Search

Modern digitalization technology known as Industrial Revolution 4.0 (IR 4.0) has the potential to enhance business operations and communication networks across a variety of sectors. The lack of high-tech processes and technology in the construction industry, however, is growing the distance between the industry and IR 4.0 change. There has not been any prior research on the drivers and challenges of the IR 4.0 transition in the construction industry using DEMATEL. Therefore, the DEMATEL method was utilised to assess the interaction between the drivers and barriers of the IR 4.0 revolution in the construction industry. From the literature review, a list of factors that influence and hinder growth was taken. During interviews, 17 experts provided data using the DEMATEL questionnaire, which was subsequently used for analysis. The impact-relation map diagram showed key elements and their relationships. The outcome demonstrates challenges with the Incompatibility of Innovations (P) is the most significant issue, which is a major barrier that must be overcome. As a result, the listed drivers can be improved further, and the mentioned barriers can be overcome.

We compared endoscopic "calabash" ligation and resection (ECLR) and endoscopic submucosal excision (ESE) in treating endophytic gastric stromal tumors (GSTs) ≤15 mm in diameter originating from the muscularis propria.We performed a retrospective study and included patients who visited our hospital for removal of small endophytic GSTs (diameter ≤ 15 mm) confirmed by postoperative pathological reports between February 2019 and December 2020. Patients were assigned to the study (received ECLR) or control (accepted ESE) groups, and their medical records were reviewed. Age, sex, GST size, resection outcomes, procedure measurements, lengths of hospital stays, medical expenses, intraoperative and postoperative complications, and follow-up outcomes were documented and compared between the two groups. Propensity score matching was used to avoid retrospective biases.A total of 277 patients were included in the analysis, with 135 in the study group and 142 in the control group. After propensity score matching, 119 cases in each group were finally included in the study. Compared to the control group, the study group had significantly shorter procedure durations and lengths of hospital stays, as well as reduced medical expenses. Compared to the control group, the study group also had significantly lower incidence rates of intraoperative stomach perforation, postoperative intraperitoneal infection, and postoperative electrocoagulation syndrome, as well as a lower intensity of postoperative pain. There were no significant differences in the other measurements between the two groups.ECLR is an effective and safe procedure for treating patients with endophytic GSTs ≤15 mm in diameter originating from the muscularis propria.

Research on the development of flexible silica aerogels (FSAs) has been ongoing due to their excellent thermal insulation, low density, and high elasticity. However, the physical properties of FSAs, such as density, thermal conductivity, mechanical strength, and surface wettability, are highly dependent on the preparation conditions. To achieve the desired properties of FSAs for various applications, it is necessary to develop a method to fine-tune their physical properties. In this paper, two modifiers of methyltrimethoxysilane (MTMS)/trimethylethoxysilane (TMES) were employed to fine-tune the bulk density of a series of flexible silica aerogels (FSAs), reflecting a series of FSAs with fine-tunable physical properties. First, the precursor was synthesized by a click reaction between vinyltrimethoxysilane (VTMS) and 2,2′ (ethylenedioxy) diethanethiol (EDDET). The VTMS, EDDET, and the as-prepared precursor were characterized by FT-IR and NMR spectroscopy. Subsequently, the precursor was converted into a series of FSAs (denoted by FSA, FSA-M, and FSA-T) through conventional sol-gel reactions with/without MTMS/TMES. Chemical structures of synthesized FSAs were confirmed by 13C and 29Si solid-state NMR spectroscopy. The porous structure of FSAs was identified by BET and SEM, respectively. Physical properties, such as thermal conductivity, mechanical strength, and surface wettability of FSAs were determined by a Hot Disk, durometer/DMA in compression mode, and contact angle measurements, respectively. This study found FSAs containing none, 1 wt%, 5 wt%, and 10 wt% of MTMS increase the density of FSAs from 0.419 g/cm3 (FSA), 0.423 g/cm3 (FSA-M1), 0.448 g/cm3 (FSA-M5), and 0.456 g/cm3 (FSA-M10). It should be noted that the thermal conductivity, surface hardness, bulk mechanical strength, and hydrophobicity of FSA-Ms of increasing MTMS loading were all found to show a rising trend, while FSA-Ts exhibited lower density. FSA-T10 exhibited lower thermal conductivity, surface hardness, and bulk mechanical strength as compared to FSA. However, it was found to show higher hydrophobicity as compared to that of FSA.

