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This study presents an efficient surrogate-based optimization (SBO) method of the aerodynamic performance of a contra-rotating open rotor (CROR). The objective was to maximize propulsion efficiency while reaching the target thrust coefficient at the cruise condition. To reduce the sample size and improve the optimization convergence speed, an infilling criterion was proposed based on the features of the interaction between the CROR front and rear rotors. The efficient front and rear rotors of the initial samples were selected and then combined to form the infilled samples. The results show that the infilled samples were closer to the Pareto front than the initial samples. For the six optimization parameters, 20 initial sample points were used, 11 samples were infilled, and the surrogate-based optimization was completed in five iterations. In total 43 samples were calculated during the optimization. The number of overall samples is approximately seven times the number of optimization parameters. The optimization results in parameter changes compared to the baseline and improved propulsion efficiency while meeting the thrust target. The optimization process increases the torque share of the rear rotor and changes the flow state at different radial positions, leading to a more uniform total pressure distribution at the outlet position, both circumferentially and radially. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Triple-negative breast cancer (TNBC) is an aggressive subtype with a poor prognosis. Minichromosome maintenance genes (MCM2-7) crucial for DNA replication are significant biomarkers for various tumor types; however, their roles in TNBC remain underexplored. MATERIALS AND METHODS: We utilized four TNBC-related GEO databases to examine MCM2-7 gene expression and predict its prognosis in TNBC, performing single-cell analysis and GSEA to discover MCM6's potential function. The Cancer Dependency Map gene effect scores and CCK8 assay were used to assess MCM6's impact on TNBC cell proliferation. The correlations between MCM6 expression, immune infiltrates, and immune cells were also analyzed. WGCNA and LASSO Cox regression built a risk score model predicting TNBC patient survival based on MCM6-related gene expression. RESULTS: MCM2-7 gene expression was higher in TNBC tissues compared to adjacent normal tissues. High MCM6 expression correlated with shorter TNBC patient survival time. GSEA and single-cell analysis revealed a relationship between elevated MCM6 expression and the cell cycle pathway. MCM6 knockdown inhibited TNBC cell proliferation. A risk model featuring MCM6, CDC23, and CCNB1 effectively predicts TNBC patient survival. CONCLUSIONS: MCM6 overexpression in TNBC links to a worse prognosis and reduced cell proliferation upon MCM6 knockdown. We developed a risk score model based on MCM6-related genes predicting TNBC patient prognosis, potentially assisting future treatment strategies. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to investigate the "Internet + rehabilitation guidance" under the theory of Information- Knowledge-Attitude-Practice (IKAP) in patients with esophageal cancer during the perioperative period and to analyze the influence on the short-term prognosis of patients with esophageal cancer. PATIENTS AND METHODS: From April 2022 to February 2023, 118 patients who underwent radical esophagectomy in the First Hospital of Huai'an Affiliated Hospital of Nanjing Medical University were enrolled using the convenience sampling method. They were divided into the IKAP group (59 cases) and the Control Group (Group C) (59 cases), according to the random number table method. The conventional intervention was performed during the perioperative period, and the IKAP group was also given "Internet + rehabilitation guidance" based on IKAP theory. The first postoperative defecation time, exhaust time, feeding time, discharge time, and postoperative complication rate of the two groups were compared. Meanwhile, blood samples were collected before surgery and 1, 3, 7, and 30 days after surgery (at outpatient review) for the detection of inflammatory factor indexes and nutritional indexes. RESULTS: Patients within the IKAP group showed a shorter first postoperative exhaust and defecation time, eating time, and hospital compared to the control group (p<0.05). Before surgery, there was no significant difference in serum inflammatory factors and nutritional indexes between the two groups (p>0.05). Comparing the levels of serum inflammatory factors in the two groups after surgery, the levels of CRP and IL-6 in the IKAP group were lower than those in the control group on days 1, 3, and 7 after surgery. After 30 days, the serum CRP level was found to be lower than the control group, but no statistical difference with the control level of serum IL-6 (p<0.05) was found. Compared with the serum nutritional index levels in the two groups: 1 d after surgery, the serum HGB, PA, and TRF levels were not different (p>0.05). The serum ALB level in the IKAP group was higher than that in the control group (p<0.05). Postoperative 3 d, 7 d, the serum levels