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Abstract Objective The aim of this study was to investigate the association between quantitative coronary flow reserve (CFR) and the blood uric acid/albumin ratio, as well as multiple clinical parameters, in order to assess the severity of coronary artery functional stenosis. Methods This retrospective cross-sectional study included 257 suspected coronary artery disease patients who underwent coronary angiography (CAG) and quantitative flow ratio (QFR) examinations in the Department of Cardiovascular Medicine at the First Affiliated Hospital of Yangtze University in Jingzhou City, China, between September 2022 and March 2023. The study subjects were divided into two groups based on their QFR values: QFR ≤ 0.80 group and QFR > 0.80 group. Correlation of uric acid-to-albumin ratio (UAR), high-density lipoprotein ratio (MHR), systemic immune-inflammation index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI) with coronary artery QFR was analyzed using univariate and multivariate logistic regression models, considering them as both continuous and binary variables. Results The QFR ≤ 0.80 group consisted of 83 patients, while the QFR > 0.80 group included 174 patients. Significant differences were observed between the QFR ≤ 0.80 and QFR > 0.80 groups in the following parameters: UAR (9.19 ± 2.47 vs 7.61 ± 1.91; p

IntroductionIn the realm of emerging e-commerce platforms, the influence of online shopping events, specifically online carnival promotions (OSC), on consumer behavior is a significant area of interest.This paper delves into the effects of such promotions on consumer perceptions, a topic that has not been extensively explored in academic research.MethodsTo investigate this phenomenon, two distinct studies were conducted. The first study employed a questionnaire-based experiment involving 220 participants, divided into two groups. The first study examined the mediating role of cognitive legitimacy in the relationship between OSC events organized by new e-commerce platforms and the perceptions of consumers. The second study utilized an event-related potentials (ERPs) experiment with 33 participants to explore the differences in consumer perceptions between OSC promotions and general promotions by new e-commerce platforms. This study measured the brain’s response to promotional stimuli to gain insights into the cognitive processes involved.ResultsThe first study yielded results that suggest OSC activities can facilitate the establishment of cognitive legitimacy for new e-commerce platforms. This, in turn, was found to be associated with an increase in positive purchase intentions among consumers. In the second study, the ERPs data indicated that exposure to OSC promotional materials elicited larger P2 and N2 ERP components when participants were presented with the logo of a new e-commerce platform. This was in contrast to the response to general promotional materials, suggesting a heightened cognitive and perceptual engagement with OSC promotions.DiscussionThe findings from both studies collectively imply that OSC promotions have a distinct impact on consumer perceptions and cognitive processes. The implicit memory triggered by these promotions appears to influence the identification of new platforms and the mechanisms of cognitive control during online shopping. This, in turn, may have implications for explicit consumer behavior, suggesting that OSC promotions could be a powerful tool for shaping consumer attitudes and behaviors in the e-commerce space. The results underscore the importance of understanding the nuances of consumer engagement with new e-commerce platforms and the role of promotional strategies in fostering a positive brand image and consumer loyalty.

C46H58N2O14Cl2, triclinic, P1‾$P\overline{1}$ (no. 2), a = 7.5623(2) Å, b = 10.87056(17) Å, c = 13.90486(15) Å, α = 105.7122(12)°, β = 98.907(2)°, γ = 91.067(2)°, V = 1084.88(4) Å3, Z = 1, Rgt(F) = 0.0341, wRref(F2) = 0.0935, T = 100(2) K.

Abstract Through extensive multisystem phenotyping, the central aim of Project PICMAN is to correlate metabolic flexibility to measures of cardiometabolic health, including myocardial diastolic dysfunction, coronary and cerebral atherosclerosis, body fat distribution and severity of non-alcoholic fatty liver disease. This cohort will form the basis of larger interventional trials targeting metabolic inflexibility in the prevention of cardiovascular disease. Participants aged 21–72 years with no prior manifest atherosclerotic cardiovascular disease (ASCVD) are being recruited from a preventive cardiology clinic and an existing cohort of non-alcoholic fatty liver disease (NAFLD) in an academic medical centre. A total of 120 patients will be recruited in the pilot phase of this study and followed up for 5 years. Those with 10-year ASCVD risk ≥ 5% as per the QRISK3 calculator are eligible. Those with established diabetes mellitus are excluded. Participants recruited undergo a detailed assessment of health behaviours and physical measurements. Participants also undergo a series of multimodality clinical phenotyping comprising cardiac tests, vascular assessments, metabolic tests, liver and neurovascular testing. Blood samples are also being collected and banked for plasma biomarkers, ‘multi-omics analyses’ and for generation of induced pluripotent stem cells (iPSC). Extensive evidence points to metabolic dysregulation as an early precursor of cardiovascular disease, particularly in Asia. We hypothesise that quantifiable metabolic inflexibility may be representative of an individual in his/her silent, but high-risk progression towards insulin resistance, diabetes and cardiovascular disease. The platform for interdisciplinary cardiovascular-metabolic-neurovascular diseases (PICMAN) is a pilot, prospective, multi-ethnic cohort study.

