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In this paper, the influence of concrete strength, diameter, cover thickness, anchorage length, and stirrups ratio on the bonding performance of the HSCR rebar in concrete are experimentally investigated. A nonlinear FE model for simulating the bond performance between HSCR and concrete is established and validated, and the influencing parameters are parametrically investigated. Moreover, the applicability of the ultimate bond strength model for HSCR-concrete is comparatively discussed, and a new model is proposed and validated to give relatively accurate prediction. Based on the proposed model, the anchorage reliability analysis is conducted, the influencing parameters as well as their variation on the reliability of bond strength are discussed, and the reliable anchorage length is recommended.

Background In colonoscopy screening for colorectal cancer, human vision limitations may lead to higher miss rate of lesions; artificial intelligence (AI) assistance has been demonstrated to improve polyp detection. However, there still lacks direct evidence to demonstrate whether AI is superior to trainees or experienced nurses as a second observer to increase adenoma detection during colonoscopy. In this study, we aimed to compare the effectiveness of assistance from AI and human observer during colonoscopy. Methods A prospective multicenter randomized study was conducted from 2 September 2019 to 29 May 2020 at four endoscopy centers in China. Eligible patients were randomized to either computer-aided detection (CADe)-assisted group or observer-assisted group. The primary outcome was adenoma per colonoscopy (APC). Secondary outcomes included polyp per colonoscopy (PPC), adenoma detection rate (ADR), and polyp detection rate (PDR). We compared continuous variables and categorical variables by using R studio (version 3.4.4). Results A total of 1,261 (636 in the CADe-assisted group and 625 in the observer-assisted group) eligible patients were analysed. APC (0.42 vs 0.35, P = 0.034), PPC (1.13 vs 0.81, P Conclusions Compared with the human observer, the CADe system may improve the clinical outcome of colonoscopy and reduce disturbance to routine practice (Chictr.org.cn No.: ChiCTR1900025235).

Both keloid and hypertrophic scars are common benign skin lesions manifested by hyperplasia of fibroblasts. Clinically, this will not only have physiological effects on patients, but also cause psychological damage. However, there is no unified standard treatment method at present. Intralesional corticosteroid injection alone and corticosteroid combined with botulinum toxin type A has been gradually found to be useful for the treatment of keloid and hypertrophic scars, but the difference in efficacy between the two is controversial. A systematic search was made of the relevant experiments from Web of Science, PubMed, Scopus, Google Scholar, Cochrane Library, and China National Knowledge Infrastructure (CNKI). The scores of Visual Analog Scale (VAS), Vancouver Scar Score sheet (VSS), scar thickness, itching degree and patient satisfaction after the combination of corticosteroid and botulinum toxin type A were superior than those after corticosteroid (P

A uniform is distinctive clothing worn by members of the same firm or organisation. In China, the market for professional garments is extremely large. However, as mandatory professional clothing, uniforms are frequently used, torn, and replaced, leading to textile waste. Further, the use of non-recyclable or non-biodegradable fabrics is bound to create greater environmental pressure. This study focuses on the textile material in the uniform market to analyse the motivational conditions behind sustainable fabric consumption. A total of 294 usable online surveys were obtained in 2019. Multi-item scales were adopted to measure five variables: corporate public image, corporate ethics, employee social status, environment awareness, and sustainable premium. Structural equation modelling was applied to test the hypothesises. Results reveal that the improvement of an employee’s social status can effectively facilitate the probability of utilising eco-friendly fabrics. This study can thus help increase the usage of eco-friendly fabric in China’s uniform market.