of HGB, ALB, PA, and TRF in the IKAP group were higher than those in the control group (p<0.05). After 30 d, there was no statistical difference in serum HGB levels between the two groups (p<0.05); Serum ALB, PA, and TRF levels in the IKAP group were higher than those in the control group (p<0.05). From preoperative to 30 days after surgery, serum CRP and IL-6 levels in 2 groups were first increased and then decreased, while serum HGB, ALB, PA, and TRF levels were first decreased and then increased. After surgery, the IKAP group showed a greater incidence of complications in patients than in controls (p<0.05). CONCLUSIONS: In patients with esophageal cancer, perioperative "Internet + rehabilitation guidance" based on IKAP theory can effectively shorten the postoperative gastrointestinal function recovery time and rapidly reduce the inflammatory response, improving the nutritional status of the body, thereby reducing the risk of short-term postoperative complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Both non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are prevalent diseases worldwide. This study aimed to explore the underlying mechanisms of NAFLD and HCC and identify new therapeutic targets for human cancers. MATERIALS AND METHODS: NAFLD and HCC gene expression profiles were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) and weighted gene co-expression network analysis (WGCNA) were utilized to identify co-expressed genes associated with NAFLD and HCC. Public databases were consulted to find common targets of NAFLD and HCC. Enrichment analysis and CIBERSORT techniques were employed to analyze the pathways enriched with DEGs and the attributes of infiltrating immune cells. Furthermore, the expression data of UROC1 and clinical information of patients were acquired from The Cancer Genome Atlas (TCGA) database. Finally, the expression of the UROC1 was validated by immunohistochemistry (IHC). RESULTS: Through a comprehensive bioinformatics analysis, eight hub genes (CCL2, CCR2, IL6, CSF3R, ATL2, SESN3, UROC1, FIGNL1) were identified. Enrichment analysis indicated that in- flammatory and immune response may be common features between NAFLD and HCC. CIBERSORT analysis revealed an imbalance of plasma cells and macrophages in NAFLD and HCC. Pan-cancer analysis demonstrated that UROC1 expression was related to clinical outcomes and tumor immunity in various cancers. Moreover, a strong correlation was exhibited between UROC1 expression and crucial elements, including tumor mutation burden (TMB), microsatellite instability (MSI), multiple immune checkpoints (ICP), and tumor microenvironment (TME). Importantly, an adverse clinical prognosis of HCC was linked to decreased UROC1 expression, which was consistent with IHC results. CONCLUSIONS: We identified eight hub genes (CCL2, CCR2, IL6, CSF3R, ATL2, SESN3, UROC1, FIGNL1), which may become early diagnostic and therapeutic targets for NAFLD and HCC. The pan-cancer analysis of UROC1 provides new evidence for its broad application prospects in the field of HCC and other cancers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Insomnia disorder (ID) is a persistent difficulty sleeping, often accompanied by anxiety and depression, which seriously reduces a person’s quality of life. Dietary changes in insomnia patients have been a concern. To explore the rationality of diet in patients with ID and its correlation with insomnia in ID patients. PATIENTS AND METHODS: This study included 216 patients diagnosed with ID and 197 individuals as the healthy control (HC) group who attended the neurology outpatient clinic or sleep clinic at Henan Provincial People’s Hospital between September 2018 and November 2019. Through the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD), sleep and mental conditions were assessed in the ID and HC groups. The dietary intake structure of both groups was observed using the food frequency table. Meanwhile, the relationship between dietary intake and sleep quality was analyzed based on the logistics regression. RESULTS: Individuals in the ID group had significantly higher age, weight, and body mass index compared to the HC group (p<0.01). Individuals within the ID category demonstrated a heightened daily consumption of carbohydrates, grains, tubers, and legumes relative to the healthy control group. In contrast, the intake levels of vegetables, fruits, and nuts were diminished compared to the HC group, with this difference being statistically significant (p<0.01). A positive correlation was observed between the daily consumption of grains, tubers, and legumes and PSQI scores. Conversely, a negative association was found between daily consumption of vegetables and fruits. CONCLUSIONS: ID patients exhibit an elevated intake of carbohydrates, whereas the consumption of vegetables, fruits, and nuts is deficient in comparison to the healthy cohort, implying that a distorted dietary structure might be a contributing factor to ID onset. Sensible and scientific dietary guidance is of considerable significance in preventing the onset of ID and facilitating its management. However, the derived conclusions warrant further extensive research. [ABSTRACT FROM AUTHOR]