The compact internal structure of the bulb tubular turbine generator (BTTG) leads to poor ventilation and heat dissipation capability (VHDC). It will result in high-temperature faults and lead to losses for the hydro-power station, if the staff at the hydropower station fail to promptly regulate the external forced air cooling for effective heat dissipation. Thus, a specific and effective ventilation control strategy (VCS) is of utmost importance for the operation of the BTTG. In this study, the finite element method (FEM) was employed to solve the magnetic-flow-thermal coupled field of a 24-MW BTTG. The distribution characteristics of electromagnetic losses and their impact on the temperature field were revealed. Experimental validation was conducted to verify the effectiveness of the numerical results. The response surface methodology (RSM) was employed to design an experimental plan by building upon this foundation. Integrated with a multiobjective genetic algorithm (MOGA), an optimal relationship between ambient temperature, fan flow rate, and heating components’ temperature was established. This relationship serves as the optimized ventilation control strategy for the BTTG. This research provides a theoretical framework for the formulation of operational guidelines to ensure the safe operation of generators.

Objective To explore the efficacy of wrapping the hepatic artery with detached ligamentum teres hepatis during pancreaticoduodenectomy (PD) on preventing postoperative intra-abdominal hemorrhage. Methods A total of 186 patients who received PD in the First Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2022 were divided into wrapping group (n=86) and non-wrapping group (n=100) according to whether the detached ligamentum teres hepatis was used to wrap the hepatic artery during the operation. The clinical data on perioperative and postoperative complications were collected and retrospectively analyzed in two groups. Results PD was successfully performed and completed in both groups, and there was no significant difference in age, gender, BMI, length of hospital stay, operative time and intra-operative blood loss between two groups (P＞0.05) . The incidences of pancreatic fistula, biliary fistula and abdominal infection were similar in two groups (P＞0.05) , but the incidence of postoperative bleeding in wrapping group was significantly lower than that in non-wrapping group (1.16% vs 9.00%, P＜0.05) . Logistic regression analysis showed that the pancreatic and biliary fistulas of grade B/C were the independent risk factors for postoperative abdominal bleeding after PD (P＜0.05) , and the wrapping of the hepatic artery with the detached hepatic round ligament during operation was an independent protective factor for postoperative abdominal bleeding after PD (P＜0.05) . Conclusion Wrapping the hepatic artery with detached ligamentum teres hepatis during PD surgery may reduce the incidence of postoperative abdominal bleeding and is simple, safe and feasible to perform without additional complications．

Objective This study aimed to identify novel pathogenic genes and variants in a Chinese family with premature ovarian insufficiency (POI).Methods A Chinese POI family was enrolled in this study. Whole exome sequencing was performed on the proband and her mother to identify the potential causative genes and variants and Sanger sequencing was used to confirm the finally identified potential pathogenic variant in the family.Results An assessment of the family pedigree suggested that POI was inherited in an autosomal dominant manner in this family. A novel missense variant of the laminin subunit gamma-1 gene (LAMC1; NM_002293.4: c.3281A > T, p.D1094V) was finally identified in the proband and her affected mother. This variant was not found in any public databases. In silico analysis indicated the amino acid encoded at the variant site was highly conserved among mammals and associated with decreased protein stability and disrupted protein function. Its presence in the POI family was confirmed by Sanger sequencing.Conclusions This study firstly reported a novel missense variant of LAMC1 in a Chinese POI family, which was inherited in an autosomal dominant manner. This variant may result in the development of POI. Our results provide supporting evidence for a causative role for LAMC1 variants in POI.

In electroencephalography (EEG) classification paradigms, data from a target subject is often difficult to obtain, leading to difficulties in training a robust deep learning network. Transfer learning and their variations are effective tools in improving such models suffering from lack of data. However, many of the proposed variations and deep models often rely on a single assumed distribution to represent the latent features which may not scale well due to inter- and intra-subject variations in signals. This leads to significant instability in individual subject decoding performances. The presence of non-trivial domain differences between different sets of training or transfer learning data causes poorer model generalization towards the target subject. However, the detection of these domain differences is often difficult to perform due to the ill-defined nature of the EEG domain features. This study proposes a novel inference model, the Joint Embedding Variational Autoencoder, that offers conditionally tighter approximation of the estimated spatiotemporal feature distribution through the use of jointly optimised variational autoencoders to achieve optimizable data dependent inputs as an additional variable for improved overall model optimisation and scaling without sacrificing model tightness. To learn the variational bound, we show that maximising the marginal log-likelihood of only the second embedding section is required to achieve conditionally tighter lower bounds. Furthermore, we show that this model provides state-of-the-art EEG data reconstruction and deep feature extraction. The extracted domains of the EEG signals across each subject displays the rationale as to why there exists disparity between subjects’ adaptation efficacy.