BACKGROUND Liver cirrhosis is the main cause of portal hypertension. The leading cause of death in patients with liver cirrhosis is its most common complication, esophageal variceal bleeding (EVB). Endoscopic variceal ligation (EVL) is recommended by many guidelines to treat EVB and prevent rebleeding; however, esophageal ulcers occur after treatment. Delayed healing of ulcers and unhealed ulcers lead to high rebleeding and mortality rates. Thus, the prevention of early postoperative rebleeding is of great significance in improving the quality of life and prognosis of patients. AIM To evaluate the efficacy of aluminum phosphate gel (APG) plus a proton pump inhibitor (PPI) in the prevention of early rebleeding after EVL in patients with EVB. METHODS The medical records of 792 patients who were diagnosed with EVB and in whom bleeding was successfully stopped by EVL at Shenzhen People’s Hospital, Guangdong Province, China from January 2015 to December 2020 were collected. According to the study inclusion and exclusion criteria, 401 cases were included in a PPI-monotherapy group (PPI group), and 377 cases were included in a PPI and APG combination therapy (PPI + APG) group. We compared the incidence rates of early rebleeding and other complications within 6 wk after treatment between the two groups. The two-sample t-test, Wilcoxon rank-sum test, and chi-squared test were adopted for statistical analyses. RESULTS No significant differences in age, sex, model for end-stage liver disease score, coagulation function, serum albumin level, or hemoglobin level were found between the two groups. The incidence of early rebleeding in the PPI + APG group (9/337; 2.39%) was significantly lower than that in the PPI group (30/401; 7.48%) (P = 0.001). Causes of early rebleeding in the PPI group were esophageal ulcer (3.99%, 16/401) and esophageal varices (3.49%, 14/401), while those in the PPI + APG group were also esophageal ulcers (5/377; 1.33%) and esophageal varices (4/377; 1.06%); such causes were significantly less frequent in the PPI + APG group than in the PPI group (P = 0.022 and 0.024, respectively). The early mortality rate within 6 wk in both groups was 0%, which was correlated with the timely rehospitalization of all patients with rebleeding and the conduct of emergency endoscopic therapy. The incidence of adverse events other than early bleeding in the PPI + APG group (28/377; 7.43%) was significantly lower than that in the PPI group (63/401; 15.71%) (P < 0.001). The incidence of chest pain in the PPI + APG group (9/377; 2.39%) was significantly lower than that in the PPI group (56/401; 13.97%) (P < 0.001). The incidence of constipation in the PPI + APG group (16/377; 4.24%) was significantly higher than that in the PPI group (3/401; 0.75%) (P = 0.002) but constipation was relieved after patients drank more water or took lactulose. In the PPI and PPI + APG groups, the incidence rates of spontaneous peritonitis within 6 wk after discharge were 0.50% (2/401) and 0.53% (2/377), respectively, and those of hepatic encephalopathy were 0.50% (2/401) and 0.27% (1/377), respectively, presenting no significant difference (P > 0.999). CONCLUSION PPI + APG combination therapy significantly reduces the incidence of early rebleeding and chest pain in patients with EVB after EVL.

Context Qingluoyin (QLY) is a traditional Chinese medicine (TCM) formula which has been used in treating human rheumatoid arthritis (RA) for years in China. Objective This study investigates the effect of QLY granules on adjuvant arthritis (AA) and the possible mechanism. Materials and methods Sprague-Dawley (SD) rats were injected with Complete Freund’s adjuvant (CFA) to induce the AA model. After the onset of arthritis, rats received intragastric administrations of the QLY granules (1.35, 2.70, and 5.40 g/kg) or Tripterygium glycosides (TG) tablets (positive drug, 10 mg/kg) for 14 d. After 28 d immunization, the symptoms, inflammatory parameters and molecular mechanisms were investigated. Results In the QLY granule (1.35, 2.70, and 5.40 g/kg) therapy groups, the arthritis index decreased to 6.30 ± 2.06, 5.80 ± 1.55, 5.30 ± 1.16 compared with the model (9.00 ± 3.01), paw swelling decreased to 1.56 ± 0.40, 1.28 ± 0.38, 1.12 ± 0.41 mL compared with the model (2.22 ± 0.73 mL). QLY granules (1.35, 2.70 and 5.40 g/kg) significantly reduced the thymus and the spleen indexes, inhibited the production of pro-inflammatory cytokines, and alleviated the pathological changes of joints compared with the model group. Furthermore, the treatment of QLY granules (2.70 and 5.40 g/kg) markedly inhibited CXCL12, CXCR4 (in spleen and synovium) and p-NF-κB p65 (in synovium) protein expression of AA rats. Conclusions QLY granules have obvious therapeutic effects on AA rats, which may be associated with downregulating the CXCL12/CXCR4-NF-κB signalling pathway. QLY granules can be used as a candidate for the treatment of RA, which deserves further study.

