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InGaN light-emitting diodes (LEDs) grown with an asymmetric multiple quantum well (MQW) are proposed for use in an optical link with an avalanche photodiode (APD) based receiver. In contrast to the high photoresponse of red AlGaInP LEDs in APDs, the proposed blue LEDs provide improved light output and enhanced system bandwidth for directed line-of-sight optical links passing through a 100-cm-long water tank. This improvement is due to the nonuniform carrier distribution within the InGaN MQWs being mitigated by using a thin GaN barrier near the n-GaN to facilitate hole transport capacity. In addition, bandwidth degradation resulting from APD module saturation can also be avoided by using these blue LEDs, successfully establishing a 300 Mbit/s LED-based underwater data link. The proposed InGaN LEDs (zero bias) under illumination exhibit a peak responsivity of 0.133 at λ = 370 nm, an ultraviolet (UV)-to-visible rejection ratio of 4849 and a 3-dB cut-off frequency of 33.3 MHz. Using violet UV laser diodes and the proposed LEDs respectively as the optical transmitter and receiver, an underwater optical link (L = 100 cm) with a data transmission rate of up to 130 Mbit/s and a bit error rate of 4.2 × 10−9 is also demonstrated.

Graphical abstract The experimental results show that the better attitude stabilization precision and the fast response speed benefit from the contactless suspension and active controllability of the axial-radial integrated AMA system, and it is potential to be applied in the airborne remote sensing system to improve the measurement accuracy., Highlights • A novel structure of AMA system is designed and constructed, and the axial control and radial control are integrated in the AMA system. • The magnetic forces and the gimbal torques of the axial-radial integrated AMA system have good actively controllability and linearity. • The good tracking performance of the AMA system is experimentally verified, and mid-frequency disturbance is effectively suppressed., Introduction The inertial stabilization platform (ISP) is widely used in the earth observation system to stably track the line of sight of the payload because it could isolate vibrations and angular motions of the aviation platform. Objectives an active magnetic actuator (AMA) system integrating the axial and the radial control is used to levitate the azimuth gimbal to improve attitude stabilization precision and dynamic performance of the ISP, and then the dynamic model of azimuth gimbal is developed. Methods The magnetic force and the gimbal torque of the axial-radial integrated AMA system are investigated, and the attitude information of the suspended azimuth gimbal is measured. Results The attitude stabilization precision of azimuth gimbal is confined at 0.02°, and the control bandwidth of the axial-radial integrated AMA system could exceed 100 Hz. Conclusion the ISP with an axial-radial integrated AMA system has better attitude stabilization precision and wider control frequency than the pure mechanical ISP, so it is potential to be applied in the airborne remote sensing system to improve the measurement precision.

Autophagy has been proved to play a vital role in cardiac hypertrophy. The present study was designed to investigate the relationship between miR-100-5p and autophagy in the development of cardiac hypertrophy. Here, miR-100-5p expression was detected in abdominal aortic coarctation (AAC)-induced cardiac hypertrophy rats and Angiotensin II (Ang II)-stimulated cardiomyocytes. In vitro and in vivo experiments were performed to explore the function of miR-100-5p on autophagy and cardiac hypertrophy. We also investigated the mechanism of miR-100-5p on autophagy with dual-luciferase reporter assays, RNA immunoprecipitation (RIP), quantitative real-time PCR (qRT-PCR), western blot, immunofluorescence, and transmission electron microscopy (TEM). The results showed that miR-100-5p was highly expressed in hypertrophic hearts and Ang II-induced cardiomyocytes. Overexpression of miR-100-5p promoted the expression of cardiac hypertrophy markers ANP, BNP and β-MHC and cell surface area, while those were suppressed by miR-100-5p inhibitor. Knockdown of miR-100-5p by antagomiR significantly improves cardiac function and attenuate cardiac hypertrophy in vivo. Mechanistic investigation has found that miR-100-5p promote autophagy by targeting mTOR. Inhibition of autophagy by 3-methyladenine (3-MA) or mTOR overexpression could reverse the function of miR-100-5p in cardiac hypertrophy. These results elucidate that miR-100-5p promoted the pathogenesis of cardiac hypertrophy through autophagy activation by targeting mTOR.

Introduction The perceived health benefits and effectiveness of electronic cigarettes (e-cigarettes) in quitting smoking may affect e-cigarette usage, however, research on the use of e-cigarettes among the Chinese, especially among the rural Chinse, is scarce. This study examined factors associated with perceptions of e-cigarette related harms, benefits, and addictiveness, among smoker and non-smoker households with children in rural China, to support the design of populationbased interventions targeting rural Chinese households. Methods In a cross-sectional study design, using a structured questionnaire, we collected data from the household members of children in two selected rural communities in China. Descriptive analyses were used to characterize respondents; χ 2 test and Fisher’s exact probability test were used to compare the perceptions of e-cigarettes between different sociodemographic groups. Logistic regression was used to determine predictors for e-cigarette harms, benefits, and addictiveness, adjusting for demographic and other characteristics. Results The overall participation rate was 81% (1211/1498). Of the participants, 668 (55%) were smokers and 543 (45%) were non-smokers; 53% knew about e-cigarettes. Participants from rural Dali (77% vs 59%), those who were ethnic minority (76% vs 59%), those who perceived increased COPD risks from smoking (mean score 4.37 vs 4.18) and concerned about harmful effects of secondhand smoke (SHS) exposure to children (mean score 4.48 vs 4.30) and adults (mean score 4.06 vs 3.87) were more likely to believe that e-cigarettes were less harmful (p

BACKGROUND Acute pancreatitis is the leading cause of hospitalization for acute gastrointestinal disease worldwide. The effects of probiotics in mild acute pancreatitis have not been studied. We hypothesized that the administration of probiotics may accelerate the recovery of intestinal function and shorten the length of hospital stay (LOS) in patients with mild pancreatitis. AIM To investigate the value of probiotics in reducing the LOS in patients with mild acute pancreatitis. METHODS We conducted a double-blind randomized clinical trial to evaluate the effects of probiotics administered to patients with mild acute pancreatitis at a tertiary medical center. The patients were given probiotics capsules (a mixed preparation of Bacillus subtilis and Enterococcus faecium) or placebo. The primary study endpoint was the LOS. The secondary endpoints included time to abdominal pain relief, recurrent abdominal pain, and time to successful oral feeding. RESULTS A total of 128 patients were included, with 64 patients in each arm. The severity of illness and the etiological distribution of disease were similar in the two groups. There was a significant reduction in the LOS in the probiotics treatment group vs the placebo group (5.36 ± 0.15 vs 6.02 ± 0.17 d, P < 0.05). The probiotics group was associated with a shorter time to abdominal pain relief and time to successful oral feeding (P < 0.01 for both) than the placebo group. No statistical difference was found in recurrent abdominal pain between the two groups. CONCLUSION The study results showed that the administration of probiotics capsules is associated with a shorter duration of hospitalization in patients with mild acute pancreatitis.

