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Objective Interspinous spacer (ISS)-based and pedicle screw-rod dynamic fixator (PDF)-based topping-off devices have been applied in lumbar/lumbosacral fusion surgeries for preventing the development of proximal adjacent segment degeneration. However, little attention has been paid to sacroiliac joint (SIJ), which belongs to the adjacent joints. Accordingly, the objective of this study was to compare how these 2 topping-off devices affect the SIJ biomechanics. Methods A validated, normal finite-element lumbopelvic model (L3–pelvis) was initially adjusted to simulate interbody fusion with rigid fixation at the L5–S1 level, and then the DIAM or BioFlex system was instrumented at the L4–5 level to establish the ISS-based or PDF-based topping-off model, respectively. All the developed models were loaded with moments of 4 physiological motions using hybrid loading protocol. Results Compared with the rigid fusion model (without topping-off devices), range of motion and von-Mises stress at the SIJs were increased by 23.1%–64.1% and 23.6%–62.8%, respectively, for the ISS-based model and by 51.2%–126.7% and 50.4%–108.7%, respectively, for the PDF-based model. Conclusion The obtained results suggest that the PDF-based topping-off device leads to higher increments in SIJ motion and stress than ISS-based topping-off device following lumbosacral fusion, implying topping-off technique could be linked to an increased risk of SIJ degeneration, especially when using PDF-based device.

In this paper, a technology named SCM−ANN combining physical scattering mechanisms and artificial intelligence is proposed to realize radar cross-section (RCS) extrapolation of non-cooperative conductor targets with higher efficiency. Firstly, an adaptive scattering center (SC) extraction algorithm is used to construct the scattering center model (SCM) for non-cooperative targets from radar echoes in the low-frequency band (LFB). Secondly, an artificial neural network (ANN) is constructed to capture the nonlinear relationship between the real LFB echoes and those reconstructed from the SCM. Finally, the SCM is used to reconstruct echoes in the high-frequency band (HFB), and these reconstructions, together with the trained ANN, optimize the extrapolated HFB RCS. For the SCM−ANN technology, physical mechanistic modes are used for trend prediction, and artificial intelligence is used for regression optimization based on trend prediction. Simulation results show that the proposed method can achieve a 50% frequency extrapolation range, with an average prediction error reduction of up to 40% compared with the traditional scheme. By incorporating physical mechanisms, this proposed approach offers improved accuracy and an extended extrapolation range compared with the RCS extrapolation techniques relying solely on numerical prediction.

Abstract The Yellow River Plain (YRP), being regarded as the cradle of Chinese civilization, is traditionally thought to be the locale of the Great Flood, a hazardous flood (or floods) tamed by Yu who started China’s first “dynasty”, Xia, in ~ 2000 BC. However, by integrating published archaeological data, we propose that the Great Flood in fact impacted the Jianghan Plain (JHP) along the middle course of the Yangtze River. The arguments include: (1) around the era of the Great Flood, the most civilized and populated society in East Asia, named the Jianghan society, was located around the JHP (at that time, the habitation on the YRP remained limited); (2) the Jianghan society lived on river resources (shipping and rice growing) and was thus subject to flood risks (but not for the people inhabiting the YRP); (3) the people in the Jianghan society were experienced in dredging moats/ditches for shipping and irrigation; (4) unlike the floods on the YRP that were characterized by dynamic sedimentation and channel avulsion, those on the JHP typically occurred with slow-moving water manageable to ancient people; (5) the JHP has been associated with lake/wetland systems serving as detention basins during floods. Here, the recorded method for controlling the Great Flood, dredging channels to divert flood water to a “sea”, was feasible. Known speleothem paleo-rainfall data from multiple sites show that the climate of the JHP had been wet since the middle Holocene (earlier than the era of the Great Flood) and significantly turned dry after ~ 1850 BC (~ 150 years later than the Great Flood). Thus, the uniqueness of the Great Flood was likely to reflect an increase in land use on the JHP with the expansion of the Jianghan society, and the success in taming this flood was mainly due to the efforts of the society, not by luck.