Norovirus outbreaks in hospitals can potentially impair patient care and result in significant financial expenses. There is currently limited information on hospital norovirus outbreaks in the Chinese mainland. To systematically review the published literature to describe the characteristics of norovirus outbreaks in Chinese mainland hospitals to facilitate prompt identification and control of outbreaks. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis standards. Databases including PubMed, Web of Science, and Chinese Journals Online databases (China National Knowledge Infrastructure (CNKI), Chinese Wan Fang digital database (WANFANG) were searched from inception to July 18th, 2022. A total of 41 norovirus Chinese hospital outbreaks occurring before July 18th, 2022 were reported in 32 articles. Most reported outbreaks were from Shanghai and Beijing, and occurred in December and January. Cases were mainly adults. The male:female ratio was 1.22:1. The majority of cases in norovirus outbreaks were hospitalized patients (56.82%); medical staff were affected in 15 outbreaks. Norovirus outbreaks occurred in both private and public hospitals, and in secondary and tertiary care centres, and occurred mainly in internal medicine and geriatric departments. Person-to-person transmission was the primary transmission mode and GII was more prevalent. Norovirus outbreaks in hospitals can affect both patients and healthcare workers, sometimes causing serious financial losses. In order to have a more complete understanding of the disease burden caused by norovirus outbreaks, surveillance needs to be established in hospitals. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Peripheral nerve block can provide effective postoperative analgesia to patients undergoing total hip arthroplasty (THA). This study aimed to compare ultrasound-guided pericapsular nerve group (PENG) block against anterior quadratus lumborum (AQL) block for pain management in primary THA. PATIENTS AND METHODS: In this prospective, double-blind, randomized controlled trial, 90 patients undergoing primary THA under general anesthesia were randomly allocated to receive ultrasound-guided PENG block + sham AQL block ("PENG group") or ultrasound-guided AQL block + sham PENG block ("AQL" group). The primary outcome was the highest pain score on a visual analogue scale while the patient was in the recovery room. Secondary outcomes included pain scores after transfer out of the recovery room, morphine consumption, quadricep strength, duration of hospitalization, pain level one year after surgery, and incidence of complications. RESULTS: Patients in the PENG group reported significantly lower maximum pain scores in the recovery room (31.3±9.1 vs. 37.3±7.4, p=0.001), as well as significantly lower pain scores at rest at 3 h after surgery and during motion at 3 and 6 h after surgery. The two groups did not differ significantly in postoperative morphine consumption, length of hospitalization, pain level at one year after surgery, or incidence of complications. Neither block significantly weakened the quadriceps. CONCLUSIONS: PENG block may provide slightly more effective postoperative analgesia than AQL block during the early recovery period after primary THA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In this work, based on intelligent computing, the biological signals of patients were analyzed to investigate the hemodynamic changes and pulmonary complications of Nalmefene Hcl combined with general anesthesia (GA) in laparoscopic gynecological tumor surgery (GTS). PATIENTS AND METHODS: Eighty computer-aided GTS patients were randomly divided into a control group (n = 40) and an observation group (n = 40). Biomedical electrocardiogram (ECG) signals were detected by wavelet neural network in all patients undergoing laparoscopic gynecological tumor surgery and were computerized according to the android interface definition language model (AIDL). GA was used during surgery. The observation group was injected intravenously with 0.2 μg/kg naproxenacin hydrochloride after operation. The control group was given 1 mL 0.9% sodium chloride solution after operation. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SPO), coma score, and adverse reactions (AR) were compared between the two groups at 10, 20, and 30 minutes after wakefulness. The hemodynamic parameters between the two groups were compared. Serum urocholine (URO) and creatinine (Cre) levels were analyzed in patients without complications. RESULTS: ECG waveform based on wavelet neural network has a high recognition rate and strong generalization ability. 37 patients in the observation group recovered within 10 minutes after surgery, and the recovery rate at 30 minutes was 95%. 