The feasibility of using InGaN/GaN multiple-quantum-well light-emitting diode arrays (LED arrays) as photodiodes (PDs) is investigated experimentally in addition to their light emitting function. Two discrete LED arrays are produced from one 4 × 4 LED array with a parallel-connected pixel configuration. Such compact designs are useful for light emission or detection at the transmitting/receiving terminals of optical wireless communication systems. Despite 4 × 2 LED arrays achieving a light output power of 67.4 mW at 250 mA, they exhibit an optical responsivity (detectivity) of 0.183 A/W (1.61 × 1012 cm Hz1/2W−1) under ultraviolet light illumination (λ = 380 nm) at zero bias. For 4 × 2 LED arrays, the presence of an appreciable ultraviolet light response, together with a high 3-dB bandwidth (∼8 MHz) for modulated light detection, allowed us to build a 15 Mbit/s directed optical link with these LEDs functioning as both the optical transmitter and the receiver. Finally, the unitary LED array-based optical link is capable of real-time transmission of digital audio signals (data rate = 6 Mbit/s) at a propagation distance of 100 cm in free space even though some of the constituent pixels are inactive for light detection.

Background: Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are a new class of treatment for renal anemia in patients with chronic kidney disease (CKD). This meta-analysis was designed to evaluate their efficacy and safety. Method: Eight databases were searched for randomized controlled trials (RCTs). Information about efficacy and safety was extracted and combined using random-effects or fixed-effects models, depending on heterogeneity. Risk of bias was assessed using the method recommended by the Cochrane Centre. Results: Nineteen articles on RCTs were selected, involving 3,289 participants. We found that HIF-PHIs improved the level of hemoglobin (Hb) (weighted mean difference [WMD] 1.40; 95% CI: 0.96–1.84; p < 0.001), response rate of Hb (risk ratio [RR] 5.95; 95% CI: 3.95–8.96; p < 0.001), and total iron-binding capacity (WMD 42.94; 95% CI: 31.39–54.49; p < 0.001), while reducing the level of hepcidin (WMD −40.42; 95% CI: −50.44 to −30.39; p < 0.001), ferritin (WMD −64.60; 95% CI: −78.56 to −50.64; p < 0.001), and transferrin saturation (WMD −5.57; 95% CI: −8.53 to −2.61; p < 0.001). Meanwhile, there was no evidence of effect on serum iron (WMD 1.60; 95% CI: −3.72 to 6.93; p = 0.55), nor on the incidence of adverse events (AEs) (RR 1.06; 95% CI: 0.99–1.15; p = 0.51) or of serious adverse events (SAEs) (RR 1.14; 95% CI: 0.88–1.46; p = 0.32). Conclusion: HIF-PHIs ameliorate renal anemia and rectify iron metabolism in the short term without increasing the incidence of AEs and SAEs.

Based on the data of 82 meteorological stations and six representative hydrological stations in four provinces in Southwest China (Guizhou, Sichuan, Yunnan, Chongqing), this paper uses standardized precipitation evapotranspiration index (SPEI) and standardized runoff index (SRI) to analyze the spatial and temporal evolution characteristics of drought in the study area from 1968 to 2018. Combined with the Southwest monsoon index and historical drought data, the correlation of drought and the applicability of different drought indices were verified. The results show that: (1) SPEI-12 in Southwest China shows a downward trend from 1968 to 2018, with a linear trend rate of −0.074/10a, and SPEI-3 has a downward trend in four seasons, the maximum linear trend rate being −0.106/10a in autumn, (2) The change in SRI-12 and SRI-24 value directly reflected the decrease in SRI value, indicating that drought events are increasing in recent times, especially in the 21st century (3). Severe drought occurred in the south of Southwest China, as indicated by the increase of drought frequency in this area. The main reason for the variations in the frequency distribution of drought in Southwest China is the combined effect of the change of precipitation and evapotranspiration. (4) The correlation between hydrological drought index and disaster areas is stronger than the correlation between meteorological drought and disaster areas.

Under the background of rapid urbanization, all kinds of urban water problems have gradually come into being: local flooding frequently happens, water environment is deteriorated, water-supply is in tension, etc. Meanwhile, with rapid development of higher education in China, campus area and scale are gradually expanding, but traditional campus construction has many drawbacks. In order to promote sponge campus planning and construction of universities in hilly areas and provide demonstration windows for sponge city construction, based on deficiencies of campus construction of Hunan City University in the aspect of water resource utilization, we used ArcGis spatial analysis method, simulation method and comparative analysis method on Storm Water Management Model (SWMM) to establish sponge campus construction indexes, content system and optimal design strategies with objectives of campus water safety, water environment and water resource utilization. Results indicate that: difference between sponge campus planning and traditional campus planning mainly lies in rainfall management. We combed the design process of sponge campus planning in hilly areas from the perspective of rainfall management, and simulated the process of sponge facilities controlling the rainfall in the campus via computer model to verify reasonability of sponge facility planning and select the optimal planning and construction plan. This study has defined design process of sponge campus planning in hilly areas to a certain degree and provided a research basis for sponge campus planning and construction of universities, setting up a typical example and driving effects on solving urban local flooding problem and rainfall resource utilization in hilly areas.

Vascular invasion (VI) in hepatocellular carcinoma (HCC) is an important clinical parameter to predict survival. In this study, we collected microRNA (miRNA) expression data from HCC patients using The Cancer Genome Atlas database and identified a novel miRNA signature associated with VI. First, we categorized HCC patients into groups with or without VI (VI+ and VI-). We identified three miRNAs (miRNA-210, miRNA-10b, and miRNA-9-1) that were associated with VI according to a Kaplan-Meier analysis. This three-miRNA signature exhibited good predictive ability for VI in patients with HCC according to a receiver operating characteristic curve analysis at 1, 3, and 5 years. Patients with HCC with a high risk score exhibited a trend toward worse outcomes as determined by multivariable Cox regression and stratified analyses. This three-miRNA signature provides an accurate prediction of VI and can be used as an independent prognostic indicator for predicting VI in HCC patients.