Waldenström’s macroglobulinemia (WM) is an uncommon lymphoproliferative disorder, and the precise cellular landscape and the mechanisms of progression from IgM monoclonal gammopathy of undetermined significance (MGUS) to WM remain unclear. We performed single-cell RNA sequencing of CD19 + and CD19-CD38 + cells from healthy donors, IgM MGUS and WM patients. We found that samples from IgM MGUS and WM patients were composed of fewer early B-cell subsets and more T cells and NK cells than those from healthy controls. Compared with those of IgM MGUS patients, mature B cells of WM patients showed upregulation of HES1, GADD45B, NEAT1, DUSP22, RGS1, RGS16, and PIM1. We also identified a subpopulation of CD3 + CD19 + cells in IgM MGUS and WM patients, and trajectory analysis suggested that this subpopulation might be a stem cell-like subset. Further targeted gene sequencing of CD3 + CD19 + and CD3-CD19 + cells proved that MYD88 might be the early events in tumorigenesis according to variant allele fraction analysis. Additional subclonal hits such as CXCR4 and MAP2K1 mutations could be acquired during tumor progression. CXCL signaling, CCL signaling, IL2 signaling and TGFβ signaling pathways were involved in communication between CD3 + CD19 + cells and other immune cells. Our findings reveal the composition of CD38 + immune microenvironment together with B cells and plasma cells in IgM MGUS and WM patients, and provide comprehensive insights into mechanisms of progression from IgM MGUS to WM. The rare CD3 + CD19 + cells might be cells with “stemness” feature.

Background. The present work aims at formulating the melatonin-loaded nanoparticles (MTNPs) exhibiting the controlled-release and pH-sensitivity to repurpose the use of melatonin in the treatment of depressive-like behaviors and hypothalamus-pituitary-adrenal (HPA) axis dysregulation.Methods. MTNPs were characterized for the size, drug incorporation, andin vitrorelease in the different pH environments. Its merits werein vivotested on the pinealectomized rats presenting the depressive-like behaviors and the abnormal HPA axis activity by calculating the improvement on saccharin preference, swimming immobility time, and the negative feedback of HPA axis.Results. Results revealed that MTNPs showed nanometer size, 15.77% of drug loading, 33.82% of encapsulation efficiency, the different controlled-release profiles in different pH environments (pH 1.2, pH 6.8, and pH 7.4), more sensitivity release in simulated intestinal fluid (pH 7.4) and blood (pH 6.8), and less sensitivity release in simulated gastric fluid (pH 1.2). Furthermore, MTNPs displayed better antidepressant actions in reducing the immobility time of forced swimming test, increasing the preference for saccharin, and sensitizing the blunt negative feedback of HPA axis, when compared to the free melatonin.Conclusions. The controlled-release nanoparticles is shown to be an effective improvement on the dosage form for melatonin, which is worthy of futuristic and complete evaluation.