Background With the exception of very early-stage small cell lung cancer (SCLC), surgery is not typically recommended for this disease; however, incidental resection still occurs. After incidental resection, adjuvant salvage therapy is widely offered, but the evidence supporting its use is limited. This study aimed to explore proper adjuvant therapy for these incidentally resected SCLC cases. Methods Patients incidentally diagnosed with SCLC after surgery at the Shanghai Pulmonary Hospital in China from January 2005 to December 2014 were included in this study. The primary outcome was overall survival. Patients were classified into different group according to the type of adjuvant therapy they received and stratified by their pathological lymph node status. Patients' survival was analyzed using a Kaplan-Meier analysis and Cox regression analysis. Results A total of 161 patients were included in this study. Overall 5-year survival rate was 36.5%. For pathological N0 (pN0) cases (n=70), multivariable analysis revealed that adjuvant chemotherapy (ad-chemo) was associated with reduced risk of death [hazard ratio (HR): 0.373; 95% confidence interval (CI): 0.141-0.985, P=0.047] compared to omission of adjuvant therapy. For pathological N1 or N2 (pN1/2) cases (n=91), taking no adjuvant therapy cases as a reference, the multivariable analysis showed that ad-chemo was not associated with a lower risk of death (HR: 0.869; 95% CI: 0.459-1.645, P=0.666), while adjuvant chemo-radiotherapy (ad-CRT) was associated with a lower risk of death (HR: 0.279; 95% CI: 0.102-0.761, P=0.013). Conclusions Patients who incidentally receive surgical resection and are diagnosed with limited disease SCLC after resection should be offered adjuvant therapy as a salvage treatment. For incidentally resected pN0 cases, ad-chemo should be considered and for pN1/2 cases, ad-CRT should be received.

Fonsecaea spp. is the most common pathogen underlying chromoblastomycosis. However, many aspects of its evolutionary history are not fully understood, and a timescale for its diversification is lacking . Here, we propose, explain, and validate the evolutionary relationships, transmission routes, and modes of transmission among pathogenic species of the genus Fonsecaea . we investigated the sequences of a total of 510 intra-ribosomal transcribed regions and 485 reported cases of eight strains of the genus Fonsecaea , that have spread epidemically worldwide, persisted, and diversified over 38.27 million years. This period coincides with the diversification of many filamentous fungi, and this evolution explains the diversity and origin of pathogenic species of Fonsecaea spp . , as well as the possible transmission routes. Fonsecaea pedrosoi originated in the Atlantic Ocean near Brazil, F. monophora originated in the Pacific Ocean near southern China, and F. nubica originated in the Indian Ocean near Madagascar. F. pugnacius originated and is endemic in the Atlantic Ocean near Brazil. We proposed the hypothesis that non-pathogenic environmental strains in the environment ( Fonsecaea brasiliensis , F. multimorphosa , F. minima , and F. erecta ) evolved into pathogenic strains ( F. pedrosoi , F. pugnacius , F. nubica , and F. monophora ) and spread globally with global tropical cyclone and ocean currents pathways. F. multimorphosa is potentially infectious to humans. The present study’s results will greatly facilitate the prevention, treatment, and cure of Fonsecaea infections and give insight and reference to researchers in the field of fungal research, especially other pathogenic fungi and environmental fungi.

To study the association of perioperative administration of renin angiotensin system inhibitors (RASi) and clinical outcomes of patients with heart failure (HF) undergoing cardiac surgery.It is controversial whether the perioperative RASi should be administered in HF patients undergoing cardiac surgery.A total of 2,338 patients with HF and undergoing CABG and/or valve surgeries at multiple hospitals from 2001 to 2015 were identified from STS database. After adjustment using propensity score and instrumental variable, logistic regression was conducted to analyze the influence of preoperative continuation of RASi (PreRASi) on short-term in-hospital outcomes. Independent risk factors of 30-day mortality, major adverse cardiovascular events (MACE), and renal failure were analyzed by use of stepwise logistic regression. The effects of pre- and postoperative use of RASi (PostRASi) on long-term mortality were analyzed using survival analyses. Stepwise Cox regression was conducted to analyze the independent risk factors of 6-year mortality. The relationships of HF status and surgery type with perioperative RASi, as well as PreRASi-PostRASi, were also evaluated by subgroup analyses.PreRASi was associated with lower incidences of 30-day mortality (p0.0001, OR: 0.556, 95% CI 0.405-0.763), stroke (p = 0.035, OR: 0.585, 95% CI: 0.355-0.962), renal failure (p = 0.007, OR: 0.663, 95% CI: 0.493-0.894). Both PreRASi (p = 0.0137) and PostRASi (p = 0.007) reduced 6-year mortality compared with the No-RASi groups.Pre- and postoperative use of RASi was associated with better outcomes for the patients who have HF and undergo CABG and/or valve surgeries. Preoperative continuation and postoperative restoration are warranted in these patients.

