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Orchalgia is a common andrological disorder and usually results from pathognomonic change of testes and regional structures. However, responsible cause is still unknown in more than one-fourth of patients.We report two men who initially suffered an acute, isolated orchalgia and posteriorly complicated with paraparesis. They had previous history of prostate cancer and cervical myelitis. The urological examination was negative in both of them. Finally, prostate cancer metastasis and recurrent myelitis at T2/3 level was identified, respectively. Although their orchalgia progressively subsided, their urological, sexual and neurological dysfunction persisted.In the literature, the responsible pathology of spinal orchalgia was exclusively found below T10 level, frequently delaying affirmative diagnosis. Therefore, a thorough evaluation of spinal cord above T10 level should be alerted for idiopathic orchalgia with a pre-existing history or risk of spinal cord disorder and a negative urological examination.

Due to the complexity and heterogeneity of obesity, the diagnosis and treatment of obesity vary greatly. Five to 10 percent of body weight can be lost through lifestyle modifications, nutritional and behavioral counseling, and the use of approved weight reduction medicines for obesity and diabetes; however, these non-surgical treatments are not effective for all patients. Compared to medical therapy, bariatric surgery is associated with higher rates of type 2 diabetes remission, lower mortality from vascular complications, and long-term, sustained weight loss. With the advent of precision medicine in surgical therapy, bariatric surgeons' fundamental understanding of laparoscopic Roux-en-Y gastric bypass surgery has evolved in recent years. The objective of surgery has shifted from short-term weight loss to the safe and successful long-term management of patient weight and comorbidities. In laparoscopic Roux-en-Y gastric bypass surgery, the concept of precision bariatric and metabolic surgery is mainly reflected in three aspects: accurate preoperative assessment, precise intraoperative operation, and comprehensive postoperative management. A new direction for the future development of precision laparoscopic Roux-en-Y gastric bypass surgery and obesity metabolic surgery is to formulate precise and individualized surgical treatment plans for patients and to use artificial intelligence and big data technology to improve the standardization of specialist data.由于肥胖本身的复杂性和异质性，导致肥胖症的诊疗方法个体化差异较大。通过改变生活方式和饮食结构、采用行为疗法以及使用已经批准的减肥药物治疗肥胖和糖尿病患者，可以实现5%~10%的体质量减轻，但并非所有患者都可以通过这些非手术的治疗手段获益。与药物治疗相比，减重代谢手术有更高的2型糖尿病缓解率和更低的血管并发症病死率并且可以长期持续减轻体质量。近些年来，随着精准医学在外科治疗中的发展，减重外科医生对腹腔镜Roux-en-Y胃旁路手术的核心理念也发生了改变。手术目的从强调短期体质量大幅下降转变为安全有效地长期控制患者的体质量和并发症。在腹腔镜Roux-en-Y胃旁路手术中，精准减重代谢外科理念主要体现在3个方面：术前的精准评估、术中的精细操作和术后的综合管理。为患者制定精准、个体化的手术治疗方案，同时利用人工智能和大数据技术，提高专科数据的标准化是精准腹腔镜Roux-en-Y胃旁路手术和减重代谢外科未来发展的新方向。.

Coal is one of the major fuels, which brings huge energy and economic benefits to global industry and daily life. large amounts of coal dust produced in the process of coal mining and transportation, which seriously threatens the health of related workers. Productive coal dust exposure not only directly leads to respiratory diseases, but also may cause health damage to various systems throughout the body. Numerous studies have shown that coal dust exposure is closely associated with decreased lung function, coal worker's pneumoconiosis, chronic obstructive pulmonary disease, lung cancer, and cardiovascular diseases, and the severity of diseases is affected by coal rank, coal dust concentration, cumulative dust exposure, coal dust composition, and individual lifestyle, etc. The article comprehensively summarized the progress of the epidemiological studies on the health hazards of coal miners from coal dust exposure, in order to provide clues for further researches on health damage and protect the health of the occupational population.煤作为主要能源之一，为全球工业和生活带来了巨大的能源和经济效益。在煤矿开采和运输过程中产生大量的煤矿粉尘，严重威胁相关作业劳动者的健康。生产性煤矿粉尘接触不仅直接导致呼吸系统疾病，还可能引起全身各个系统的健康损害。大量研究认为煤矿粉尘接触与肺功能下降、煤工尘肺、慢性阻塞性肺疾病、肺癌以及心血管疾病等密切相关，且疾病的严重程度受煤阶、接尘浓度、累积接尘量、煤矿粉尘组分以及个体的生活方式等的影响。本文就煤矿粉尘对工人健康损害的流行病学研究及进展进行综述，为推进煤尘的健康损害研究和保障职业人群健康服务。.