Structural features control the thermal conductivity of a material by modulating phonon scattering. Here, simulations and theory reveal the effect that atomic-scale defects and pores have on the crossover of thermal transport regimes in graphene.

The degradation process of a red iron oxide epoxy coating on three kinds of metals under a periodic cycling exposure to 3.5 wt% NaCl solution (45 °C 12 h + 25 °C 12 h) was comparatively studied using electrochemical impedance spectroscopy (EIS), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-ray diffraction (XRD) methods. The influence of the metal substrates (carbon steel, brass, and Al alloy) on the protection performance of the coating was analyzed using variations in the electrochemical and chemical parameters. The failure criteria of the coating were discussed. The results show that the coating on the three substrates presents different failure times, with the coating on steel presenting the shortest time and the coating on Al alloy the longest time. The characteristics of metal substrates and their corrosion products influence the coating failure behavior. The corrosion products with loose and hygroscopic properties of steel and brass have promoting effects on the diffusion of water through the coating. The passive film of the Al alloy substrate and the formation of salt film containing Cl− have corrosion-inhibiting effects on the substrate. Evaluation of the coating performance by |Z|0.01Hz should consider the characteristics of the metal substrates.

Abstract Extracellular vesicles (EVs) can be produced from red blood cells (RBCs) on a large scale and used to deliver therapeutic payloads efficiently. However, not much is known about the native biological properties of RBCEVs. Here, we demonstrate that RBCEVs are primarily taken up by macrophages and monocytes. This uptake is an active process, mediated mainly by endocytosis. Incubation of CD14+ monocytes with RBCEVs induces their differentiation into macrophages with an Mheme‐like phenotype, characterized by upregulation of heme oxygenase‐1 (HO‐1) and the ATP‐binding cassette transporter ABCG1. Moreover, macrophages that take up RBCEVs exhibit a reduction in surface CD86 and decreased secretion of TNF‐α under inflammatory stimulation. The upregulation of HO‐1 is attributed to heme derived from haemoglobin in RBCEVs. Heme is released from internalized RBCEVs in late endosomes and lysosomes via the heme transporter, HRG1. Consequently, RBCEVs exhibit the ability to attenuate foam cell formation from oxidized low‐density lipoproteins (oxLDL)‐treated macrophages in vitro and reduce atherosclerotic lesions in ApoE knockout mice on a high‐fat diet. In summary, our study reveals the uptake mechanism of RBCEVs and their delivery of heme to macrophages, suggesting the potential application of RBCEVs in the treatment of atherosclerosis.

In order to investigate the effect of nano-modified ethylene-vinyl acetate （MEVA） on physical and rheological properties of styrene-butadiene rubber （SBR） modified asphalt, MEVA/SBR composites modified asphalt with different proportion of MEVA were prepared by blending method. The basic physical properties of the composite modified asphalt were tested, and rheological characteristics was analyzed by using temperature scanning of dynamic shear rheometer. The high and low temperature performance and traffic load grade that the composite modified asphalt could withstand were evaluated by multiple stress creep recovery test and ben-ding beam rheometer. The results showed that the addition of MEVA could effectively improve the physical and rheological properties of SBR modified asphalt, and the modification effect gradually increased with the increase of MEVA amount. Consi-dering high and low temperature properties, the re-commended amount of MEVA was mass fraction of 5%. Compared with SBR modified asphalt, the high temperature grade of MEVA/SBR composite modified asphalt with the best mixing ratio was increased by 18 ℃, and it could bear traffic load of “S” grade at 76 ℃, and its low temperature performance could meet the service temperature grade requirements of -28 ℃.

BackgroundThe impact of using invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) as an initial examination on the incidence of major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease and the occurrence of major operation-related complications is uncertain.ObjectiveThis study aimed to explore the effects of ICA vs. CCTA on MACEs, all-cause death, and major operation-related complications.MethodsA systematic search of electronic databases (PubMed and Embase) was conducted for randomized controlled trials and observational studies comparing MACEs between ICA and CCTA from January 2012 to May 2022. The primary outcome measure was analyzed using a random-effects model as a pooled odds ratio (OR). The main observations were MACEs, all-cause death, and major operation-related complications.ResultsA total of six studies, comprising 26,548 patients, met the inclusion criteria (ICA n = 8,472; CCTA n = 18,076). There were statistically significant differences between ICA and CCTA for MACE [OR 1.37; 95% confidence interval (CI), 1.06–1.77; p = 0.02], all-cause death (OR 1.56; 95% CI, 1.38–1.78; p