30 patients in the control group awoke 10 minutes after the operation, and the recovery rate at 30 minutes m-AR was 75%. The average abstract windows toolkit (AWT) of the observation group and control group was 11.87 ± 5.78 min and 16.46 ± 5.32 min, respectively, and the difference was significant (p < 0.05). There were significant differences in HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the observation group and the control group during the extubation (p < 0.05). Blood gas indexes PaO2, PvO2, PaCO2, and PvCO2 in the observation group were significantly different from those in the control group half an hour after the operation and half an hour after pneumoperitoneum (p > 0.05). CONCLUSIONS: Intelligent computational biological signal detection was beneficial to the development of surgery. Nalmefene Hcl combined with GA on the basis of the AIDL model has a significant effect on the awakening of GTS patients and can shorten sleep time. Patients with underlying cardiac disease were more likely to develop postoperative lung complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study will explore whether the femoral neck osteotomy angle (FNOA) has an effect on hip anatomical functional reconstruction and clinical outcomes after total hip arthroplasty (THA). PATIENTS AND METHODS: The study included 254 patients (296 hips) who underwent primary total hip arthroplasty using the same uncemented short stem (Tri-Lock BPS) between December 2018 and December 2019. Correlations between FNOA and the radiologic and clinical outcomes of patients were analyzed. RESULTS: Patients were divided into 3 groups according to different FNOA. FNOA ≤50° is Group A, 50°< FNOA <55° Group B, and FNOA ≥55° Group C. There were significant differences among the three groups in distal D1 (p=0.029), sitting proud (SP) (p<0.001), varus and valgus alignment (p<0.001), FO (p=0.001), and caput-collum-diaphysis angle (CCD) (p<0.001). There were significant differences in the incidence of complications among the three groups (p<0.007). There was a significant linear correlation with D1 (B=0.005, CI=0.002 to 0.008, p=0.004), SP (B=-0.266, CI=-0.286 to 0.166, p<0.001), the femoral stem varus-valgus alignment angle (B=-0.359, CI=-0.422 to -0.297, p<0.001), femoral offset (FO) (B=-0.500, CI=-0.795 to -0.205, p=0.001), and CCD (B=0.696, CI=0.542 to 0.849, p<0.001). In logistic regression analysis, inappropriate FNOA increased the risk of dislocation (OR=0.892, CI=0.812 to 0.979, p=0.016) and thigh pain (OR=0.920, CI=0.851 to 0.995, p=0.037). CONCLUSIONS: The study demonstrates the relationship between FNOA and short-term radiological and clinical outcomes of patients after THA using a Tri-Lock femoral prosthesis. Inappropriate FNOA was significantly associated with failure of hip anatomical reconstruction and a higher risk of complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to compare the efficacy and safety of laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) to determine which one provides a better outcome for patients with gallbladder and common bile duct stones. MATERIALS AND METHODS: An electronic literature search was undertaken using Embase, Medline, PubMed, and Cochrane Library databases up to April 2022. For quality assessment of included studies, randomized controlled trials (RCTs) were assessed by utilizing the Jadad scale. The primary outcome includes surgical success rate, retained stone rate, stone clearance rate, major morbidity, and mortality. The second outcome includes conversion to open surgery rate, postoperative pancreatitis, bile leakage, cholangitis, hemorrhage, pneumonia, and surgical-site infection. RESULTS: 14 randomized controlled trials with 2,181 patients were included. No significant difference was seen between the two groups in terms of surgical success, stone clearance, retained stones, operation time, and total morbidity. LC-LCBDE had higher rate of bile leakage [relative risk (RR): 4.52; 95% confidence interval (CI): 2.19-9.31] and lower rate of postoperative pancreatitis (RR: 0.25; 95% CI: 0.13-0.46), cholangitis (RR: 0.17; 95% CI: 0.05-0.67), and hemorrhage (RR: 0.18; 95% CI: 0.07-0.42). CONCLUSIONS: Both LC+LCBDE and LC+ERCP are safe, effective, and minimal-invasive treatments for concomitant gallbladder and CBD stones. LC-LCBDE was associated with comparable effects compared with LC+ERCP in terms of surgical success rate, stone clearance rate, retained stones rate, operation time, and total morbidity. At the same time, LC-LCBDE had a higher rate of bile leakage and a lower rate of postoperative pancreatitis, cholangitis, and hemorrhage. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate the correlation between high-resolution CT (HRCT) signs and serum tumor markers, to improve the diagnostic level and identify different pathological types of lung cancer. PATIENTS AND METHODS: 102 patients with pathologically confirmed lung cancer were selected as the observation group. HRCT scan and serum tumor markers [cancer antigen 125 (CA125), squamous cell carcinoma antigen (SCCA), and neuron-specific enolase (NSE)] were performed to analyze the correlation. RESULTS: Among the 102 cases of lung cancer, 88 cases were of lobulation sign, 78 cases of speculation sign, 45 cases of pleural indentation sign, 35 cases of vessel tracking sign, and 34 cases of vacuole sign. CA125 had the highest concentration in lung adenocarcinoma (55.74±14.18) ng/ml, and SCCA had the highest concentration in lung squamous cell carcinoma (18.98±6.37) ng/ml. The concentration of NSE in small cell lung cancer was the highest (48.12±16.19) ng/ml. CONCLUSIONS: Pleural indentation sign and vacuole sign were more likely to happen in lung adenocarcinoma and lung squamous cell carcinoma, respectively. The significant increase of CA125, SCCA, and NSE concentrations suggested that lung cancer patients were more likely to suffer from lung adenocarcinoma, lung squamous cell carcinoma, and small cell lung cancer, respectively. [ABSTRACT FROM AUTHOR]