We hypothesized that the adipose-derived mesenchymal stem cells (ADMSCs), which secrete high amounts of soluble molecules, such as soluble tumor necrosis factor receptor 1 (sTNFR1), may ameliorate sepsis-induced acute lung injury (ALI). A total of 120 male adult Sprague-Dawley rats were separated into four groups: the sham control (SC), sepsis induced by cecal ligation and puncture (CLP), CLP-ADMSCs, and CLP-sTNFR1 small interfering RNA (siRNA) groups; CLP groups underwent CLP and then received 1 × 106 ADMSCs with or without knockdown of sTNFR1 intravenously at 1 hr after surgery. Rats were killed at 3, 6, 24, and 48 hr after the SC or CLP procedures. 5-Ethynyl-2'-deoxyuridine-labeled ADMSCs extensively colonized the lungs at 6, 24, and 72 hr after injection. The lung wet/dry (W/D) weight ratios in the CLP group were higher than those in SC group; however, ADMSCs ameliorated the W/D weight ratios following CLP, and this effect was abolished by sTNFR1 siRNA treatment. The levels of serum sTNFR1 and interleukin-10 (IL-10) were higher in the CLP-ADMSCs group and lower in the SC group than in other groups; interestingly, these levels were higher in CLP and CLP-sTNFR1 siRNA groups than in SC group. Tumor necrosis factor-α and IL-6 levels increased significantly after CLP, and ADMSCs could alleviate these changes, but the effect was weakened by sTNFR1 siRNA treatment. The lung cell apoptosis and edema levels were consistent with IL-6 levels among all groups. Therapeutically administered ADMSCs secrete sTNFR1, which most likely protects against ALI in septic rats by ameliorating inflammation and lung edema.

In this paper, a mm-Wave phased array system in package (SiP) module is designed for user equipment (UE) in 5G communication where miniature designs and full coverage is desired. An 8-element endflre linear array, its feeding network and two mm-Wave phased array integrated circuits (IC) are integrated and co-designed within an 18 × 14 × 0.575mm3 ceramic package. This module is capable of steering ±450 in Azimuth and ±300 Elevation plane delivers 10dBi array gain over 5 GHz bandwidth. With four such modules a cellular device could achieve full coverage enabling high data throughput. This proposed phased array SiP design is a good candidate for next generation mm-Wave high speed 5G UE

Background Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods. Methods The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation. Results After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216–1.596). Male had higher risk than female. People under 5 years old and people aged 15–64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons. Conclusions This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.

Biochemistry and molecular biology experiment is an important professional basic experimental course for biology majors, which plays a very important role in the cultivation of practical skills of related majors. Network teaching platform can expand the teaching time and space, and provide a public platform for the release of experimental course resources and the reform and innovation of teaching mode. This paper discusses the establishment of network assisted teaching of Biochemistry and molecular biology experiment course under the network environment combined with cloud course platform. Starting from the training objectives of the course teaching, the online course platform is used to promote the reform of practical teaching.

Objective: To delve into the correlation between miR-92b expression in peripheral plasma and hypertension, heart disease and cerebral hemorrhage. Methods: We enrolled 204 patients hospitalized in our institution from March 2016 to May 2017, including patients with hypertension (group B), hypertensive left ventricular hypertrophy (HTN-LVH) (group C), HTN-LVH complicated heart failure (group D), with 68 cases each group, and recruited another 60 healthy volunteers as control group (group A). Our team compared miR-92b level in peripheral plasma, and ultrasound indexes among the four groups and inquired into their correlation. The patients were followed up to assay miR-92b level in the peripheral plasma, cerebral edema volume and cerebral hematoma volume before and after treatment. Results: (1) In contrast to group B, the LVDs and LVMI in group C, D waxed, whereas LVEF and E/A waned (PConclusion: miR-92b expression in peripheral plasma of patients with hypertension, myocardial hypertrophy and cerebral hemorrhage is down-regulated. miR-92b probably harbors a defensive impact and participates in the pathophysiological process of hypertension, heart disease and cerebral hemorrhage.

Supplemental Digital Content is available in the text, Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, and its mortality rate is 10% to 20%. However, there are currently only a few markers to predict the prognosis in patients with TTP. We aimed to identify several clinical indices and laboratory parameters for predicting the prognosis of TTP at admission. A single-centre observational cohort study that included patients with TTP from the First Affiliated Hospital of Zhengzhou University in China was conducted from January 1, 2012 to November 30, 2018. The primary outcome was prognosis, including in-hospital mortality, major thromboembolic events, or failure to achieve remission at discharge. We used the random forest method to identify the best set of predictors. Eighty-seven patients with TTP were identified, of whom 12 died during the treatment. The total number of patients within-hospital mortality, major thromboembolic events, and failure to achieve remission at discharge was 58. The machine learning method showed that the D-dimer level was the strongest predictor of the primary outcome. Receiver operating characteristic (ROC) analysis demonstrated that the sensitivity and specificity of the D-dimer level alone for identifying high-risk patients were 78% and 81%, respectively, with an optimum diagnostic cut-off value of 770 ng/mL. The area under the ROC curve (AUC) was 0.80, and the 95% confidence interval (CI) was 0.70 to 0.90. This study found that the D-dimer level exhibited a good predictive ability for prognosis in patients with TTP. These findings may aid in the development of new and intensive treatment strategies to achieve remission among high-risk patients. However, external validation is necessary to confirm the generalizability of our approach across populations and treatment practices.

Background Adipocyte fatty acid–binding protein (FABP4) is an adipokine that plays an important role in development of cardiovascular and metabolic diseases. The aim of this study was to assess the 3-month prognostic value of serum levels of FABP4 in Chinese patients with aneurysmal subarachnoid hemorrhage (aSAH) on hospital admission. Methods This was a prospective observational study from a stroke treatment center in Zhengzhou, China. From October 2016 to May 2018, patients with aSAH who were hospitalized within 24 h were included. In addition, 202 age- and gender-matched healthy volunteers were assigned to the healthy control group. At admission, serum levels of FABP4 were measured, and patients’ characteristics, Hunt–Hess grade, and modified Fisher grade evaluated. At 3-month follow-up, functional outcome (Glasgow Outcome Scale score; dichotomized as poor [score 1–3] or good [score 4–5]) and all-cause mortality were recorded. Univariate and multivariate logistic regression models were used to investigate the association of FABP4 with the two endpoints. Results A total of 418 patients with aSAH were included in this study. The median age was 58 years (interquartile range, 49–66 years), and 57.9% were women. FABP4 serum levels were related to Hunt–Hess score (r[Spearman] = 0.381; P P P = 0.001) and 5% (odds ratio 1.05, 95% CI, 1.01–1.12; P = 0.003), respectively. Receiver operating characteristics to predict functional outcome and mortality were significantly different between conventional risk factors (difference area under the curve 0.024, 95% CI 0.018–0.032) and FABP4 plus conventional risk factors (area under the curve 0.015, 95%CI 0.011–0.020). After FABP4 was added to the existing risk factors, mortality was better reclassified and was associated with the net reclassification improvement statistic (P = 0.009), while poor outcome was better reclassified and associated with both the integrated discrimination improvement and net reclassification improvement statistics (P Conclusions Elevated serum FABP4 levels were related to poor outcome and mortality in a cohort of patients with aSAH.