Background Published researches have suggested some associations between PPAR‐γ and ischemic stroke (IS) development. This meta‐analysis was conducted to evaluate the association between PPAR‐γ gene polymorphisms and IS risk. Materials and methods A systematic search was conducted in PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and WanFang databases. The pooled association of odd ratios (ORs) and its 95% confidence interval (CI) was calculated to assess the IS risk of PPAR‐γ rs1801282 C/G and rs3856806 C/T polymorphisms. Furthermore, the heterogeneity test, cumulative analyses, sensitivity analyses, and publication bias were conducted. Result Sixteen publications with 3786 cases and 5343 controls were identified. Overall findings indicated that rs1801282 C/G polymorphism may be associated with an increased risk for IS (GG vs. CC: OR = 2.17 95%CI = 1.09–4.35, p = .03, I 2 = 0%; GG vs. CC+CG: OR = 2.15, 95%CI = 1.07–4.32, p = .03, I 2 = 0%). The similar results were also found in the subgroup analysis. In addition, no significant association was observed between rs3856806 C/T polymorphism and IS risk. Conclusion In conclusion, our study showed that PPAR‐γ rs1801282 C/G polymorphism probably plays an important role in IS occurrence. The result should be verified with more studies in the future., Ischemic strokes (IS) are one of the most common diseases resulting in disabilities and death among adults. Our meta‐analysis indicated that the individuals with G mutation of rs1801282 C/G polymorphism would face an increased risk of IS. But there was no significant association between rs3856806 C/T polymorphism and IS risk.

Scalable deep neural network training has been gaining prominence because of the increasing importance of deep learning in a multitude of scientific and commercial domains. Consequently, a number of researchers have investigated techniques to optimize deep learning systems. Much of the prior work has focused on runtime and algorithmic enhancements to optimize the computation and communication. Despite these enhancements, however, deep learning systems still suffer from scalability limitations, particularly with respect to data I/O. This situation is especially true for training models where the computation can be effectively parallelized, leaving I/O as the major bottleneck. In fact, our analysis shows that I/O can take up to 90% of the total training time. Thus, in this article, we first analyze LMDB, the most widely used I/O subsystem of deep learning frameworks, to understand the causes of this I/O inefficiency. Based on our analysis, we propose LMDBIO—an optimized I/O plugin for scalable deep learning. LMDBIO includes six novel optimizations that together address the various shortcomings in existing I/O for deep learning. Our experimental results show that LMDBIO significantly outperforms LMDB in all cases and improves overall application performance by up to 65-fold on a 9,216-core system.

Presently, optimal proportions and synergistic mechanisms of component-based Chinese medicines are critical for developing novel strategies to treat cardiovascular diseases (CVDs). A new multi-objective optimization algorithm based on uniform design (UD) and stepwise regression (SR) modeling is proposed to find the synergistic effect of orientin (Ori), quercitrin (Que) and vitexin (Vit), the three effective components from Polygonum orientale L., using the H9c2 cells injury induced by hypoxia/reoxygenation (H/R). The optimal proportion of these three components was calculated by simulated annealing (SA). In this research, the excellent combination named OQV-e (Ori: Que: Vit =12.55 μM: 39.99 μM: 19.99 μM) could exert significant cardioprotection against the H9c2 cells injury induced by H/R through increasing cell viability, decreasing leakage rate of lactate dehydrogenase (LDH) and the level of nitric oxide (NO). Moreover, western blot analysis revealed that OQV-e could activate autophagy by inhibiting the p-JNK/JNK signaling pathway, which showed that the method (UD-SR-SA) was a feasible strategy. Mathematical system modeling may be a considerable approach for the powerful mathematical analysis of the complex pharmacological effects of component-based Chinese medicines from herbal medicines, which might greatly enhance the efficiency to find new modern Chinese drugs for CVDs based on Chinese herbal medicine (CHM) with affirmative therapeutic effect.

As a moderately toxic organophosphorus pesticide, profenofos (PFF) is widely used in agricultural practice, resulting in the accumulation of a high amount of PFF in agricultural products and the environment. This will inevitably damage our health. Therefore, it is important to establish a convenient and sensitive method for the detection of PFF. This paper reports a photoresponsive surface-imprinted polymer based on poly(styrene-co-methyl acrylic acid) (PS-co-PMAA@PSMIPs) for the detection of PFF by using carboxyl-capped polystyrene microspheres (PS-co-PMAA), PFF, 4-((4-(methacryloyloxy)phenyl)diazenyl) benzoic acid, and triethanolamine trimethacrylate as the substrate, template, functional monomer, and cross-linker, respectively. PS-co-PMAA@PSMIP shows good photoresponsive properties in DMSO/H2O (3:1, v/v). Its photoisomerization rate constant exhibits a good linear relationship with PFF concentration in the range of 0~15 μmol/L. PS-co-PMAA@PSMIP was applied for the determination of PFF in spiked tomato and mangosteen with good recoveries ranging in 94.4–102.4%.

