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Abstract This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selected from two multicenter prospective cohorts (NCT02457637,NCT03641872) and included in separate training and validation cohorts (n = 180 and n = 148). In the training cohort, the CATCH-LIFE A nomogram (based on age, bilirubin, international normalized ratio, serum sodium, and hepatic encephalopathy score) and CATCH-LIFE B nomogram (based on age, bilirubin, international normalized ratio, serum albumin, white blood cell, platelet count, and hepatic encephalopathy score) had discriminatory ability for predicting 28-day (c-indexes of 0.910 and 0.899) and 90-day mortality (c-indexes of 0.878 and 0.887, respectively). The area under the curve values for 28-day and 90-day mortality prediction by the CATCH-LIFE A nomogram were 0.922 (95% CI : 0.874, 0.971) and 0.905 (0.856, 0.956), respectively, while those for the CATCH-LIFE B nomogram were 0.916(0.861,0.972) and 0.915 (0.866,0.964), respectively. Similar performance results were observed in the validation cohort. Optimal cut-off scores for each nomogram could be used for patient stratification in high- and low-risk groups, and the high-risk groups showed shorter survival times than the low-risk groups in both the training and validation cohorts. Two nomograms constructed from the first short-term follow-up data from patients with AoCLD due to combined HBV infection and alcohol exposure showed good predictive performance for 28-day and 90-day mortality and might be used to guide clinical management.

Abstract Hepatitis B virus (HBV) causes hepatitis B (HB) and distinct HBV genotypes can lead to different prognoses. However, HBV genotyping is rarely done in clinics, because the traditional method by PCR-based DNA sequencing is impractical for clinical diagnosis with tedious process and low success rate. Herein, we have established an ELISA-based genotyping method to quickly determine the HBV genotypes of HB patients in China. First, two commercial antibodies, 16D12 and 6H3 specific for HBV genotypes B and C respectively, are chosen as capture antibodies, since these two genotypes dominate in China. Then two home-made genotype-specific antibodies, B19 and C04, are used as the detection antibodies for genotypes B and C in sandwiched ELISA. The ELISA kit shows high sensitivity (> 95%) and specificity (> 95%) in detecting genotypes B and C of Chinese HB patients. Moreover, the ELISA kit has demonstrated higher success rate (98.7%) than PCR-based DNA sequencing (93.5%) and a commercial PCR-based genotyping kit (92.2%) for sera with HBV DNA ≥ 1000 IU/mL and HBsAg ≥ 250 IU/mL. Such an advantage is more obvious for the sera with HBV DNA

To study the mechanism of bongkrekic acid production by Pseudomonas cocovenenans subsp. farinofermentans at proteome level, data-dependent acquisition (DDA) unlabeled quantitative proteomics technique was used to analyze the protein changes of P. cocovenenans before and after toxin production. The results showed that 25 proteins were up-regulated and 31 proteins were down-regulated in toxin-producing strains. Among them, ABC transporters, response regulatory receptor protein, methyl-accepting chemotaxis protein II were related to bacterial chemotactic signal transduction. And flagellins such as P-cyclin, M-cyclin and FlgE were all related to chemotaxis. It is supposed that chemotactic movement plays an important role in the production of bongkrekic acid. The study on the production mechanism of bongkrekic acid can provide theoretical evidence to decrease the incidence of foodborne diseases.

Flexible job shops motivated by small batches and multiple orders require the collaboration of machines and automated guided vehicles (AGVs) scheduling to boost shop floor flexibility and productivity. The joint scheduling of machines and AGVs can better achieve global optimization. However, joint scheduling requires two NP hard problems to be solved simultaneously. Therefore, this paper employs a multi-AGV flexible job shop scheduling problem (MA-FJSP) with an effective hybrid algorithm. First of all, a model is established with the objectives of minimizing the makespan, the total AGV running time and the total machine load. To solve the MA-FJSP, high-quality initialization methods and improved elite strategies are designed to improve global convergence in the proposed algorithm. In addition, a problem-knowledge-based neighborhood search is integrated to improve its exploitation capability. At last, a series of comparative experimental studies were performed to exam the effectiveness of the improved algorithm. The results demonstrate that the solutions gained by the proposed algorithm perform well in respect of convergence, diversity and distribution.

In accordance with the actual production circumstances of enterprises, a scheduling problem model is designed for open-shop environments, considering AGV transport time. A Q-learning-based method is proposed for the resolution of such problems. Based on the characteristics of the problem, a hybrid encoding approach combining process encoding and AGV encoding is applied. Three pairs of actions are constituted to form the action space. Decay factors and a greedy strategy are utilized to perturb the decision-making of the intelligent agent, preventing it from falling into local optima while simultaneously facilitating extensive exploration of the solution space. Finally, the proposed method proved to be effective in solving the open-shop scheduling problem considering AGV transport time through multiple comparative experiments.