Disorders of bile acids (BAs) are closely related to the development of liver and intestinal diseases, including acute pancreatitis (AP). However, the mechanism underlying the involvement of BAs in AP development remains unclear. We used intraperitoneal injection of cerulein to construct AP mouse models. These mice had significantly reduced tauroursodeoxycholic acid (TUDCA) and an imbalance of intestinal microbiota, based on 16S rDNA gene sequencing. To explore the role of AP-induced intestinal microbiota changes in the development of AP, we transplanted stool obtained from AP mice to antibiotic-treated, microbiota-depleted healthy mice. Microbiota-depleted mice presented injury to the intestinal barrier function and pancreas. Additionally, microbiota depletion reduced AP-associated pancreatic injury. This indicated that the gut microbiota may worsen AP. As TUDCA was deficient in AP mice, we gavaged AP mice with it, and evaluated subsequent expression changes in the bile acid signaling receptors farnesoid-x-receptor (FXR) and its target gene fibroblast growth factor (FGF) 15. These were downregulated, and pancreatic and intestinal barrier function injury were mitigated. Similar results were found in microbiota-depleted AP without BA treatment. However, we did not observe further downregulation of the FXR signaling pathway in microbiota-depleted AP mice given TUDCA, indicating that improvement of pancreatitis by TUDCA may be associated with gut microbiota. Our analysis of changes to the gut microbiota in AP indicated that Lactobacilli may be the key contributors. Taken together, our study shows that supplementation with BAs could improve bile acid-FXR-FGF15 signaling, and reduce pancreatic and intestinal injury, and that this effect may be associated with the gut microbiota.

Background Prenatal lipopolysaccharide (LPS) exposure causes hypertension in rat offspring through an unknown mechanism. Here, we investigated the role of the intrarenal renin-angiotensin system (RAS) in hypertension induced by prenatal LPS exposure and also explored whether adipose tissue-derived mesenchymal stem cells (ADSCs) can ameliorate the effects of prenatal LPS exposure in rat offspring. Methods Sixty-four pregnant rats were randomly divided into 4 groups (n = 16 in each), namely, a control group and an LPS group, which were intraperitoneally injected with vehicle and 0.79 mg/kg LPS, respectively, on the 8th, 10th, and 12th days of gestation; an ADSCs group, which was intravenously injected with 1.8 × 107 ADSCs on the 8th, 10th, and 12th days of gestation; and an LPS + ADSCs group, which received a combination of the treatments administered to the LPS and ADSCs groups. Results Prenatal LPS exposure increased blood pressure, Ang II expression, Ang II-positive, monocyte and lymphocyte, apoptotic cells in the kidney, and induced renal histological changes in offspring; however, the LPS and control groups did not differ significantly with respect to plasma renin activity levels, Ang II levels, or renal function. ADSCs treatment attenuated the blood pressure and also ameliorated the other effects of LPS-treated adult offspring. Conclusions Prenatal exposure to LPS activates the intrarenal RAS but not the circulating RAS and thus induces increases in blood pressure in adult offspring; however, ADSCs treatment attenuates the blood pressure increases resulting from LPS exposure and also ameliorates the other phenotypic changes induced by LPS treatment by inhibiting intrarenal RAS activation.

Background Despite significant progress in drug treatment, the prognosis of patients with advanced pulmonary arterial hypertension (PAH) remains extremely poor. Many preclinical studies have reported the efficacy of stem cell (SC) therapy for PAH; however, this approach remains controversial. The aim of this systematic review and meta-analysis is to assess the potential efficacy of SC therapy for PAH. Methods The Medline, EMBASE, Cochrane Library, and Web of Science databases were searched from inception to August 12, 2018. Preclinical studies that evaluated the use of SC therapy for PAH were included. The primary outcome was pulmonary haemodynamics, as assessed by measurement of the right ventricular systolic pressure (RVSP), mean pulmonary arterial pressure (mPAP), and/or mean right ventricle pressure (mRVP). The secondary outcomes included the weight ratio of the right ventricle to the left ventricle plus septum (RV/LV+S), the right ventricle to body weight ratio (RV/BW), the percentage of pulmonary arteriole area index (WA), and/or the percentage of medial wall thickness of the pulmonary arteriole (WT). The quality of outcomes was evaluated using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) bias risk tool. The inverse-variance method with random-effects modelling was used to calculate pooled weighted mean differences (WMDs) and 95% CIs. Statistical analysis was performed with STATA 14.0. Results Twenty-eight eligible articles (722 animals) were included. SC therapy reduced the pooled WMDs (95% CIs) of RVSP, mPAP, mRVP, RV/LV+S, RV/BW, WA, and WT for animals with PAH, with values of − 14.12 (− 14.63, − 13.61), − 11.86 (− 12.35, − 11.36), − 17.33 (− 18.10, − 16.56), − 0.10 (− 0.10, − 0.09), 0.23 (0.21, 0.24), − 13.66 (− 15.71, − 11.62), and − 7.96 (− 7.99, − 7.93), respectively. Conclusions SC therapy is effective for PAH in preclinical studies. These results may help to standardise preclinical animal studies and provide a theoretical basis for clinical trial design in the future. Systematic review registration PROSPERO (http://www.crd.york.ac.uk/PROSPERO). Electronic supplementary material The online version of this article (10.1186/s13287-019-1162-8) contains supplementary material, which is available to authorized users.

