Search

Shell-and-tube heat exchangers are widely used in many research fields and industrial production processes, but little research has been conducted on the use of heat exchangers for drying crops. This study conducted a numerical simulation of the temperature, velocity, and pressure fields based on the shell-and-tube fluids of a heat exchanger in a biomass particle hot-blast stove. The correctness of the simulation results was verified by test data before simulation, and the mesh was verified to be irrelevant. The application of a multi-objective genetic algorithm in heat exchanger design and optimization was explored, considering five design variables, such as hot tube diameter, transverse pitch, longitudinal pitch, cold flow velocity, and hot flow velocity for optimization. The Nusselt number, friction factor, and comprehensive performance coefficient were used as objective functions for 2D and 3D response surface analysis. The final design variables P1=74.91 mm, P2=104.23 mm, P3=121.37 mm, P4=4.83 m/s, and P5=8.48 m/s were obtained to improve the comprehensive performance coefficient by 16.11%. The heat transfer performance was improved by 9.55% and the resistance performance was reduced by 15%.

Aim:Short-acting β2-agonist (SABA) overuse adversely impacts asthma-related outcomes and the environment. The SABA rEductioN Through ImplemeNting Hull asthma guidELines (SENTINEL) programme aims to reduce SABA overuse through supported implementation of an adult asthma guideline, which advocates for a SABA-free maintenance and reliever therapy (MART)-preferred treatment where appropriate, across six primary care networks (PCNs) in the UK. We present findings on patient/disease characteristics, asthma prescribing patterns and exacerbation rates from the pilot PCN.Methods:Patients (aged ≥18 years, prescribed at least one inhaled therapy) and their prescribed asthma treatments were characterised using National Health Service data. Asthma treatments and exacerbations were analysed for three periods: 24‒12 months pre-, 12 months pre- and 12 months post-SENTINEL implementation (November 2020‒January 2021).Results:Of the 2571 registered asthma patients, 33.6% (n=864) underwent an asthma review, of whom 44.7% (n=386) were transitioned to MART. Fewer patients were prescribed three or more SABA canisters per year post-implementation in the overall asthma population (45.4% and 46.2% during 24‒12 months and 12 months pre-implementation, respectively, and 23.9% 12 months post-implementation), and in the two subgroups: 1) those who had an asthma review (74.5% and 83.6% during 24‒12 months and 12 months pre-implementation, respectively, and 26.5% post-implementation); and 2) those transitioned to MART following a review (76.4% and 86.5% during 24‒12 months and 12 months pre-implementation, respectively, and 16.3% post-implementation). A higher proportion of patients were exacerbation-free post-implementation in the overall asthma population and in the two subgroups. At least 71.5% of patients transitioned to MART were still prescribed MART 12 months post-implementation, of whom ≥86.7% were SABA-free.Conclusion:SENTINEL implementation led to reduced SABA prescribing, increased inhaled corticosteroid uptake and fewer asthma exacerbations. MART was considered appropriate for ∼50% of reviewed patients, with improved prescribing patterns sustained post-implementation.

In this work, a transmission polarizer is described by using a frequency-selective surface to transform linearly polarized waves into circularly polarized waves. The linear to circular (LTC) polarizer consists of four layers. Two types of unit cells are designed in the LTC polarizer to improve design freedom. As a result, two orthogonal polarized components of transmission waves display nearly 90° phase differences while maintaining nearly high transparency for the generation of CPWs. The less than 3 dB axial ratio with a fractional width of over 76.8% from 9.20 to 20.67 GHz for this LTC polarizer is obtained. Even when the incident angle reaches 20°, its operating frequency band covers 9.69 to 20.21 GHz. Compared with the converters proposed before, the one proposed in this paper has a wider bandwidth. In order to evaluate the design strategy, a prototype is manufactured and tested. The results of the simulation and the experiment are in good accord.