The signal source of synthetic aperture radar (SAR) usually adopts the linear frequency modulation (LFM) signal, which exhibits the characteristics of a wide pulse. Hence, in the case of usage of the LFM signal by time-domain shooting and bouncing ray (TDSBR) to simulate the SAR echo signal, numerous time sampling points are generated, resulting in huge computational efforts; thereby, it is hard to exploit the TDSBR algorithm for simulating the SAR echo. In order to unlock this dilemma, the hybrid approach, the transfer function in conjunction with the range frequency-domain pulse coherence, is developed, in which the transfer function is stated by the radar cross-section. The proposed methodology is capable of enhancing the computational efficiency through avoiding the massive time sampling, so that the suggested TDSBR approach could be more conveniently applied to the SAR echo simulations. Furthermore, because of the efficiency advantage of the TDSBR in the calculation of wideband scattering field, the proposed methodology exhibits higher computational efficiency than the frequency-domain shooting and bouncing ray in the SAR image simulation. Finally, the key equation of the TDSBR for the transient scattering field of dielectric targets based on a closed-form integration formula is analytically derived, which is the basis of SAR imaging simulation for the composite scene of ships above the sea surface.

Abstract Under whole body vibration, how the cement augmentation affects the vibration characteristic of the osteoporotic fusion lumbar spine, complications, and fusion outcomes is unclear. A L1-L5 lumbar spine finite element model was developed to simulate a transforaminal lumbar interbody fusion (TLIF) model with bilateral pedicle screws at L4-L5 level, a polymethylmethacrylate (PMMA) cement-augmented TLIF model (TLIF-PMMA) and an osteoporotic TLIF model. A 40 N sinusoidal vertical load at 5 Hz and a 400 N preload were utilized to simulate a vertical vibration of the human body and the physiological compression caused by muscle contraction and the weight of human body. The results showed that PMMA cement augmentation may produce a stiffer pedicle screw/rod construct and decrease the risk of adjacent segment disease, subsidence, and rod failure under whole-body vibration(WBV). Cement augmentation might restore the disc height and segmental lordosis and decrease the risk of poor outcomes, but it might also increase the risk of cage failure and prolong the period of lumbar fusion under WBV. The findings may provide new insights for performing lumbar interbody fusion in patients affected by osteoporosis of the lumbar spine. Graphical abstract

Low-density lipoprotein cholesterol (LDL-C) has been considered as the primary target for the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). However, there are still residual cardiovascular risks in some patients even if LDL-C achieves the target level. Emerging evidence suggestes that elevated triglyceride (TG) level or triglyceride-rich lipoprotein (TRL) cholesterol (TRL-C) is one of the important components of the residual cardiovascular risks. Omega-3 fatty acids have been shown to be one of the effective drugs for reducing TG. However, its efficacy in reducing the risk of ASCVD is inconsistent in large randomized clinical trials. There is lack of consensus among Experts regarding the application of omega-3 fatty acids in cardiovascular diseases including heart failure, arrhythmia, cardiomyopathy, hypertension, and sudden death. Hence, the current consensus will comprehensively and scientifically present the detailed knowledge about the omega-3 fatty acids from a variety of aspects to provide a reference for its management of omega-3 fatty acids application in the Chinese population.

Abstract Background Exenatide, a glucagon like peptide 1 analog, has been suggested to reduce the cardiovascular disease risk factors, such as body weight, blood pressure and subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This was the first randomized, open-label, controlled trial to compare the effects of exenatide versus insulin on subclinical atherosclerosis, as assessed by carotid-intima media thickness (CIMT), in patients with T2DM. Methods A total of 66 patients with T2DM admitted from March 10, 2015 to June 20, 2017 in the Department of Endocrinology, Beijing Hospital were randomized to receive twice-daily exenatide or aspartate 70/30 insulin for 52 weeks. The primary endpoint was change from baseline in CIMT, and secondary endpoints included changes at week 52 from baseline in body weight, glycemic markers, lipid metabolism markers, blood pressure, C-reactive protein, fibrinogen, 8-hydroxydeoxyguanosine, irisin, and brain natriuretic peptide. Results Exenatide more significantly reduced the CIMT from baseline compared with insulin after 52 weeks, with a mean difference of − 0.14 mm (95% interval confidence: − 0.25, − 0.02; P = 0.016). Weight and body mass index were both significantly reduced in the exenatide group over 52 weeks. Exenatide reduced total lipoprotein and low-density lipoprotein cholesterol levels more significantly than insulin at weeks 16 and 40. Correlation analyses showed that CIMT was positively correlated with low-density lipoprotein cholesterol. Conclusions Twice-daily exenatide could prevent atherosclerosis progression in patients with T2DM over a 52-week treatment period compared with insulin therapy. Trial registration Chinese Clinical Trial Registry ChiCTR-1800015658