Background: Contrast-induced nephropathy (CIN) has become a common cause of hospital-acquired acute kidney injury in elderly patients. Trimetazidine (TMZ) is a type of anti-ischemic drug developed in recent years, which can reduce the incidence of CIN. This study aimed to evaluate the efficacy of TMZ in the prevention of contrast-induced nephropathy in elderly patients with renal insufficiency undergoing percutaneous coronary intervention (PCI) and to explore the mechanism of action. Methods: A total of 310 elderly patients with renal insufficiency undergoing elective PCI were enrolled and randomly assigned to a control group (n = 155, hydration only) and a TMZ group (n = 155, 20 mg thrice daily orally 24 hours before and 72 hours after PCI). The primary endpoint of the study was the incidence of CIN, which was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dL or more in serum creatinine from baseline value, at 48 to 72 hours following the exposure to contrast media (CM). Results: The incidence of CIN was significantly lower in the TMZ group than that in the control group (3.2% vs. 9.7%, p = 0.021). There was no difference regarding the incidence of major adverse events during hospitalization between the TMZ group and control group (1.9% vs. 2.6%, p = 1.000). Binary logistic regression results showed that TMZ was protective factors of CIN (OR = 0.274; 95% CI: 0.089–0.847; p = 0.025). Conclusion: Therefore, we came to the conclusion that prophylactic administration of TMZ can prevent the occurrence of CIN in elderly patients with renal insufficiency undergoing PCI and has a certain protective effect on the renal function of patients. According to the experimental results and the mechanism of TMZ on cardiomyocytes, we speculate that TMZ increases kidney glucose metabolism, reduces fatty acid oxidation, and also has a protective effect on kidney free radical damage and ischemia-reperfusion injury.

Crack assessment of bridge piers using unmanned aerial vehicles (UAVs) eliminates unsafe factors of manual inspection and provides a potential way for the maintenance of transportation inf...

This paper expounds the basic theory of composite mechanics, and discusses the damage forms, damage analysis and failure criteria of composite materials. Then, the basic mechanical properties of unidirectional CFRP laminates with different layers, including modulus of elasticity, strength and so on, were obtained through a large number of experiments. Based on the experimental data, the relationship between the number of layers and the properties of materials was studied. The brittle fracture process of CFRP laminates was simulated by finite element analysis based on progressive damage model and compared with the force-displacement curves obtained by experiments. The validity of progressive damage model was proved.

Adiponectin is a potent vascular protective molecule. Recent findings have suggested adiponectin resistance during early diabetes. However, the molecular mechanisms responsible remain unidentified. Here, we took an unbiased approach to identify whether hyperlipidemic plasma molecules exist that bind and inhibit adiponectin function, contributing to adiponectin resistance and diabetic vascular injury.Adult rats were randomly assigned to receive either a normal or a high-fat diet for 8 weeks. Plasma was co-immunoprecipitated with anti-APN antibody and analyzed by mass spectrometry. The APN binding molecules and their effect upon APN biological activity were determined.As expected, the high-fat-diet increased plasma triglyceride, total cholesterol, and low-density lipoprotein. Importantly, the circulating APN level was significantly increased at this time point. Mass spectrometry identified 18 proteins with increased APN binding in hyperlipidemic plasma, among which four proteins critical in lipid metabolism, including apolipoprotein A1 (APOA1), APOA4, APOC1, and paraoxonase 1, were further investigated. Incubating recombinant APN with APOA1 markedly (P 0.01), and incubating with APOC1 significantly (P 0.05), inhibited APN activity as evidenced by the reduced AMPK activation in HUVECs. APOA4 and paraoxonase 1 incubation had no effect upon APN activity. Finally, plasma APOA1 was significantly increased (P 0.05) in hyperlipidemic plasma compared with the control plasma.It was demonstrated for the first time that increased APOA1 and APOC1 in hyperlipidemic plasma binds and inhibits APN activity. This result not only identifies a novel molecular mechanism responsible for adiponectin resistance during early stage diabetes, but also provides additional new insight into the diverse/controversial (protective and harmful) functions of high-density lipoprotein.