BACKGROUND: There are conflicting results regarding whether corticosteroids have better efficacy than placebo in acute respiratory distress syndrome (ARDS) patients. Therefore, we aim to further evaluate the efficacy and safety of corticosteroids in adult ARDS patients. METHODS: The databases, including Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, were searched from their inception to May 2, 2020. Randomized controlled trials (RCTs) and observational cohort studies were selected to assess the use of corticosteroids in adult ARDS patients. The quality of the results was judged by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The inverse-variance method with random or fixed effects modeling was used to compute pooled odds ratio (OR), standardized mean difference (SMD), and their 95% confidence interval (CI). RESULTS: Eight eligible RCTs and six cohort studies were included. The use of corticosteroids was associated with reduced mortality (OR 0.57, 95% CI 0.43–0.76, I2=35.1%, P=0.148) in ARDS patients, and the result was confirmed in the included cohort studies (OR 0.51, 95% CI 0.27–0.95, I2=66.7%, P=0.010). The subgroup analysis stratified by the initiation time and duration of corticosteroid use showed that early ARDS and prolonged corticosteroid use had significant survival benefits in the RCTs. The low-dose corticosteroid use was also associated with significantly more ventilator-free days and a reduced rate of new infections in ARDS patients. CONCLUSIONS: The low-dose corticosteroid therapy may be safe and reduce mortality, especially in patients with prolonged treatment and early ARDS.

How to perform sheet metal forming in a rapid and cost-efficient way, especially for the small-batch productions, has been a challenge to the manufacturing industry for a long time. Incremental sheet forming (ISF) has vast potentials in rapid and economical production of small-batch thin-walled parts, but so far, the technology is mainly applied in a limited forming range of planar sheets, most with a deformation mode of bi-axial stretching. To establish a more complete forming chain based on ISF and then take full advantage of it, this paper proposed a new methodology called “Multi-directional Incremental Sheet Forming (MISF),” particularly aiming to accomplish the non bi-axial stretching formation of thin-walled structures such as flanging, curling, and localized forming of planar sheets and hollow profiles. The method can not only extend the application of conventional ISF, but also can fabricate some special-shaped shell components which are hard to integrally form by any other ways. Thus, it can provide a strong support to realize the lightweight of structures. The progress review of MISF was presented, and the mechanical features during forming, including the complex coupled elastic-plastic deformation, buckling and post-buckling, the combination of constrained and free deformations, etc., were summarized. Moreover, key items of defect control were addressed.

Comparing with the normal mechanical inertial stabilized platform (ISP), the novel ISP with magnetic bearing to suspend the yaw gimbal owns the ability of isolating the vibration and disturbance of external gimbal. However, on the one hand, complex structure of the magnetically suspended gimbal introduces parametric uncertainties into modeling of magnetic suspension force, and the disturbance of magnetic fields brings the unmodeled force into dynamics of magnetically suspended gimbal. On the other hand, external disturbances such as wind drag affect the stability of magnetically suspended gimbal. Therefore, H∞robust controllers for translation and tilting of gimbal are designed to dampen the negative influence on stability and improve the robustness of system. The experimental results indicate that the robust controller of magnetically suspended gimbal owns the excellent robustness when the load of magnetically suspended gimbal changes.

Purpose The purpose of this paper is to explore self-management among informal tourism employees in urban China with the theoretical basis of Jianghu and reveal the forming process and operation mechanism of China’s urban informal organizations’ self-management. Design/methodology/approach This paper adopts process–event analysis of informal tourism photographers surrounding Guangzhou Tower. Conducting field inspection and in-depth interviews, the forming process is analyzed and typical events are captured to unveil this self-management mechanism. Findings The self-management of informal tourism employees in China is based on the Jianghu theory, which specifies the role, obligation and responsibility of a member. These above rely on word-of-mouth order or implicit ways to treat newcomers, realize internal communication and deal with public affairs. Brotherhood, benevolence and etiquette make up the core values of the Jianghu theory that advises strategies in dealing with different events. This self-management, based on the Jianghu theory, has not only effectively solved internal conflicts, but has also achieved the goal of social management. Originality/value Informal employees’ self-management is extremely important due to the high cost of government intervention. Through China’s urban informal tourism employees’ Jianghu-styled self-management, the paper shows that the government should not crack down on this group indiscriminately. Instead, it should, through the management agent, set up effective Jianghu rules to realize regular control over this group.

Flanging of sheet metals in a rapid and cost-efficient way is strongly needed in practice. This paper describes a flexible and versatile flanging method based on the single-point incremental sheet forming (ISF) technology utilizing simple bar tools with tapered shoulders in a two-stage procedure. The experiment and numerical simulation used Al 6061 sheets with a thickness of 1 mm. The results confirmed that forward/backward flanging of various open edges and hole rims of plates can be performed by this method without dedicated die. This gives a more complete flexible forming chain based on ISF. In contrast to conventional ISF, however, dieless incremental flanging gives particular force and deformation modes and might form different defects including plate warpage and buckling at flange onset. A larger inclination angle θ of the tool shoulder decreases the tendency of buckling but might incur larger warpage. The recommended θ -value for round-hole-flanging is 20–30°. Curved plates have less warpage versus planar ones because the curvature enhances structural stiffness. Moreover, control strategies of typical defects were presented mainly through the path optimization and geometry modification of tools.

A comparative investigation on device characteristics of AlGaN/GaN high electron mobility transistors (HEMTs) with SiNx, SiOx, and SiON passivation by using plasma enhanced chemical vapor deposition (PECVD) technique is conducted. The electrical performance of passivated GaN HEMTs are evaluated through DC current-voltage, pulsed current-voltage, and small-signal measurements. Obvious increases of 10.5% in drain current and of 8.6% in transconductance are observed for SiON passivated HEMT as compared with both the SiOx and SiNx passivated HEMTs. The SiOx passivated device is found to have lowest gate leakage current as well as off-state drain leakage current as compared to SiNx and SiON passivated devices. However, the pulsed I-V measurement shows a severe current collapse for SiOx passivated HEMT caused by the introducing of deep traps when compared with the SiNx and SiON passivated devices. Moreover, the small-signal measurement shows that the SiON passivated HEMT has a higher cut-off frequency due to the improvement in transconductance, which makes it a promising passivation layer for GaN based high power HEMT applications.

