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Aortic regurgitation (AR) is a volume overload disease causing eccentric left ventricular (LV) hypertrophy and eventually heart failure. There is currently no approved drug to treat patients with AR. Endoplasmic reticulum (ER) stress and ER stress-mediated apoptosis is involved in many cardiovascular diseases, but whether they also participate in AR-induced heart failure is still elusive. In this study, we found ER stress activation in myocardial samples from patients with AR. With a unique murine model of AR which induced eccentric cardiac hypertrophy and heart failure, we also found aggravation of cardiac ER stress and apoptosis, as evidenced by a reduction of Bcl-2/Bax ratio and an increase of caspase-3 cleavage. We then examined the signaling effectors involved in ER-initiated apoptosis and found volume overload specifically activated C/EBP homologous protein (CHOP), but not caspase-12 or Jun N-terminal kinase (JNK). Interestingly, tauroursodeoxycholic acid (TUDCA), an ER stress inhibitor, improved cardiac function, and suppressed ER stress, apoptosis, and CHOP. Furthermore, genetic knockdown of CHOP inhibited cardiac Bcl-2/Bax ratio reduction and caspase-3 activation and rescued cardiac dysfunction. In summary, our findings suggest that ER stress-CHOP signaling is involved in the development of volume overload cardiac hypertrophy induced by AR through promoting cardiomyocytes apoptosis and provide a previously unrecognized target in heart failure induced by volume overload.

Concrete-filled stainless steel tube (CFSST) has great potential to be applied in the marine environment attributed to its excellent structural behavior and corrosion resistance. This paper presents numerical investigation and parametric study on the performance of CFSST members subjected to concentric tension. Firstly, a three-dimensional finite element analysis (FEA) model is established and validated against the experimental results reported in a companion paper. Secondly, the calibrated FEA model is used to investigate the tensile behavior of CFSST members, especially the composite action and stress distribution between the outer stainless steel tube and the concrete infill, which determines the load-carrying capacity of the steel–concrete composite member. Then, a wide-range parametric analysis is conducted by varying the parameters of both the stainless steel tube and concrete infill, and the influence of different parameters on the load-carrying capacity of CFSST tensile members is studied. Finally, a calculation model is proposed to be used to predict the ultimate strength of CFSST tensile members, and a good agreement is achieved between the model-predicted values and the FEA-computed ones.

Introduction Cirrhotic patients with septic shock have a poorer prognosis compared with the general population. Our study aimed to investigate the survival benefit of the implementation of hour-1 bundle proposed by Surviving Sepsis Campaign, and to analyze the predictors associated with short-term mortality of these patients. Methods A single-center, retrospective case-control study was conducted among adult patients who visited the emergency department between January 1, 2018 and December 31, 2019. All patients with a diagnosis of liver cirrhosis and septic shock were enrolled. Their baseline characteristics, laboratory results, source of sepsis, and sepsis bundle management were recorded. We further divided the patients into survivor and non-survivor groups to identify independent prognostic factors. Results A total of 88 patients were eligible for this study. The overall 30-day mortality rate was 53.4% (47/88). The proportion of hour-1 bundle achievement was 30.7% (27/88). There were no significant mortality differences between the hour-1 bundle achievement and non-achievement groups (44.4% vs. 57.4%, p = 0.35). Compared with the patients in the survivor group, patients in the non-survivor group had significantly more advanced stage of cirrhosis and a lower proportion of receiving source control (4.3% vs. 22.0%, p = 0.02). The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score (adjusted hazard ratio [AHR] =1.52, p p p = 0.02) were identified as independent prognostic factors in the multivariate regression model. Furthermore, the CLIF-SOFA score (area under curve [AUC]: 0.81) and lactate levels (AUC: 0.77) revealed good mortality discrimination ability in cirrhotic patients with septic shock. Conclusions The application of the hour-1 bundle did not reveal a significant survival benefit to cirrhotic patients with septic shock. Clinicians could utilize CLIF-SOFA scores and lactate levels for mortality risk stratification and put more emphasis on the feasibility of source control to improve their prognosis.

Capacitive proximity sensors have been widely used in human-robot interaction, but suffer from the problem of the imperfect measurement accuracy in the nonlinear detection range. Meanwhile, sensor calibration makes the measurement tedious, time consuming, and is difficult to be used in 3D positioning. In this paper, we use a hand as the sensing target and propose a new distance estimation and positioning method, which combines with capacitive sensing configurations of a sensor array and machine learning. Fourteen sensing configurations are designed to generate 14 capacitive sensors to detect the target, and the capacitances are used as the input vector of the machine learning models. We compare the four machine learning algorithms (i.e. fitting method, support vector regression (SVR), radial basis function (RBF) network and BP neural network (BPNN)) for hand distance estimation. The experimental results show the RBF offers the best performance that the root mean squared error (RMSE), mean absolute error (MAE) and mean relative error (MRE) are 0.59 cm, 0.45 cm and 5.32%. Due to the lack of a proper 3D positioning device to verify the target positions, all tests for positioning are grounded on the simulation data using COMSOL, which can mimic the real world applications with high accuracy. The testing results are compared regarding the use of a Y-shaped sensor arrangement, and show that our proposed method performs better than the method with a Y-shaped sensor arrangement, the accuracy is improved by more than 98.8% and the BPNN model achieves the highest accuracy.

In order to study the influence of heavy truck dynamic parameters on the vehicle’s ride comfort under the random road excitation, the weighted RMS (root-mean-square) acceleration responses of the vertical driver’s seat and cab pitch angle are chosen as objective function, a dynamic model of the vehicle with 10 degrees of freedom is established to simulate and analyze the results. The influence of different parameters of all the suspension systems of the vehicle, such as the stiffness and damping of the suspensions of the seat, cab, vehicle, and wheel, on the vertical driver’s seat and cab pitch angle are respectively analyzed. The study results show that the influence of the stiffness and damping parameters in the suspension systems on the vehicle ride comfort is very obvious. The vehicle’s ride comfort changes worse with the increase of the suspension stiffness and the reduction of the suspension damping, and vice versa. The study proposes an optimal range of the stiffness and damping parameters for the optimal design and control of the vehicle suspension systems, concurrently, the study can also provide a theoretical basis for the suspension system designed for heavy trucks.