To investigate the impact of combining aluminum sulfate with straw and irrigation water to enhance soil quality in soda saline–alkali soil, in this study a field experiment was conducted in Tongliao City, Inner Mongolia Autonomous Region, China. With beet IM1162 as the indicator crop, four levels of aluminum sulfate dosage (30, 60, 90, 120 g m−2) and four levels of drip irrigation water quota (225, 270, 315, 360 m3 ha−1) were set. The study examined the impact of varying levels of aluminum sulfate and irrigation water on soil water salt and crop yield. Next, using a comprehensive evaluation method, the optimal quantities of aluminum sulfate and irrigation water needed for effective soil improvement were determined. The research findings indicate that the most effective treatment (W2S3) involved an aluminum sulfate dosage of 90 g m−2 and an irrigation quota of 270 m3 ha−1. This treatment resulted in significant improvements compared to the control (CK) group. Specifically, in the 0–50 cm soil layer, the following improvements were observed: the water storage capacity (SWS) increased by 51.7%; evapotranspiration (ET) increased by 16.2%; water use efficiency (WUE) increased by 55.0%; and irrigation water use efficiency (IWUE) increased by 98.1% (p < 0.05). These results emphasize the importance of optimizing the combination of aluminum sulfate dosage and irrigation water quota to improve soil conditions and crop performance. It is worth nothing that this study highlights the potential for enhancing water use efficiency and crop yield in agricultural practices, which can contribute to sustainable and efficient farming practices. The study results revealed significant improvements in soil quality and crop yield when compared to the control group (CK). Specifically, in the 0–50 cm soil layer: the soil salt content decreased by 19.8%, soil pH increased by 8.7%, and exchangeable sodium percentage (ESP) decreased by 34.0%. Moreover, the crop yield in the treatment group increased significantly, by 32.1%. These findings indicate the positive impact of the intervention on soil health and agricultural productivity. The study employed the game theory combination weighting method to comprehensively evaluate soil water, salt, and various yield indicators. The results showed that the sustainability weight for crop yield reached 0.116, emphasizing the aim of soil improvement: the sustainable enhancement of crop yield. This approach underscores the importance of balanced soil management practices to ensure long-term agricultural productivity and environmental sustainability. The comprehensive evaluation results of grey relation analysis and the TOPSIS coupling model showed that the soil improvement effect score was the highest when the dosage of aluminum sulfate was 61.7–120.0 g m−2, and the irrigation quota was 250.4–319.4 m3 ha−1, which was the recommended range for the local area. The research findings discussed in the provided sources contribute to the theoretical basis for soil improvement in soda–saline–alkali land.

Abstract Background The clinical features and factors affecting the prognostic survival of hepatic hydrothorax (HH) are currently unknown. Methods We conducted a retrospective cohort study of 131 patients with HH using the Kaplan–Meier method and Cox proportional hazards regression analysis to assess factors influencing the prognosis of HH. Results A total of 131 patients were enrolled: the male to female ratio was 80:51 (1.59:1), and the mean age was 52.76 ± 11.88 years. Hepatitis B cirrhosis was the main cause of HH, and abdominal distention and dyspnea were the most common clinical signs. Ascites was present in varying amounts in all patients and was the most common decompensated complication, with pleural effusions mostly seen on the right side (107/131; 82%), followed by the left side (16/131; 12%) and bilateral effusions (8/131; 6%). For overall survival without transplantation, the estimated median survival time was 21 (95% confidence interval [CI]:18–25) months, and survival rates at 6 months, 1 year, and 2 years were 77.2%, 62.4%, and 29.7%, respectively. After controlling for covariates that were associated with liver-related mortality in the univariate analysis, males (hazard ratio [HR]: 1.721, 95% CI: 1.114–2.658, P = 0.005) and combined hepatic encephalopathy (HR: 2.016, 95% CI: 1.101–3.693, P = 0.001) were found to be associated with an increase in liver-related mortality. Conclusions In this cohort of HH patients without liver transplantation, male sex and hepatic encephalopathy were associated with a higher risk of liver-related death.

Liver cancer is a common malignant tumor known for its difficult treatment and poor prognosis. As a traditional Chinese medicine prescription, Aitongxiao prescription (ATXP) has been used in clinical treatment of primary liver cancer (PLC) for more than ten years, and its therapeutic effect is obvious and has been verified over time. However, the mechanism of ATXP in treating PLC has not been fully elucidated. This study aimed to detect the liver-protective effect of ATXP on a PLC rat model and explore its potential mechanism from the perspective of plasma extracellular vesicle miRNAs. Fifty SPF male SD rats were randomly selected, with six rats as the control group, and the remaining rats were injected with DEN to establish a primary liver cancer model. The model rats were randomly divided into the model group and the ATXP group. After 4 weeks of intervention, the liver-protective effect of ATXP was evaluated using plasma biochemical indicators and histopathological methods. Plasma extracellular vesicles were isolated and extracted, and identified by transmission electron microscopy, nanoparticle tracking analysis, and western blot. Significant differentially expressed miRNAs in extracellular vesicles were screened by Illumina sequencing to explore the therapeutic targets of ATXP and conduct functional analysis. The results showed that ATXP significantly reduced plasma liver function in PLC rats and alleviated liver pathological damage. In addition, plasma extracellular vesicles were isolated and identified. According to the results of GO and KEGG analysis, they were related to multiple biological processes and covered multiple signaling pathways (PI3K-Akt and MAPK signaling pathways, etc.). The interaction between miR-199a-3p and MAP3K4 was determined by bioinformatics methods and dual-luciferase reporter gene detection, confirming that MAP3K4 is the target gene of miR-199a-3p. In conclusion, ATXP protects the liver from DEN-induced PLC, which may be related to the regulation of plasma extracellular vesicle miR-199a-3p. This study further reveals the mechanism of ATXP in treating liver cancer and provides a theoretical basis for subsequent research.