Background: Collateral status is an important predictor for the outcome of acute ischemic stroke with large vessel occlusion. Multiphase computed-tomography angiography (mCTA) is useful to evaluate the collateral status, but visual evaluation of this examination is time-consuming. This study aims to use an artificial intelligence (AI) technique to develop an automatic AI prediction model for the collateral status of mCTA. Methods: This retrospective study enrolled subjects with acute ischemic stroke receiving endovascular thrombectomy between January 2015 and June 2020 in a tertiary referral hospital. The demographic data and images of mCTA were collected. The collateral status of all mCTA was visually evaluated. Images at the basal ganglion and supraganglion levels of mCTA were selected to produce AI models using the convolutional neural network (CNN) technique to automatically predict the collateral status of mCTA. Results: A total of 82 subjects were enrolled. There were 57 cases randomly selected for the training group and 25 cases for the validation group. In the training group, there were 40 cases with a positive collateral result (good or intermediate) and 17 cases with a negative collateral result (poor). In the validation group, there were 21 cases with a positive collateral result and 4 cases with a negative collateral result. During training for the CNN prediction model, the accuracy of the training group could reach 0.999 ± 0.015, whereas the prediction model had a performance of 0.746 ± 0.008 accuracy on the validation group. The area under the ROC curve was 0.7. Conclusions: This study suggests that the application of the AI model derived from mCTA images to automatically evaluate the collateral status is feasible.

The limited success of immunotherapies targeting immune checkpoint inhibitors is largely ascribed to the lack of infiltrating CD8+ T lymphocytes. Circular RNAs (circRNAs) are a novel type of prevalent noncoding RNA that have been implicated in tumorigenesis and progression, while their roles in modulating CD8+ T cells infiltration and immunotherapy in bladder cancer have not yet been investigated. Herein, we uncover circMGA as a tumor-suppressing circRNA triggering CD8+ T cells chemoattraction and boosting the immunotherapy efficacy. Mechanistically, circMGA functions to stabilize CCL5 mRNA by interacting with HNRNPL. In turn, HNRNPL increases the stability of circMGA, forming a feedback loop that enhances the function of circMGA/HNRNPL complex. Intriguingly, therapeutic synergy between circMGA and anti-PD-1 could significantly suppress xenograft bladder cancer growth. Taken together, the results demonstrate that circMGA/HNRNPL complex may be targetable for cancer immunotherapy and the study advances our understanding of the physiological roles of circRNAs in antitumor immunity.

A connected vehicle platoon with unknown input delays is studied in this article. The control objective is to stabilize the connected vehicles, ensuring all vehicles are traveling at the same speed while maintaining a safety spacing. A decentralized control law using only onboard sensors is designed for the connected vehicle platoon. A novel switching-type delay-adaptive predictor is proposed to estimate the unknown input delays. By using the estimated unknown input delays, the control law can guarantee the stability of the successive vehicles. The platoon control adopts a one-vehicle look-ahead topology structure and a constant time headway (CTH) policy, which makes the desired spacing between vehicles vary with time. In this framework, the stability of the connected vehicles can be derived through the analysis of each pair of two successive vehicles in the platoon. Finally, an example is presented to illustrate the applicability of the obtained results.

Major symptoms of depression are commonly observed in patients requiring total hip arthroplasty (THA), and this is associated with increased pain scores and opioid consumption. We aimed to investigate the analgesic effect of duloxetine in these high-risk patients.Among 263 patients scheduled for primary unilateral THA, 67 patients who scored at least 8 on the 17-item Hamilton Depression Scale (HAMD) were enrolled in this study. Patients were randomized to the duloxetine group (60 mg daily, from the day of surgery to postoperative day 6) or the placebo group. The postoperative visual analog scale (VAS) score during walking, the VAS score during hip flexion, and resting VAS score was measured. Postoperative morphine consumption, hip range of motion (ROM), Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function, postoperative length of stay (LOS), and adverse events were recorded.The duloxetine group had significantly lower VAS scores during walking and hip flexion from postoperative day 3 to week 3 than the placebo group. With regard to the resting VAS score, duloxetine showed a better analgesic effect from postoperative day 3 to week 2 than placebo. Patients in the duloxetine group had less consumption of morphine. The duloxetine group exhibited better hip function scores, including ROM, HHS, and WOMAC function scores than the placebo group. No significant difference was observed in LOS or adverse events between groups.Perioperative short-term duloxetine provides advantages in decreasing pain, reducing morphine consumption, and increasing hip function in THA patients who have depressive symptoms.

