Search

The severity of failure consequences of turbine blades, e.g., aero engine turbine blades, is critical which calls for comprehensive reliability analysis as a basis of that to ensure safe operations. Hence, in order to analyze the fatigue reliability of turbine blades subjected to combined high and low cycle fatigue (CCF), a fatigue reliability analysis is conducted in this study. Initially, the uncertainties related are considered by determining the distributions of strength as well as load parameters. Subsequently, a dynamic reliability model is established by using strength damage interaction method from fatigue accumulation perspective, in which the load spectrum of CCF test is applied. The validation of the proposed method is carried out by a numerical example of turbine blades. The results indicate that the model proposed is capable for quantitatively analyzing the effects of variation in stress and strength parameters on fatigue reliability of turbine blades.

Background and Aims Actual behaviors of drugs in the upper GI tract are not well elucidated. We assess the feasibility of magnetically controlled capsule endoscopy (MCE) in direct and real-time visualization of oral drug behaviors in the stomach. Methods From November 2019 to December 2019, 9 patients with a recent history of upper GI symptoms and 10 healthy volunteers were enrolled in this study. Participants swallowed magnetically controlled capsules to examine the whole stomach. After baseline examination, participants ingested dyed sucralfate gel, and MCE recorded the adhesion time, retention time, and distribution area of sucralfate gel. Outcomes included behaviors of sucralfate gel, safety, and satisfaction assessment of the procedures. Results Adhesion time of sucralfate gel in the abdominal symptoms group was significantly shorter than in the healthy control group (23.76 ± 1.37 minutes vs 31.96 ± 3.09 minutes; P = .032), whereas retention time was longer (98.85 ± 13.94 minutes vs 63.93 ± 8.57 minutes; P = .043). The distribution area of sucralfate gel in the abdominal symptoms group was significantly larger than in healthy control group in cardia (24.29 ± 7.39 vs 9.18 ± 4.06; P < .0001), fundus (18.90 ± 7.08 vs 8.49 ± 4.10; P = .0015), and pylorus (4.64 ± 2.72 vs 0.94 ± 0.90; P = .0019). No adverse events were observed. All participants had a high degree of satisfaction. Conclusions MCE is a feasible and noninvasive tool for direct and real-time visualization of drug behaviors (eg, sucralfate gel) in the stomach. (ClinicalTrials.gov. ID: NCT04327869.), Video Video 1 Magnetically controlled capsule endoscopy direct visualization of drug behaviors in the stomach.

Semantic features, word sequences, and syntactic structures are three key elements for human classification of multi-category sentiment texts. However, current sentiment classification neural network models focus mostly on semantic features and word sequences, thereby losing syntactic structure information in modeling and limiting classification accuracy. In this paper, we combine three key elements at different levels and propose an enhanced model with semantic dual-granularity and syntax-path encoding for multi-category sentiment classification. In particular, at the semantic level, we utilized two long short-term memories to process semantic dual-granularity units that are word and n-gram sequences; then we combined the two memory outputs via the attention mechanism to highlight keywords or key phrases in sentences. At the syntactic level, we extracted syntactic features by encoding each word's syntax path into a syntactic neural network, aiming to capture implied sentiments through an expression pattern. Finally, the two levels' models were combined for multi-category sentiment classification. We applied our model to three common and public multi-category sentiment datasets. Experimental results showed our model significantly outperforming eight strong baseline models with a maximum accuracy improvement of 48.8%; a minimum accuracy improvement of 1%; and average accuracy improvements of 20.9%, 19.3%, and 14.8% on each dataset, respectively.

This paper proposed a health warning system to effectively help individuals or companies fetch the significant parameter of sleep deficiency, protect privacy, and further decrease related accidents due to a person's sleep deficiency. Significantly, it benefits public safety in major industries such as agriculture, manufacturing, and services. This system employs face recognition and optical character recognition for the individual identity and daily sleep time from the daily health report of the Garmin Connect mobile app on the user's smartphone screen.

Patients with chronic pain often report being sensitive to pain at night before falling asleep, a time when the synchronization of cortical activity is initiated. However, how cortical activity relates to pain sensitivity is still unclear. Because sleep is characterized by enhanced cortical delta power, we hypothesized that enhanced cortical delta power may be an indicator of intensified pain. To test this hypothesis, we used pain thresholds tests, EEG/electromyogram recordings, c-Fos staining, and chemogenetic and pharmacological techniques in mice. We found that sleep deprivation or pharmacologic enhancement of EEG delta power by reserpine and scopolamine dramatically decreased mechanical pain thresholds, but not thermal withdrawal latency, in a partial sciatic nerve ligation model of neuropathic pain mice. On the contrary, suppression of EEG delta power using a wake-promoting agent modafinil significantly attenuated mechanical allodynia. Moreover, when EEG delta power was enhanced, c-Fos expression decreased in most regions of the cortex, except the anterior cingulate cortex (ACC), where c-Fos was increased in the somatostatin- and parvalbumin-positive GABAergic neurons. Chemogenetic activation of GABAergic neurons in ACC enhanced EEG delta power and lowered mechanical pain thresholds simultaneously in naive mice. However, chemogenetic inhibition of ACC GABAergic neurons could not block mechanical allodynia. These results provided compelling evidence that elevated EEG delta power is accompanied with aggravated neuropathic pain, whereas decreased delta power attenuated it, suggesting that enhanced delta power can be a specific marker of rising chronic neuropathic pain and that wake-promoting compounds could be used as analgesics in the clinic.