This study explores the implementation strategy of environmental management systems (EMSs) with integration improvement processes in the supply chain. It also explores the change in environmental p...

To observe the therapeutic efficacy of sinew-bone balancing manipulation plus exercise therapy in treating postures of primary school students with upper crossed syndrome (UCS). Sixty pupils with UCS were divided into an exercise group and a combination group using the random number table method, with 30 cases in each group. The combination group received treatments of sinew-bone balancing manipulation plus exercise therapy, while the exercise group received exercise therapy alone. The two groups received interventions once every other day, for a total of 1 month. The sagittal static posture assessment total score, forward head angle (FHA) and forward shoulder angle (FSA) were compared before and after treatment; the sagittal static assessment total score, FHA and FSA were compared between the exercise group and the combination group. Before treatment, there were no significant differences comparing the sagittal static posture assessment total score, FHA and FSA between the two groups (all P>0.05); after treatment, the sagittal static posture assessment total score, FHA and FSA decreased in the two groups, with intra-group statistical significance (all P

As a supply chain system, the development of cold chain depends on the progress of technology, involving many disciplines, science and technology, and the attention is increasing year by year. Ther...

This study aimed to evaluate the incidence and prognosis of primary cardiac lymphoma (PCL) by using the Surveillance, Epidemiology, and End Results Program (SEER) database. Patients diagnosed with PCL and the disease incidence in the SEER database from 1975 to 2016 were included. Overall survival (OS) and cause-specific survival (CSS) curves were calculated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariable Cox proportional hazard regression analyses were used to identify associations with outcome measures. The incidence of PCL was 0.011/100 000, and a predominance of elderly and male patients was observed. A total of 144 patients were enrolled. The median age of onset was 68 (9-96) years, including 80 (55.6%) males and 64 (44.4%) females. Multivariate analysis revealed that age and chemotherapy were independent prognostic factors for OS (both P < .05). Ann Arbor stage and chemotherapy were independent prognostic factors for CSS (both P < .05). In terms of treatment modality, chemotherapy combined with surgery was an independent protective factor for OS and CSS (both P < .05). For patients with primary cardiac diffuse large B-cell lymphoma (cardiac DLBCL), multivariate analysis also showed that age, Ann Arbor stage, and chemotherapy were all independent prognostic factors for OS and CSS (all P < .05). Chemotherapy combined with surgery was associated with a significant benefit in terms of OS and CSS (both P < .05). Our study confirmed that older age and advanced Ann Arbor stage were independent risk factors for PCL, and treatment with chemotherapy or cooperation with surgery resulted in better long-term survival.

Background: Cardiac troponin T (cTNT) has been widely used in detecting cardiac damage. Elevated cTNT level has been reported to be associated with increased mortality in multiple cardiac conditions. It is not uncommon to observe an increased level of cTNT in patients after left atrial appendage occlusion (LAAO). The objective of the study is to study the incidence, significance, and factors associated with cTNT elevation after LAAO.Methods: We prospectively included patients who underwent LAAO from January 2019 to July 2020 in Fudan Zhongshan Hospital. Patients were divided into those with elevated cTNT after procedure and those with normal postprocedure cTNT. All individuals were followed up for 1 year. The primary outcome is major adverse cardiovascular events, which include myocardial infarction, heart failure, cardiac death, and stroke. The second outcome is periprocedure complication, including chest pain, tachycardia, cardiac tamponade, change of electrocardiograph, and atrial thrombus.Results: A total of 190 patients were enrolled. Of the patients, 85.3% had elevated cTNT after LAAO, while 14.7% of them did not. Exposure time, dosage of contrast, types of devices, shapes, and sizes of LAA could contribute to elevated postprocedure cTNT. We found that patients with a Watchman device were more likely to have elevated postprocedure cTNT than those with a Lambre device (89.2 vs. 76.7%, p = 0.029). LAAO shapes were associated with cTNT levels in patients with a Watchman device, while the diameter of the outer disc and LAA depth mattered for the Lambre device. There was no significant difference in the primary and second outcome between the two groups (p-value: 0.619, 0.674).Conclusion: LAAO was found to be commonly accompanied with cTNT elevation, which might not to be related to the complications and adverse cardiac outcomes within 1 year of follow-up. Moreover, eGFR at baseline, exposure time, dosage of contrast, types of LAAO device, and LAA morphology could contribute to cTNT elevation.

INTRODUCTION Elderly patients are more susceptible to sepsis and septic shock. Early administration of broad-spectrum antibiotics is a key element of the sepsis management of bundle. Our study aimed to investigate the association between the timing of antibiotics administration and the risk of adverse outcomes in elderly patients with septic shock, and to examine the prognostic value of other bundle elements. METHOD This is a single-center, retrospective, case-control study including elderly patients (aged ≥ 65 years) diagnosed with septic shock in the emergency department between October 1, 2018, and December 31, 2019. Eligible patients were divided into early (within 1 h) and late (beyond 1 h) groups according to the time interval between septic shock recognition and initial antibiotic administration. The characteristics, sepsis-related severity scores, management strategy, and outcomes were recorded. A multivariate logistic regression model was used to identify the independent prognostic factors. RESULTS A total of 331 patients were included in the study. The overall 90-day mortality rate was 43.8% (145/331). There were no significant differences in baseline characteristics, sepsis-related severity scores, and management strategy between the two groups. There was no significant difference between the early and late groups in the rate of intensive care unit transfer (46.4% vs. 46.6%, p = 0.96), endotracheal intubation (28.3% vs. 27.5%, p = 0.87), renal replacement therapy (21.7% vs. 21.8%, p = 1.00), or 90-day mortality (44.2% vs. 43.5%, p = 0.90). Serum lactate level (hazard ratio [HR] = 1.15, p

Previous studies revealed an association of tumor necrosis factor super family-15 (TNFSF15) gene polymorphisms with several autoimmune diseases, but their roles in the development of Graves’ diseas...