Rice germ is rich in a variety of nutrients, but at present, most of that is used as a by-product of rice processing for feed or wasted by discarding. The degree of deep processing and utilization is not high, and the economic benefit is low. Through the study about basic nutrients of rice germ, the results showed that there were a lot of proteins composed of abundant kinds of amino acids with high contents of proline, serine, aspartic acid, arginine and leucine. The contents of Mn, Fe and Zn were significantly higher than that of milled rice. The content of fatty acid was higher than that of wheat germ and corn germ, and the proportion of unsaturated fatty acid was higher, so the nutritional quality was better with higher development and utilization value. X-ray diffraction results showed that germ starch was a typical type A starch, with high amylopectin/amylopectin ratio and good digestibility. Through the determination of the nutritional components of rice germ and the comparative study with the common staple food on the market, we can further understand its nutritional characteristics and provide scientific reference for the development and utilization of rice germ.

A metasurface-based light-to-microwave transmitter, which can convert a light intensity signal to two microwave signals directly, was proposed to achieve the dual-channel data transmissions in light-to-microwave hybrid wireless communications.

The flat design of security and stability control system (SSCS) can realize the information interaction between each control sub-station and each sub-grid,which is conducive to reducing the number of SSCS layers and improving its reliability,thus increasing the difficulty of searching the control paths and differentiating the vulnerable components. The bidirectional/loop communication channels are added to the tree-shape SSCS to reduce the intermediate stations and find all the paths from the top to bottom stations based on the adjacent matrix. Considering availability of components and controllable capacity of underlying stations,the control capability of the flat SSCS is newly quantified. Average control ability and average associated path number are defined to evaluate the influence of flattening on the control ability of each station. Analytical sensitivity model of the control capability of flat SSCS with respect to the components' availability is proposed to determine the vulnerable components. The numerical analysis shows that the flat design reduces levels and intermediate stations,and improves the controllability of the SSCS. The impact on the controllability of the SSCS increases by the number of paths and controllable power,but decreases by the number of layers.

Abstract Background Polypoidal choroidal vasculopathy (PCV), a subtype of age-related macular degeneration (AMD), is a global leading cause of vision loss in older populations. Distinct from typical AMD, PCV is characterized by polyp-like dilatation of blood vessels and turbulent blood flow in the choroid of the eye. Gold standard anti-vascular endothelial growth factor (anti-VEGF) therapy often fails to regress polypoidal lesions in patients. Current animal models have also been hampered by their inability to recapitulate such vascular lesions. These underscore the need to identify VEGF-independent pathways in PCV pathogenesis. Results We cultivated blood outgrowth endothelial cells (BOECs) from PCV patients and normal controls to serve as our experimental disease models. When BOECs were exposed to heterogeneous flow, single-cell transcriptomic analysis revealed that PCV BOECs preferentially adopted migratory-angiogenic cell state, while normal BOECs undertook proinflammatory cell state. PCV BOECs also had a repressed protective response to flow stress by demonstrating lower mitochondrial functions. We uncovered that elevated hyaluronidase-1 in PCV BOECs led to increased degradation of hyaluronan, a major component of glycocalyx that interfaces between flow stress and vascular endothelium. Notably, knockdown of hyaluronidase-1 in PCV BOEC improved mechanosensitivity, as demonstrated by a significant 1.5-fold upregulation of Krüppel-like factor 2 (KLF2) expression, a flow-responsive transcription factor. Activation of KLF2 might in turn modulate PCV BOEC migration. Barrier permeability due to glycocalyx impairment in PCV BOECs was also reversed by hyaluronidase-1 knockdown. Correspondingly, hyaluronidase-1 was detected in PCV patient vitreous humor and plasma samples. Conclusions Hyaluronidase-1 inhibition could be a potential therapeutic modality in preserving glycocalyx integrity and endothelial stability in ocular diseases with vascular origin.

COVID-19 highlights the lack of interdisciplinary medical talents. The international history of medical education shows the urgent need of high-level interdisciplinary medical talents. Anchoring the goal to develop a global center of talents and highland of innovation, this article takes medical education of Zhejiang University as an example, focusing on and exploring the training mode of high-level interdisciplinary medical talents in the new era. It includes: firstly, optimizing the training mode of eight-year program for medical doctors with non-medical bachelor degree followed with complete education for a medical doctorate that innovates the curriculum system of clinical medicine; secondly, creating the training system of postdoctor of clinical medicine and integrating medical resources that include high-quality talents and health care system, in order to build a high-quality teaching staff with a interdisciplinarity background and innovative bases. It not only strengthens the residents' competency and frontier creativity, but also ensures the sustainable development of interdisciplinary medical talents. The reform of training mode, curriculum system, teaching staff and clinical teaching bases all contribute to the goal of building a country with interdisciplinary talents that serve the frontier of science and technology in the world, the major needs of the country and people's health in the new era.