OBJECTIVE To study the effect of nurse-led counselling on the anxiety symptoms and the quality of life following percutaneous coronary intervention for stable coronary artery disease. DESIGN Randomised control trial. SETTING Rural and remote China. PARTICIPANTS Rural and remote patients were consecutively recruited from a medical centre located in China between January and December 2014. INTERVENTIONS The control group received standard pre-procedure information from a ward nurse on the processes of the hospitalisation and percutaneous coronary intervention, and post-procedural care. The intervention group received a structured 30-minute counselling session the day before and 24 hours after the percutaneous coronary intervention, by nurse consultants with qualifications in psychological therapies and counselling. The health outcomes were assessed by a SF-12 scale and the Seattle Angina Questionnaire at 6 and 12 months after percutaneous coronary intervention. The anxiety and depression symptoms were evaluated by a Zung anxiety and depression questionnaire. MAIN OUTCOME MEASURES Cardiac outcomes, quality of life and mental health status. RESULTS Eighty patients were randomly divided into control (n = 40) and intervention groups (n = 40). There was a significant increase in the scores of the three domains of Seattle Angina Questionnaire 12 months after percutaneous coronary intervention in the intervention group (P

Background Treatment with bone marrow mesenchymal stem cells (BM-MSCs) has been demonstrated to be an excellent cellular-based therapeutic strategy for treating myocardial infarction (MI). However, most of the patients suffering with MI are elderly. Hypoxic conditions can cause apoptosis of BM-MSCs, and this type of apoptosis is more prevalent in aged BM-MSCs. Decreased autophagy is one of the mechanisms underlying aging. The aim of this study is to uncover whether the increased hypoxic injury of aged BM-MSCs is due to autophagy and whether reducing autophagy diminishes the tolerance of hypoxia in aged BM-MSCs. Methods Young and aged BM-MSCs were isolated from male young and aged GFP/Fluc transgenic C57BL/6 mice respectively and then exposed to hypoxia and serum deprivation (H/SD) injury. The apoptosis level induced by H/SD was measured by terminal deoxynucleotidy transferase-mediated dUTP nick end-labeling (TUNEL) assay. Additionally, autophagy was analyzed via transfection with plasmids encoding green fluorescent protein-microtubule-associated protein lightchain3 (GFP-LC3), and autophagic vacuoles were visualized with transmission electron microscopy. Meanwhile, protein expression was measured by western blot analysis. Autophagic activity was manipulated by the administration of IGF-1 (insulin-like growth factor siRNA) and 3-methyladenine (3MA). Furthermore, young, aged, and the IGF-1 siRNA-transfected aged BM-MSCs were transplanted to myocardial infarcted adult C57BL/6 mice respectively. In vivo longitudinal in vivo bioluminescence imaging (BLI) of transplanted BM-MSCs was performed to monitor the survival of transplanted BM-MSCs in each groups. Results Aged BM-MSCs exhibited a higher rate of apoptosis compared with young BM-MSCs under hypoxic conditions. Additionally, the level of autophagy was lower in aged BM-MSCs compared with young BM-MSCs under normoxic and hypoxic conditions. Meanwhile, hypoxia decreased the activity of the protein kinase B (Akt) and mammalian target of rapamycin (mTOR) signaling pathway in young and aged BM-MSCs, but aged BM-MSCs exhibited a relatively stronger Akt/mTOR activity compared with young BM-MSCs. In addition, IGF-1 knockdown significantly decreased the level of apoptosis in aged BM-MSCs under normoxic and hypoxic conditions. IGF-1 knockdown also decreased the activity of the Akt/mTOR signaling pathway and increased the level of autophagy in aged BM-MSCs under hypoxic condition. Furthermore, IGF-1 knockdown protected aged BM-MSCs from hypoxic injury by increasing the level of autophagy, thereby promoting the survival of aged BM-MSCs after myocardial infarction transplantation. Conclusion This study demonstrates that reducing autophagy decreases the hypoxia tolerance of aged BM-MSCs. Maintaining optimal levels of autophagy may serve as a new strategy in treating MI by BM-MSC transplantation in aged patients. Electronic supplementary material The online version of this article (10.1186/s13287-018-1028-5) contains supplementary material, which is available to authorized users.

Background The ProCESS, ARISE, and ProMISe trials have failed to show that early goal-directed therapy (EGDT) reduces mortality in patients with severe sepsis and septic shock. Although lactate-guided therapy (LGT) has been shown to result in significantly lower mortality, its use remains controversial. Therefore, we performed a meta-analysis to evaluate EGDT vs. LGT or usual care (UC) in adult patients with severe sepsis and septic shock. Methods Relevant randomized controlled trials published from January 1, 2001 to March 30, 2017 were identified in PubMed, EMBASE, Web of Science, and the Cochrane Library. The primary outcome was mortality; secondary outcomes included red cell transfusions, dobutamine use, vasopressor infusion, and mechanical ventilation support within the first 6 h and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Results Sixteen studies enrolling 5968 patients with 2956 in EGDT, 2547 in UC, and 465 in LGT were included in this meta-analysis. Compared with UC, EGDT was associated with a lower mortality (10 trials; RR 0.85, 95% CI 0.74–0.97, P = 0.01), and this difference was more pronounced in the subgroup of UC patients with mortality > 30%. In addition, EGDT patients received more red cell transfusions, dobutamine, and vasopressor infusions within the first 6 h. Compared with LGT, EGDT was associated with higher mortality (6 trials; RR 1.42, 95% CI 1.19–1.70, P = 0.0001) with no heterogeneity (P = 0.727, I2 = 0%). Conclusion EGDT seems to reduce mortality in adult patients with severe sepsis and septic shock, and the benefit may primarily be attributed to red cell transfusions, dobutamine administration, and vasopressor infusions within the first 6 h. However, LGT may result in a greater mortality benefit than EGDT. Electronic supplementary material The online version of this article (10.1186/s12967-018-1700-7) contains supplementary material, which is available to authorized users.

The massive scale of future wireless networks will create computational bottlenecks in performance optimization. In this paper, we study the problem of connecting mobile traffic to Cloud RAN (C-RAN) stations. To balance station load, we steer the traffic by designing device association rules. The baseline association rule connects each device to the station with the strongest signal, which does not account for interference or traffic hot spots, and leads to load imbalances and performance deterioration. Instead, we can formulate an optimization problem to decide centrally the best association rule at each time instance. However, in practice this optimization has such high dimensions, that even linear programming solvers fail to solve. To address the challenge of massive connectivity, we propose an approach based on the theory of optimal transport, which studies the economical transfer of probability between two distributions. Our proposed methodology can further inspire scalable algorithms for massive optimization problems in wireless networks., 6 pages, 5 figures

In this paper, a novel millimetre wave (mm-Wave) flat lens antenna system and its feed network co-designed on a mainstream print circuit board (PCB) technology is presented. It is capable of achieve 3600 coverage scan in Azimuth plane with> 14 dBi measured peak gain and the measured return loss is < 10 dB. Steering in the Elevation plane is designed to be 150upwards; this is controlled by the metal flanges opening angles as they are soldered on both side of the lens. This lens antenna system can be a great candidate for 5G access point operates at mm-Wave. The same technique could be also applied in smaller devices such as cellular phone or tablets.