Purpose The purpose of this paper is to empirically analyze the relationship between institutional investors research meeting and performance of companies being researched. Design/methodology/approach Using empirical research method, this study designs and conducts an empirical research according to empirical research’s basic norms. Thus, the authors acquire needed and credible empirical data. Findings By analyzing the empirical data, there is a significant positive effect between institutional investors research meeting and the earnings per share of company being researched. Improvement in the level of the research meetings of the institutional investors strengthens the external supervision of management, alleviates the information asymmetry between management and shareholders, improves the management efficiency of the company and ultimately increases the performance of the company. When the performance of a company is better, we can find that the role of II research meetings is more significant. In addition, II research meetings are better able to improve the performance of state-owned enterprises. Originality/value This study empirically analyzes and verifies the roles of institutional investors research meeting in improve the performance of the company being researched. The authors expand the channel of institutional investors research behaviors to improve the performance of listed companies by strengthening the supervision and restraint of management behavior. Additionally, via a reverse study, it is found that the situation of the researched company itself is also one of the factors that determine the results of institutional investors research meetings.

Background:. Sleep disorders are one of the earliest non-motor symptoms of Parkinson's disease (PD). Sleep disorders could, therefore, have value for recognition and diagnosis in PD. However, no unified classification and diagnostic criteria exist to evaluate sleep disorders by polysomnography (PSG). Utilizing PSG to monitor sleep processes of patients with PD and analyze sleep disorder characteristics and their relationship with demographic parameters could aid in bridging this gap. This preliminary study aimed to evaluate the clinical characteristic of sleep disorders in PD using PSG. Methods:. PSG was used to evaluate sleep disorders in 27 patients with PD and 20 healthy volunteers between August 2015 and July 2018 in Fujian Medical University Union Hospital. Total sleep time (TST), sleep efficiency (SE), total wake time, and other parameters were compared between the two groups. Finally, the correlation between sleep disorders and age, disease duration, Unified Parkinson's Disease Rating Scale-III scores, Hoehn-Yahr stage, and levodopa dose were analyzed. The main statistical methods included Chi-square test, two independent samples t test, Fisher exact test, and Pearson correlation. Results:. Sleep fragmentation in the PD group was significantly increased (74.1%) while difficulty falling asleep and early awakening were not, as compared to healthy controls. No significant differences were found in time in bed, sleep latency (SL), non-rapid eye movement (NREM) stage 1 (N1), N1%, N2, N2%, N3%, and NREM% between PD and control groups; but TST (327.96 ± 105.26 min vs. 414.67 ± 78.31 min, P = 0.003), SE (63.26% ± 14.83% vs. 76.8% ± 11.57%, P = 0.001), R N3 (20.00 [39.00] min vs. 61.50 [48.87] min, P = 0.001), NREM (262.59 ± 91.20 min vs. 337.17 ± 63.47 min, P = 0.003), rapid-eye-movement (REM) (32.50 [33.00] min vs. 85.25 [32.12] min, P

Stone masonry walls may be constructed using different types of stonework. This paper investigates the effectiveness of a technique that strengthens traditional ashlar stone masonry by embedding polymer mortar and steel bars in bed joints. The seismic behaviour of stone masonry walls with enhanced mortar joints is experimentally evaluated. Seven single-bay, single-storey wall specimens were fabricated and tested under different combinations of constant vertical loads and reversed cyclic lateral loads. One specimen was constructed using a traditional construction method; the other six specimens were constructed similarly, but their joints were strengthened with a combination of embedded polymer-based mortar and steel reinforcing bars. The influence of applied normal stress and strengthening method on the failure mode, lateral resistance, strength degradation, stiffness degradation, energy dissipation and ductility was investigated. The experimental results show that strengthening the joints effectively enhances the lateral load-carrying capacity and integrity of stone masonry walls. As expected, an increase in vertical load increased both the lateral strength and pre-peak stiffness of the tested specimens, but decreased the ductility. Within the limitation of the present tests, the failure mechanisms of the stone masonry walls were dominated by either diagonal stepped cracks or slip-shear cracks, depending on the specific strengthening method.

In this brief, a high sensitivity measuring system for capacitive sensor to detect moving target is presented. It mainly consists of a capacitance measuring circuit and a dc-blocking circuit. The capacitance measuring circuit is used to convert a capacitance to a dc voltage and the dc-blocking circuit is employed to extract the voltage variation. The experimental results show that when the measured capacitor is between 1 pF to 7.5 pF, the sensitivity is 3.53 V/pF, the linearity error is 6.13%, the SNR increases from 26.6 dB to 57.7 dB, the resolution is 3.1 fF and the time delay is about $4\,\mu \text{s}$ . Comparing to five other common capacitance measuring circuits, the proposed one offers plain design, high sensitivity, and fast speed. Simulation results show that the proposed dc-blocking circuit has short time delay and unattenuated output. Moreover, as demonstrated by system tests, the proposed measuring system is qualified for capacitive sensor for detection of moving target with different speeds.

Transient neurologic syndrome (TNS) is a common self-limited complication of spinal anesthesia. Many local anesthetics can cause transient neurological syndrome, in which the incidence of lidocaine is relatively high. In addition, bupivacaine, levobupivacaine, articaine, and ropivacaine can also cause TNS. We conducted a consecutive retrospective cohort study to investigate the incidence of TNS and its associated factors in patients treated with bupivacaine and ropivacaine. We conducted a retrospective cohort study, reviewing the medical records of surgical patients who received bupivacaine and ropivacaine spinal anesthesia in Chengdu Shuangliu District First People’s Hospital in the past year to determine the incidence of TNS. For the first time, we used the TNS score table to quantify the occurrence of TNS. There were 24 cases (41.38%) of TNS in the bupivacaine group and 45 cases (33.33%) of TNS in the ropivacaine group. There was no significant difference in VAS and TNS scores between the two groups. It was found that the occurrence of TNS with bupivacaine was correlated with VAS score (Pearson correlation = 0.1813), while the occurrence of TNS with ropivacaine was correlated with sensory blockade (Pearson correlation = − 0.0642). The TNS scale can be used to evaluate the postoperative TNS of patients, and ropivacaine is used for spinal anesthesia with appropriate high anesthesia, which is less likely to lead to postoperative TNS.

The research mainly aims at the hotspot of supply chain management from the perspective of a social network by drawing knowledge mapping and provides the visualization reference in this research fi...