IntroductionThe aim of this study was to develop a noninvasive prediction model for histological stages in PBC that is simple, easy to implement, and highly accurate.MethodsA total of 114 patients with PBC were included in this study. Demographic, laboratory data and histological assessments were collected. The independent predictors of histological stages were selected to establish a noninvasive serological model. The scores of 22 noninvasive models were calculated and compared with the established model.ResultsThis study included 99 females (86.8%) and 15 males (13.2%). The number of patients in Scheuer’s stage 1, 2, 3 and 4 was 33 (29.0%), 34 (29.8%), 16 (14.0%), and 31 (27.2%), respectively. TBA and RDW are independent predictors of PBC histological stages. The above indexes were used to establish a noninvasive model-TR score. When predicting early histological change (S1) or liver fibrosis and cirrhosis (S3-S4), the AUROC of TR score were 0.887 (95% CI, 0.809-0.965) and 0.893 (95% CI, 0.816-0.969), higher than all of the other 22 models included in this study. When predicting cirrhosis (S4), its AUROC is still as high as 0.921 (95% CI, 0.837-1.000).ConclusionTR score is an easy, cheap and stable noninvasive model, without complex calculation formulas and tools, and shows good accuracy in diagnosing the histological stages of PBC.

Abstract To address the problems of poor welding completeness and inefficient configuration for defective automotive body-in-white panels, we propose a method for detecting and configuring the welding completeness of automotive body-in-white panels based on digital twin (DT) and mixed reality (MR). The method uses DT to build an MR-oriented DT framework for the detections and configuration of body-in-white panel welding completeness. We propose a method to build a DT knowledge base for panels, a Yolov4-based welding completeness detection method, and a MR-based configuration method for the welding completeness in panels. Our team develop a panel welding completeness detection and configuration system to fully validate the effectiveness of the method.

Imbalanced data cause low recognition of wind turbine blade cracking. Existing data-level augmentation methods, including sampling and generative strategies, may yield lots of high-confidence but low-value samples, which fail to improve the detection of blade cracking. Therefore, this paper designs a novel RTAE (roundtrip auto-encoder) method. Based on the idea of the roundtrip approach, we design two generator networks and two discriminator networks to ensure the cycle mapping between cracking samples and latent variables. Further, by leveraging cycle consistency loss, generated samples fit the distribution of historical cracking samples well. Thus, these generated samples effectively realize data augmentation and improve recognition of blade cracking. Additionally, we apply an auto-encoder method to reduce the dimension of historical samples and thus the complexity of the generator network and discriminator network. Through the analysis of real wind turbine blade cracking data, the recognition of cracking samples is improved by 19.8%, 23.8% and 22.7% for precision, recall and F1-score.

Objective: To determine the therapeutic effect of pulmonary arterial hypertension (PAH) agents for portal pulmonary hypertension (POPH).Design: Systematic review and meta-analysis.Background: POPH is a serious complication of end-stage liver disease with a low survival rate. Liver transplantation (LT) is an effective treatment. Due to the presence of POPH, some patients cannot undergo LT. After PAH treatment, patients with POPH can obtain good hemodynamics and cardiac function for LT, but there are no standard guidelines.Methods: Two independent researchers searched PubMed, EMBASE, Cochrane Library, and Web of Science for studies published from inception to 27 September 2022, focusing on the changes in hemodynamics and cardiac function in all patients with POPH to understand the effect of PAH treatment on the entire population of POPH patients. Among these, we specifically analyzed the changes in hemodynamics and cardiac function in moderate and severe POPH patients. After collecting the relevant data, a meta-analysis was carried out using the R program meta-package.Results: A total of 2,775 literatures were retrieved, and 24 literatures were included. The results showed that in all POPH patients (n = 1,046), the following indicators were significantly improved with PAH agents: mPAP: (MD = −9.11 mmHg, p < 0.0001); PVR: (MD = −239.33 dyn·s·cm−5, p < 0.0001); CO: (MD = 1.71 L/min, p < 0.0001); cardiac index: (MD = 0.87 L/(min·m2), p < 0.0001); 6MWD: (MD = 43.41 m, p < 0.0001). In patients with moderate to severe POPH (n = 235), the following indicators improved significantly with PAH agents: mPAP (MD = −9.63 mmHg, p < 0.0001); PVR (MD = −259.78 dyn·s·cm−5, p < 0.0001); CO (MD = 1.76 L/min, p < 0.0001); Cardiac index: (MD = 1.01 L/(min·m2), p = 0.0027); 6MWD: (MD = 61.30 m, p < 0.0001).Conclusion: The application of PAH agents can improve cardiopulmonary hemodynamics and cardiac function in patients with POPH, especially in patients with moderate to severe POPH, and the above changes are more positive.Systematic Review Registration:https://inplasy.com, identifier INPLASY202250034.