Current evidence on cigarette smoking associated with pancreatic cancer mortality is limited. We searched MEDLINE, Web of Science, and Embase databases to identify relevant studies published through January 31, 2018. A random-effects model was used to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 20 studies were retrieved, involving 2,517,623 participants. Of these, more than 15,341 patients with pancreatic cancer died. Compared with never smokers, current (summary HR, 1.56; 95% CI, 1.34-1.83) and former (summary HR, 1.15; 95% CI, 1.06-1.26) smokers had elevated risk of total mortality in patients diagnosed with pancreatic cancer. This effect of cigarette smoking is observed both in the Western regions and the Asia-Pacific regions. This effect of smoking is independent of alcohol use, body mass index, and history of diabetes but is modified by tumor stage and study settings. Dose-response associations between smoking and pancreatic cancer mortality were revealed for smoking intensity, cumulative amount of cigarettes smoked, and duration of smoking. Cigarette smoking was associated with an increase in total mortality for patients with pancreatic cancer. Future studies should further clarify the role of smoking as an effect modifier in treatment trials of pancreatic cancer.

Via the idea of social computing, a simple experimental model is developed as a reference for exploring the variation of journal impact factors, particularly between different disciplines. Our model intends to simulate the publication and citation behaviors of the articles in journals belonging to a similar discipline, in a distributed manner. Based on the citation networks generated, the mechanism of influence from several fundamental factors to the trend of impact factor is better revealed. These factors include the average review cycle, the average number of references, and yearly distribution of references. The analysis also reveals a satisfactory capability of the model for approximation between actual data and simulation results.

A simulation model based on parallel systems is established, aiming to explore the relation between the number of submissions and the overall standard of academic journals within a similar discipline under peer review. The model can effectively simulate the submission, review, and acceptance behaviors of academic journals in a distributed manner. According to the simulation experiments, it could possibly happen that the overall standard of academic journals deteriorates due to excessive submissions., Comment: This paper is already published in the journal IEEE Access and its copyright is fully open. The title was adjusted according to the review comments

The key to fault diagnosis of rotating machinery is to extract fault features effectively and select the appropriate classification algorithm. As a common signal decomposition method, the effect of wavelet packet decomposition (WPD) largely depends on the applicability of the wavelet basis function (WBF). In this paper, a novel fault diagnosis approach for rotating machinery based on feature importance ranking and selection is proposed. Firstly, a two-step principle is proposed to select the most suitable WBF for the vibration signal, based on which an optimized WPD (OWPD) method is proposed to decompose the vibration signal and extract the fault information in the frequency domain. Secondly, FE is utilized to extract fault features of the decomposed subsignals of OWPD. Thirdly, the categorical boosting (CatBoost) algorithm is introduced to rank the fault features by a certain strategy, and the optimal feature set is further utilized to identify and diagnose the fault types. A hybrid dataset of bearing and rotor faults and an actual dataset of the one-stage reduction gearbox are utilized for experimental verification. Experimental results indicate that the proposed approach can achieve higher fault diagnosis accuracy using fewer features under complex working conditions.

Splanchnic vein thrombosis is a severe complication of pancreatitis. To date, no consensus over the management of pancreatitis-related splanchnic vein thrombosis has been established. Based on the consensus of multidisciplinary experts, this practice guidance systematically reviewed the epidemiology, anatomy, pathophysiology, risk assessment and clinical presentations of splanchnic vein thrombosis, and formulated a diagnosis and treatment strategy for providing guidance in clinical practice for this disease.

ObjectivePerioperative shivering (POS) is a common complication in patients undergoing spinal anaesthesia. The present study investigated the efficacy of 5-HT3receptor antagonists in preventing POS following spinal anaesthesia.DesignSystematic review and meta-analysis.Data sourcesPubmed, Embase, the Web of Science and Cochrane Library were searched from database establishment on 31 July 2019.Eligibility criteriaRandomised controlled trials that reported the effects of 5-HT3receptor antagonists in the prevention of POS in patients after spinal anaesthesia.Data extraction and synthesisTwo reviewers independently extracted data. The primary outcome of the present study was the incidence of POS. The risk of bias for the included studies was assessed according to the Cochrane Handbook. The quality of primary outcome was evaluated by Grading of Recommendations Assessment, Development and Evaluation. Trial sequential analysis for the primary outcome was performed to reduce the type 1 error caused by repeated meta-analysis and the required information size was calculated.ResultsA total of 13 randomised controlled trials consisting of 1139 patients were included. The overall incidence of POS was significantly lower in the 5-HT3receptor antagonists group (risk ratio 0.31; 95% CI 0.26 to 0.38; p2=0%). Subgroup analysis for different types of 5-HT3receptor antagonists and timing of administration produced similar results. Also, patients had a lower incidence of postoperative nausea and vomiting after administrating 5-HT3 receptor antagonists. No statistically significant differences in drug-related adverse effects were observed. Grading of Recommendations Assessment, Development and Evaluation revealed a high level of evidence. The cumulative z-curve crossed the trial sequential monitoring boundary.ConclusionsThe present study revealed that prophylactic 5-HT3receptor antagonists were an effective measure for reducing the incidence of POS in patients after spinal anaesthesia. However, further studies investigating the different types of surgeries are required.PROSPERO registration numberCRD42019148191.