Abstract Background The safety of hypoglycemic drugs should be paid more attention to in elderly patients with type 2 diabetes mellitus due to their concomitant diseases, physiological decline of liver and kidney function and cognitive decline. The aim of this study was to evaluate the efficacy and safety of DPP-4 inhibitors in elderly patients with type 2 diabetes mellitus. Methods From January 2010 to November 2018, 300 patients with type 2 diabetes mellitus who were over 60 years old were enrolled in the outpatient clinic of Geriatric Medical Center. Their medication records and follow-up medical records were used for retrospective analysis. The duration of treatment with DPP-4 inhibitors was more than 3 months. The changes of fasting blood glucose (GLU), glycosylated hemoglobin (HbA1C), body weight, body mass index (BMI) and liver and kidney function were compared before and after treatment. Results The average age of 300 patients (212 males and 88 females) was 73.7 ± 9.1 years old, BMI was 26.5 ± 2.8 kg/m2 and the duration of diabetes was 10.7 ± 8.2 years. The results of retrospective analysis showed that HbA1C decreased by 0.27% after treatment (P

Background. Exenatide is a glucagon-like peptide-1 receptor agonist that can reduce body weight. This study aimed to determine the efficacy of exenatide on body mass index (BMI) reduction in patients with type 2 diabetes mellitus (T2DM) with differing baseline body weight, blood glucose, and atherosclerotic status and to determine if there is a correlation between BMI reduction and cardiometabolic indices in these patients. Methods. This retrospective cohort study used data from our randomized controlled trial. A total of 27 T2DM patients treated with combination therapy of exenatide twice daily and metformin for 52 weeks were included. The primary endpoint was a change in the BMI from the baseline to week 52. The secondary endpoint was a correlation between BMI reduction and cardiometabolic indices. Findings. The BMIs of overweight and obesity patients and those with glycated hemoglobin (HbA1c) ≥ 9% significantly decreased −1.42 ± 1.48 kg/m2P=0.015 and −0.87 ± 0.93 kg/m2P=0.003, respectively, at the baseline after 52 weeks of treatment. There was no reduction in BMI in patients with normal weight, HbA1c

In this paper, a weighted arctangent function is used in conjunction with the spectral method to generate a land–sea junction composite rough surface under the spatially homogeneous and time-stationary hypotheses. The exponential correlation function and the Joint North Sea Wave Project (JONSWAP) spectrum, combined with an experiment-verified shoaling coefficient, are applied to model the land surfaces and the time-varying sea surfaces separately. The second-order small slope approximation (SSA-II) with tapered wave incidence is utilized for evaluating the electromagnetic scattering characteristics and Doppler characteristics of the generated composite rough surface. The influence of land–sea interface factors on radar cross-section (RCS) and Doppler shift of radar echoes is investigated in detail by comparing the RCS and Doppler spectra of the land–sea junction composite rough surfaces with those of finite-depth sea surfaces. It can be found that the Doppler spectra of the land–sea junction composite rough surface is narrower than that of the finite-depth sea surface under upwind directions and wider than that of the finite-depth sea surface under crosswind directions.

Due to subjective evaluation and qualitative characteristics, the assessment processes of loyalty often cannot use the crisp value to express the final value. That makes the evaluation of online store performance usually filled with uncertainty and ambiguity. The loyalty assessment of electronic shopping is complex, and online stores' strategy and production control problems are frequently accompanied by uncertain conditions. This study constructs a conceptual model to leverage the fuzzy logic approach for understanding the consumers' decision-making in the e-service context of shopping. This study also exposes the relationships between system quality, information quality, and service quality to understand their impacts on customer loyalty. Implications and future research directions for service providers and researchers are discussed.