Alkaline extraction is an important process in the integrated biorefining of leafy biomass to obtain protein, but the resulting alkaline protein extract (APE11 alkaline protein extract: APE.) may have poor emulsification properties for food applications. In this study, the components in the APE fractionations obtained by size exclusion chromatography were determined. The emulsification properties of APE were determined using oil/water with a ratio of 7:3. Whey protein and soybean protein isolate were used as controls while enzymes were used to improve APE's emulsification properties. The results showed that the APE could be divided into three fractions with protein content of 83, 56, and 34%. Carbohydrates mainly derived from homogalacturonan pectin were mostly in Fraction 2, while Fraction 3 consisted of peptides, oligosaccharides, and free polyphenols. The APE had similar emulsification capacity and emulsification stability as those of whey protein and soybean isolate. The emulsion made by the APE had a creaming index of 92% with emulsification activity index value of 44 m2 g−1, and these numbers could retain after storing at 25 °C for 15 days. The emulsification properties of the APE can be further improved by carbohydrate degradation. With the use of Viscozyme® L, the emulsification activity index value of treated APE was increased by 60%, and then still retained at 67 m2 g−1 after storing for 15 days. Treated by either pepsin or alkaline protease, the emulsification properties of APE were decreased, suggesting the key role of protein in APE for emulsification.

Dysregulation of metabolic functions in the liver impacts the development of diabetes and metabolic disorders. Normal liver function can be compromised by increased inflammation via the activation of signaling such as nuclear factor (NF)-κB signaling. Notably, we have previously identified lysine demethylase 2A (KDM2A)—as a critical negative regulator of NF-κB. However, there are no studies demonstrating the effect of KDM2A on liver function. Here, we established a novel liver-specific Kdm2a knockout mouse model to evaluate KDM2A’s role in liver functions. An inducible hepatic deletion of Kdm2a, Alb-Cre-Kdm2afl/fl (Kdm2a KO), was generated by crossing the Kdm2a floxed mice (Kdm2afl/fl) we established with commercial albumin-Cre transgenic mice (B6.Cg-Tg(Alb-cre)21Mgn/J). We show that under a normal diet, Kdm2a KO mice exhibited increased serum alanine aminotransferase (ALT) activity, L-type triglycerides (TG) levels, and liver glycogen levels vs. WT (Kdm2afl/fl) animals. These changes were further enhanced in Kdm2a liver KO mice in high-fat diet (HFD) conditions. We also observed a significant increase in NF-κB target gene expression in Kdm2a liver KO mice under HFD conditions. Similarly, the KO mice exhibited increased immune cell infiltration. Collectively, these data suggest liver-specific KDM2A deficiency may enhance inflammation in the liver, potentially through NF-κB activation, and lead to liver dysfunction. Our study also suggests that the established Kdm2afl/fl mouse model may serve as a powerful tool for studying liver-related metabolic diseases.

In order to develop new anti-mold agents and reduce the effect of mildew on the quality and safety during storage, transportation, and circulation of cereals, oils and foods, microorganisms with strong anti-mold activity were screened in this study. Bacteriostasis method was applied and Fusarium graminearum was taken as indicator. Morphological observation, biochemical characterization and 16S rDNA gene sequences alignment were used to identify the strains. The anti-mold bioactive substances were analyzed in different temperatures, pH, and proteinase K treatment. After primary screening, 33 strains with strong inhibitory activity against F. graminearum were obtained. Seven strains were selected after secondary screening and classified as Bacillus. Through the analysis of bioactive substances, the anti-mold effects of the seven strains were not of high temperature and strong acid or base resistant, or obviously influenced by proteinase K treatment. It indicated that the bioactive substances were peptides. Finally, the strain ASAG 62 had good inhibitory effect on common molds (Penicillium flavum, Aspergillus Niger, Aspergillus ochre, Aspergillus flavus and F. graminearum).

Twelve endophytic fungus strain from artemisia sacrorum ledeb were isolated and purified with the method of surface disinfection and tip mycelium selection. The activity of eight strains of endophytic fermentation broth against wheat scab were studied by mycelial growth rate method. Most active strain were identified as Fusarium Redolens by the combination of morphology and ITS rDNA gene sequence. A mass spectrometry method was established to analyze the main metabolites. The results showed that the endophytic fungus (No: 20202707) from artemisia sacrorum ledeb demonstrated the strongest inhibitory effect on Fusarium graminearum, and the inhibitory rate was 65.27%. Its main metabolites were 3, 4-dihydrocoumarin, 5′deoxyribonuc leoside, Harmala alkaloid, benzofuran and benzothiazole.