Objective Previous studies reported the effect of dexmedetomidine on intrathecal anesthesia. In this review, we explored the impact of dexmedetomidine as an adjunct for lumbar anesthesia in patients undergoing cesarean section. Methods Two authors searched eligible random controlled trials in electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, the Chinese BioMedical database, Chinese Scientific Journal Database, and the Wanfang database. Results Ten trials comprising 970 patients were included in this review. Intrathecal dexmedetomidine significantly reduced the onset time of sensory block (standardized mean difference (SMD), −1.50, 95% confidence interval (CI) −2.15, −0.85, I2 = 92%) and motor block (SMD −0.77, 95% CI −1.50, −0.49, I2 = 60%) and prolonged the block duration time (sensory block: SMD 2.02, 95% CI 1.29, 2.74, I2 = 93%; motor block: SMD 1.90, 95% CI 1.07, 2.74, I2 = 94%). Patients who received dexmedetomidine showed a lower incidence of shivering. No significant difference was reported for the neonatal Apgar score and other complications. Conclusion The use of intrathecal dexmedetomidine during cesarean section can shorten the onset time of spinal anesthesia and enhance the effect of local anesthetic. It has no significant impact on neonates and there were no other adverse events.

The gelling process of chicken meat batters, which were heated (75 °C) under atmospheric pressure or high pressure (200/400 MPa), was investigated by determining the hardness of batter, residual denaturation enthalpy, microstructure, and protein secondary structure. The results showed that meat batters heated at 200 MPa showed a similar increase in hardness to heat-only samples, but meat batters heated at 400 MPa showed a texture decreasing tendency after a limited increase. High pressure disrupted the myofibrils, promoted protein denaturation and aggregation in the first stage of heating under pressure treatment. In the second stage of treatment, heating was the main driving force for protein gelation, which was disturbed by hindering the structural transformation of proteins in the presence of high pressure during heating. The effect of 200 MPa on muscle proteins was relatively gentle and had a less negative effect. Excessive high pressure should be avoided when applying heating under pressure for gel-type meat products processing. Industry relevance High-pressure processing is increasingly applied in the meat industry. By combining high pressure with heating, their effects on texture improvement and microbial inactivation can be maximized. In this study, the influence of high pressure on the texture of meat products was analyzed, which showed that excessive pressure would significantly interfere with the thermal denaturation of the protein, thus adversely affecting the formation of the gel structure. High pressure at 400 MPa and above should be avoided when applying heating under pressure for gel-type meat products processing.

Efficient electrocatalytic hydrogen evolution reaction (HER) is one of the most promising ways to low-cost hydrogen production in the future. However, it is still a challenge to develop efficient, durable, and affordable catalysts. In this paper, we choose ultrasmall Pt nanoclusters, metallic MoO2 semiconductor, and conductive material with ultralow Pt loadings as an active and durable catalyst for HER in acid media. The obtained 0.5 wt % Pt–MoO2/MWCNTs catalyst with ultralow Pt loadings exhibits high-efficiency electrocatalytic activity and excellent stability. Benefiting from the space confinement effect and good electric conductivity of metallic MoO2 and MWCNTs, the HER activity of as-made 0.5 wt % Pt–MoO2/MWCNTs catalyst is comparable to that of commercial 20 wt % Pt/C catalyst. Remarkably, the strong interaction between metallic Pt and MoO2 support can prevent the aggregation of Pt species; the 0.5 wt % Pt–MoO2/MWCNTs sample shows better stability than 0.5 wt % Pt–MWCNTs and commercial 20 wt % Pt/C. ...

The main research work of this paper focuses on the theoretical prediction of the constitutive relationship for rock, concrete, and other quasi-brittle materials under dynamic and complex stress state and the influence of dynamic mechanical behavior of rock on practical engineering problems was studied. A damaged elastoplastic model (DEPM) is established for the investigation and prediction of static or dynamic mechanical behavior of rock material. The mechanical behavior (brittleness or plasticity) and dynamic response (due to underground impact pressure and high-velocity impact of projectile) of rock under high in situ stress were investigated via the DEPM combined with the explicit finite element method. This paper suggests the influence of the brittle or plastic mechanical behavior of rock material on deep underground rock engineering.

Aim To assess efficacy ofDA alginate-antacidchewable tablets for reducing esophageal acid exposure in Chinese patients with gastroesophageal reflux disease (GERD) Methods Forty-fourpatients reporting moderately severe heartburn symptomsunderwent two pHmonitoring visits. Treatment sequence was randomized:patients receivedDAalginate-antacid or placebo at one visit and the alternate treatment seven days later. Aftera standardizedreflux-provoking meal,patients took four tablets of DAalginate-antacid or placebo. Esophageal pH was measured for 4 h post-dosing,using an electrode positioned 5 cm above the lower esophageal sphincter.Primary endpoint: percentage of 4-hpost-dosing period with pH

In this paper, we use virtual prototype with finite element modeling to customize footwear design for hallux valgus foot with the purpose of offloading plantar peak pressure from the local metatarsal head. The footwear consists of two material layers to achieve deformation patterns during foot-insole contact interactions (i.e., soft tissue squeezes the insole FE model). The deformed model of the footwear is exported and a metatarsal pad is added in different placement. From the results of simulation, the metatarsal pad and the deformation synergistically achieve the purpose of decompression, and an optimal design could be found by virtually varying with the position of metatarsal pad.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a frequent and distressing complication of general anaesthesia in paediatric patients. Dexamethasone was reported to prevent PONV in previous randomized controlled trials (RCTs). The purpose of this meta-analysis was to evaluate the role of dexamethasone in the prevention of PONV in children undergoing non-cardiac surgery. METHODS: PubMed, EMBASE, the Cochrane Library, and Web of Science were searched to identify randomized trials that reported the efficacy of perioperative dexamethasone in paediatric non-cardiac surgical patients. RESULTS: Fourteen randomized controlled trials that included 1700 children were included. Compared with placebo, dexamethasone showed a lower incidence of PONV by intravenous injection (RR 0.38, 95% confidence interval (CI) 0.30–0.49) and by local infiltration (RR 0.58, 95% CI 0.34–0.99). The combination of dexamethasone and a 5-HT3 receptor antagonist was more effective than the 5-HT3 antagonist or dexamethasone alone in preventing PONV. CONCLUSION: Perioperative dexamethasone was an effective measure with few complications for preventing PONV in children after non-cardiac surgery.