In modern cities, the number of vehicles is increasing day by day, which makes it difficult to find parking spaces during travel and takes a lot of time to drive at a slow speed. This not only causes local traffic chaos but also interferes with the driving efficiency of the entire roads. This phenomenon is a common problem faced by modern metropolitan areas. To reduce the time spent in finding parking spaces, fuel consumption, and carbon dioxide emissions, and to effectively improve overall driving efficiency, the systemization of urban roadside or off-street parking has become a key issue that needs attention and demonstration in so-called “smart” cities. In this paper, we have designed and applied an mm-Wave Radar to detect the presence or absence of available parking spaces, and the parking space data can be quickly uploaded to the cloud. Therefore, the status of the parking space can be updated in real-time. Based on this parking space status data, we build a Long Short-Term Memory (LSTM) model to conduct deep learning. The input data of this model includes parking space location, parking space status, and parking time factors. Using mm-Wave radar experiment with the trained LSTM output provides parking space status prediction which enables drivers to obtain parking space status before they arrive at the destination. This can save half of the drivers' time wasted in finding parking spaces and head to the smart cities.

Background COVID-19 pandemic has forced physicians to quickly determine the patient’s condition and choose treatment strategies. This study aimed to build and validate a simple tool that can quickly predict the deterioration and survival of COVID-19 patients. Methods A total of 351 COVID-19 patients admitted to the Third People’s Hospital of Yichang between 9 January to 25 March 2020 were retrospectively analyzed. Patients were randomly grouped into training (n = 246) or a validation (n = 105) dataset. Risk factors associated with deterioration were identified using univariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression. The factors were then incorporated into the nomogram. Kaplan-Meier analysis was used to compare the survival of patients between the low- and high-risk groups divided by the cut-off point. Results The least absolute shrinkage and selection operator (LASSO) regression was used to construct the nomogram via four parameters (white blood cells, C-reactive protein, lymphocyte≥0.8 × 109/L, and lactate dehydrogenase ≥400 U/L). The nomogram showed good discriminative performance with the area under the receiver operating characteristic (AUROC) of 0.945 (95% confidence interval: 0.91–0.98), and good calibration (P = 0.539). Besides, the nomogram showed good discrimination performance and good calibration in the validation and total cohorts (AUROC = 0.979 and AUROC = 0.954, respectively). Decision curve analysis demonstrated that the model had clinical application value. Kaplan-Meier analysis illustrated that low-risk patients had a significantly higher 8-week survival rate than those in the high-risk group (100% vs 71.41% and P Conclusion A simple-to-use nomogram with excellent performance in predicting deterioration risk and survival of COVID-19 patients was developed and validated. However, it is necessary to verify this nomogram using a large-scale multicenter study.

The fiscal transfer payment system is an effective way to reduce regional financial differences and plays an important role in promoting the equalization of basic services in various regions. Based on the financial transfer payment data of 21 cities in Guangdong Province from 2013 to 2018, this paper first analyzes the basic financial situation of each region, then constructs a fiscal equalization indicator system and uses the coefficient of variation method to study the effect of the transfer payment system on the fiscal improvement of each region, so as to clarify the effectiveness of various transfer payment channels. Finally, provide a reference basis for optimizing the fiscal transfer payment system.

Purpose. The purpose of this study is to investigate the clinical effect of lower-limb exercise, when combined with celecoxib, on pain management of patients undergoing posterior lumbar fusion surgeries. Methods. The patients undergoing posterior lumbar fusion surgeries between 01/2018 and 06/2021 were retrospectively identified, with their data collected. After surgery, some patients took celecoxib for analgesia (celecoxib group, 200 mg/day) while the others took celecoxib together with lower-limb exercise (combined group, celecoxib-200 mg/day). On postoperative days (POD) 1, 3, 7, and 14, data were collected and analyzed regarding the following items: patient satisfaction, lower-limb muscle force, lumbar JOA score (29 points), Oswestry Disability Index (ODI), and visual analog scale (VAS) score. Results. A total of 225 participants were included in this study. Specifically, 120 cases were admitted into in the celecoxib group and 105 were included in the combined group. Comparisons of baseline data did not indicate any difference between the combined group and the celecoxib group. Data analysis showed that patient satisfaction in the combined group was significantly higher than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.001 ). Moreover, the combined group had less VAS score compared with the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.01 ). In addition, lower-limb muscle force in the combined group was significantly stronger than that in the celecoxib group on POD 3 and POD 7, respectively (both p < 0.01 ). Furthermore, the combined group achieved less ODI score than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.05 ). Comparisons of the lumbar JOA score did not suggest any statistical difference during the whole follow-up period. Conclusions. In conclusion, postoperative lower-limb rehabilitation exercise can help to release pain after lumbar fusion surgeries. Additionally, postoperative lower-limb exercise can facilitate the recovery of lower-limb muscle force, as well as improving patient satisfaction.

Pollution from supply chains can be controlled through the high level of efficiency realized by green supply chains. However, realizing a green supply chain depends on partners' collaboration intentions. The purposes of this study are to explore the influence of oligopolies created through government intervention and how they can promote supply chain partners' collaboration intentions in the context of green supply chains. Spearman's correlation analysis, partial least squares, and the Sobel test are the main approaches adopted to evaluate the theoretical framework and hypotheses of this study. Our findings indicate that, in addition to a few leaders of the supply chain obtaining market order distribution authority, oligopolies created through government intervention guide consumers to more fully scrutinize these supply chain leaders and their partners. When their partners exhibit a lower collaboration intention in green supply chain improvement and increase the pollution emission risk, it is easy to induce and increase social pressure from consumers and thus pressure these leaders to reduce or even cancel the order distribution of these partners. To avoid order profit loss, these partners will continue to actively maintain their collaboration intentions in the green supply chain. In addition, environmental risk audits by supply chain leaders' interventions are a common approach to improve green supply chains. However, partners are usually unwilling to cooperate with leaders' audit interventions and show lower collaboration intentions. However, social pressure can threaten partners' order profits and thus drive partners to show positive collaboration intentions and further accept leaders' reasonable interventions in environmental risk audits and will have a positive effect on green supply chain improvement. Based on the above, to expedite the improvement of the green supply chain, oligopolies created through government intervention are not only an important external force but also an important national strategy in green environmental improvement.