This study addresses the measurement of three-dimensional (3D) bubble rising behaviour in still water with bubble equivalent diameters ranging from 2.61 mm to 5.11 mm using high-speed imaging and virtual stereo vision technology. The bubble shape, 3D trajectory/velocity, displacement angular frequency and terminal velocity of bubbles are analysed. The bubble equivalent diameter is obtained by the elliptic volume method. The bubbles are divided into small and large bubbles with a critical equivalent diameter of 4.49 mm, according to whether they are accompanied by deformation. The small bubbles (deq<4.49 mm) are spherical or ellipsoid, while the large bubbles (deq=4.49 mm) exhibit ellipsoid, mushroom and hat shapes. The 3D trajectory is obtained by 3D reconstruction of bubble centroid coordinates. The rising trajectory of small bubbles shows 3D spiral motion, while the pitch increases gradually with the increase in the equivalent diameter. The trajectory of large bubbles is a two-dimensional (2D) zigzag. The bubble displacement curves in x- and z-directions are evaluated with third-order Fourier fitting. The results show that the bubble displacement frequency in the xand z-directions decreases with the increasing bubble diameter, and the displacement frequency in the xdirection is larger than that in the z-direction. The relative proportions of the viscous force, buoyancy, surface tension and inertial force on bubbles with different equivalent diameters are different, which leads to three trends in the vertical velocity of bubbles within the diameter range of this study. Finally, the bubble terminal velocity in still water is investigated. The terminal velocity first decreases and then increases with the increase in the equivalent diameter. The minimum value is 16.17 cm/s when the diameter of the bubble equivalent diameter is 4.49 mm. Moreover, the applicability of some classical prediction models is discussed. [ABSTRACT FROM AUTHOR]

Understanding how hydrological features affect habitat invasibility is crucial for predicting whether variations of such hydrological features may act as important inducement regulating range-expansion of invasive species in tidal channel-salt marsh systems. Although lateral hydrological connectivity (LC), or the hydrological connections between tidal channels and adjacent marsh flats, is an important hydrological feature, its effect on plant invasion has rarely been studied in depth. Here, we examined the effects of lateral hydrological connectivity on range-expansion of Spartina alterniflora (S. alterniflora) in tidal channel margins of a typical tidal channel-salt marsh system, in the Yellow River Delta, China. Field surveys and transplanting experiments showed that high LC greatly favors S. alterniflora to expand its invasion ranges along tidal channel margins by mediating such habitat physical forms of stress as soil salinity, soil moisture and soil hardness. In contrast, low LC, exacerbates those forms of stress, thereby significantly checking the lateral expansion of S. alterniflora. Moreover, human-made and naturally formed geomorphic structures in salt marshes (e.g., artificial ditches, pools, and hollow microtopography), particularly at high elevations, could potentially enhance LC over time, thereby making such sites prone to invasion by S. alterniflora. These results highlight the importance of lateral hydrological connectivity as an essential driver to regulate S. alterniflora lateral expansion along with the tidal channels. Our results imply that considering the relationships between hydrological processes and spread processes of exotic species should be incorporated into future management frameworks for risk assessment and ecological control of invasive plant species. [ABSTRACT FROM AUTHOR]

"A Ming Confucian's World: Selections from Miscellaneous Records from the Bean Garden" is a book by Lu Rong, translated by Mark Halperin. The book offers a glimpse into the personal history and reflections of Lu Rong, who lived during the Ming dynasty in Suzhou, Jiangnan. Lu Rong's writings follow the Biji genre, recording trivial anecdotes and thoughts on cultural traditions. The book is divided into five chapters, covering topics such as social life, family and gender, politics and government, deities and clergy, and knowledge and technology. The translation by Halperin, along with the introduction, provides valuable insights into Lu Rong's world and is a useful resource for understanding late imperial China. [Extracted from the article]