Background The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC). Methods We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded. Results For all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type. Conclusions RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.

This paper describes an experimental study on the flexural and eccentric compressive behavior of concrete-filled square steel tube (CFSST) beam-columns stiffened with PBL stiffeners. Three types of CFSST beam-columns were fabricated and tested under the flexural moment and eccentric compressive load. Among the three types of columns, the two types of columns were strengthened with the PBL and steel plate stiffeners; the other type of columns was not strengthened. In addition, extensive finite element analyses (FEA) were carried out to evaluate the stress distribution. Flexural test results show that failure modes of specimens without stiffeners were different from specimens with the PBL or steel plate stiffeners. The results also demonstrate the distribution of cracks in the concrete was affected by stiffeners and the columns with the PBL stiffeners have the most uniformed crack distributions. The capacity improved by the PBL stiffeners was insignificant. However, the flexural stiffness of the specimen stiffened with the PBL stiffeners was about 20% larger than the unstiffened specimen. Eccentric compressive load test results show the capacity of specimen with the PBL stiffeners was 6.95% larger than the unstiffened specimen. The eccentric compressive capacity decreased with the increase of the eccentricity ratio or slenderness ratio. FEA results show that stiffeners can effectively improve the mechanical behavior of CFSST specimens under bending and eccentric compressive loads.

EDITOR’S PERSPECTIVE What We Already Know about This Topic The parabrachial nucleus is a brainstem region involved in arousal. Brain regions involved in arousal regulate anesthetic induction and emergence. What This Article Tells Us That Is New Using chemogenetic techniques, activation of parabrachial nucleus glutamatergic neurons prolonged anesthetic induction and hastened emergence in mice. Inhibition of these neurons provided opposite effects. Modulating the activity of arousal centers may provide an approach to controlling the duration of general anesthesia. Background The parabrachial nucleus (PBN), which is a brainstem region containing glutamatergic neurons, is a key arousal nucleus. Injuries to the area often prevent patient reanimation. Some studies suggest that brain regions that control arousal and reanimation are a key part of the anesthesia recovery. Therefore, we hypothesize that the PBN may be involved in regulating emergence from anesthesia. Methods We investigated the effects of specific activation or inhibition of PBN glutamatergic neurons on sevoflurane general anesthesia using the chemogenetic “designer receptors exclusively activated by designer drugs” approach. Optogenetic methods combined with polysomnographic recordings were used to explore the effects of transient activation of PBN glutamatergic neuron on sevoflurane anesthesia. Immunohistochemical techniques are employed to reveal the mechanism by which PBN regulated sevoflurane anesthesia. Results Chemogenetic activation of PBN glutamatergic neurons by intraperitoneal injections of clozapine-N-oxide decreased emergence time (mean ± SD, control vs. clozapine-N-oxide, 55 ± 24 vs. 15 ± 9 s, P = 0.0002) caused by sevoflurane inhalation and prolonged induction time (70 ± 15 vs. 109 ± 38 s, n = 9, P = 0.012) as well as the ED50 of sevoflurane (1.48 vs. 1.60%, P = 0.0002), which was characterized by a rightward shift of the loss of righting reflex cumulative curve. In contrast, chemogenetic inhibition of PBN glutamatergic neurons slightly increased emergence time (56 ± 26 vs. 87 ± 26 s, n = 8, P = 0.034). Moreover, instantaneous activation of PBN glutamatergic neurons expressing channelrhodopsin-2 during steady-state general anesthesia with sevoflurane produced electroencephalogram evidence of cortical arousal. Immunohistochemical experiments showed that activation of PBN induced excitation of cortical and subcortical arousal nuclei during sevoflurane anesthesia. Conclusions Activation of PBN glutamatergic neurons is helpful to accelerate the transition from general anesthesia to an arousal state, which may provide a new strategy in shortening the recovery time after sevoflurane anesthesia.

Background Drugs that inhibit the MEK/ERK pathway have therapeutic benefit in bladder cancer treatment but responses vary with patients, for reasons that are still not very clear. Interferon-α (IFN-α) is also used as a therapeutic agent for bladder cancer treatment but the response rate is low. It was found that IFN-α could enhance the cytotoxic effect of MEK inhibition. However, the potential mechanisms of that are still unclear. Understanding of the cross-talk between the IFN-α and MEK/ERK pathway will help enhance the efficacy of IFN-α or MEK inhibitors on bladder cancer. Methods Immunoprecipitation and pull-down assay were used to reveal the formation of signaling complex. The protein expressions were detected by western blot and immunohistochemistry. The cAMP level, Phosphodiesterase 4D (PDE4D) activity and Prostaglandin E2 (PGE2) concentration in cells, serum and tissues were detected by enzyme-linked immunosorbent assay. The role of PDE4D in bladder tumorigenesis in vivo was examined by the xenograft model. Tissue microarray chips were used to investigate the prognostic roles of PDE4D and tumor progression locus 2 (TPL2) in bladder cancer patients. Results IFN-α down-regulated the cyclooxygenase-2 (COX-2) expression in bladder cancer cells through the inhibition of TPL2/NF-κB pathway; IFN-α also inhibited COX-2 expression by suppressing cAMP signaling through TPL2-ERK mediated PDE4D activity. Reduction of the intracellular cAMP level by PDE4D potentiated the antitumor effect of IFN-α against bladder cancer in vitro and in vivo. Further analysis of clinical samples indicated that low PDE4D expression and high level of TPL2 phosphorylation were correlated to the development and poor prognosis in bladder cancer patients. Conclusions Our data reveal that IFN-α can exert its antitumor effect through a non-canonical JAK-STAT pathway in the bladder cancer cells with low activity of IFN pathway, and the TPL2 inhibition is another function of IFN-α in the context of bladder cancer therapy. The antitumor effects of IFN-α and MEK inhibition also depend on the PDE4D-mediated cAMP level in bladder cancer cells. Suppression of the TPL2 phosphorylation and intracellular cAMP level may be possible therapeutic strategies for enhancing the effectiveness of IFN-α and MEK inhibitors in bladder cancer treatment. Electronic supplementary material The online version of this article (10.1186/s13046-018-0971-4) contains supplementary material, which is available to authorized users.