Background and aimsHepatic Hydrothorax (HH) is one of the complications in patients with decompensated cirrhosis and its impact and role in the prognosis of patients with decompensated cirrhosis are not yet clear. Thus, this study aimed to determine the role of HH in patients with decompensated cirrhosis and the long-term impact on their mortality.Materials and methodsA retrospective study analyzed 624 patients with ascites without pleural effusion in decompensated cirrhosis and 113 patients with HH. Propensity scores were calculated based on eight variables, and the HH and non-HH groups were matched in a 1:1 ratio. The effect and role of HH on the prognosis of patients with decompensated cirrhosis was analyzed using the Kaplan–Meier method and Cox proportional hazards regression model.ResultsA total of 737 patients were included. Out of 113 HH patients, 106 could be matched to 106 non-HH patients. After matching, baseline characteristics were well-balanced. The multifactorial Cox proportional hazards model indicated that hepatic encephalopathy and HH were independent risk factors affecting prognostic survival in patients with decompensated cirrhosis (P < 0.01), with risk ratios and 95% confidence intervals (CI) of 2.073 (95% CI: 1.229–3.494, P < 0.01) and 4.724 (95% CI: 3.287–6.789, P < 0.01), respectively. Prognostic survival was significantly worse in the HH group compared to patients in the non-HH group, with mortality rates of 17.9, 30.1, and 59.4% at 6 months, 1 year, and 2 years in the HH group, compared to 0.9, 3.8, and 5.6% in the non-HH group, respectively. The estimated median survival time was 21 (95% CI: 18–25) months in the HH group and 49 (95% CI: 46–52) months in the non-HH group (P < 0.001).ConclusionHepatic hydrothorax is significantly associated with higher mortality in patients with decompensated cirrhosis and is a highly negligible independent decompensated event affecting their prognosis.

Integrated process planning and scheduling (IPPS) is important for modern manufacturing companies to achieve manufacturing efficiency and improve resource utilization. Meanwhile, multiple objectives need to be considered in the realistic decision-making process for manufacturing systems. Based on the above realistic manufacturing system requirements, it becomes increasingly important to develop effective methods to deal with multi-objective IPPS problems. Therefore, an improved NSGA-II (INSGA-II) algorithm is proposed in this research, which uses the fast non-dominated ranking method for multiple optimization objectives as an assignment scheme for fitness. A multi-layer integrated coding method is adopted to address the characteristics of the integrated optimization model, which involves many optimization parameters and interactions. Elite and mutation strategies are employed during the evolutionary process to enhance population diversity and the quality of solutions. An external archive is also used to store and update the Pareto solution. The experimental results on the Kim test set demonstrate the effectiveness of the proposed INSGA-II algorithm.

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Objective: We investigated the pathogenesis of a patient with severe acute pancreatitis by comprehensively analysing a rare carbapenem-resistant hypervirulent K1/ST1265 Klebsiella pneumoniae (CR-HvKP) strain. Methods: We conducted virulence and multidrug-resistance phenotypic characterization and identified a CR-HvKP strain from the patient. It was subjected to Pacbio sequencing, and subsequent analysis of virulence, resistance genes and mobile genetic elements. Results: We described the phenotype and genotype of a rare CR-HvKP strain with an untypeable blaKPC-harboured conjugative plasmid and a pLVPK-like virulent plasmid. Resistance gene analysis showed that the untypeable blaKPC-2-harboured plasmid was formed by IS26-mediated recombination of blaKPC-embedded transposon Tn6500 into pCN061p4 from Escherichia coli. Interestingly, it had an R-M system that might protect plasmid from cleavage. This may facilitate the stabilization of plasmids in bacteria in the event of missing CR-plasmid during transmission. Virulence gene analysis indicated 78 virulence genes on the genome, including 67 on the chromosome (37 in high-pathogenic island) and 11 on the pLVPK-like virulence plasmid (harbouring rmpA/rmpA2). Further phylogenetic analysis revealed that the CR-HvKP evolved from HvKP through acquiring an antimicrobial-resistance plasmid. Conclusion: Our research, to our knowledge, first reported a ST1265/K1 CR-HvKP strain with an untypeable blaKPC-harboured plasmid. The trend that HvKP could evolve into CR-HvKP by obtaining stabilized/conjugative blaKPC-carrying plasmids is a considerable threat to public health and should be closely supervised.