ObjectivesThis study investigated the clinical efficacy and safety of metformin hydrochloride sustained-release (SR) tablet (II) produced by Dulening and the original metformin hydrochloride tablet produced by Glucophage in the treatment of type 2 diabetes mellitus (T2DM).MethodsThis randomized, open and parallel controlled clinical trial consecutively recruited a total of 886 patients with T2DM in 40 clinical centers between May 2016 and December 2018. These patients were randomly assigned to the Dulening group (n=446), in which patients were treated with Dulening metformin SR tablets, and the Glucophage group (n=440), in which patients were treated with Glucophage metformin tablets, for 16 weeks. The changes in the levels of glycated hemoglobin (HbAc1) and fasting blood glucose (FBG) as well as weight loss were compared between these two groups. Also, the overall incidence of adverse drug reactions (ADRs) and the incidence of ADR of the gastrointestinal system observed in patients of these two groups were also compared.ResultsThere were no significant differences in demographic and basal clinical characteristics between these two groups. The Dulening and Glucophage groups showed comparable levels of decrease in HbA1c levels, FBG and weight loss after 12-week treatment (all p>0.05). The Dulening group had a significantly lower overall incidence of ADRs as well as gastrointestinal ADR than the Glucophage group.ConclusionsMetformin SR tablets (II) and the original metformin tablets exhibit similar therapeutic efficacy in the treatment of T2DM, but metformin SR tablets (II) has the significantly lower incidence of ADRs than the original metformin tablets.

Effects of nonuniform weakly ionized dusty plasma on the polarization properties of obliquely incident electromagnetic (EM) waves were theoretically investigated in this paper. The dielectric coefficient of magnetized dusty plasma is obtained based on the Bhatnagar–Gross–Krook collision model. Then, the effects of external magnetic field, dust radii, and density on the polarization mismatch loss of obliquely incident EM waves in the L-band were analyzed using the equivalent impedance method. Results indicate that the larger the external magnetic field, the greater the polarization mismatch loss. In addition, we also found that dusty particles alleviate the deterioration of the polarization state significantly; regulating and controlling dust radius and density can avoid polarization reversal and reduce the polarization mismatch loss. We further analyzed the variation of the polarization state under different reentry heights. Our analysis reveals interesting features concerning polarization properties of obliquely incident EM waves, which provide an important theoretical basis for information reception in the plasma sheath containing ablative particles.

In this study, a new methodology, hybrid Strength Pareto Evolutionary Algorithm Reference Direction (SPEA/R) with Deep Neural Network (HDNN&SPEA/R), has been developed to achieve cost optimization of stiffness parameter for powertrain mount systems. This problem is formalized as a multi-objective optimization problem involving six optimization objectives: mean square acceleration of a rear engine mount, mean square displacement of a rear engine mount, mean square acceleration of a front left engine mount, mean square displacement of a front left engine mount, mean square acceleration of a front right engine mount, and mean square displacement of a front right engine mount. A hybrid HDNN&SPEA/R is proposed with the integration of genetic algorithm, deep neural network, and a Strength Pareto evolutionary algorithm based on reference direction for multi-objective SPEA/R. Several benchmark functions are tested, and results reveal that the HDNN&SPEA/R is more efficient than the typical deep neural network. stiffness parameter for powertrain mount systems optimization with HDNN&SPEA/R is simulated, respectively. It proved the potential of the HDNN&SPEA/R for stiffness parameter for powertrain mount systems optimization problem.

In this paper, a new CS-FMM method that conjugates compressive sensing (CS) with the fast multipole method (FMM) is proposed and validated to efficiently solve monostatic scattering from an arbitrary conducting target. The far zone scattered fields are viewed as the signal of interest. CS is introduced to reduce the number of computations. A new set of incident sources has been generated according to CS. By solving the matrix equations under the new set of incident sources and calculating the related far zone scattered fields, the measurements of the aforementioned signal can be derived. Then, the CS inversion is employed to reconstruct the desired monostatic far zone scattered fields by finding the smallest possible ℓ1 norm solution. Monostatic radar cross section (RCS) from several conducting targets is studied by CS-FMM and by the traditional FMM. And the results are compared with each other to illustrate the accuracy and efficiency of the proposed method.