Background To investigate the unique features of inflammatory bowel disease (IBD) in children, we wanted to identify whether there might be a strong correlation between the disease phenotype and its prognosis at various ages in paediatric patients. Methods We collected data from patients diagnosed with IBD (ulcerative colitis (UC) or Crohn’s disease (CD)) from 2002 to 2016. The diagnosis was made according to the Porto criteria and Paris Classification. Patient characteristics, clinical manifestations and treatments were collected. Risk factors for surgery, mortality and relapse were analysed by Cox proportional hazard models. Results Of the 143 patients, 113 had CD, and 30 had UC; there were 89 males and 54 females with a median age of 9 years (y). Thirteen patients in the 0–2 y group were identified as having mutations in IL-10 receptor A, and this mutation was significantly more common in this age group than in 3–9 and 10–16 y patients. The risk factor for surgery was the B3 phenotype; risk factors for death were age 0–2 y and B3 phenotype; 0–2 y, B3 phenotype and steroid dependency were risk factors for early relapse. Conclusions Clinical manifestations of the onset of IBD in infants and toddlers were extensive and aggressive and were closely associated with early relapse and death. It is of particular interest that some of these patients developed IBD due to monogenic disorders; thus, introduction of genetic testing is essential for these patients.

Pancreatic cancer (PC) is the fourth leading cause of cancer-related mortality in the United States. There is no effective serum biomarker for the early diagnosis of PC at present. Although serum UL16-binding protein 2 (ULBP2) and macrophage inhibitory cytokine-1 (MIC-1) levels are reported to be elevated in PC patients, the diagnostic and prognostic value of ULBP2 and MIC-1 alone or in combination remains unknown. The aim of the present case-control study was to compare the diagnostic value of ULBP2, MIC-1 and carbohydrate antigen 19-9 (CA19-9) in 359 serum samples, consisting of 152 cases of PC, 20 cases of pre-pancreatic cancer, 91 cases of chronic pancreatitis (CP) and 96 normal controls (NC). All patients were followed up for a median of 2 years. It was found that the serum levels of ULBP2, MIC-1 and CA19-9 were significantly higher in the PC patients compared with those in the NC group. In distinguishing PC from the CP, the highest sensitivity and specificity were ULBP2 (0.878) and CA19-9 (0.816), respectively. The area under the receiver operating characteristic curve of ULBP2 was 0.923, which was the highest of the three biomarkers. MIC-1 was the optimal choice for the diagnosis of early-stage PC (area under the curve, 0.831). Overall, MIC-1 in combination with ULBP2 improved the diagnostic accuracy in differentiating PC from CP and NC. In addition, a higher level of MIC-1 was correlated with a poorer prognosis, as calculated by the Kaplan-Meier test (P=0.039). Patients with serum MIC-1 levels of ≥1,932 ng/ml had a median survival time of 15.62±2.44 months (mean ± standard deviation) vs. 18.66±2.43 months in patients with a lower level of MIC-1. Overall, combined detection of serum MIC-1 and ULBP2 improved the diagnostic accuracy in differentiating PC from CP and NC, and serum MIC-1 level alone was a predictor of survival in the patients with PC.

Objective This study aimed to compare the value of sentinel lymph node biopsy (SLNB) with that of elective neck dissection (END) for the prediction of cervical lymph node metastasis in patients with clinically diagnosed T1-2N0 (cT1-2N0) oral tongue squamous cell carcinoma (OTSCC), and it aimed to examine the prognostic value of individualized treatment in sentinel lymph node (SLN)-negative patients. Study Design The study entailed a retrospective review of 82 patients with cT1-2N0 OTSCC. Thirty patients underwent SLNB, and 52 patients underwent END. Results There was a significant difference between the SLNB and END groups in the incidence of occult cervical lymph node metastasis in initial specimens (30% vs 11.5%; P = .037). However, there were no significant differences between the groups for 10-year overall and cervical recurrence-free survival rates and 10-year overall survival rate. Conclusions SLNB is superior to END for the prediction of cervical lymph node metastasis in patients with cT1-2N0 OTSCC. Neck dissection may be reduced for SLN-negative patients, owing to the comparable prognosis of SLNB.