Nitric oxide (NO), as a free radical, is produced by inflamed microglia cells and is one of the destructive factors of the immune system and a factor in myelin degradation. Therefore, inhibition of microglia activity is a chief strategy in reducing neurotoxic damage to the central nervous system. In this study, an herbal Immunomodulatory Drug (IMOD) was used to evaluate the effects of this drug in controlling the amount of nitric oxide. Nitric oxide induction was performed by bacterial lipopolysaccharide (LPS) in rat inflamed microglial cell line, CHME-5. ELISA test was used to measure the produced nitric oxide at 24, 48, and 72 hours. The results showed that the high concentrations of IMOD (1.2, and 4% V/V) had anti-inflammatory effects on microglial cells and were able to reduce the amount of nitric oxide in these cells but the effective dose of IMOD was in the range of 1.2% V/V. Therefore, the safest dose and the best time for the effect of IMOD on inflammatory cell groups are 1.2% V/V and 72h, respectively. Hence, with further studies, IMOD can be considered as an herbal anti-inflammatory drug that is effective in controlling neurodegenerative diseases.

The Mehran risk score (MRS) was used to classify patients with coronary heart disease and evaluate the preventive effect of alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention. The patients (n = 1146) were randomized into an alprostadil and control group and then divided into 3 groups on the basis of the MRS: low-risk, moderate-risk, and high-risk groups. The primary end point was the occurrence of CIN (alprostadil + hydration vs simple hydration treatment); secondary end points included serum creatinine, blood urea nitrogen, creatinine clearance rate, cystatin C, interleukin-6, C-reactive protein, proteinuria, and differences in the incidence of major adverse events. In the low-risk, moderate-risk, and high-risk groups, the incidence of CIN in the control and alprostadil group was 2.9 versus 2.6% ( P = .832), 11.4 versus 4.9% ( P = .030), 19.1 versus 7.7% ( P = .041), respectively. Multivariate logistic regression analysis showed that alprostadil treatment was a favorable protective factor for moderate-risk and high-risk CIN patients (OR = 0.343, 95% CI: 0.124-0.951, P = .040). Alprostadil can be used as a preventive treatment for moderate- and high-risk CIN patients classified by the MRS. The reduction of CIN by alprostadil may be related to an anti-inflammatory effect.

We investigated the preventive effect of nicorandil on contrast-induced nephropathy (CIN) in patients with moderate renal insufficiency undergoing percutaneous coronary intervention (PCI). A total of 250 patients with a creatinine clearance (crCl) ≤60 mL/min undergoing PCI were randomly assigned to either a nicorandil group (nicorandil 10 mg 3 times/d and hydration; n = 125) or a control group (hydration only; n = 125). The first end point was the incidence of CIN defined as an increase in serum creatinine (Scr) levels by ≥0.5 mg/dL or ≥25% within 72 hours after exposure to the contrast medium. The secondary end points were (1) changes in Scr, blood urea nitrogen, and crCl and (2) the incidence of major adverse events during hospitalization. The incidence of CIN was 1.6% (2/125) in the nicorandil group and 9.6% (12/125) in the control group ( P = .011). There was no obvious difference in the incidence of major adverse events during hospitalization between the nicorandil and the control group (4.0% vs 4.8%, P = 1.000). Multivariate logistic regression analysis showed that nicorandil was a protective factor for CIN (odds ratios = 0.126, 95% confidence interval: −19.996 to −0.932, P = .012). Prophylactic administration of nicorandil may prevent against CIN in patients with moderate renal insufficiency undergoing PCI.