The impact damage of a carbon fiber-reinforced polymer (CFRP) is on-line detected and examined using infrared thermography. The energy dissipation of CFRP during the impact process is first analyzed, followed by the above procedure. Impact tests were performed on several specimens at different energy levels, and the process was monitored with an infrared camera. The postimpact specimens are off-line examined with the combination of SEM and ultrasonic C-scanning. The results obtained with infrared thermography, SEM, and ultrasonic C-scanning are comprehensively analyzed. The matrix cracking and delamination can be characterized by the dark point at the impact center, slight temperature rise, and double-peak temperature curve, respectively, while the fiber breakage can be evaluated by the bright point at the impact center, large temperature rise, and single-peak temperature curve, respectively.

Cynanchum bungei Decne. and its related species C. auriculatum Royle ex Wight. and C. wilfordii (Maxim.) Hemsl. are well known Chinese herbal medicines known by the name Baishouwu, and have a beneficial effect on health. Endophytic fungi exist widely inside host plants and are important components of plant micro-ecosystems. Previous studies have shown that there are significant differences among the isolated fungi from the three species of Baishouwu. To explore the fungal diversity in Cynanchum genus, we characterized and compared the endophytic fungal communities among different plant organs, species and localities of Baishouwu by a High-throughput 18S rDNA gene Illumina MiSeq sequencing technique. The results showed that the main factor affecting the distribution and population structure of endophytes was plant organs, rather than the species and localities. Moreover, Rank abundance curves demonstrated that the richness and evenness of JTG was the highest, while the evenness of JTY was the lowest, the richness of JTJ was the lowest. Furthermore, the samples from three localities had relatively similar fungal communities, as indicated by PCA and UPGMA analysis. The Fusarium, Exophiala, Plectosphaerella, Botryosphaeria, and Filobasidium were the predominant fungal genera in the seven samples, which might play an important role in the plant micro-ecosystems and were beneficial to their host plant. These findings contribute to an understanding of the diversity of the endophyte microbiome of Baishouwu and may be beneficial to the rational development and utilization of the medicinal plants.

A bimetallic coordination polymer is prepared via a hydrothermal reaction of H2DDBA and In(NO3) water with NaOH as a pH regulator. Its chemical formula is [In2Na(H2O)6(ddba)3](NO3)(H2O)7 (1, H2ddba = 4,4′-dithiodibenzoic acid). The composition and atomic arrangement of the prepared complexes are studied by the elemental analysis (EA) and the thermogravimetric analysis (TGA), powder and single crystal X-ray diffraction measurements. Moreover, a process of sonochemistry with oleic acid treatment at 453 K is used to produce nanostructure the biological function detection, a miRNA relative expression is detected via RT-PCR and Bcl-2 expression level is determined with the Western blot. The Annexin V-FITC/PI staining is performed to detect retinoblastoma cell apoptosis after treatment with nano-1.

Merkel 细胞癌是一种罕见的、侵袭性原发恶性肿瘤，伴有神经内分泌特征。现报道舌部Merkel细胞癌1例，并结合文献对其临床和病理特征、诊断和治疗等进行讨论。.

и рис. 5c в [2] соответственно. Таким образом, главный редактор больше не доверяет представленным данным. Ни один из авторов не ответил на запросы редактора или издателя по поводу этого опровержения.