The existing joining by forming technologies all have limitations in the connection of metallic sheets with large differences in thickness and mechanical properties. This paper developed a new clinching method called flat hole-clinching (FHC) that is suitable for assembling two layers of sheets with dissimilar (as well as similar) materials and thicknesses without protrusion at the joints. The method utilizes a simple punch to force the material of one plate (the upper plate) to flow into the cavity of a specially prepared hole on another plate (the lower plate), forming an interlocked structure. Al 6063 and AZ31 plates with thicknesses of 0.8 and 1.0 mm, respectively, were employed in the experiment and numerical simulation to examine the impact of tool and hole geometries, material properties, and relative thicknesses on joints. Inverted conical holes were used as the precut hole. The results confirmed that various combinations of sheets can be connected reliably by FHC, with even higher joining strengths in comparison to conventional clinching. Besides the diameter dH of the precut hole, hole conicity β and punch diameter dp were found to have a significant influence on the strength according to the results of the response surface analysis (RSA). The suitable β-value is about 25 degrees in this case.

In order to improve the prediction precision and accuracy of Chinese food price, the application of fuzzy neutral network on it in studied in depth. Firstly, the situation of China food price is analyzed. Secondly, the basic theory of fuzzy neutral network is analyzed. Thirdly, the training algorithm of fuzzy neutral network is designed. Finally, a simulation analysis is carried out for food prices in a province and results show that the fuzzy neutral network is an effective tool for predicting the Chinese price.

To compare extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) in terms of efficacy, complications, and overall efficiency in the management of proximal ureteral calculi. ESWL and URSL are the 2 most common modalities for treating ureteral stones. Previous studies and meta-analyses suggest that for stones 10 mm, ESWL is safer and of comparable efficacy compared with URSL. However, the choice between one modality over the other for the treatment of stones10 mm is not as clear.The literature was reviewed in the databases, and resulting reports were screened for relevance. This process yielded 10 articles, which were analyzed in terms of the initial stone-free rate (primary outcome measure) compared between the 2 treatment modalities. Pretreatment rate, operation time, auxiliary procedure rate, and complication rate constituted secondary measures in the analysis.A statistically higher initial stone-free rate was demonstrated for URSL compared with ESWL (odds ratio [OR] = 0.349; 95% confidence interval [CI] = 0.183-0.666; P = .001). ESWL showed a statistically higher retreatment rate compared with URSL (OR = 7.192; 95% CI = 4.934-10.482; P .001). The 2 treatment modalities did not show statistically significant differences in mean operating time (OR = 10.35; 95% CI = -0.29 to 20.99; P = .056), auxiliary procedure rate (OR = 1.043; 95% CI = 0.415-2.616; P = .929), or in the complication rate (OR = 0.78; 95% CI = 0.304-1.984; P = .598).For treating large (10 mm) proximate ureteral stones, URSL tends to be more effective than ESWL, yet without adding significant risk.

In the processing of large and ultra-large forgings, the heated billets need to be properly placed on the lower forging die as quickly as possible before the plastic forming, or else the cooling of billets incurs enormous risks to the operation. This paper presents a novel methodology for examining the positioning status of billets on a forging die based on multi-body dynamics simulation and design of experiment (DOE). Using this method, the position and posture of a billet can be theoretically predicted after falling into the cavity of lower die from a manipulator with varying initial states. The method can also clarify the initial geometrical position parameters of the billet that should be strictly controlled in the operation of the manipulator above the lower die. Furthermore, finite element method (FEM) simulation can be used to analyze plastic deformations of the billets on the lower die surface with varying states, to attain in-depth understanding of the influence of the geometric states of billets in forming processes. A case study of forging with Al 7050 indicates that the method can provide a valuable reference for the rapid positioning of billets on the lower die.

In a recent paper, Chang et al. proposed an authentication scheme for E-coupon systems and proved that their scheme can prevent a range of attacks. In this paper, we reanalyze the Chang et al.’ scheme and demonstrate that it cannot resist off-line password attack, masquerading shop attack and masquerading customer attack. Moreover, it cannot achieve two security properties that is anonymity and traceability. Meanwhile, Lee proposed an efficient chaotic maps-based authentication and key agreement scheme using smartcards for telecare medicine information systems. In the scheme, we find it also cannot resist off-line password attack, masquerading attack. Unfortunately, it resists an deadly error. So the scheme cannot run.

As an emerging flexible manufacturing technology, incremental forming of tubes has the ability to produce various tubular parts, including those that are difficult to integrally form using other methods. Due to the nature of hollow and thin-walled geometry, the deformation mechanism in the incremental forming of tubes is quite different from that of conventional incremental forming of sheets. This paper summarizes a list of typical tubing that can be formed incrementally and then examines the processes used to form four types of tubular parts, including axisymmetric expansion/reduction of tube ends, tube wall grooving, and hole flanging. This is done primarily from the perspective of phenomenology by using experiments and numerical simulation. Typical deformation behaviors of the workpieces were revealed and discussed. Three basic deformation modes in terms of variations in wall thickness, namely thinning (such as in end expansion), thickening (such as in end reduction), and invariant or almost constant thickness (such as in part of the wall grooving), were found to exist during incremental tube forming. Regarding the formability limits of the tube, incremental forming has its own advantages and disadvantages when compared with pressing.

An on-chip DC-DC converter for energy harvesting is proposed for a new battery-less solar cell tag applied to the Internet of Things (IoTs) devices. The main purpose of this design is to maximize the transfer efficiency and to stably provide a high enough supply voltage to the back-end loads. The overall circuit consists of a crosscoupled charge pump, a maximum power point tracking (MPPT) circuit, a timing control circuit and regulator. The input voltage range is from 0.45V to 3V. The output voltage can be boosted to the required level, in the range of 1V to 3.3V, with more than 60% power conversion efficiency. The throughput power is at least 500pW. A gated clock frequency modulation circuit is designed and adopted in the MPPT unit to lock the input resistance of the charge pump. In addition, a low-dropout (LDO) regulator circuit is used to provide a stable voltage to the load. The experimental results of chip show that the maximum power conversion efficiency (PCE) is 80% at 33pW input power condition.

This paper proposes a high resolution capacitive touch panel readout circuit to sense the Variation by self-capacitance method. This AM display of in-cell structure includes an active architecture for improved resolution, that controlling the TFT (Thin-film transistor) to make the accuracy better. In addition, the panel has 60 sensing point per 0.88 inches and the proposed readout circuit used switched capacitor charge amplifier (SCCA) to sensing the charge change and enhances the SNR (Signal-to-noise) by eliminating the baseline. The experimental results show that the proposed readout circuit SNR achieves 38dB and the frame rate is 200Hz.

