly alleviated postoperative resting and movement pain from 4 h to 48 h after surgery by 6 to 25 mm on a 100 mm visual analogue scale. Peri-incisional stimulation showed a better reduction in postoperative opioid consumption. No studies compared the effects of the combined peri-incisional and distal stimulation with either mode alone. Overall the quality of evidence was moderate due to a lack of blinding in some studies, and unclear risk of allocation concealment. Conclusion Both distal and peri-incisional modes of stimulation were effective in reducing postoperative pain. Whether a combined peri-incisional stimulation and distal acupuncture has superior results requires further studies.

Introduction Auricular acupuncture has been used for pain management but a more recent technique which buries an intradermal needle into the skin may provide longer lasting stimulation and enhance analgesia. The purpose of this study was to evaluate the efficacy and feasibility of perioperative auricular acupuncture technique via intradermal needling buried on postoperative movement-evoked pain reduction in patients with advanced gastric cancer following open radical gastrectomy. Methods This research is a protocol for a prospective, assessor- and analyst-blinded, randomized controlled pilot trial with two parallel groups. Forty patients who undergo elective open radical gastrectomy will be recruited from 210-bed oncology surgery ward at a 2500-bed medical center between 2019/8/23 and 2020/2/20. Patients will be randomized to either the control group receiving non-invasive sham auricular acupuncture or to the experimental group receiving auricular acupuncture technique via intradermal needling buried, delivered 24 h before surgery and retained & replaced every 3 days for 6 consecutive days. A standard general anesthetic technique will be used for both groups. Rescue analgesia will be given when the VAS score is≥4. Primary outcome measures are Functional Activity Score (FAS) and Numerical Rating Scale score (NRS) for movement-evoked pain. Secondary outcome measures are NRS score for pain at rest, use of rescues analgesic, total opioid consumption, postoperative nausea and vomiting, physiological recovery Outcomes, Quality of Recovery-9 (QoR-9) and patient’s satisfaction. Ethics and dissemination This protocol has been approved by the Institutional Review Board (IRB) of the Clinical Research Centre (Affiliated Hospital of Nanjing University of Chinese Medicine, IRB No. 2019NL-032-02). In addition, the results of the preliminary study will be disseminated through peer-reviewed publications.

College English writing, as one of the most important skills of college English teaching and learning, can reveal the English comprehensive level of learners. The development of computer and Internet creates conditions for college English teaching reform. This paper explores what influence will be caused when students write autonomously under the network environment and probes into a new method of college English writing teaching through studying autonomous learning mode of college English writing based on constructivism.

With the development of Web-based Intelligent Learning System in the information society, we should pay attention to its usage in autonomous English learning. At first, this thesis shows the basic knowledge of Artificial Intelligence and discusses the feasibility of combining Artificial Intelligence with Web-based Intelligent English self-learning system. Second, it analyzes the combination of Expert system with Web-based Intelligent English self-learning system. Finally, it probes into that this new system will promote the revolutionary of the English self-learning mode.

Introduction Electroacupuncture (EA) has been shown to have antiemetic and analgesic effects; however, optimal timing for the therapy is unclear. Our study aims firstly to investigate the effectiveness and safety of preoperative EA, delivered 24 h before surgery, on postoperative nausea and vomiting (PONV) and postoperative pain in patients undergoing gynecologic laparoscopic surgery; and secondly to identify the optimal timing and dose of stimulation of preoperative EA for preventing PONV and postoperative pain. Methods This is a single-center, randomized, controlled, four-arm clinical trial. Participants who meet the selection criteria will be randomly assigned to one of the following four groups: Group 1 (EA delivered 24 h before surgery, n = 103), Group 2 (EA delivered 30 min before surgery, n = 103), Group 3 (EA delivered both 24 h before, and 30 min before surgery, n = 103), Group 4 (usual care, n = 103). All groups will receive routine treatment for PONV and pain. EA will be delivered at bilateral Neiguan (PC6) and Zusanli (ST36). The primary outcomes are the incidence of postoperative nausea (PON) and postoperative vomiting (POV), and pain scores at 24 h after the operation. Secondary outcomes include the incidence of PON and POV, and pain scores at 6 h, 48 h and 72 h after the operation, also the severity of PON and POV, consumption of opioid medications, Quality of Recovery-15 (QoR-15), days in hospital and time to passage of first flatus. The assessor and the treating anesthetists will be blinded from group allocation. Participants in the three EA groups are unaware of the purpose of the study. Discussion An understanding of optimal timing and dosage of preoperative acupuncture will facilitate the implementation of this non-drug therapy and contribute to the overall improvement of post-surgical care.