Background The association between international normalized-ratio (INR) and long-term prognosis among patients with coronary artery disease (CAD) without atrial fibrillation (AF) or anticoagulant therapy was still unclear. We analyzed the association of INR levels and long-term mortality in a large cohort of CAD patients without atrial fibrillation or using of anticoagulant drugs. Method We obtained data from 44,662 patients who were diagnosed with CAD and had follow-up information from January 2008 to December 2018. The patients were divided into 4 groups (Quartile 1: INR ≤0.96; Quartile2: 0.961.06). The main endpoint was long-term all-cause death. Kaplan-Meier curve analysis and Cox proportional hazards models were used to investigate the association between quartiles of INR levels and long-term all-cause mortality. Result During a median follow-up of 5.25 years, 5,613 (12.57%) patients died. We observed a non-linear shaped association between INR levels and long-term all-cause mortality. Patients in high INR level (Quartile4: INR >1.06) showed a significantly higher long-term mortality than other groups (Quartile2 or 3 or 4), (Compared with Quartile 1, Quartile 2 [0.961.06], aHR=1.33, 95% CI: 1.22–1.45, P Conclusion Our study demonstrates high levels of INR were associated with an increased risk of all-cause mortality. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): This study was supported by Guangdong Provincial People's Hospital Dengfeng Project Fund (DFJH201919) and The National Science Foundation for Young Scientist of China (grant no.8197021596, 81500520). Survival curves for mortalitySubgroup analysis

为探讨上颌骨囊肿开放术后避免囊肿开窗口闭锁的改进方法，本文回顾性分析了2015—2020年于山东大学齐鲁医院行手术治疗的22例上颌骨囊肿患者的临床资料。其中含牙囊肿10例，上颌骨囊肿12例。采用改良泪前隐窝入路，延长下鼻甲前缘纵切口，切除上颌窦内侧壁及鼻腔底壁，将囊肿开放于鼻腔，拔除囊肿内牙齿，使用黏膜瓣消除裸露骨面。所有患者术后囊肿均保持开放。.

The synthesis and characterization of two new pyran derivatives (1 and 2) are characterized by infrared (IR) and 1H nuclear magnetic resonance spectroscopy (1H NMR), high resolution mass spectrum (HRMS), and single crystal X-ray crystallography. The anticancer activity of compounds is investigated against four human liver cancer cells (Hep G2, SMMC-7721, HHCC, and HB611) by 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumbromide (MTT) assay. Furthermore, molecular docking studies support the biological assay data and suggest that the two compounds have a similar interaction strength with protein.

A bimetallic coordination polymer is prepared via a hydrothermal reaction of H2DDBA and In(NO3)3 in water with NaOH as a pH regulator. Its chemical formula is [In2Na(H2O)6(ddba)3]·(NO3)(H2O)7 (1, H2ddba = 4,4'-dithiodibenzoic acid). The composition and atomic arrangement of the prepared complexes are studied by the elemental analysis (EA) and the thermogravimetric analysis (TGA), powder and single crystal X-ray diffraction measurements. Moreover, a process of sonochemistry with oleic acid treatment at 453 K is used to produce nano­structure 1. In the biological function detection, a miRNA relative expression is detected via RT-PCR and Bcl-2 expression level is determined with the Western blot. The Annexin V-FITC/PI staining is performed to detect retinoblastoma cell apoptosis after treatment with nano-1.

Occupational noise is one of the most common occupational hazards in the workplace. Long-term exposure to occupational noise could not only lead to the damage of the hearing system, but also may cause a certain impact on the cardiovascular system. Studies have shown that occupational noise exposure was positively associated with cardiovascular diseases, including hypertension, coronary heart disease and myocardial infarction. However, the results of studies on occupational noise exposure and stroke are still controversial. This paper reviews the relationship between occupational noise exposure and hypertension, coronary heart disease, stroke, myocardial infarction by summarizing the epidemiological data of domestic and foreign population in recent years. Our study could provide evidence for the design and implementation of well-designed epidemiological and mechanism studies, and the recognition of the role of occupational noise exposure in the occurrence and development of cardiovascular diseases, so as to better protect workers' health.职业性噪声是工作场所最常见的职业性有害因素之一，长期暴露于职业性噪声不仅可导致听觉系统的损伤，还可能会对心血管系统造成一定影响。大量研究认为职业性噪声接触可导致心血管系统的损伤，包括高血压、冠心病和心肌梗死，但职业性噪声接触和中风的研究结果尚存在争议。本文汇总了近年来国内外人群流行病学资料，综述了职业性噪声接触与高血压、冠心病、中风和心肌梗死等心血管疾病之间的关系，为设计和开展更完善的流行病学和机制研究、深入认识职业性噪声接触在心血管疾病发生发展中的作用奠定基础，从而更好地保护劳动者的健康。.