OBJECTIVE: Obesity and overweight are risk factors for chronic disease worldwide. The purpose of this study was to compare the transcriptome of exercise-induced fat mobilization in obese people, and to explore the effect of different exercise intensity on the correlation of immune microenvironment remodeling and lipolysis in adipose tissue. MATERIALS AND METHODS: Microarray datasets of adipose tissue before and after exercise were downloaded from the Gene Expression Omnibus. Then, we used gene-enrichment analysis and PPI-network construction to elucidate the function and enrichment pathways of the differentially expressed genes (DEGs) and to identify the central genes. A network of protein-protein interactions was obtained using STRING and visualized with Cytoscape. RESULTS: A total of 929 DEGs were identified between 40 pre-exercise (BX) samples and 65 post-exercise (AX) samples from GSE58559, GSE116801, and GSE43471. Among these DEGs, adipose tissue-expressed genes were duly recognized. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses indicated that DEGs were mostly enriched in lipid metabolism. Studies have found that mitogen-activated protein kinase (MAPK) signaling pathway and forkhead box O (FOXO) signaling pathway are up-regulated, while Ribosome, coronavirus disease (COVID-19) and IGF-1 gene are down-regulated. Although we found the up-regulated genes that noted IL-1 among others, and the down-regulated gene was IL-34. The increase of inflammatory factors leads to changes in cellular immune microenvironment, and high-intensity exercise leads to increased expression of inflammatory factors in adipose tissue, leading to inflammatory responses. CONCLUSIONS: Exercise at different intensities leads to the degradation of adipose and is accompanied by changes in the immune microenvironment within adipose tissue. High intensity exercise can cause the imbalance of immune microenvironment of adipose tissue while causing fat degradation. Therefore, moderate intensity and below exercise is the best way for the general population to reduce fat and weight. [ABSTRACT FROM AUTHOR]

This paper concentrates on the trajectory tracking problem for a stratospheric airship subject to underactuated dynamics, unmeasured velocities, modeling inaccuracies and environmental disturbances. First, a coordinate transformation is performed to solve the underactuated issue, which simultaneously permits a priori assignment of the tracking accuracy. Second, a finite-time observer is integrated into the control structure to offer the exact information of unmeasured velocities and uncertainties in an integral manner. Then, by combining the backstepping technique with the method of adding a power integrator, a new output-feedback control strategy is derived with several salient contributions: (1) the airship's position errors fall into a predetermined residual region near zero within a finite settling time and stay there, while all the closed-loop signals maintain bounded during operation; and (2) no artificial neural networks and filters are adopted, resulting in a low-complexity control property. Furthermore, the presented method can be extended readily to a broad range of second-order mechanical systems as its design builds upon a transformed system model. Rigorous mathematical analysis and simulations demonstrate the above theoretical findings. [ABSTRACT FROM AUTHOR]

Background: Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) poses serious challenges to public health. Only a few sporadic reports of strains co-producing NDM-1 and KPC-2 (NDM-1-KPC-2-CR-hvKP strains) are available to date.Objectives: This retrospective study investigated the clinical features, prevalence and antibiotic resistance of hvKP in a tertiary hospital in central China, and characterized an NDM-1-KPC-2-CR-hvKP strain (KP169).Methods: Clinical data were collected. Antimicrobial and virulence-associated phenotyping and genotyping, capsular serotype gene analysis and multi-locus sequence typing of hvKP isolates were performed. Whole-genome sequencing (WGS) was performed on strain KP169.Results: Forty-five of 109 K. pneumoniae clinical isolates were hvKP. Of these, 37 originated from nosocomial infections and 24 expressed carbapenemases. Eight NDM-1-KPC-2-CR-hvKP strains were identified, and enterobacterial repetitive intergenic consensus polymerase chain reaction showed that they were clonally related. WGS revealed that strain KP169, which belongs to ST11-K64, had a single 5.5-Mb chromosome and six plasmids of 5.5-221.6 kb. The blaNDM-1 gene was located on plasmid pKP169-P3, and blaKPC-2, blaSHV-12 and blaTEM-1 were located on IncFII/IncR pKP169-P2. IncHI 1/IncFIB virulence plasmid pKP169-P1 was similar to pKPC-CR-hvKP-C789 plasmid reported previously. Plasmid stability testing showed that blaKPC-2- and blaNDM-1-harbouring plasmids were maintained stably in the host.Conclusion: To the best of the authors' knowledge, this study identified the largest cohort, to date, of eight NDM-1-KPC-2-CR-hvKP strains, and suggests that antimicrobial stewardship and protocols to prevent transmission are needed urgently. [ABSTRACT FROM AUTHOR]