For grid structures, damages of structural members such as crookedness significantly affect the overall structural safety. Traditional assessment methods can hardly evaluate the impact of crooked members in existing grid structures accurately due to difficulties lying in crookedness measurement and residual load-bearing capacity analysis. In this paper, a new method of refined model adjustment and structural assessment with crooked tubular members of steel grid roofs taken into consideration is proposed, while the crooked measurement is conducted with an image-based 3D measurement method for the first time. Firstly, the original shape of crooked members is recovered using image-based 3D measurement method. Secondly, the measured deformation of the crooked members is adjusted from the load status at the time of measurement to the zero-load status in two ways. Finally, the FE model of the entire grid structure, together with the adjusted crooked tubular members is adopted in the residual load-bearing capacity analysis considering both geometric nonlinearity and material nonlinearity. A large span steel grid roof structure containing four crooked tubular members is utilized for the illustration and validation of the proposed methodology. The proposed method inventively offers a new direction for refined assessment of existing grid structures with crooked members and provides significant potential for practical implementation.

A series of cobalt-based spinel composite metal oxides doped with alkaline earth metals, viz., MxCo3-xO4 (M = Mg, Ca, Sr and Ba; x = 0, 0.1, 0.3, 0.5, 0.7 and 0.9), were prepared by the coprecipitation method and characterized by XRD, SEM, nitrogen sorption, H2-TPR, O2-TPD-MS and XPS; the effect of alkaline earth metal doping on the catalytic performance of MxCo3-xO4 composites in N2O decomposition was investigated in a fixed bed micro-reactor. The results showed that after doping with the alkaline earth metals, the particle size of MxCo3-xO4 catalysts is decreased, accompanying with an increase in the specific surface area and the amount of surface adsorbed oxygen and Co2+ species. Meanwhile, the redox performance and catalytic activity of MxCo3-xO4 in N2O decomposition are also greatly enhanced. Under the conditions of 0.68% N2O, 3% O2 and Ar as balance gas, the Sr0.7Co2.3O4 catalyst doped with Sr (x = 0.7) exhibits highest activity in N2O decomposition; the reaction temperatures where the N2O conversion reaches 10% and 95% are as low as 312 and 451°C, respectively.

The fertilizer and shading management of Coffea arabica in dry-hot area is extensive, resulting in lower yield and fertilizer utilization efficiency. A field experiment was carried out to find the coupling mode of shading and fertilizer for fertilizer-saving and high yield of C. arabica in dry-hot region. Four shading levels (100% NR, 75% NR, 60% NR, 45% NR, NR was natural radiation) and four fertilizer levels (No fertilization and 666.67, 1000, 1333.33 kg·hm干热区小粒咖啡肥光管理粗放,产量和肥料利用率受到限制。为探明干热区小粒咖啡节肥高产的肥光耦合模式,通过大田试验,设置4个遮荫度(100%NR、75%NR、60%NR、45%NR,NR为自然光照)和4个施肥量(不施肥及666.67、1000、1333.33 kg·hm

Lysyl oxidase-like 2 (LOXL2), a member of the lysyl oxidase gene family, is involved in the progression of hepatocellular carcinoma progression and metastasis. Increased expression of LOXL2 has been identified in several types of cancer, including hepatocellular carcinoma. Recently, LOXL2 has been reported to promote epithelial-mesenchymal transition by reducing E-cadherin expression via the upregulation of Snail expression. The present study provided evidence demonstrating that LOXL2 inhibited the expression of fructose-1, 6-biphosphatase (FBP1) and enhanced the glycolysis of Huh7 and Hep3B hepatocellular carcinoma cell lines in a Snail-dependent manner. Overexpression of the point-mutated form of LOXL2 [LOXL2(Y689F)], which lacks enzymatic activity, does not affect the expression of Snail1 or FBP1. Notably, targeting extracellular LOXL2 of Huh7 cells with a therapeutic antibody was unable to abolish its regulation on the expression of Snail and FBP1. Knockdown of LOXL2 also interrupted the angiogenesis of Huh7 and Hep3B cells, and this effect could be rescued by the overexpression of Snail. Furthermore, upregulation of hypoxia-inducible factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF) expression was observed in Huh7 and Hep3B cells expressing wild-type LOXL2. Notably, the selective LOXL2 inhibitor LOXL2-IN-1 could upregulate the expression of FBP1 and inhibit the expression of Snail, HIF-1α and VEGF in HCC cells, but not in FBP1-knockdown cells. The results of the present study indicated that the intracellular activity of LOXL2 upregulated HIF-1α/VEGF signaling pathways via the Snail-FBP1 axis, and this phenomenon could be inhibited by LOXL2 inhibition. Collectively, these findings further support that LOXL2 exhibits an important role in the progression of hepatocellular carcinoma and implicates LOXL2 as a potential therapeutic agent for the treatment of this disease.