Shuai Yu,&ast; Zhi-Chao Huang,&ast; Huai-Shun Wang,&ast; Shan-Wen Liu, Shou-Jiang You, Jie Hou, Zhi-Liang Guo, Guo-Dong Xiao Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guo-Dong Xiao; Zhi-Liang Guo, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu Province, 215004, People’s Republic of China, Email yarrowshaw@hotmail.com; guozhiliang3@163.comObjective: Acute ischemic stroke (AIS), caused by occlusion of large vessel, is a serious life-threatening disease. This study aimed to comprehensively investigate the association of 14 common and readily available circulating biomarkers with the 90-day modified Rankin Scale (mRS) score in patients undergoing mechanical thrombectomy (MT).Methods: This study included patients with anterior circulation large vessel occlusive stroke treated with MT from 05/2017 to 12/2021. Baseline comparisons of poor outcome were performed among enrolled patients. Factors that may be associated with the mRS score were assessed using correlation analysis. Univariate and multivariate logistic regression analyses were used to evaluate the predictive value of circulating biomarkers and poor outcome.Results: The mRS score has a strong correlation with neutrophil to lymphocyte ratio (NLR) and eosinophil levels (all rs> 0.4 in absolute value and all P< 0.001) in addition to a high correlation with National Institute of Health Stroke Scale (NIHSS) score (rs=0.40, P< 0.001). There was also a high correlation between NLR and eosinophil (rs=− 0.58, P< 0.001). In the multivariate regression analysis, only neutrophil (adjusted OR=1.301, 95% CI: 1.155− 1.465, P< 0.001), eosinophil (adjusted OR< 0.001, 95% CI: < 0.001− 0.016, P< 0.001), and NLR (adjusted OR=1.158, 95% CI: 1.082− 1.241, P< 0.001) were independently associated with poor outcome.Conclusion: This study evaluated a series of circulating biomarkers and found that neutrophil, eosinophil, and NLR independently predicted poor outcome after MT in AIS patients. There was a significant negative correlation between eosinophil and NLR levels.Keywords: acute ischemic stroke, mechanical thrombectomy, biomarker, eosinophil, poor outcome

Accurate citywide traffic inference is critical for improving intelligent transportation systems with smart city applications. However, this task is very challenging given the limited training data, due to the high cost of sensor installment and maintenance across the entire urban space. A more practical scenario to study the citywide traffic inference is effectively modeling the spatial and temporal traffic patterns with limited historical traffic observations. In this work, we propose a dynamic multi-view graph neural network for citywide traffic inference with the method CTVI+. Specifically, for the temporal dimension, we propose a temporal self-attention mechanism that is capable of learning the dynamics of traffic data with the time-evolving traffic volume variations. For spatial dimension, we build a multi-view graph neural network, employing the road-wise message passing scheme to capture the region dependencies. With the designed spatial-temporal learning paradigms, we enable our traffic inference model to encode the dynamism from both spatial and temporal traffic patterns, which is reflective of intra- and inter-road traffic correlations. In our evaluation, CTVI+ achieves consistent better performance compared with different baselines on real-world traffic volume datasets. Further ablation study validates the effectiveness of key components in CTVI+. We release the model implementation at https://github.com/dsj96/TKDD.

Aims The aim of our study was to assess differences in post-ablation atrial fibrillation (AF) recurrence and burden and to quantify the change in LVEF across different congestive heart failure (CHF) subcategories of the DECAAF-II population. Methods and results Differences in the primary outcome of AF recurrence between CHF and non-CHF groups was calculated. The same analysis was performed for the three subgroups of CHF and the non-CHF group. Differences in AF burden after the 3-month blanking period between CHF and non-CHF groups was calculated. Improvement in LVEF was calculated and compared across the three CHF groups. Improvement was also calculated across different fibrosis stages. There was no significant differences in AF recurrence and AF burden after catheter ablation between CHF and non-CHF patients and between different CHF subcategories. Patients with heart failure with reduced ejection fraction (HFrEF) experienced the greatest improvement in EF following catheter ablation (CA, 16.66% ± 11.98, P < 0.001) compared to heart failure with moderately reduced LVEF, and heart failure with preserved EF (10.74% ± 8.34 and 2.00 ± 8.34 respectively, P-value < 0.001). Moreover, improvement in LVEF was independent of the four stages of atrial fibrosis (7.71 vs. 9.53 vs. 5.72 vs. 15.88, from Stage I to Stage IV respectively, P = 0.115). Conclusion Atrial fibrillation burden and recurrence after CA is similar between non-CHF and CHF patients, independent of the type of CHF. Of all CHF groups, those with HFrEF had the largest improvement in LVEF after CA. Moreover, the improvement in ventricular function seems to be independent of atrial fibrosis in patients with persistent AF.