Recently, after analyzing Jiang et al. and He et al.’s remote user authentication scheme, Kumari et al. detected some defects in their own protocol and designed a user anonymous password authentication scheme without smart card. They claimed that their protocol is rigorous to resist a wide range of network attacks. Unfortunately, based on the analysis of a large amount of experiments, we found that their protocol is not robust enough when facing with changing session key attack. The user and server cannot achieve the consistency of the session even though they have been authenticated each other.

Telecare medicine information system (TMIS) provides a convenient and efficient communicating platform for patients at home and physicians at medical clinics. To protect the information of patients and servers secret, a series of authentication schemes for TMIS have been proposed. Recently, Debasis et al. proposed an RSA-based remote user authentication for TMIS. Meanwhile, they claimed that their scheme can resist various attacks. Unluckily, after analyzed Debasis et al.’s scheme, we find that their scheme cannot resist some attacks. Besides, if an adversary has guessed the patient’s password, he/she can compute the session key between the patient and server. In order to enhance the security of authentication scheme for TMIS, we propose a new scheme based on extended chaotic map. Compared with the previous schemes, our scheme not only possesses robust security, but also has better efficiency.

Extending incremental forming technology into the production of tubular parts has promising prospects; however, fundamental rules of the approach have not yet been fully revealed and knowledge on the technology is lacking. This paper is focused on the dieless incremental hole-flanging of thin-walled tube for producing branched tubing. 316L stainless steel tubes with an outer diameter of 38 mm and thickness of 0.5 mm were used for the experiment and numerical simulations. Considering the uncertainty of initial curl direction of the tube wall at the extrados, where buckling is also prone to occur due to the excessive axial pressure during the forming course, an improved bar tool with a conical surface was proposed. Estimation of the precut hole size and processing route planning were discussed based on the designed branching. Force and deformation behavior along with the defects in the process, which are quite different from those in conventional incremental sheet forming, were summarized. The results prove that it is feasible to produce specific tubular parts by means of incremental forming with obvious flexibility, agility, and expandability.

Background Despite the fact that recent evidence from meta-analysis of randomized trials indicates an increase in mortality, perioperative treatment with β-blockers is still widely advocated. We therefore performed a meta-analysis of cohort studies to evaluate the effects of perioperative β-blockers on mortality in patients undergoing non-cardiac surgery in the real world scenarios. Methods We searched PubMed and Embase from the inception to April 2014 for cohort studies, assessing the effect of perioperative β-blockers on mortality in patients undergoing non-cardiac surgery. Adjusted relative risk (RR) with 95% confidence interval (CI) was pooled using random effect models. Results Eight cohort studies with a total of 470,059 participants (180,441 patients in the β-blocker group and 289,618 patients in the control group) were included in this meta-analysis. Perioperative β-blockers were not associated with a reduced risk of mortality (RR=0.88, 95% CI, 0.75 to 1.04), postoperation myocardial infarction (RR=1.30, 95% CI, 0.76 to 2.23), and postoperation stroke (RR=1.17, 95% CI, 0.53 to 2.57). However, in subgroup analysis of mortality, taking β-blockers on the day of surgery caused statistically significant increase in mortality of 91% (RR=1.91, 95% CI, 1.01 to 3.62). Conclusions In the real world scenarios, for patients undergoing non-cardiac surgery, the routine use of β-blockers does not seem to reduce the risk of death. Moreover, those who are taking β-blockers on the day of surgery may have an increased risk of postoperative mortality. However, these results should be interpreted with caution because of the significant heterogeneity across the studies.

Developments in endovascular therapy and laparoscopy have led to the expansion of minimally invasive surgical techniques in the treatment of renal artery aneurysm (RAA). In this study, we introduced a new surgical technique that combined the clipping technique widely used in neurosurgery with laparoscopic surgery to clip the aneurysm. RAA clipping was performed by retroperitoneal laparoscopy, and the procedures were completed with no conversions to open surgery. In addition, no perioperative complications were recorded. Our preliminary experience suggests that laparoscopic RAA clipping surgery is feasible and appears to be safe. Laparoscopic RAA clipping surgery has advantages of a simplified surgical process, short warm ischemia time, and excellent cosmetic results.

Differential pressure flow meter is a kind of very promising flow measuring instrument, the application range is very wide. But aiming at the defects that the mechanical structure of all kinds of existing flow meters is complex, the throttling way disturbs the fluid greatly and the stability of differential pressure signal is insufficient, a kind of new inside and outside tube differential pressure flow meter was designed.

A traditional rotary draw bending die on the numerically controlled (NC) tube benders or other benders can bend tubes with only one kind of outer diameter. It is difficult for such a situation to meet the requirement of modern manufacturing with characters of much varieties and small batch. The present study proposed a new concept of rotary draw bending die called MDB-Die (Multiple-diameter Bending Die), on which tubes with different outer diameters within a definite range can be bent using the same die by only adjusting the pads inside the die set. Numerical and experimental approaches were employed to investigate the forming process of tubes with different outer diameters when bent on the MDB-Die, especially on the characters of force and elastic-plastic deformation of tube wall, and the effects of groove shapes and bending parameters on the cross-section distortion and wall thinning in the process. Analytical expressions in simple tube bending based on plastic theories given by Tang (2000) for calculating the magnitude of stresses, together with the wall thickness change, deviation of the neutral axis, and section flattening, were also used for comparison. The result proved that tubes with different outer diameters (from 18 to 25 mm in the study) can be bent successfully on MDB-Die without degrading the bending quality, i.e., the aspect ratios of section distortion of less than 5% and wall thinning of less than 7.8%.

The existence of relatively high protrusions above the sheets on most of the clinched joints could sometimes bring about an undesired result in the subsequent processing and, therefore, the application of the clinching technologies might be restricted. The current study proposed a countermeasure by imposing compression on the joints with a pair of contoured tools and then obtaining a controlled local plastic deformation of the joints, resulting in a reduction of the protrusion height. A typical two-layer clinching of 6063 aluminum alloy sheets with the thickness of 0.8 mm was employed to study the successional processes of clinching, reshaping, and separation. Geometrical parameters of the reshaping tools were optimized in terms of pull-out strength on the basis of numerical simulation and orthogonal design. It was found that diameter d of the truncated cone end on the reshaping die, inclination α of the truncated cone, and then fillets of the die and punch are of important influence on the connecting strength. Moreover, connecting strengths of the clinched joints before reshaping and after reshaped with the optimal parameters of the tools were compared experimentally. The results show that the protrusion height of the clinched joints can be reduced dramatically by the method without decreasing the connecting strength. In the example, the protrusion height of the clinched joint decreased from 1.7 to 0.68 mm, while the average pull-out strength of the joints increased from 230.8 to 331.4 N, and the shear strength increased from 559.7 to 657.5 N.