ObjectiveWe aimed to describe the clinical picture, management and outcomes of Chinese patients with peptic ulcer bleeding (PUB), especially in those with high risks. MethodsA multicenter endoscopic survey was conducted. All consecutive patients with endoscopy confirmed PUB from October 2010 to June 2011 were enrolled. Data including patients' gender, age, symptoms and endoscopic findings, Forrest classification, and endoscopic and medical treatment were documented. High-risk ulcer was defined as Forrest grades Ia to IIb upon endoscopy. Rates of rebleeding, surgery and mortality were recorded. ResultsIn all, 1006 patients were included. Of these 437 (43.4%) were categorized with high-risk PUB, among whom 110 (25.2%) received endoscopic treatment, and the success rate was 99.1%. Rebleeding rates 1-3 days, 4-5 days and 6-30 days after treatment in high-risk patients who did and did not receive endoscopic treatment were 10.9% versus 10.4%, 3.6% versus 3.7% and 0.9% versus 1.5%, respectively. The surgery rates of high-risk patients with or without endoscopic treatment were 1.8% (2/110) versus 1.8% (6/327). During the 9-month study period, two patients with high-risk PUB died, therefore, the overall mortality rate of high-risk PUB was 0.5% (2/437). ConclusionThe study suggests that the proportions of high-risk PUB in China is 43.4%, while rebleeding and surgery rate after endoscopic treatment as well as the mortality rate of high-risk PUB in China are 15.6%, 1.8% and 0.5%, respectively.

In P2P networks, malice peers forge identity to interrupt routing, called Sybil attack. To avoid it, methods in related works consider routing as random walk. Since the destination of random walk is hard to predict, Sybil-proof P2P networks need large routing information to support routing. However, a large size routing table constrains the scalability of the system. Therefore, we aim to develop a routing algorithm to satisfy the requirement of P2P networks which has a good performance at Sybil-Proof by using a reasonable size of routing table. Social links are useful to prevent a Sybil attack because friend peers have little chance to be a Sybil peer. In this proposed method, reputation of social link is useful for achieving this objective. Considering the distance to destination peers can help for routing efficiency and considering the reputation can make routing to have better performance resisting Sybil-attacks.

With the long-distance oil and gas pipelines are to development of the direction of large-diameter, high-pressure, high grade pipeline steel applications gradually become the trend of the development of the oil and gas pipeline construction. The welding process of the X100 line pipe which is about to industrial application is not yet to be determined. It is not clear that the affect to the weldability from the metallurgical composition, organization, performance, and other factors which would affect the site construction welding process and welding measures. In addition, it is not yet the discussion and analysis of the key technologies X100 line pipe-site welding process and defect types. In this paper, the X100 pipeline on-site application of welding technology research commenced work and studied the weldability and welding process of X100 which solve the field application of X100 pipeline steel pipe welding issues.

We report an investigation of the optical performance of a conformal-shaped phosphor coating fabricated using pulsed spray techniques on horizontal LED chips. Both the nitride and YAG:Ce phosphor mixed configuration and the multilayer configuration were studied. Also, 3535-packaged LED devices with the two typical phosphor configurations were prepared and analyzed. The results revealed that the LED devices with multilayer phosphor configurations emitted an average of 5.6% more radiant flux than those with mixed phosphor configurations. However, such LED devices presented an interesting reversed tendency in the luminosity measurements, which were 0.3 lm and 6 lm lower at 10 mA and 350 mA, respectively. Finally, the color rendering index (CRI) and correlated color temperature (CCT) homogeneity of the LED devices were further analyzed. A twofold reduction in CCT variation was observed compared with the conventional phosphor coating methods. It was found that the mixed phosphor LED devices demonstrated outstanding angular CCT distributions for viewing angles ranging from ${-}{\hbox{80}}^{\circ}$ to 0 $^{\circ}$ , and a CCT variation of only 45 K was detected, while the multilayer phosphor coating had higher color rendering capabilities, reaching a ${\rm CRI}_{\rm general}$ value as high as 85.6. A promising guideline found through this work is that the pulse-sprayed conformal phosphor configuration would particularly be able to improve the light quality of LED devices by a significant amount: the mixed phosphor configuration achieves excellent CCT homogeneity, and the multilayer phosphor configuration reveals a novel concept for fabricating a low-CCT and high-CRI LED device with less nitride phosphor. The findings of our research should provide valuable insight to LED industries.

Objective The aim of this study was to analyze whether pathologic complete response (PCR) to neoadjuvant chemotherapy (NAC) affected long-term survival in advanced head and neck squamous cell carcinoma (HNSCC) patients. Materials All patients with advanced HNSCC were previously untreated and underwent NAC followed by surgery. The 5-year overall survival, disease-free survival, local control rate, and reasons for treatment failure were analyzed. Results A total of 101 cases were included, and the response rate to NAC was 67.3%, including 17 patients (16.8%) who achieved PCR. The 5-year overall survival (OS) of the PCR group (82.4%; histologically complete response group [HCG]) was higher than that of the pathologic incomplete responder group (45.4%; histologically incomplete response group [HICG]) (P = 0.045). No statistically significant difference was noted between the two groups in terms of local recurrence and nodal recurrence, but the local control rate in HCG (88.2%) was higher than that in HICG (62.7%) (P = 0.034). Conclusions Achieving PCR could improve locoregional control and long-term survival in patients with advanced HNSCC.

The convening of Copenhagen Climate Conference marks that carbon emission accepted as a hard constraint in most countries. This paper first reviewed the development course of the carbon emission study; Secondly, the paper forecasts the energy demand and carbon intensity before 2020 of China by the method of the elasticity coefficient; As China's current energy consumption structure cannot reach the 2020carbon reduction target, we optimized China's energy structure, proposing the measures of "speeding up the transformation of economic growth mode, promoting the energy saving of the whole society, accelerating the exploitation of non-fossil energy and developing the coal orderly " accordingly.

Splenogonadal fusion is a rare congenital non-malignant anomaly characterized by fusion of splenic tissue to the gonad and can be continuous or discontinuous. Very few cases have been diagnosed preoperatively. We reported one case of the continuous type presenting with scrotal mass which underwent laparoscopy and the related literature was reviewed.