BackgroundClinical prediction rules (CPRs) developed to predict adverse outcomes of suspected pulmonary embolism (PE) and facilitate outpatient management have limitations in discriminating outcomes for ambulatory cancer patients with unsuspected PE (UPE). The HULL Score CPR uses a 5‑point scoring system incorporating performance status and self-reported new or recently evolving symptoms at UPE diagnosis. It stratifies patients into low, intermediate and high risk for proximate mortality. This study aimed to validate the HULL Score CPR in ambulatory cancer patients with UPE.Patients and methods282 consecutive patients managed under the UPE-acute oncology service in Hull University Teaching Hospitals NHS Trust were included from January 2015 to March 2020. The primary end-point was all-cause mortality, and outcome measures were proximate mortality for the three risk categories of the HULL Score CPR.Results30-day, 90-day and 180-day mortality rates for the whole cohort were 3.4% (n=7), 21.1% (n=43) and 39.2% (n=80), respectively. The HULL Score CPR stratified patients into low-risk (n=100, 35.5%), intermediate-risk (n=95, 33.7%) and high-risk (n=81, 28.7%) categories. Correlation of the risk categories with 30-day mortality (area under the curve (AUC) 0.717, 95% CI 0.522–0.912), 90-day mortality (AUC 0.772, 95% CI 0.707–0.838), 180-day mortality (AUC 0.751, 95% CI 0.692–0.809) and overall survival (AUC 0.749, 95% CI 0.686–0.811) was consistent with the derivation cohort.ConclusionThis study validates the capacity of the HULL Score CPR to stratify proximate mortality risk in ambulatory cancer patients with UPE. The score uses immediately available clinical parameters and is easy to integrate into an acute outpatient oncology setting.

Costimulatory domains (CSD) of 4-1BB and CD28 are most widely used in chimeric antigen receptor (CAR)–engineered T cells. These CAR T cells have shown encouraging efficacy in the treatment of hematologic malignancies but have limited efficacy in solid tumors. The herpes virus entry mediator (HVEM) is a costimulatory molecule with a novel downstream signaling pathway. In response to target cells, CAR T cells with a HVEM CSD (HVEM-CAR T) displayed more robust cytokine release and cytotoxicity than 4-1BB-CAR T or CD28-CAR T in vitro. Furthermore, HVEM-CAR T showed superior therapeutic efficacy in several mouse tumor models. Mechanistically, the HVEM CSD endowed CAR T cells with attenuated exhaustion, improved function and persistence, and enhanced metabolic activities in tumor tissue compared with 4-1BB–based or CD28-based CAR T cells. These studies establish that the HVEM CSD has the potential to improve the therapeutic efficacy of CAR T cells against solid tumors.

An interesting ring-closing/ring-opening cascade reaction selectively induced by aliphatic primary amine for the synthesis of functionalized aminomaleimides is described. This work features phenolic hydroxyl as a traceless directing group that forms a critical six-membered intermediate and then a lactone ammonolysis/intramolecular amidation sequence. This two-step, one-pot practical protocol has broad substrate scope (39 examples) and delivers structurally diverse aminomaleimides in good to excellent yields.

Using textual analysis, this paper divides green finance into green initiatives and green business activities. The former discusses whether environmental initiatives shall be signed, while the latter explores whether various emerging green commodities and services are provided. This paper investigates the influence of corporate size, the degree of internationalization, profits and competitiveness on the engagement degree of green finance, according to data collected from 410 Chinese listed companies on the Shanghai Stock Exchange. The results show that corporate size exerts a positive influence on green initiatives, and that the degree of internationalization, profits and corporate competitiveness of an enterprise each have a significant effect on green business activities. In addition, profits have a negative influence on green business activities. This paper provides insights and suggestions for developing green business activities in China.