Process planning and scheduling are two crucial components in a flexible manufacturing system. Lots of novel meta-heuristics have been applied to the integrated process planning and scheduling (IPPS) problem for an efficient utilization of manufacturing resources; nevertheless, the tricky part in real life stems from the uncertainty in processing times. Existing publications regarding IPPS problems mainly focus on cases with nominal or fixed processing times; nevertheless, processing time fluctuations will certainly result in an intolerable deviation between the actual makespan and the nominal one. This research focuses on the IPPS problem with uncertain processing times to hedge against the uncertainty in makespan. The novel neutrosophic numbers are first introduced to model the uncertain processing times. A neutrosophic number based mixed integer linear programming (MILP) model is established; due to the non-deterministic polynomial (NP)-hardness and the complexity in solving the model, a variable neighborhood search (VNS) incorporated memetic algorithm (MA) is then developed to facilitate more robust solutions. In the proposed algorithm, the nominal makespan criterion and the deviation (robustness) criterion have been considered in a weighted sum manner. The well-known Kim's benchmark is adopted to test the performance of the proposed algorithm and different degrees of fluctuations are also defined in experiments. Computational results reveal that the VNS based local search method is powerful in capturing promising solutions; competitive solutions with superior nominal makespan and robustness have been obtained. This research presents a novel perspective or methodology to seek more robust solutions for the uncertain IPPS problem.

This paper studies the green single-machine scheduling problem that considers the delay cost and the energy consumption of manufacturing equipment and builds its integrated optimization model. The improved ant colony scheduling algorithm based on the Pareto solution set is used to solve this problem. By setting the heuristic information, state transition rules, and other core parameters reasonably, the performance of the algorithm is improved effectively. Finally, the model and the improved algorithm are verified by the simulation experiment of 10 benchmark cases.

Background and aims: Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is a complicated syndrome with extremely high short-term mortality. Whether plasma exchange (PE) improves HBV-ACLF outcomes remains controversial. Here, PE-based non-bioartificial liver support system (NB-ALSS) effects on short-term HBV-ACLF patient outcomes were investigated.Materials and methods: HBV-ACLF patients from Chinese Acute-on-chronic Liver Failure (CATCH-LIFE) cohort receiving standard medical therapy (SMT) alone or PE-based NB-ALSS in addition to SMT were allocated to SMT and SMT+PE groups, respectively; propensity score matching (PSM) was used to eliminate confounding bias. Short-term (28/90-day and 1-year) survival rates were calculated (Kaplan-Meier).Results: In total, 524 patients with HBV-ACLF were enrolled in this study; 358 received SMT alone (SMT group), and the remaining 166 received PE-based NB-ALSS in addition to SMT (SMT+PE group). PSM generated 166 pairs of cases. In the SMT+PE group, 28-day, 90-day, and 1-year survival rates were 11.90, 8.00, and 10.90%, respectively, higher than those in the SMT group. Subgroup analysis revealed that PE-based NB-ALSS had the best efficacy in patients with ACLF grade 2 or MELD scores of 30–40 (MELD grade 3). In MELD grade 3 patients who received SMT+PE, 28-day, 90-day, and 1-year survival rates were improved by 18.60, 14.20, and 20.10%, respectively. According to multivariate Cox regression analysis, PE-based NB-ALSS was the only independent protective factor for HBV-ACLF patient prognosis at 28 days, 90 days, and 1 year (28 days, HR = 0.516, p = 0.001; 90 days, HR = 0.663, p = 0.010; 1 year, HR = 0.610, p = 0.051). For those who received SMT+PE therapy, PE-based NB-ALSS therapy frequency was the only independent protective factor for short-term prognosis (28-day, HR = 0.597, p = 0.001; 90-day, HR = 0.772, p = 0.018).Conclusions: This multicenter prospective study showed that the addition of PE-based NB-ALSS to SMT improves short-term (28/90 days and 1-year) outcomes in patients with HBV-ACLF, especially in MELD grade 3 patients. Optimization of PE-based NB-ALSS may improve prognosis or even save lives among HBV-ACLF patients.

In this study, the radial basis function (RBF) which has good performance for nonlinear problem is introduced to approximate the implicit relationships between EDM parameters and performance responses for 304 steel. The fitting precision of RBF is compared with the second order polynomial response surface (PRS), support vector regression (SVR) and Kriging model (KRG) using the multiple correlation coefficient (R2) based cross validation error method. Then the RBF model is called to conduct multi-objective optimization using non-dominated sorting genetic algorithm II (NSGA-II) method. The energy consumption index unit energy consumption (UEC) and the air-pollution indices PM2.5 and PM10 are considered in proposed multi-objective optimization model. UEC is considered as the objective function to reduce the machining cost and the PM indices are termed as the constraints to protect the operators' health. The pulse current, time period and duty cycle are considered as the main factors affecting the EDM responses. According to the Pareto plots of multi-objective optimization model, conclusion can be drawn that SR and PM10 play significant roles in multi-optimization and PM2.5 has less influence on optimization results. The results of the present study reveal that using maximum material removal rate (MRR) and minimum UEC as objective and using surface roughness (SR), PM2.5 and PM10 as constraints can be an effective method to provide appropriate process parameters reference for EDM machining.