The term 'hydrological connectivity' is used in different disciplines to refer to the water-mediated transfer of matter, energy, and/or organisms within or between elements of the hydrologic cycle. Extensive research has been devoted to methods of evaluating hydrological connectivity. However, most of these methods pertain to the connectivity of runoff, sediment, chemicals, and organisms. To our knowledge, no evaluation of thermal energy connectivity has been conducted to date, and there is no consistent assessment framework available that takes into account thermal energy connectivity based on flux. Thermal energy flux affects many basic biogeochemical reaction processes and ecological functions of healthy river-lake systems. Here, we propose a method to evaluate runoff and thermal connectivity based on a modified version of the index of runoff/sediment connectivity proposed by Borselli et al. (2008). It was tested in an urban area (Tongling, China, which covers an area of 3008 km2) — characterized by the presence of numerous rivers and lakes — during normal, wet, and dry periods from year 2016 to year 2018. We found that areas with poor runoff connectivity exhibited high thermal connectivity in dry periods. Connectivity variation in lakes was higher than that in rivers. Models of the measured data were satisfactory for the test periods. Overall, our results indicate that public data can be used to map runoff and thermal connectivity within an existing joint evaluation framework. Evaluations of thermal connectivity can assist research on hydrological connectivity, and the proposed method can serve as a valuable tool for analyzing the runoff and thermal connectivity of urban river-lake systems. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Currently, there are still no convincing clinical models predicting closed lower extremity fracture-associated deep vein thrombosis in patients treated through thromboprophylactic methods. We aimed at using two retrospective cohorts to develop and externally verify a clinical prediction model for deep vein thrombosis in patients treated with anticoagulants after suffering closed lower extremity fractures. PATIENTS AND METHODS: We evaluated the patients’ pre- and post-operatively, to accurately determine the predictive power of the biomarkers and clinical risk factors. Two retrospective cohorts were used for the development and external verification of a pre-operative clinical prediction model (development: n = 2,253; verification: n = 833) and post-operative clinical prediction model (development: n = 1,422; verification: n = 449), respectively. RESULTS: The C-indices were used to show the predicted incidence of objective thrombosis at the pre- and post-operative stage, which were then compared with the observed incidence of thrombosis in both cohorts. Biomarkers and clinical indicators were included in pre- and post-operative nomograms, which were adequately calibrated in both cohorts. The cross-validated C-indices of the pre- and post-operative clinical prediction models in the verification cohort were 0.706 (95% Cl, 0.67-0.74) and 0.875 (95% Cl, 0.84-0.91), respectively. CONCLUSIONS: We present our findings of novel pre- and post-operative nomograms for the prediction of deep venous thrombosis in patients who received thromboprophylaxis after suffering closed lower extremity fractures. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of our study was to determine whether abnormal hyperplasia of chondrocytes occurs in glucocorticoid-induced osteonecrosis of the femoral head (GC-ONFH) using a well-established rat model. MATERIALS AND METHODS: Rats were injected with lipopolysaccharide and methylprednisolone to induce GC-ONFH, while control animals were injected with saline (12 animals per group). Establishment of the disease model was confirmed using micro-computed tomography and hematoxylin-eosin (HE) staining of femoral head tissue sections. Chondrocyte hyperplasia was detected using HE staining and semi-quantitated using toluidine blue and saffron O staining. Expression of the autophagy marker LC3B was assessed in cartilage tissues of femoral head using immunohistochemistry. RESULTS: G C-ONFH a nimals s howed s ignificantly greater area of abnormal chondrocyte hyperplasia in femoral head tissue sections than control animals. They also showed significantly higher expression of LC3B in articular cartilage of the femoral head. CONCLUSIONS: GC-ONFH may be associated with abnormal chondrocyte hyperplasia in articular surface cartilage, which may be related to glucocorticoid-induced overactivation of autophagy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Our aim is to analyze the effect of adaptive roller-skating on emotional regulation of autistic children. MATERIALS AND METHODS: Adaptive roller-skating course was designed for autistic children based on adaptive sports and A-B-A experiments. RESULTS: The adaptive roller-skating intervention focuses on improving emotional regulation ability, and directs the children to reasonably vent, recognize and stabilize their emotions. Adaptive roller-skating has a significant effect in intervening sadness, anger, anxiety and fear in autistic children; the intervention content setting and difficulty setting of the course have a certain impact on the intervention effect. Highly difficult and risky content can stimulate children. CONCLUSIONS: Adaptive roller-skating intervention course should obey the concept of adaptive movement in view of the differences between autistic children and the fun of roller-skating and guide the autistic children in emotion regulation with positive emotions. [ABSTRACT FROM AUTHOR]