Background This study aimed to compare serum cystatin C (CysC) levels between hypertensive and non-hypertensive patients, and to explore the correlation between serum CysC and left ventricular hypertrophy (LVH). We also investigated the effects of pressure overload on cardiac expression and secretion of CysC, and explored the direct effect of CysC on the hypertrophy of primary cardiomyocytes. Methods Serum CysC was compared in patients with hypertension (634 patients) and those without hypertension (411 patients), and the correlation between serum CysC levels and LVH was explored. A transverse aortic constriction (TAC) mouse model and a mechanical stretch model of primary cardiomyocytes and fibroblasts were developed to compare cardiac expression and secretion of CysC under pressure overload. After intervention with exogenous CysC, we compared the cross-sectional area of primary cardiomyocytes, cardiac hypertrophy-associated gene expression, and phosphorylation of the MAPK signaling pathway. Results In chronic kidney disease (CKD) stage 1 patients, serum CysC was higher in hypertensive patients independent of renal function. Serum CysC elevation was an independent predictor of LVH after correction for endogenous creatinine clearance rate (eCCr), left ventricular ejection fraction (LVEF), and NT-proBNP. Cardiac levels of CysC in TAC mice were elevated. CST3 gene expression was upregulated, and both intracellular and culture supernatant CysC levels increased after mechanical stretch of primary cardiomyocytes. After intervention with exogenous CysC, the cross-sectional area of primary cardiomyocytes increased, as well as the gene expression of Nppa, Nppb, and Myh7, and the phosphorylation of ERK, p38, and TAK1. Conclusions Serum CysC levels were higher in hypertensive patients, and serum CysC elevation was an independent predictor of LVH after correction for eCCr. Pressure overload induced greater cardiomyocyte secretion of CysC. Exogenous CysC can enter cardiomyocytes, having a pro-hypertrophic effect on primary cardiomyocytes through regulation of the MAPK signaling pathways.

Patients with liver cirrhosis and septic shock have a significantly higher risk of mortality and morbidity compared with non-cirrhotic patients. The peripheral blood lymphocyte-to-monocyte ratio (LMR) can determine the prognosis of cirrhotic patients. Our study aimed to investigate the usefulness of LMR as a predictive marker of mortality risk in cirrhotic patients with septic shock.This single-center, retrospective case-control study included adult patients who visited the emergency department between January 1, 2018 and June 30, 2020 and diagnosed with liver cirrhosis and septic shock. They were divided into survivor and non-survivor groups according to their survival status at the 60-day follow-up. We used a Cox proportional hazards regression model to identify independent factors associated with mortality risk and tested the mortality discriminative ability of those factors using the area under a receiver operating characteristic curve.A total of 93 patients were eligible for this study. Compared with the patients in the survivor group, those in the non-survivor group had significantly higher Child-Pugh (11 ± 2 vs. 9 ± 2, p 0.001) and MELD scores (29 ± 6 vs. 22 ± 8, p 0.001), higher serum international normalized ratio (1.7 vs.1.4, p = 0.03), bilirubin (6.0 vs. 3.3 mg/dL, p = 0.02), lactate (5.4 vs. 2.7 mmol/L, p 0.01), creatinine (2.2 vs. 1.6 mg/dL, p = 0.04), higher neutrophil-to-lymphocyte ratio (13.0 vs. 10.3, p = 0.02), and lower LMR (1.1 vs. 2.3, p 0.01). The LMR (adjusted hazard ratio [aHR] = 1.54, p = 0.01) and lactate (aHR = 1.03, p 0.01) were identified as independent predictive factors for mortality in the multivariate regression model. Furthermore, LMR (area under curve [AUC]: 0.87) revealed a superior discrimination ability in mortality prediction compared with the Child-Pugh (AUC: 0.72) and MELD (AUC: 0.76) scores.The LMR can be used to predict mortality risk in cirrhotic patients with septic shock.

The paper propose an equilibrium decision-making method for the emergency relief medicine distribution during an earthquake response by considering demand uncertainty. The proposed method objects to minimize transport time, as well as distribution equity of each affected area. Besides, this model also consider the equilibrium between wrong decision risk and late decision risk. Then, simulation research is carried out in this paper. Results shows that the proposed model can generate proper distribution plan by inputting relative data.

Background No therapeutics have demonstrated specific efficacy for patients with COVID-19. Methods We retrospectively evaluated 351 patients with COVID-19 admitted to the Third People's Hospital of Yichang from 9 January to 25 March, 2020.Univariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression were employed to identify risk factors associated with progression, which were then incorporated into the nomogram. Survival of patients between high-risk and low-risk groups was compared by kaplan-Meier analysis. Moreover, we assessed the effects of existing common drugs on survival of patients with high-risk. Results Based on the LASSO, four variables (white blood cell, C-reactive protein, whether lymphocyte ≥ 0.8 × 109/L, and whether lactate dehydrogenase ≥ 400 U/L) were selected for construction of the nomogram. Patients in the total cohort were stratified into low-risk group (total point

Sepsis-induced myocardial dysfunction (SIMD) contributes significantly to cardiovascular dysfunction during septic shock. We aimed to evaluate the potential role of Xinmailong injection (XMLI), a polypeptide medicine extracted from Periplaneta americana, in reversing the progression of myocardial damage to SIMD in sepsis patients. This was a multicenter, randomized, double-blind, parallel-group trial. We recruited all patients consecutively admitted to intensive care units (ICUs) who were aged 18 to 85 years old and met the sepsis 3.0 criteria. The primary outcome measure was the incidence of sepsis-induced myocardial dysfunction while in the ICU. Of the 192 patients, 96 were assigned to the treatment group, and 96 to the control group. Subsequently, 41 patients [41/96 (42.7%)] in the XMLI group and 61 patients in the placebo group [61/96 (63.5%)] were confirmed to have diastolic dysfunction on the fifth day (D5). The incidence of diastolic SIMD was significantly different between the two groups (P = 0.004). There were 36 deaths in the two groups during the 28-day follow-up, with a general mortality rate of 18.8% (36/192). The 28-day mortality rates were not significantly different between the groups (P = 0.45). However, the brain natriuretic peptide (BNP) plasma concentration trends on D0, D2, and D5 significantly differed between the two groups (P = 0.049). In septic patients, XMLI decreased the occurrence rate of diastolic SIMD more effectively than the placebo. The improvement in serum BNP concentration was also greater in the XMLI group. XMLI may, therefore, effectively and safely improve cardiac function in patients with sepsis.