Product-service system (PSS) is an important way of the transformation and upgrading of modern manufacturing industry, it is also one of core development trends of intelligent manufacturing. A PSS can be configured quickly and cheaply to meet the customer's personalized product and service requirements via a PPS design platform, and a modular master structure is the core of PSS design platform. When a PSS instance is configured, it needs to determine the module types and make decisions on the types of PSS firstly, so as to build a master structure for PSS. Therefore, the decision-making on module types and customization degree is a key step to establish the PSS modular master structure. This article proposes a five-step planning method for the modular structure planning of PSS. Firstly, the PSS module types are classified based on the Kano model. Then, bi-level decision-making on modules and its properties are finished by using conjoint analysis method, includes the customer's decision-making on modules and their properties, and the manufacturer's modules and their properties, which provides support for PSS modular optimization configuration design. Finally, the proposed methodology is validated through the case of power transformer. The proposed module planning method for the PSS modular structure helps to determine the module types for PSS services solution layer and generic part layer.

Research on integrated process planning and scheduling (IPPS) is of great significance to the improvement of the overall quality of machinery manufacturing system. In the actual manufacturing process, the manufacturing system is often accompanied by some unpredictable uncertain disturbance factors, for instance uncertain processing time of jobs and changes of due date, etc . These uncertain disturbance events will ultimately affect production efficiency and customer satisfaction. Consequently, this paper considers the multi-objective IPPS problem with uncertain processing time and uncertain due date. A multi-layer collaborative optimization (MLCO) method is designed for the fuzzy multi-objective IPPS (FMOIPPS) problem, including three layers. For the process planning layer, the basic genetic algorithm is used to provide various near optimal process plans for the process selection system. For the process selection layer, a multi-objective genetic algorithm (MOGA) is designed to optimize the process selection population. A sharing function method is introduced to maintain population diversity. An individual comprehensive evaluation method is introduced to evaluate non-dominated solutions. The crowded distance, fast non-dominated sorting and elite strategy based on NSGAII is adopted in the proposed MOGA. The external archive method is employed to preserve the non-dominated solutions generated during population evolution. For the scheduling layer, a MOGA with a boundary search strategy is proposed. The boundary search strategy is designed to improve the search ability of boundary solutions. Three optimization objectives are minimizing the spread of fuzzy makespan, minimizing fuzzy makespan and maximizing average customer satisfaction simultaneously. The target of scheduling layer is to make scheduling arrangements for the process information obtained by process selection layer. Through mutual cooperation among each layer, guide the overall optimization process, and finally get satisfactory solutions. Different problem examples of various scales are employed to verify feasibility and effectiveness of the MLCO method. The experimental results indicate that the MLCO method can effectively address FMOIPPS problem.

Objectives To demonstrate the screening value of echocardiography for portopulmonary hypertension (POPH) in liver transplant candidates. Design Systematic review and meta-analysis. Background POPH is a complication of end-stage liver disease that adversely affects the outcome of orthotopic liver transplant. There are no specific symptoms in the early stage of POPH. POPH reduce the survival rate of patients with end-stage liver disease specially if they are not diagnosed. Therefore, early detection may improve prognosis. The objective of this study is to explore the screening value of echocardiography on liver transplant candidates for screening of POPH compared to right heart catheterization (RHC). Method PubMed, EMBASE and the Cochrane Library were searched by two independent reviewers for potentially eligible studies published up to 30 June 2019 to retrieve data based on per-patient analysis. STATA, Meta-DiSc, and RevMan were applied to perform this meta-analysis. Results Our search yielded 1576 studies, of which 11 satisfied the inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the summary receiver operating characteristic (SROC) curve (AUC) of echocardiography for POPH were 0.85 (95% CI [0.65–0.94]), 0.83 (95% CI [0.73–0.90]), 4.99 (95% CI [3.03–8.21]), 0.19 (95% CI [0.07–0.46]), and 0.91 (95% CI [0.88–0.93]), respectively. Deeks’ funnel plot did not indicate the existence of publication bias (P = 0.66). Conclusions Echocardiography, a noninvasive modality, provides superior screening for POPH, but the diagnosis of POPH still requires RHC. PROSPERO registration number CRD42019144589.