This thesis researches mathematical models and optimization problems of solar photovoltaic cells. According to the defined priority, the arrays of photovoltaic cells on every wall are given. The thesis then identifies the optimal inclination and the optimal direction angle with the help of spherical coordinate system, thereby further optimizing the model. Meanwhile, according to the given data of the problem B of China Undergraduates Mathematical Contest of Higher Education Cup in 2012, the thesis demonstrates example analysis of optimization model of solar photovoltaic architecture.

Properly adjusting the transmission power of the wireless sensor nodes has shown to be an effective approach to reduce energy consumption and to improve the network reliability. I In this paper, an adaptive Node Degree adjustment based Power Control method for wireless sensor networks (NDPC) is proposed to dynamically adjust the transmission power of the nodes. In NDPC, each node is embedded with a fuzzy neural controller which is used to adjust the target node degree so as to control the communication range properly. The fuzzy neural controller consists of two Fuzzy Inference Systems (FIS). One adopts closed-loop feedback mechanism to adjust the target node degree according to the residual energy. The other adjusts the communication range by a self-learning neural network to control the transmission power based on the target node degree. Consequently, the actual energy consumption of the node is reduced while keeping the desired node degree. Several simulation experiments are conducted to evaluate the performance of NDPC, and the results show that NDPC can reduce the actual energy consumption as well as extend the network lifetime.

This paper presents the modeling and analysis of the longitudinal dynamic of variable-sweep aircraft. The variable-sweep aircraft have complex nonlinear and time-varying characteristics. To capture the complicated characteristics of variable-sweep aircraft, a systematic modeling method of the longitudinal dynamics is investigated. By using Digital Datcom software, aerodynamic data of the morphing aircraft is obtained; then the nonlinear dynamic models of the variable-sweep aircraft is established. To facilitate future control design, a T-S fuzzy model was constructed based on the nonlinear model. Both models are simulated and analyzed. Comparison verifies the effectiveness of the T-S fuzzy model. The characteristics of the longitudinal dynamic are analyzed based on simulation results.

To investigate the pharmacokinetics of single dose morphine inhaled by modified ultrasonic nebulizer versus intravenous administered in ventilated dogs.Six healthy dogs were randomly assigned to receive nebulized or intravenous morphine and crossed over to the alternative medication 1 week after. Morphine was nebulized by modified ultrasonic nebulizer (YuYue 402A, Jiangsu, China). Arterial blood was sampled every minute during the 10 min of administration and at 2, 5, 7, 10, 15, 20, 45, 60, 90, 120, 150, 180, 240, and 360 min after the administration for the determination of morphine concentration by RP-HPLC.The main pharmacokinetic parameters of morphine by inhaled and intravenous administration were: MRT 59±14 min versus 19±4 min, T(1/2) 21.9±5.1 min versus 3.3±1.0 min, T(max) 23.0±2.7 min versus 8.8±2.4 min, C(max) 0.245±0.09 mg·L⁻¹ versus 1.09±0.32 mg·L⁻¹, AUC(0-∞) 9.7±1.1 mg·min·L⁻¹ versus 15.2±7.2 mg·min·L⁻¹, CL 0.069±0.019 L·min⁻¹·kg⁻¹ versus 0.063±0.028 L·min⁻¹·kg⁻¹, and the absolute bioavailability of inhaled morphine was 35.5±10%. There were no significant differences (p0.05) between inhaled and intravenous morphine in AUC and CL. As expected, the T(½) and MRT of inhaled morphine were significantly greater than those of intravenous morphine.Morphine nebulized by ultrasonic nebulizer can be rapidly and extensively absorbed by lungs in ventilated dogs.