When earthquakes occur in the mountains, numerous rescuing resources need to be distributed among affected areas. The distribution mission is a long-term response process, which requires consideration of factors such as weather conditions, aftershock damage, and complex mountainous topography. These factors lead to uncertainties, such as transportation time and supply and demand information as well as several disaster sites. This study aims to develop a new scheduling method based on uncertainties of mountain earthquakes and several disaster sites in a long-term response process. The proposed methodology focuses on two problems, namely, (1) how to coordinate supplies between different phases of the response process and (2) how to deal with uncertainties. A follow-up sharing mechanism is put forward to ensure that resources from previous phases are partly shared with the ensuing phases as needed. A scheduling methodology is then established with the uncertainties in demand and traffic conditions. Results from numerous studies show that a schedule with this mechanism is effective, and the resource distribution principle significantly affects the resource allocation plan.

This paper aims to solve the problem of Risk assessment for enterprise merger and acquisition (M&A), which is an important problem in modern company management. Firstly, we design an index system to assess risks of enterprise M&A behavior, and six risks are considered: 1) Systemic risk, 2) Law risk, 3) Financial risk, 4) Intermediary risk, 5) Integrated risk, and 6) Information risk. Furthermore, 18 indexes are chosen to cover these six aspects. Secondly, we illustrate how to utilize the proposed risk assessment in the decision system for enterprise M&A risk assessment. We separate the M&A risk assessment process to three steps, that is, 1) Before M&A, and 2) In M&A, and 3) After M&A. Particularly, after the risk assessment process, there are three decisions for enterprise managers, that is, 1) implement the original M&A plan, 2) modify the original M&A plan, and 3) refuse it. Thirdly, we propose the multiple classifier fusion based risk assessment algorithm, which aims to effectively combine the six support vector machines. To relax the limitation of the SVM classifier, we introduce the fuzzy theory in the multiple classifier fusion algorithm, and the category label assignment is determined by utilizing a maximum membership rule. Finally, we conduct an experiment to make performance evaluation by constructing a dataset which includes the M&A data of 200 enterprises, among which 185 enterprises are used as training dataset and others are regarded as testing dataset. Using ROC curve, MAE and MAPE as evaluation criterions, performance of the proposed method is compared with single SVM scheme. Experimental results demonstrate that combining multiple the SVM classifiers together, accuracy of M&A risk assessment is greatly enhanced.

By the development of product servitization in China, the idea of iPSS was accepted and applied in more and more field. The iPSS for cutting-tools (ct-iPSS for short) was proposed in recent years. Though the application of ct-iPSS, cutting-tools are transformed from tangible stuff to intangible service, and the value of cutting-tool service is improved remarkably. But during the cutting-tools servitization, the using cost of cutting-tools was transferred too. In order to analyze the value transfer paths of the cutting-tool under the ct-iPSS environment, an order-driven cutting-tool service demand network (CTDN for short) based on complex network theory is built and its characteristics are analyzed. Firstly, based on the manufacturing outsourcing, the order-driven CTDN was established though the production orders outsourcing. Secondly, the 6 characteristics indexes were defined to analyze the performance of the CTDN. Finally, A case study was given to show how does the CTDN work.

Background Although aortic regurgitation (AR) is a clinically important condition that is becoming increasingly common, few relevant murine models and mechanistic studies exist for this condition. In this study, we attempted to delineate the pathological and molecular changes and address the roles of some potentially relevant molecules in an animal model of surgically induced AR. Methods AR was induced by puncturing the aortic valve leaflets in C57BL/6J mice under echocardiographic guidance. Results As early as 1 week following AR, the left ventricles (LV) displayed marked impairments in diastolic function and coronary flow reserve (CFR), as well as cardiac hypertrophy and chamber dilatation at both end-systole and end-diastole. LV free wall thickening and cardiomyocyte hypertrophy in LV were observed 2 weeks following of AR while a decline in ejection fraction was not seen until after 4 weeks. Nppa (natriuretic peptide A) and Nppb (natriuretic peptide B) increased over time, in conjunction with prominent Akt activation as well as slight CaMKII (Ca2+/calmodulin-dependent protein kinase II) activation and biphasic changes in β-arrestin-2 expression. Treatment of AR mice with Akt inhibition exacerbated the eccentric hypertrophy, while neither inhibition of CaMKII nor β-arrestin-2 overexpression influenced the response to AR. Conclusions Our structural, functional, molecular and therapeutic analyses reveal that Akt, but not CaMKII or β-arrestin-2, plays a regulatory role in the development of LV remodeling after AR in Mice. These results may shed important light on therapeutic targets for volume overloaded cardiomyopathy.

Purpose The research mainly aims at the hotspot of inventory management by knowledge mapping and provides a visualization reference in this research field. Design/methodology/approach First, inventory management journals during 1986 to 2017 were selected as the research object and text formatting in the Web of Science (WOS) database is exported. Then inventory management knowledge mapping is done and clustering keywords are extracted by using CiteSpace and VOSviewer software. Based on co-word analysis, the three special clusters are exported: inventory optimization strategy, inventory pricing and inventory technology. Besides, the clustering structure and time evolution are analysed. Finally, bibliographic item co-occurrence matrix builder (BICOMB) was used to extract the “journal” and “researchers” keywords in the inventory management research fields. Setting three parameters such as the cited half-life, centrality, frequency and keywords for data mining, it can infer the trend keywords of future research. Findings Results showed that inventory management research has been abundant in literature over the past 30 years and has experienced a change from focusing on inventory optimization strategy to inventory pricing and inventory technology in process. It shows that inventory management research focused on the classic topics and includes economic order quantity, dynamic pricing, design and technology, and the new topics include channel coordination, hierarchical price and simulation. Research limitations/implications Based on knowledge mapping, this study is still relatively macro and cannot cover all areas of inventory management. This study only investigated the state of correlational research in WOS and Google Trends and not additional databases. Originality/value The current research mainly builds on knowledge mapping for the research hotspot of inventory management and provides visual references for future research in this field.