The new technology of intelligent manufacturing makes the data of process planning and shop scheduling easier to interconnect, and the integration optimization of different manufacturing processes is an important technology to ensure the implementation of intelligent manufacturing. Integrated process planning and scheduling is a significant research focus in recent years, which could improve the performance of manufacturing system. At present, the research on integrated process planning and scheduling is insufficient to consider the multi-objective and uncertain characteristics widely existing in real manufacturing environment. Therefore, multi-objective integrated process planning and scheduling problem with uncertain processing time and due date is addressed in this article. The mathematical model of multi-objective uncertain integrated process planning and scheduling problem with uncertain processing time and fuzzy due date is established based on fuzzy set, in which the calculation method of uncertainty measurement objective is designed. An effective modified honey bees mating optimization algorithm has been designed to solve the proposed model. Queens set is constructed to maintain the non-dominated solutions found in the optimization process. The calculation method of mating probability between drone and queen bee based on Euclidean distance is designed. Fuzzy operators were utilized to evaluate fitness, judge the non-dominated relationship, and decode the scheduling solution. Different instances were designed and carried out to test the performance of the proposed method. The results show that the proposed method is very effective for solving multi-objective uncertain integrated process planning and scheduling.

Background and objectiveThe relationship between antimitochondrial antibody (AMA) levels and the severity or prognosis of primary biliary cholangitis (PBC) is unclear. This study explored the clinical significance of serum IgG antimitochondrial M2 antibody (IgG-M2) levels.MethodsFrom 2008 to 2017, a retrospective analysis was conducted with PBC patients who had available quantitative values of serum IgG-M2 levels obtained with ELISA based on triple expression hybrid clones. The patients were divided into two groups based on high and low concentrations of IgG-M2. Baseline parameters, the incidence of adverse events, and prognosis were compared.ResultsAmong the 530 PBC patients, the levels of albumin, cholinesterase, hemoglobin, fibrinogen and triglycerides and the red blood cell count were significantly lower in the high-concentration group than in the low-concentration group (n = 263, 49.6%). The red cell distribution width (RDW) and levels of serum immunoglobulin (Ig) G, IgM and IgA were significantly higher in the high-concentration group than in the low-concentration group. Spearman's correlation analysis suggested that the correlation between the above baseline indicators and IgG-M2 levels was statistically significant but weak (r < 0.2, P < 0.05). In total, 203 patients were followed up, of whom 87 (42.9%) were in the high-concentration group. During the median follow-up period of 52 months (range: 28-75), 121 (59.6%) experienced hepatic decompensation, and 37 (18.2%) died or underwent liver transplantation. There was no significant difference in the incidence of complications or survival (log-rank test: P = 0.079) between the two groups. One year after ursodeoxycholic acid (UDCA) treatment, the two groups had similar responses. In addition, the levels of IgG-M2 did not fluctuate significantly during treatment.ConclusionIgG-M2 levels were not related to the disease severity, prognosis or efficacy of UDCA. The levels of IgG-M2 did not change significantly during treatment.

Summer ozone (O3) pollution in China has become increasingly serious in recent years. This study is based on hourly data of near-surface ozone (O3) and nitrogen oxides (NOx) and volatile organic compounds (VOCs) from June to August 2020 in Yuncheng, combined with meteorological data to analyse the characteristics of O3 pollution in summer and the influence of meteorological factors, precursors, and long-range transport on O3 pollution. In this paper, the VOCs/NOx characteristic ratio method was used to explore the sensitivity of O3 generation. Backward trajectories, cluster analysis, potential source contribution factor (PSCF) analysis and concentration weight trajectory (CWT) analysis were also calculated using Trajstat software. In 2020, Yuncheng had persistent O3 pollution, with the highest concentrations in June, significantly higher than July and August. Conditions of high temperature, low relative humidity and low wind speed contribute to the O3 accumulation. VOCs are the main precursors to the local production of O3. Besides, the long-range transport analysis shows that southeast-oriented air masses are the main direction influencing summer O3 pollution. The primary potential source areas of O3 are in the central and southern part of Henan province, the north-western Anhui province, and the northern Shaanxi. In addition, northern Hubei and southwestern Shandong also influence O3 pollution in summer Yuncheng.

Objective China’s national hepatitis burden is high. This study aims to provide a detailed national-level description of the reported incidence of viral hepatitis in China during 2004–2016.Design Observational study.Setting Data were obtained from China’s National Notifiable Disease Reporting System, and changing trends were estimated by joinpoint regression analysis.Participants In this system, 16 927 233 reported viral hepatitis cases occurring during 2004–2016 were identified.Primary outcome measure Incidence rates per 100 000 person-years and changing trends were calculated.Results There were 16 927 233 new cases of viral hepatitis reported in China from 2004 to 2016. Hepatitis B (HBV) (n=13 543 137, 80.00%) and hepatitis C (HCV) (n=1 844 882, 10.90%) accounted for >90% of the cases. The overall annual percent change (APC) in reported cases of viral hepatitis and HBV were 0.3%(95% CI −2.0 to 0.8, p=0.6) and −0.2% (95% CI −1.6 to 1.2, p=0.8), respectively, showing a stable trend. HBV rates were highest in the 20–29 year old age group and lowest in younger individuals, likely resulting from the universal HBV vaccination. The reported incidence of HCV and hepatitis E (HEV) showed increasing trends; the APCs were 14.5% (95% CI 13.1 to 15.9, p