Supplemental Digital Content is available in the text, The presentation, pathology, and prognosis of pancreatic neuroendocrine tumors (PNETs) in Asian patients have not been studied in large cohorts. We hypothesized that the clinicopathological features of PNETs of Chinese patients might be different from those of US patients. The objectives of this study were to address whether PNETs in Chinese patients exhibit unique clinicopathological features and natural history, and can be graded and staged using the WHO/ENETS criteria. This is a retrospective review of medical records of patients with PNETs in multiple academic medical centers in China (7) and the United States (2). Tumor grading and staging were based on WHO/ENETS criteria. The clinicopathological features of PNETs of Chinese and US patients were compared. Univariate and multivariate analyses were performed to find associations between survival and patient demographics, tumor grade and stage, and other clinicopathological characteristics. A total of 977 (527 Chinese and 450 US) patients with PNETs were studied. In general, Chinese patients were younger than US patients (median age 46 vs 56 years). In Chinese patients, insulinomas were the most common (52.2%), followed by nonfunctional tumors (39.7%), whereas the order was reversed in US patients. Tumor grade distribution was similar in the 2 countries (G1: 57.5% vs 55.0%; G2: 38.5% vs 41.3%; and G3: 4.0% vs 3.7%). However, age, primary tumor size, primary tumor location, grade, and stage of subtypes of PNETs were significantly different between the 2 countries. The Chinese nonfunctional tumors were significantly larger than US ones (median size 4 vs 3 cm) and more frequently located in the head/neck region (54.9% vs 34.8%). The Chinese and US insulinomas were similar in size (median 1.5 cm) but the Chinese insulinomas relatively more frequently located in the head/neck region (48.3% vs 26.1%). Higher grade, advanced stage, metastasis, and larger primary tumor size were significantly associated with unfavorable survival in both countries. Several clinicopathological differences are found between Chinese and US PNETs but the PNETs of both countries follow a similar natural history. The WHO tumor grading and ENETS staging criteria are applicable to both Chinese and US patients.

The author firstly summarized the principles, performance and theoretical resilience model of the new type electromagnetic damper. The theoretical resilience model is further improved on this basis—normalizing the impact of vibrant frequency and vibrant amplitude on resilience as the impact of single parameter velocity amplitude. The results show that improved model can give a better effect as shown in experiment. This lays a sound foundation for simulation calculation in developing products using for practical engineering and installing the structural vibration reduction system of electromagnetic damper.

Fractalkine (FKN), a chemokine that acts as both an adhesion molecule and a chemoattractant, is expressed in many inflammatory diseases. Chemokines play a crucial role in severe acute pancreatitis (SAP). This study used adenovirus-mediated siRNA to target FKN overexpression and assessed its ability to suppress inflammation development in a SAP rat model. Adenovirus-mediated FKN siRNA was transfected into cerulein-stimulated AR42J cells. The growth of cerulein-stimulated AR42J cells was determined by colony formation and MTT assays. The inhibitory effect of the FKN siRNA was studied in a SAP rat model in vivo and detected by ELISA, RT-PCR, western blot analysis and immunohistochemistry. FKN, IL-8 and TNF-α were found to be overexpressed in cerulein-stimulated AR42J cells by ELISA and western blot analysis (P

Effects of YAG: Ce phosphor particle size on the luminous flux and angular color uniformity have been studied by using Monte Carlo ray-tracing simulation. A white LED model basing on Cree XLamp is constructed. The phosphor particle size is changed from 2 to 20 μm. Different simulation cases are carried out by changing the phosphor concentration and thickness. Results revealed that the luminous flux and angular color uniformity have complex relationships with the particle size depending on applied phosphor concentration and desired color temperature. A general finding is that an increase of the particle size is beneficial for the improvement of luminous flux but leads to worse angular color uniformity. A 2 μm particle achieves not only the best angular color uniformity but the lowest luminous flux. A particle size larger than 10 μm generates the highest luminous flux at low color temperature when the concentration is around 1.5 g/cm3. A particle size between 2 μm and 10 μm shows combined moderate performance when the phosphor concentration is higher than 2 g/cm3. To realize the best combined performance, a particle size around 6 μm is suggested.

OBJECTIVE: The aim of this study was to study the role of fractalkine (FKN) in the development of severe acute pancreatitis (SAP) in animal model. METHODS: Serum FKN levels in rat model (control, SAP6h, 16h, 24h and 48h) were determined by enzyme-linked immunosorbent assay. FKN mRNA and protein levels in the pancreas tissue were measured by reverse transcription polymerase chain reaction (RT-PCR), Western blot and immunohistochemistry. RESULTS: Serum FKN level in the SAP rat increased significantly (P

Objective: To investigate the clinical therapeutic outcomes and neck node control of a pretreatment neck dissection in the chemoradiation protocol of organ preservation for N2-N3 of supraglottic and hypopharyngeal carcinoma. Methods: Forty-six patients (group A) with untreated N2 or N3 squamous cell carcinoma of the supraglottis or hypopharynx underwent pretreatment neck dissection in a chemoradiation protocol, while 39 patients (group B) did not undergo pretreatment neck dissection in a chemoradiation protocol. Salvage surgeries were used for local or cervical node residual tumor or recurrence after chemoradiotherapy. Results: In group A, the mean time between neck dissection and chemoradiation was 21 days (range 15-29). Only 3 patients (6.5%) experienced wound complications. A ‘boost' of radiation of 12 Gy was delivered after 33 neck dissections (64.8%) in patients with extracapsular spread. The Kaplan-Meier 5-year overall survival rate was 42.5%. The 5-year overall survival rate and disease-specific survival rate in group A was 42.5 and 46.4%. The rate of neck node control in group A was better than that in group B (86.3 vs. 65.9%, p = 0.02). Conclusions: Pretreatment neck dissection in a chemoradiation protocol for supraglottic or hypopharyngeal carcinoma showed low complication rates, no delay for radiation, optimal radiation doses, and a high nodal disease control.