OBJECTIVE To study ventricular-arterial coupling(VAC) in uremic patients by application of two-dimensional speckle tracing imaging (2DSTI). METHODS One hundred uremic patients were divided into two groups based on left ventricular ejection fraction (LVEF): group 1 with LVEF ≥ 5%, and group 2 with LVEF

Capacitive proximity sensor uses electric fields to detect contactless objects like human body. Owing to its simplicity and low cost, it is an attractive choice for the application of human–computer interaction. For existing capacitive proximity sensor systems, their detection ranges are less than 20 cm that cannot meet the requirements of the applications for long distance sensing. This motivates us to develop a new capacitive proximity sensor system for human–computer interaction in this paper. A capacitive sensor array, which consists of $4 \times 4$ sensor units with comb shapes, is first designed. The dimensions of the whole array and a single unit are, respectively, 30 cm $\times$ 30 cm and 4 cm $\times$ 4 cm, which are comprehensively considered with hand swing distance in natural state and the sensing distance. More specifically, an outer guard with a lattice-like structure which encloses sensor cells is designed to reduce the crosstalk from its neighboring cells, and a simple capacitance measuring circuit is presented. Comparing to the charge/discharge, ac-based and CDC-chip-based capacitance measuring circuit, the proposed measuring circuit offers plain design, highest sensitivity (3.53 V/pF), and fastest speed ( $4~\mu \text{s}$ ). The experimental results show that the system can capture hand motion up to 45 cm and get hand motion trajectory using the hand position tracking algorithm. These features indicate that the proposed system is very suitable for human–computer interaction applications in the future, such as rehabilitation training and somatosensory game.

Cardiac hypertrophy after myocardial infarction (MI) is an independent risk factor for heart failure. Regression of cardiac hypertrophy has emerged as a promising strategy in the treatment of MI patients. Here, we have been suggested that heat‐shock transcription factor 1 (HSF1) is a novel repressor of ischaemia‐induced cardiac hypertrophy. Ligation of left anterior descending coronary was used to produce MI in HSF1‐deficient heterozygote (KO), HSF1 transgenic (TG) mice and their wild‐type (WT) littermates, respectively. Neonatal rat cardiomyocytes (NRCMs) were treated by hypoxia to mimic MI in vitro. The HSF1 phosphorylation was significantly reduced in the infarct border zone of mouse left ventricles (LVs) 1 week after MI and in the hypoxia‐treated NRCMs. HSF1 KO mice showed more significant maladaptive cardiac hypertrophy and deteriorated cardiac dysfunction 1 week after MI compared to WT MI mice. Deficiency of HSF1 by siRNA transfection notably increased the hypoxia‐induced myocardial hypertrophy in NRCMs. Mechanistically, Janus kinase 2 (JAK2) and its effector, signal transducer and activator of transcription 3 (STAT3) were found to be significantly increased in the LV infarct border zone of WT mice after MI as well as the NRCMs treated by hypoxia. These alterations were more significant in HSF1 KO mice and NRCMs transfected with HSF1 SiRNA. Inversely, HSF1 TG mice showed significantly ameliorated cardiac hypertrophy and heart failure 1 week after LAD ligation compared to their WT littermates. Our data collectively demonstrated that HSF1 is critically involved in the pathological cardiac hypertrophy after MI via modulating JAK2/STAT3 signalling and may constitute a potential therapeutic target for MI patients.

This paper is an attempt to study the mechanical behavior of square concrete-filled bimetallic tubular (CFBT) stub columns subjected to axial compression. The bimetallic tubes in the CFBT columns in this research comprised an outer layer made of stainless steel and an inner layer made of carbon steel. 200-mm square carbon steel tubes (wall thickness tsc = 3.30 mm) were manufactured first, then the bimetallic tubes were fabricated by cladding the carbon steel tubes with stainless steel sheets. In the experimental program, fourteen CFBT columns and two conventional concrete-filled steel tubular (CFST) counterparts were tested to failure under axial compressive loading. The test parameters included the stainless steel grade (Grade 316, 304, and 202), wall thickness of the stainless steel tube layer (tss = 0.84, 1.32, and 1.88 mm), and cube compressive strength of concrete (fcu = 54.5, 68.4, and 80.5 MPa). A finite element analysis (FEA) model was established and validated against the experimental measurements. The failure mode and mechanical behavior of the square CFBT stub columns were then investigated and compared with those of the conventional CFST columns. Finally, the ultimate loads obtained from the experiments were compared to those predicted by the available design codes.

Concrete-filled bimetallic tubes (CFBT) could be recognized as a type of steel-concrete composite members, and have the potential to be applied in engineering structures. A three-dimensional finite element analysis (FEA) model is established to further study the axial compressive behaviour of circular CFBT stub columns in this paper. The preciseness of the FEA predictions is evaluated by comparison with experimental results collected from ten CFBT column specimens tested in a companion paper (Ye et al., 2016) [15]. Good agreement is obtained between the FEA predictions and the test results in terms of failure pattern, load versus deformation response, ultimate strength, and strain development of the two steel tube layers. In light of the FEA results, the stresses of concrete and steel, as well as the interactions and load distribution between different components of the composite section are investigated. Finally,parametric study is performed and a simplified model is proposed to be used to calculate the ultimate strength of circular CFBT stub columns.

Ultrasound imaging is an effective approach for diagnosing breast cancer, but it is highly operator-dependent. Recent advances in computer-aided diagnosis have suggested that it can assist physicians in diagnosis. Definition of the region of interest before computer analysis is still needed. Since manual outlining of the tumor contour is tedious and time-consuming for a physician, developing an automatic segmentation method is important for clinical application. The present paper represents a novel method to segment breast ultrasound images. It utilizes a combination of region-based active contour and neutrosophic theory to overcome the natural properties of ultrasound images including speckle noise and tissue-related textures. First, due to inherent speckle noise and low contrast of these images, we have utilized a non-local means filter and fuzzy logic method for denoising and image enhancement, respectively. This paper presents an improved weighted region-scalable active contour to segment breast ultrasound images using a new feature derived from neutrosophic theory. This method has been applied to 36 breast ultrasound images. It generates true-positive and false-positive results, and similarity of 95%, 6%, and 90%, respectively. The purposed method indicates clear advantages over other conventional methods of active contour segmentation, i.e., region-scalable fitting energy and weighted region-scalable fitting energy.