BackgroundThis study assesses the competency of maternal and neonatal health (MNH) professionals at district-level and subdistrict-level health facilities in northern Bangladesh in managing maternal and newborn complications using clinical vignettes. The study also examines whether the professional’s characteristics and provision of MNH services in health facilities influence their competencies.Methods134 MNH professionals in 15 government hospitals were interviewed during August and September 2016 using structured questionnaire with clinical vignettes on obstetric complications (antepartum haemorrhage and pre-eclampsia) and neonatal care (low birthweight and immediate newborn care). Summative scores were calculated for each vignette and median scores were compared across different individual-level and health facility-level attributes to examine their association with competency score. Kruskal-Wallis test was performed to identify the significance of association considering a p value75% of total) in maternal and neonatal vignettes, respectively. Medical doctors had higher competency than nurses and midwives (score=11 vs 8 out of 19, respectively; p=0.0002) for maternal vignettes, but similar competency for neonatal vignettes (score=30.3 vs 30.9 out of 50, respectively). Professionals working in health facilities with higher use of normal deliveries had better competency than their counterparts. Professionals had higher competency in newborn vignettes (significant) and maternal vignettes (statistically not significant) if they worked in health facilities that provided more specialised newborn care services and emergency obstetric care, respectively, in the last 6 months.ConclusionsDespite the overall low competency of MNH professionals, exposure to a higher number of obstetric cases at the workplace was associated with their competency. Arrangement of periodic skill-based and drill-based in-service training for MNH professionals in high-use neighbouring health facilities could be a feasible intervention to improve their knowledge and skill in obstetric and neonatal care.

Recently, there is ample evidence suggesting the important role of microRNAs (miRNAs) in autoimmune diseases via modulating B cells function. Primary biliary cholangitis (PBC) is a progressive immune-mediated liver disease with unclear pathogenic mechanism. Whether the miRNA in peripheral B cells of PBC involve the mechanisms of pathology and progression is not known. The present study explores miRNA deregulation in peripheral B-cell of PBC from stage I to IV and healthy controls. Peripheral B cells were obtained from 72 PBC patients (stage I, n = 17; stage II, n = 23; stage III, n = 16; stage IV, n = 16) and 15 healthy controls. Initially, in a discovery study, miRNA array analysis was performed, subsequently, in a validation study, quantitative PCR was used to investigate miRNA expression profile in B cells of PBS patients compared to healthy controls. Based on bioinformatics analysis, we identified the potential biological processes and significant signaling pathways affected by these microRNAs, and generated the microRNA-gene network. The discovery study identified 558 miRNAs differentially expressed in B cells of PBC patients compared to controls. Interestingly, among all differentially expressed miRNAs, hsa-miR-223-3p and hsa-miR-21-5p were the only miRNAs that showed consistent and significant down-regulation from stage I to stage III of PBC. Bioinformatics showed that potential target genes of both miRNAs involved in migration, cell differentiation, apoptosis, and signal transduction pathways. In conclusion, our results suggest that the expression profiles of miRNA in peripheral B cells of PBC patients are closely associated with the disease progression, especially the down-regulation of hsa-miR-223-3p and hsa-miR-21-5p. Taken together, our study offers novel perspectives on the role of miRNAs in PBC pathogenesis.

To eliminate hepatitis C virus (HCV) from infected hepatocytes, we generated two therapeutic molecules specifically activated in cells infected with HCV. A dominant active mutant of interferon (IFN) regulatory factor 7 (IRF7) and a negative regulator of HCV replication, VAP-C (Vesicle-associated membrane protein-associated protein subtype C), were fused with the C-terminal region of IPS-1 (IFNβ promoter stimulator-1), which includes an HCV protease cleavage site that was modified to be localized on the ER membrane, and designated cIRF7 and cVAP-C, respectively. In cells expressing the HCV protease, cIRF7 was cleaved and the processed fragment was migrated into the nucleus, where it activated various IFN promoters, including promoters of IFNα6, IFNβ, and IFN stimulated response element. Activation of the IFN promoters and suppression of viral RNA replication were observed in the HCV replicon cells and in cells infected with the JFH1 strain of HCV (HCVcc) by expression of cIRF7. Suppression of viral RNA replication was observed even in the IFN-resistant replicon cells by the expression of cIRF7. Expression of the cVAP-C also resulted in suppression of HCV replication in both the replicon and HCVcc infected cells. These results suggest that delivery of the therapeutic molecules into the liver of hepatitis C patients, followed by selective activation of the molecules in HCV-infected hepatocytes, is a feasible method for eliminating HCV.