The parabolic equation method based on digital elevation model (DEM) is applied on propagation predictions over irregular terrains. Starting from a parabolic approximation to the Helmholtz equation, a wide-angle parabolic equation is deduced under the assumption of forward propagation and the split-step Fourier transform algorithm is used to solve it. The application of DEM is extended to the Cartesian coordinate system and expected to provide a precise representation of a three-dimensional surface with high efficiency. In order to validate the accuracy, a perfectly conducting Gaussian terrain profile is simulated and the results are compared with the shift map. As a consequence, a good agreement is observed. Besides, another example is given to provide a theoretical basis and reference for DEM selection. The simulation results demonstrate that the prediction errors will be obvious only when the resolution of the DEM used is much larger than the range step in the PE method.

Background:. For patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and type 2 diabetes mellitus (T2DM), the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glycemic excursions and reduce insulin sensitivity. This study aimed to investigate the effect of continuous positive airway pressure (CPAP) therapy in patients with OSAHS and T2DM. Methods:. Continuous glucose monitoring system (CGMS) was used in 40 patients with T2DM and newly diagnosed OSAHS. The measurements were repeated after 30 days of CPAP treatment. Subsequently, insulin sensitivity and glycohemoglobin (HbA1c) were measured and compared to the pretreatment data. Results:. After CPAP therapy, the CGMS indicators showed that the 24-h mean blood glucose (MBG) and the night time MBG were significantly reduced (P < 0.05 and P = 0.03, respectively). The mean ambulatory glucose excursions (MAGEs) and the mean of daily differences were also significantly reduced (P < 0.05 and P = 0.002, respectively) compared to pretreatment levels. During the night, MAGE also significantly decreased (P = 0.049). The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than prior to CPAP treatment (P < 0.05 and P = 0.024, respectively). The 24 h and night time durations of high blood glucose (>7.8 mmol/L and > 11.1 mmol/L) decreased (P < 0.05 and P < 0.05, respectively) after the treatment. In addition, HbA1c levels were also lower than those before treatment (P < 0.05), and the homeostasis model assessment index of insulin resistance was also significantly lower than before CPAP treatment (P = 0.034). Conclusions:. CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.

An efficient iterative analytical-numerical method is proposed for three-dimensional (3D) electromagnetic scattering from an inhomogeneous object buried beneath a two-dimensional (2D) randomly dielectric rough surface. In the hybrid method, the electric and magnetic currents on the dielectric rough surface are obtained by current-based Kirchhoff approximation (KA), while the scattering from the inhomogeneous object is rigorously studied by finite element method (FEM) combined with the boundary integral method (BIM). The multiple interactions between the buried object and rough surface are taken into account by updating the electric and magnetic current densities on them. Several numerical simulations are considered to demonstrate the algorithm’s ability to deal with the scattering from the inhomogeneous target buried beneath a dielectric rough surface, and the effectiveness of our proposed method is also illustrated.

The artificial bee colony (ABC) algorithm is a recently introduced optimization method in the research field of swarm intelligence. This paper presents an improved ABC algorithm named as OGABC based on opposition-based learning (OBL) and global best search equation to overcome the shortcomings of the slow convergence rate and sinking into local optima in the process of inversion of atmospheric duct. Taking the inversion of the surface duct using refractivity from clutter (RFC) technique as an example to validate the performance of the proposed OGABC, the inversion results are compared with those of the modified invasive weed optimization (MIWO) and ABC. The radar sea clutter power calculated by parabolic equation method using the simulated and measured refractivity profile is utilized to carry out the inversion of the surface duct, respectively. The comparative investigation results indicate that the performance of OGABC is superior to that of MIWO and ABC in terms of stability, accuracy, and convergence rate during the process of inversion.