This paper describes an experimental and analytical program focused on developing a strengthening technique to enhance the flexural performance of stone slabs. The technique involves the use of reinforced mortar bonded to the soffit of the stone slabs, which can be used for strengthening of stone slabs in existing structures, or manufacturing of composite stone members for new constructions. The experimental program consisted of flexural testing of strengthened stone slabs and an unstrengthened specimen serving as the benchmark. The amount of reinforcement ratio and mortar strength were varied as the test variables. An analytical model was also developed to predict the cracking and ultimate moment of strengthened stone slabs. The unstrengthened specimen failed suddenly in a brittle fashion; however, the strengthened stone slabs experienced a ductile failure mode and developed a higher flexural strength. As expected, the enhanced performance was proportional to the reinforcement ratio, but the strength of mortar affected only the cracking moment. The stone slab and the reinforced mortar layer exhibited good composite action, and no obvious interfacial failure was observed. The analytical model developed could reasonably predict the cracking and ultimate moment of stone slabs strengthened with reinforced mortar.

Hybrid memory comprised of a big SCM and a little DRAM (BSLD) is widely studied to address the growing power consumption challenge of pure DRAM. However, the performance degradation, limited endurance and immature mass production of ultra-high-density SCM are still the painful points of BSLD. Here we propose a Retention-Aware Hybrid Main Memory (RAHMM) architecture with a big DRAM and a little SCM (BDLS) for the first time. DRAM is refreshed at a much longer interval by using SCM to store the small quantity of leaky tail bits in DRAM. A two-step search technology combined with outcome forecasting is put forward to get ultra-fast read access, as well as to diminish the power and performance overheads. A hidden buffer strategy (HBS) is proposed to optimize write performance and endurance hurt. The experimental results show 45 percent reduction of power consumption and 30 percent performance optimization, which are significantly improved compared to that of both serial and parallel BSLD with a counterpart capacity

According to the characteristics of coal seam mining, an intelligent monitoring system of coal mine abscission is designed. The intelligent monitoring device includes micro laser ranging module, an integrated protective fixture, wireless transmission module, DC module, base station and upper computer software. In this paper, the structure of the system and the arrangement of measuring points are presented, the hardware and software design of the system used to accurately measure the displacement of roof abscission layer is introduced in detail, and the alarm threshold of roof abscission layer displacement is analyzed. The test results show that the system can monitor the displacement of the roof separation layer in real time.

Fluorescent and robust fibers based on gold nanoclusters-loaded alginate were successfully prepared by wet spinning of gold nanoclusters and alginate. The relationship between process conditions, mechanical properties, and fluorescent properties of fibers was investigated. The as-prepared fibers exhibited high mechanical strength (up to 7.09 cN/dtex) and remarkable red emission under ultraviolet excitation. The fibers could be used as a simple, low-cost, and high-selectivity fluorescent sensor for detecting Cu2+ and Hg2+ among various metal ions in aqueous solution, with a detection limit as low as 187.99 nM for Cu2+ and 82.14 nM for Hg2+, respectively. Furthermore, the novel fluorescent fibers were used as an anti-counterfeiting label through knitting into textile materials. The wet-spun functional fibers may be applied to the design of smart wearable sensors and flexible optical sensors.

Context: Charcoal of Chinese drugs is a kind of special processing product in Chinese medicine and used for treatment of haemoptysis, hematemesis and haemorrhage in the clinic during ancient times. During carbonizing, significant changes occur in chemical constituents and the efficacy of haemostasis will be enhanced. But the quality control standard of ‘carbonizing retains characteristics’ should be followed. Objective: This review introduces the typical methods of carbonizing, which highlight current research progress on haemostatic substances of charcoal drugs so as to provide a reasonable explanation for the theory of haemostasis treated by charcoal medicine. Methods: English and Chinese literature from 2004 to 2019 was collected from databases including Web of Science, PubMed, Elsevier and CNKI (Chinese). Charcoal drug, chemical constituents, processing, haemostasis and carbon dots were used as the key words. Results: Charcoal drugs mainly play a haemostatic role and the effect can be classified into four types to stop bleeding: removing blood stasis, cooling blood, warming meridians and astringing. Changes in composition lead to changes in pharmacodynamics. Carbonizing methods and basic research on haemostasis material in charcoal drugs have also been summarized. Conclusions: This review summarizes the classification of charcoal drugs and highlights the possible material bases for the haemostatic effect of charcoal drugs in recent years, providing new insights to future research.

Bladder cancer is the fourth most common cancer in men and is considered to have the highest rate of recurrence of all cancers at ~70%, and transitional cell carcinoma (TCC) is the most common form of intrabladder malignancy. Current standard-of-care for Stages 2 or higher is radical cystectomy, which involves removal of the urinary bladder and nearby lymph nodes. Alternative, organ-sparing treatments such as chemo- or radiotherapy are relatively ineffective against these cancers. The latter is effective when precisely targeted, but suffers from accuracy issues due to low contrast from computed tomography guidance. These motivate an innovative approach to more precisely visualize and spatially pinpoint TCC. This manuscript presents a novel non-invasive computer vision pipeline that can extract 3D structural information from 2D images obtained during routine flexible cystoscopy. The pipeline utilized camera calibration, adaptive thresholding, Scale Invariant Feature Transform (SIFT), and a Structure from Motion (SFM) implementation to reconstruct 3D point clouds of the inner surface of organ phantoms and an ex vivo porcine bladder. 3D point clouds were processed by Poisson reconstruction to generate a textured, triangle meshed 3D surface. The reconstruction pipeline generated a visually recognizable, qualitative 3D representation of the bladder from 2D video captured via flexible cystoscopy. Once further developed, this approach will enhance the targeting precision of external beam radiotherapy, providing clinicians with better organ-sparing methods to treat TCC.