Objectives: Although subchondral bone marrow lesions (BMLs) and synovitis have been well acknowledged as important sources of pain in knee osteoarthritis (KOA), it is unclear if synovitis plays the mediating role in the relationship between BMLs and knee pain.Methods: We analyzed 600 subjects with magnetic resonance imaging (MRI) in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium (FNIH) cohort at baseline and 24-month. BMLs and synovitis were measured according to the MRI Osteoarthritis Knee Score (MOAKS) scoring system. BMLs were scored in five subregions. A summary synovitis score of effusion and Hoffa-synovitis was calculated. Knee pain was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Linear regression models were applied to analyze the natural direct effect (NDE) of BMLs and synovitis with knee pain, respectively, and natural indirect effect (NIE) mediated by synovitis.Results: 590 participants (58.8% females, with a mean age of 61.5) were included in the present analyses. For NDE, knee pain was cross-sectionally associated with medial femorotibial BMLs (β = 0.23, 95% CI: 0.09, 0.38) and synovitis (β = 0.40, 95% CI: 0.20, 0.60). Longitudinal associations retained significant [medial femorotibial BMLs (β = 0.37, 95% CI: 0.21, 0.53); synovitis (β = 0.72, 95% CI: 0.45, 0.99)]. In the NIE analyses, synovitis mediated the association between medial femorotibial BML and knee pain at baseline (β = 0.051, 95% CI: 0.01, 0.09) and over 24 months (β = 0.079, 95% CI: 0.023, 0.15), with the mediating proportion of 17.8% and 22.4%, respectively.Conclusion: Synovitis partially mediates the association between medial femorotibial BMLs and knee pain. [ABSTRACT FROM AUTHOR]

Aggregation of fluidization media may appear at the dense phase region of the pant-leg fluidized bed near the incline walls. When the particles flow along the inclined wall, the friction and drag force will cause the particles to accumulate on the inclined wall, resulting in an uneven distribution of particles. The stagnant zones can be minimized by correctly arranging secondary air. Computational particle fluid dynamics (CPFD) method was used to simulate the gas-solid two-phase flow pattern in the dense phase region of pant-leg fluidized bed. Cold tests were performed on a benchtop pant-leg fluidized bed. A high speed imaging technology was used to monitor the flow pattern in the dense phase area, whereas the bubble size and residence time were compared to verify the accuracy of the simulation. The gas-solid flow patterns under various models were simulated. The influence of different secondary air velocities on the reduction of stagnant zone in the dense phase zone of the fluidized bed were predicted. The results indicated that the introduction of secondary air could effectively promote the mixing of particles, and weaken the accumulation of particles on the inclined wall surface. Moreover, secondary air can effectively promote the flow between the gas-solid two-phases and improve the combustion characteristics in the furnace. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the clinical value of high mobility group box-1 (HMGB-1), C-reactive protein (CRP), procalcitonin (PCT), and CRP to albumin (Alb) ratio in the diagnosis and evaluation of the severity of sepsis in children. PATIENTS AND METHODS: A total of 90 children, 50 with sepsis and 40 with general infection, whose symptoms did not meet the criteria for diagnosis of sepsis, were admitted to the Pediatrics Department of Jingzhou Central Hospital in Hubei Province between November 2021 and December 2022, were enrolled and selected as experimental and control group, respectively. The serum of two groups was collected within 24 hours after admission, the levels of HMGB-1 were detected by enzyme-linked immunosorbent assay (ELISA), and CRP, PCT, Alb, and hospitalization days were recorded. The differences in indicators between the two groups were compared, and correlation analysis was performed between hospitalization days and various indicators. The receiver operating characteristic (ROC) curve was drawn to evaluate the independent or combined value of CRP, PCT, HMGB-1, and CRP/Alb ratio in the early diagnosis of sepsis in children. RESULTS: These four indicators of children with sepsis were significantly higher than those in the general infection group (all p=0.000). The levels of CRP, PCT and CRP/Alb ratio were significantly positively correlated with the hospitalization days (r=0.329, 0.333, 0.329; p=0.02, 0.01, 0.002). The area under curve (AUC) of CRP, PCT, HMGB-1, and CRP/Alb ratio for the diagnosis of sepsis in children was 0.798, 0.817, 0.838, 0.809, respectively, and that of the combination of four indicators was 0.952. CONCLUSIONS: CRP, PCT, HMGB-1, and CRP/Alb ratio resulted as effective indicators for early diagnosis and evaluation of childhood sepsis, having a higher value in combined diagnosis. [ABSTRACT FROM AUTHOR]