The rise of a flourishing online shopping market has expanded the range of purchase channels available to consumers. Meanwhile, the competition among channels has become increasingly fierce. In this study, the changes in cognitive processes caused by price variance among channels were investigated using event-related potentials. Several daily necessities with low or high price variance between a self-operated business channel and third-party seller channels were chosen as the study objects from a well-known electronic business platform. Thirty participants’ electroencephalograms were collected while they faced higher or lower price variance during the experiment. The results showed that small price variances between the two channels tended to intensify component N2, while big price variances tended to diminish component P3. These results suggest that N2 may reflect consumers’ identification process for price variance and inhibition of a planned response, while P3 may reflect the activation of attention caused by task difficulty due to price variance. These findings indicate that the changes in ERP components N2 and P3 may act as cognitive indices that measure customers’ identification and attention distribution when considering product price variances among online purchase channels.

Abstract Phase change materials (PCMs) can be used for efficient thermal energy harvesting, which has great potential for cost-effective thermal management and energy storage. However, the low intrinsic thermal conductivity of polymeric PCMs is a bottleneck for fast and efficient heat harvesting. Simultaneously, it is also a challenge to achieve a high thermal conductivity for phase change nanocomposites at low filler loading. Although constructing a three-dimensional (3D) thermally conductive network within PCMs can address these problems, the anisotropy of the 3D framework usually leads to poor thermal conductivity in the direction perpendicular to the alignment of fillers. Inspired by the interlaced structure of spider webs in nature, this study reports a new strategy for fabricating highly thermally conductive phase change composites (sw-GS/PW) with a 3D spider web (sw)-like structured graphene skeleton (GS) by hydrothermal reaction, radial freeze-casting and vacuum impregnation in paraffin wax (PW). The results show that the sw-GS hardly affected the phase transformation behavior of PW at low loading. Especially, sw-GS/PW exhibits both high cross-plane and in-plane thermal conductivity enhancements of ~ 1260% and ~ 840%, respectively, at an ultra-low filler loading of 2.25 vol.%. The thermal infrared results also demonstrate that sw-GS/PW possessed promising applications in battery thermal management.

Puan and San Luis et al. find that FUT6, encoding a fucosyltransferase, is required for the “rolling” behavior of certain white blood cells that enables them to move from blood vessels to tissues. They show that FUT6 deficiency leads to a loss of the tetrasaccharide sLex on the surface of basophils, resulting in cells that are less sticky and therefore less able to form the necessary adhesions for exiting the blood vessel to drive the allergic reaction.

Abstract Extreme torrential rainfall events are low‐probability events. A “China‐Record Extremely Heavy Rainfall” (CREHR) event with rain rate of 201.9 mm/hr occurred on 20 July in Zhengzhou in North China. Using high‐density meteorological observations, ERA5 reanalysis data, remote sensing data from China's FY‐4A satellite, and numerical simulation, we revealed that sufficient warm–humid airflows were continuously transported to the Zhengzhou area via multiple pathways that were mainly modulated by the large‐scale western Pacific subtropical high to the north along with the anomalies of the westerly belt and a meso‐scale binary typhoon system. At the local scale, under the combined action of the vertical circulation that caused low‐level convergence and high‐level divergence, and the rapid uplift of water vapor related to the blocking by mountainous terrain, this CREHR event was eventually triggered. Particularly, our present work shows the roles of both typhoon Cempaka and meso‐scale convective systems to south of Henan province can not be ignored, producing a strong super‐thick water vapor transport layer. The existence of the binary typhoon raises the level of uncertainty involved in the water vapor transport of this CREHR event.

Objective To investigate the diagnosis, treatment and prognosis of lymphoepithelial carcinoma of the parotid gland. Methods Data from 22 patients with parotid lymphoepithelial carcinoma from 2012 to 2019 were collected, and their clinical manifestations, imaging examinations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 22 patients, 8 were males and 14 were females. The patients ranged from 26 to 61 years old, with a complaint duration ranging from 3 days to 18 years. One patient had multiple unilateral lumps in the parotid gland, and the other 21 patients had single unilateral lumps in the parotid gland. All patients underwent preoperative spiral CT examination. CT showed a soft tissue lump in the parotid tissue, the internal density shadow was not uniform, the CT value ranged from 26 to 81 Hu, and 15 patients presented elliptical lesions with clear boundaries. Seven patients presented nodular lesions, and the boundary was not clear. The diagnosis of all cases was ultimately based on pathological examination. Hematoxylin-eosin (HE) staining images showed active epithelial cell growth with atypia, mitotic figures could be seen, and abundant lymphocyte and plasma cell infiltration could be seen in the tumor stroma. All 22 patients received surgical treatment; 9 patients did not undergo cervical lymph node dissection. Twenty patients received adjuvant radiotherapy after surgery, and 10 of them received adjuvant chemotherapy at the same time. One patient only received chemotherapy after surgery, and one patient did not receive any other adjuvant therapy after surgery. All patients received follow-up visits. One patient died of liver metastasis 16 months after the operation, and the remaining patients survived without tumors for periods of 13 months to 8 years until the present. Conclusion Parotid lymphoepithelial carcinoma is a rare malignant tumor clinically. Pathology is still the gold standard for the diagnosis of lymphoepithelial carcinoma of the parotid gland. Radical resection of the tumor is the first choice of treatment. Selective neck lymph node dissection and postoperative adjuvant radiotherapy and chemotherapy can obtain better therapeutic effects according to clinical examination, imaging examination and neck conditions.