Transmission loss (TL) is often used to evaluate the acoustic attenuation performance of a silencer. In this work, a three-dimensional (3D) finite element method (FEM) is employed to calculate the TL of some representative silencers, namely, circular expansion chamber silencer and straight-through perforated pipe silencer. In order to account for the effect of mean flow that exists inside the silencer, the 3D FEM is used in conjunction with the Computational Fluid Dynamics (CFD) simulation of the flow field. More concretely, the 3D mean flow field is computed by firstly using CFD, and then the obtained mean flow data are imported to an acoustic solution undertaken using FEM. The data transfer between the two steps is accomplished by mesh mapping. The results presented demonstrate good agreement between present TL predictions and previously published experimental and numerical works. Also, the details of the flow inside the silencers may be studied. Furthermore, the effect of mean flow velocity on acoustic attenuation performance of the silencers is investigated. It is concluded that for the studied silencers, in general, increasing flow velocity increases the TL and decreases the resonance peaks.

This paper proposes an approach to investigating the effect of different temperatures and flow velocities on the acoustic performance of silencers in a more accurate and meticulous fashion, based on steady computational results of the flow field inside the silencer using computational fluid dynamics (CFD). This approach can transfer the CFD results—including temperature and flow velocity distribution—to acoustic meshes by mesh mapping. A numerical simulation on the sound field inside the silencer is then performed, using the CFD results as a boundary condition. This approach facilitates the analysis of complex silencer designs such as perforated tube silencers, and the numerical predictions are verified by a comparison with available experimental data. In the case of the three-pass perforated tube silencer of a car, the proposed approach is implemented to calculate the transmission loss (TL) of the silencer at different temperatures and flow velocities. We found that increasing the air temperature shifts the TL curve to a higher frequency and reduces the acoustic attenuation at most frequencies. As the air flow increases, the curve moves to a slightly lower frequency and the acoustic attenuation increases slightly. Additionally, the pressure loss of perforated tube silencers could be calculated according to the total pressure distribution of their inlet and outlet from the steady computational results using CFD.

An open slot antenna with extended bandwidth for WLAN and UWB applications is proposed. The radiating structure is composed of a rectangular microstrip patch antenna exciting an L-shaped slot etched on the ground plane. The feed position is optimized to get better impedance match for the higher range of the UWB spectrum, while a step in the slot, realized in the ground plane, is employed to extend the lower limit of the bandwidth so as to cover the 2.4 GHz WLAN frequency band. Using these design solutions the antenna bandwidth is successfully extended to 140% so as to cover both the WLAN and the UWB spectrum.

A hybrid algorithm of the finite element method (FEM) is presented to solve two-dimensional (2D) scattering from multiple dielectric objects above the rough sea surface. Compared with traditional FEM based on approximate absorbing boundaries, FEM based on the boundary integral method (BIM) can reduce the calculational region and solution time of the scattering problem. In the hybrid method, the whole computational region is divided into the sea surface and multiple isolate interior regions for the dielectric objects. FEM is only used to simulate the scattering from multiple interior regions enclosing the objects, whereas the large sea is considered exactly by BIM. The coupled interaction among the isolate interior regions and the sea can be taken into account by BIM. The hybrid technique presented here is efficient and versatile for addressing scattering from multiple arbitrary targets above rough sea surfaces. Scattering properties of multiple dielectric objects above the sea surface under different conditions are discussed in detail.

A fast hybrid method combining the reciprocity theorem with high frequency approximation algorithm is presented to deal with the problem of the monostatic scattering from a two-dimensional (2D) plasma-coated target above a one-dimensional (1D) Gaussian rough surface illuminated by the tapered incident wave. Without numerical solution of the polarization currents on the target and the surface, this hybrid method does not only save computer resources but also improve the computing speed significantly in contrast to the numerical methods. The hybrid method based on equivalent principle and reciprocity theorem, which is an improved and generalized version of the traditional multipath technique, can deal with the interactions between plasma-coated target and underlying surface much more accurately. Numerical results are given to verify the validity of the hybrid method, and then the hybrid method is employed to investigate the monostatic scattering from a plasma-coated airfoil above a Gaussian rough surface, including the effects of several key parameters on stealth performance, such as plasma angular frequency and electron collision frequency.

The TDIE/FDTD hybrid method is applied to calculate the transient responses of thin wire above a lossy layered half-space. The time-domain reflection of the layered half space is computed by one-dimensional modified FDTD method. Then, transient response of thin wire induced by two excitation sources (the incident wave and reflected wave) is calculated by TDIE method. Finally numerical results are given to illustrate the feasibility and high efficiency of the presented scheme.