Rationale: Despite the fact that treatment of paraquat poisoning in pregnant women and their fetuses is challenging and raises ethical issues, it is rarely reported in the literature. We report the case of a pregnant woman who took paraquat intentionally. Patient concerns: A 36-year-old woman at 38+ weeks gestational age, in an apparent suicide attempt, drank 1 mouthful (about 20 ml) of paraquat solution. Ten hours later, her urine dithionate test showed light blue color with a plasma paraquat concentration of 0.547 μg/ml. Six hours after admission, a male infant, whose plasma paraquat concentration was 0.761 μg/ml, together with 0.673 μg/ml in the amniotic fluid measured by high-performance liquid chromatography, was delivered but the woman's lung, liver, and kidney function declined rapidly. Diagnosis: 1. Acute paraquat poisoning; 2. Third trimester of pregnancy (38+ weeks); 3. Placenta previa. Interventions: Because of placenta previa and multiple organ failure, emergency cesarean section, and panhysterectomy were performed for the pregnant woman. Intravenous injection of antibiotic to prevent infection and dexamethasone 30 mg once a day were administered. Mechanical ventilation was performed for the infant and meropenem and penicillin injection was administered. Outcomes: The infant died 33 hours after birth while the mother died on the 3rd day after ingestion. Lessons: Paraquat can enter the fetus through the placenta and the amniotic fluid via fluid exchange. The pathological changes of fetal organs may relate to gestational age, and the prognosis was very poor in both the mother and the fetus.

Objective Spontaneous esophageal rupture (SER) is a rare but life-threatening condition with high mortality. The prognosis of patients with SER treated with surgical intervention or the traditional “three-tube” method is controversial. Thus, the aim of this study was to evaluate the clinical efficacy, feasibility, and safety of a new “two-tube” method involving a trans-fistula drainage tube and a three-lumen jejunal feeding tube for the treatment of SER without concomitant pleural rupture. Methods From January 2007 to June 2016, patients with SER and managed with the “two-tube” method or other methods were retrospectively analyzed. Data collected included initial presentation, procedure time, duration of treatment, numbers of patients with eventual healing of leaks, and complications. Results The average procedure time for the “two-tube” method was 22.1 ± 5.5 minutes. In comparison with the control method, the “two-tube” method had a similar diagnosis time (3.6 ± 1.4 vs. 3.4 ± 1.4 days) but a significantly higher successful closure rate (94.4% vs. 63.6%) and shorter treatment time (38.2 ± 5.6 vs. 53.6 ± 16.9 days). No complications associated with performance of the “two-tube” method occurred. Conclusion The “two-tube” method is an effective and safe approach for patients with SER.

Introduction The aim of our study was to determine the effect of metformin administration on juvenile type 1 diabetes mellitus and atherosclerosis in apolipoprotein E null (ApoE−/−) mice and to explore the mechanism involved. Methods Eighteen male ApoE−/− mice were injected with streptozotocin to induce diabetes (diabetic group) and 18 mice who received no streptozotocin injection were assigned to the control (non-diabetic) group. Six mice in each group were then orally administered metformin, simvastatin, or vehicle, respectively, following which the mice were euthanized and tissue samples collected. Results Fasting plasma glucose, low-density lipoprotein-cholesterol, and triglyceride concentrations were significantly higher in the three diabetic groups than in the three non-diabetic groups. Plasma N∈-(carboxymethyl)lysine and N∈-(carboxyethyl)lysine concentrations were higher in the diabetic mice than in the non-diabetic mice, but metformin treatment reduced these concentrations more effectively than simvastatin. All three diabetic groups demonstrated obvious arterial plaques, but these were largest in the vehicle-treated diabetic group. The expression of extracellular nitric oxide synthase was highest in the simvastatin-treated non-diabetic group, and in diabetic mice it was higher in the simvastatin-treated group than in the other two groups. No significant expression of AMP-activated protein kinase (AMPK) was measured in the three diabetic groups, but a low level of AMPK expression was detected in the non-diabetic groups. Conclusions Metformin can limit the development of atherosclerosis secondary to diabetes in young diabetic mice. A possible mechanism is the removal of methylglyoxal, thereby reducing the formation of advanced glycation endproducts, rather than by lowering the blood glucose level. Funding This work was supported by the National Natural Science Foundation of China (81901106) and Jinan clinical medical science and technology innovation plan (201907002).