Abstract Background The completion rate of Advance Directives (ADs) has been low. This study aims to examine the effectiveness of two interventions 1) active counseling sessions coupled with passive patient education pamphlets, and 2) patient education pamphlets alone, compared with 3) control group (usual care), in increasing the completion rates of ADs in the primary care setting. Methods Multicenter randomised controlled trial in four public primary care clinics in Singapore under Singapore Health Services. Randomization was performed via block randomization with Sequential Numbered Opaque Sealed Envelopes. Participants were randomized into 1) active intervention group (both counseling by primary care physicians and patient education pamphlets) or 2) passive intervention group (only patient education pamphlets), and 3) control group (usual care) with follow-up at 6 weeks. The main outcome measure is the proportion of participants who completed / planned to complete) ADs six weeks post-intervention. Results Four hundred five participants were eligible to participate in the study. One hundred eighty-eight participants were recruited into the study (response rate = 46.4%), of which 158 completed the study. There was no significant difference between the control group, passive intervention group, and active intervention group, in terms of completion rates of ADs (29.4, 36.4, and 30.8% respectively). Conclusions This randomized controlled trial did not support the use of patient education pamphlets with or without active counseling sessions in increasing the completion of ADs in a primary care setting in Singapore. The optimal intervention strategy depends on each health system’s context and resources, taking into consideration patients’ profiles, which deserves further studies. Trial registration Registered on April 17, 2018 clinicaltrials.gov ( NCT03499847 ).

In recent years, (big) data science has emerged as the “fourth paradigm” in physical science research. Data-driven techniques, e.g. machine learning, are advantageous in dealing with problems of high-dimensional features and complex mappings between quantities, which are otherwise of great difficulty or huge cost with other scientific paradigms. In the past five years or so, there has been a rapid growth of machine learning-assisted research on thermal transport. In this perspective, we review the recent progress in the intersection between machine learning and thermal transport, where machine learning methods generally serve as surrogate models for predicting the thermal transport properties, or as tools for designing structures for the desired thermal properties and exploring thermal transport mechanisms. We provide perspectives about the advantages of machine learning methods in comparison to the physics-based methods for studying thermal transport properties. We also discuss how to improve the accuracy of predictive analytics and efficiency of structural optimization, to provide guidance for better utilizing machine learning-based methods to advance thermal transport research. Finally, we identify several outstanding challenges in this active area as well as opportunities for future developments, including developing machine learning methods suitable for small datasets, discovering effective physics-based descriptors, generating dataset from experiments and validating machine learning results with experiments, and making breakthroughs via discovering new physics.

Abstract Background Smoking exerts substantial medical burdens on society. Precise estimation of the smoking-attributable medical expenditures (SAME) helps to inform tobacco control policy makers. Based on the epidemiological approach, prior studies in China only focused on a few smoking-related diseases to estimate SAME. In contrast, this study used the econometric approach, which is capable of capturing all of the potential costs. Methods Three waves of panel data from the 2011–2015 national China Health and Retirement Longitudinal Study (CHARLS) were used. A total of 34,503 observations aged 45 and above were identified. Estimates from econometric models were combined to predict the smoking-attributable fraction (SAF) and medical expenditures attributable to smoking by sex, registered residency and healthcare service categories. All monetary amounts were adjusted to 2015 dollars. Results In 2015, the overall smoking-attributable fraction (SAF) of China was 10.97%, ranging from 5.77% for self-medication to 16.87% for inpatient visits. The smoking-attributable medical expenditure (SAME) was about $45.28 billion, accounting for 7.24% of the total health expenditure. The SAME was $226.77 per smoker aged 45 and above. The regression results suggest that being a former smoker has the greatest impact, which decreases over time after quitting however, on the value of medical expenditures. Conclusions Smoking-attributable medical expenditures was substantial and placed a heavy burden on Chinese society. Comprehensive tobacco control policies and regulations are still needed to promote progress toward curbing the tobacco related losses.