Coupon tests confirmed that Q345GJ steel had good ductility and rarely cyclic hardening. Therefore, 12 shear links using such steel were designed and tested. The explored parameters included web aspect ratio, flange width-thickness ratio, the equivalent link length coefficient eV p / M p , stiffener spacing and thickness, hysteretic loadcase, and welding details. Discussions and analysis on the failure mode, the hysteretic behavior of shear load and displacement angle, the strain distribution, the bearing capacity and stiffness, the plastic overstrength, the deformation and energy dissipation capacity, were also conducted. The shear links had satisfactory energy dissipation capacity under multiple hysteretic loading with almost no cyclic hardening. Web aspect ratio and stiffener spacing had determinate influence on cyclic web buckling, as well as the ultimate deformation capacity. Yet, more intensive stiffener spacing was prone to result in more serious stress concentration in the web, and caused web fracture. Also, smaller coefficient eV p / M p was harmful to the ultimate deformation capacity. The ultimate plastic overstrength V u / V p of the shear links was about 1.35 to 1.5, influenced by web aspect ratio, the coefficient eV p / M p , and stiffener spacing. To avoid cyclic flange fracture, the coefficient eV p / M p was also suggested be within 1.7.

Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, costs, and consequences of calcium supplementation on osteoporosis/osteoporotic fractures, cardiovascular events, kidney stones, gastrointestinal diseases, and other important diseases. In the end, we suggest that calcium supplementation should be prescribed and taken cautiously, accounting for individual patients' risks and benefits. Clearly, further studies are needed to examine the health effects of calcium supplementation to make any solid recommendations for people of different genders, ages, and ethnicities.

The yield and quality of Coffea arabica cannot be guaranteed due to irrational irrigation and light management in dry-hot region. To investigate the best coupling mode of irrigation and shade cultivation of C. arabica in dry-hot region, a field experiment was carried out with different irrigation levels and shade cultivation modes. Three levels of irrigation, i.e., full irrigation, light deficit irrigation and severe deficit irrigation, and four modes of shade cultivation, i.e., no shade cultivation (C. arabica monoculture), light shade cultivation (intercropping of four-line C. arabica and a line banana), moderate shade cultivation (intercropping of three-line C. arabica and a line banana) and severe shade cultivation (intercropping of two-line C. arabica and a line banana) were designed to examine the effects of deficit irrigation on growth, photosynthetic characteristics of lea-ves, water-radiation use and yield of C. arabica under the shade of banana trees. The results showed that net photosynthesis rate (P干热区小粒咖啡水光管理粗放,产量和品质得不到保证.为探明干热区小粒咖啡最佳灌水和荫蔽栽培耦合模式,通过大田试验,设3个灌水水平(充分灌水、轻度亏缺灌水和重度亏缺灌水)和4个荫蔽栽培模式(无荫蔽:单作咖啡;轻度荫蔽:4行咖啡间作1行香蕉;中度荫蔽:3行咖啡间作1行香蕉;重度荫蔽:2行咖啡间作1行香蕉),研究香蕉荫蔽栽培下亏缺灌溉对小粒咖啡生长、叶片光合特性、水光利用和产量的影响.结果表明: 小粒咖啡叶片的净光合速率(