In upsetting forging process of the crank of crankshaft the defects such as lap and caving probably occurs since the bending and upsetting is not in good coordination. In this paper, aiming at 305 crankshaft for marine engine, the coordinative relation between bending and upsetting was thoroughly studied based on 3-step crank upsetting forging approach, i.e. bending-upsetting, upsetting and finish forming. Numerical simulation was carried out to find the reasonable stroke matches of bending and upsetting and physical experiment of using lead sample reduced at the ratio 1:6 in size was conducted to verify the match scheme gained from numerical simulation. The result found from numerical simulation is in good accordance with the one gained through experiment. The work in this paper provides theoretical basis for practice of upsetting forging technique of crank.

To standardize the diagnosis and management of Barrett's esophagus (BE) in China, the Chinese Society of Gastroenterology convened the Second National Conference on BE in June 2011 in Chongqing, China. After intense discussion among experts in this field and an extensive review of the literature, a revised consensus on the diagnosis and management of BE was generated.

Numerical computations using finite difference method and unified strength theory are reported to analyze the slope stability problem. The Factor of safety of plane strain and axisymmetric slopes was calculated by strength reducing method, and the influences of intermediate principal stress on slope stability problem was analyzed. The associative and non-associative flow rule was taking into account in plane strain slope problem analysis. The intermediate principal stress has equivalent influences on slope stability problem under associative and non-associative flow rule. The Factor of safety of plane strain slope is lower than the axisymmetric situation. The influence of intermediate principal stress on slope stability under plane strain condition is heavier than axisymmetry.

In this paper, a model for evaluating the quality of Baikal skullcap root based on the chromatographic fingerprint and pharmacological effect correlation mode was established by using multivariate polynomial fitting technique. This result is new and the accuracy of the model is tested by comparing the modeled results with the experimental data. In addition, a related piece of software was developed. This paper also provides us with a new modelling method for the quality evaluation of traditional Chinese herbal medicine.

In this paper, with the aid of a quality evaluation model, we study sensitivity analysis of the quality evaluation system for Baikal skullcap root and compute related sensitivity indices, hence determine the response of pharmacological effect under the model by varying chromatographic fingerprint data. This result is new and provides us with a feasible method for the quality evaluation of Traditional Chinese Herbal Medicine.

Background: To retrospectively evaluate the prognostic factors and treatment outcomes of patients treated with intra-arterial concurrent chemo-radiation therapy (IACCRT). Methods: We retrospectively analyzed patients treated with intra-arterial concurrent chemo-radiation therapy between 2010 and 2016. Intra-arterial catheters were placed in superficial temporal arteries. Two different radiotherapy techniques were used, conventional and simultaneous integrated boost (SIB). The significance of each prognostic factor was estimated using survival analysis. Results: 31 patients were sequentially reviewed with median follow-up time of 11.6 months. There was no renal toxicity. Different radiotherapy techniques, conventional dose fraction versus SIB, did not differ significantly, in terms of locoregional-recurrence-free survival (P=0.057) and overall survival (P=0.069). Better overall survival was found in patients receiving salvage surgery than no surgery (P=0.001) as well as in treatment-naive patients than recurrent ones (P=0.001). Conclusions: Preoperative concurrent intra-arterial chemoradiation therapy is feasible and effective, has lower toxicity when compare to reports from intravenous chemoradiotherapy. SIB may seemly increase the conversion of inoperable tumor into operable tumor when compare the conventional dose fraction, but this may require further prospective study with more patient accrual. Prognostic factor that significantly improves the overall survival is if the patients receive the salvage surgery.

OBJECTIVE: To evaluate the efficacy and safety of Combizym treatment in Chinese patients with dyspepsia. METHODS: In this multicenter, randomized, placebo-controlled cross-over study, a total of 151 patients (76 men and 75 women, mean age: 44.67 ± 6.46 years, range: 22–67 years) with dyspepsia whose symptoms were not relieved by placebos were recruited. They were randomly divided into group A (79 patients, 2 weeks of Combizym treatment, two tablets post-meal, t.i.d.; then 1 week of wash-out, followed by 2 weeks of placebo treatment, two tablets post-meal, t.i.d.) or group B (72 patients, 2 weeks of placebo treatment, two tablets post-meal, t.i.d. then one week of wash-out, followed by 2 weeks of Combizym treatment, 2 tablets post-meal, t.i.d.). The index of severity of the dyspepsia symptoms was evaluated before and after each treatment phase with Combizym or the placebo. RESULTS: Compared with the placebo, 2 weeks of Combizym treatment decreased the severity index of dyspepsia symptoms significantly (27.64 ± 1.77 to 9.72 ± 1.33 vs 23.99 ± 1.28 to 22.03 ± 1.40, P

Steganalysis can be used to classify an object whether or not it contains hidden information. In this article, is presented, a novel approach to detect the presence of least significant bit (LSB) steganographic messages in the voice secure communication system. A distance measure, which has proven to be sensitive to LSB steganography by analysis of variance (ANOVA), is denoted to estimate the difference between the host signal and the stego signal. Then an maximum likelihood (ML) decision is combined to form the classifier. Statistical experiments show that the proposed approach has a highly accurate rate and low computational complexity.