A proper burden and porosity distribution of the bed in the upper shaft are important prerequisites for realizing a stable and efficient operation of the ironmaking blast furnace. The discrete element method was used to investigate the effects of the static friction coefficient between burden particles and shaft angle on the burden profile and porosity distribution in the bed formed by charging the burden with a bell-less charging equipment. The results indicate that a large static friction coefficient makes the particles stay closer to the impact point (i.e., where they fall) from the rotating chute. A large mixed region of the burden bed decreases the gas permeability, and an increase in the burden particle roughness will worsen this problem. The burden surface shape becomes flatter with an increase in the shaft angle. These findings explain the effect of particle properties and wall geometry on the inner structure of the burden bed.

A fumigation with dosage of 20 g/m3 sulfuryl fluoride was carried out in a warehouse stored 8 000 t of wheat and equipped with recirculation system, in which the temperature was 27～30 ℃ for head space,26～28 ℃ for top layer of the bulk, 16～19 ℃ for middle and bottom layers of central bulk and 26～29 ℃for surrounded bulk grain in the warehouse. The fumigant was applied in five points on the bulk surface and through the ventilation ducts under bottom of the bulk by a pipe connection while the recirculation running.The concentrations of sulfuryl fluoride in bulk surface, 1.5 m and 4.5 m depth under grain surface were all monitored during the process. The killing effect on Cryptolestes ferrugineus (Stephens) was also examined for the adults, pupae, larvae, and eggs of lab cultured strain and adults of field strain. The peak concentration was monitored on surface of the bulk and in the depth of 4.5 m of that, the concentration was lower in the depth of 1.5 m of the bulk, just after fumigant applied and while recirculation running. During exposure of 3 to 12 h, the sulfuryl fluoride concentration was above 20 g/m3 and distributed uniformly.The concentration of sulfuryl fluoride in the grain pile was generally higher, and the concentration decreased obviously with the time after 12 h. Sulfuryl fluoride concentration descended more quickly after 24 h when recirculation stopped and descended rate of sulfuryl fluoride concentration in higher temperature part of grain located in surround bulk was bigger than that in lower temperature part located in central bulk. When the concentration of sulfuryl fluoride in the grain pile decreased to 2 g/m3 (about 13 d), the decay rate decreased, and the time from 2 g/m3 to 0 g/m3 was about 10 days. During the fumigation that sulfuryl fluoride concentration changed in range of 27～24 g/m3, adults and larvae can be killed completely in 3 h exposure. Pupae can be given 100% mortality in 6 h when exposure under 27～22 g/m3 of the fumigation. The full mortality for eggs needed 24 h in 27～19 g/m3 of sulfuryl fluoride concentration. The tolerance of four life stages of C. ferrugineus to sulfuryl fluoride was eggs＞pupae＞adults≈larvae. In the grain bulk where temperature was 26～29 ℃ for top layer and surround bulk and 16～19 ℃ for middle and bottom grain of central bulk, all life stages of C.ferrugineus can be fumigated successfully by sulfuryl fluoride that concentration varied from about 24 g/m3 to 0 g/m3 during 23 d of the exposure time.

Soy whey (SW) is generated as a process waste during soy isolate protein preparation. SW has low content of soluble sugar and high content of oligosaccharide, which is suitable for the growth of lactic acid bacteria (LAB). In this study, a strain of Lactobacillus casei GJ00412 (by 16S rRNA genesequencing and identification) was isolated from soy whey. In order to reduce the cost of culture medium, improve its biomass, and facilitate the next utilization, Response surface methodology (RSM) was employed to optimize the composition of seed medium of Lactobacillus casei By Plackett-Burman design, sucrose, yeast power, MgSO4, Tween80 and pH value were found to have significant effects on biomass, and were further analyzed by Box-behnken design, an application of response surface. The optimized medium was as follows (w/v): 2.5% sucrose, 1.8% soy peptone, 0.4% yeast powder, 0.08% MgSO4, 0.04% MnSO4, 0.08% Tween80, pH 7.17. The results showed that the cost of the optimized medium was decreased and the biomass of Lactobacillus casei has no significant difference when compared with MRS medium.

Taking the gear transmission mechanism of a five-gear transmission as the research object,the simulation model of the gear transmission mechanism of the transmission is established by using Romax Designer software,and the load-bearing situation,transmission error and load distribution on the tooth surface of the 4 th gear are simulated and analyzed. According to the theory of tooth lead modification and tooth profile modification,the variable range of three-dimensional modification parameters of the 4 th gear is analyzed by orthogonal experiment principle. Then the genetic algorithm is used to optimize the modification parameters of gear,and the optimal combination of modification parameters is obtained. The validity of this method is verified by vehicle test. By comparing the results before and after optimization,it can be seen that the three-dimensional gear modification technology can greatly reduce the stress of the gear,reduce the fluctuation amplitude of the transmission error of the gear,optimize the stress distribution of the gear tooth surface,and reduce the vibration noise. At the same time,it can be proved that this method can effectively improve the meshing condition of gears and is an effective means to optimize the meshing performance of gears.