This paper introduces an intelligent visual surveillance system based on TI multimedia Digital Signal Processor (DSP) TMS320DM642, including hardware platform, software platform and algorithm realization. As the core of this system, DSP communicates with host PC via PCI bus. User can set rules via GUI software. The video input from either analog camera or IP camera can be processed by DM642 in real time. If any event breaks the rules, alarm information will be sent to users. Finally, a shadow suppression algorithm based on HSV color information is introduced to reduce the impact of shadow on motion target detection in the sunshine background. Experimental results show that this system can work well outdoors and the CPU load is low enough to meet the requirements of future work such as recognition and tracking.

Conflict resolution is one of the most challenging tasks in collaborative engineering design. In our previous research, a web-based intelligent collaborative system was developed to address this challenge based on intelligent computational argumentation. However, two important issues were not resolved in that system: priority of participants and self-conflicting arguments. In this paper, we develop two methods for incorporating priorities of participants into the computational argumentation network: 1) weighted summation and 2) re-assessment of strengths of arguments based on priority of owners of the argument using fuzzy logic inference. In addition, we develop a method for detection of self-conflicting arguments. Incorporation of priority of participants and detection of self-conflicting arguments have strengthen the capability of managing intelligent argumentation network for the web-based collaborative engineering design system developed in our previous research.

Modern product design is a very complicated process which involves groups of designers, manufacturers, suppliers, and customer representatives. Conflicts are unavoidable in collaboration among multiple stakeholders, who have different objectives, requirements, and priorities. Unfortunately, current web-based collaborative engineering design systems do not support collaborative conflict resolution. In this paper, we will develop an intelligent computational argumentation model to enable management of a large scale argumentation network, and resolution of conflicts based on argumentation from many participants. A web-based intelligent argumentation tool is developed as a part of a web-based collaborative engineering design system based on the above model to resolve conflicts over the internet by enabling selection of the most favored design alternative in the design argumentation from multiple perspectives in collaborative engineering design.

To the Editor: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia characterized with sudden onset of regular and narrow QRS complex tachycardia. P6 (Neiguan) is a well-known acupoint lessening postoperative nausea and vomiting (PONV) [1]. Here, we present a case of PSVT successfully terminated by P6 acupressure during anesthesia. A 51-year-old woman underwent titanium plate removal surgery with spinal anesthesia. Preoperative 12-lead electrocardiogram (ECG) showed sinus rhythm and normal heart rate (Supplementary Fig. 1). Spinal anesthesia was performed with ropivacaine 15 mg, and adequate anesthesia was controlled at the L1 level. When the supine posture was changed to Trendelenburg position, she complained of chest tightness. Her BP was 131/84 mmHg. The ECG showed a narrow complex tachycardia with heart rate of 138–160 beats per minute and absence of P waves. ST depression with 3 mm is also noted in lead II (Supplementary Fig. 2). A diagnosis of PSVT was made. Immediate management included changing to supine posture, carotid sinus massage, and slight ocular compression, but these interventions failed. Just before adenosine (50 lg/kg) was given intravenously, P6 acupressure was suggested. Obtaining the patient’s permission, P6 acupressure was performed with the thumb for continuous compression at the acupoint. To our surprise, her heart rate dropped to 76 bpm in 5 s, and the ECG converted to sinus rhythm from then on (Supplementary Fig. 3). No further episodes of PSVT occurred, and she was discharged home 5 days later. P6 stimulation was reported to reduce heart rate through increasing vagal modulation [2]. Compared with vagal stimulation maneuvers and anti-arrhythmic drugs, P6 acupressure is relative safe and easy to perform. Further confirmation should include randomized controlled clinical studies.