To evaluate the efficacy of rotation cross-advancement flap method in repairing the nasolabial deformity of complete unilateral cleft lip. A retrospective study was performed to analyze the children who were treated by using the rotating cross-advancement flap for repairing the complete unilateral cleft lip at the Fujian Medical University Union Hospital from October 2018 to July 2019. The clinical data such as patient's lip height, lip length, nostril height, nostril width, nostril area and so on were collected at the pre-operation, post-operation and following-up visits respectively and used to evaluate the efficacy of the treatment. Six children were included in the present study. The ratios of lip height on noncleft side to cleft side were 2∶1 at the pre-operation time. The ratios of nostril height on the noncleft side to the cleft side were about 2∶1. The ratios of the width and the area of the nostril were 1∶2 to 1∶3. At the post-operation time, the ratios of length and height of the lip at the cleft side to the noncleft side were around 1∶1. The shape of the nostrils and nasolabial fold were almost symmetrical between the cleft side and noncleft side. The shapes of the nasal sill were acceptable and the postoperative scars were not obvious. There were no obvious incision healing complications and the treatment effects were satisfactory. Rotation cross-advancement flap method was safe and reliable for repairing the nasolabial deformities in children with complete unilateral cleft lip.为评价旋转交叉推进瓣法修复单侧完全性唇裂的鼻唇畸形的疗效，本研究回顾性纳入2018年10月至2019年7月就诊于福建医科大学附属协和医院口腔科采用旋转交叉推进瓣进行单侧完全性唇裂修复的患儿6例，通过数码照片分析采集患者术前、术后即刻、术后1个月及术后1年复诊时唇高、唇长、鼻孔高度、鼻孔宽度、鼻孔面积等信息以评价该术式的疗效。本研究中6例患儿术前健患侧唇高比2∶1，健患侧鼻孔高度比值约2∶1，但鼻孔宽度及鼻孔面积比却为1∶2~1∶3。术后健患侧唇高比近1∶1，鼻孔形态对称、鼻唇沟形态对称、鼻堤形态良好、术后瘢痕不明显，未见明显切口不良愈合。旋转交叉推进瓣在单侧完全性唇裂患者鼻唇畸形整复上是一种安全可靠的术式。.

BackgroundAxial spondyloarthritis (axSpA) is characterised by inflammation of the sacroiliac joints and spine. Sleep disturbance, pain and fatigue are reported in the literature to be key symptoms and impacts of axSpA. Three customised Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms (Sleep Disturbance, Pain Interference and Fatigue), previously developed for use in rheumatoid arthritis, have been proposed for use in patients with axSpA to assess the key concepts.ObjectivesTo conduct in-depth qualitative interviews to further understand the patient experience of axSpA and evaluate the content validity of the three PROMIS Short Forms to support their use as endpoints in axSpA clinical trials.MethodsA non-interventional, cross-sectional qualitative (concept elicitation [CE] and cognitive debriefing [CD]) study was conducted in 28 adult patients with diagnosed axSpA, including radiographic axSpA (r-axSpA), also known as ankylosing spondylitis (AS, n=12), and non-radiographic axSpA (nr-axSpA, n=16). Patients took part in 90-minute telephone interviews. A semi-structured interview guide was used to assist discussions. The CE section used broad, open-ended questions to elicit information about symptoms and impact experienced by patients. The CD section involved a ‘think-aloud’ exercise in which patients read out each instruction, item and response option for the three PROMIS Short Forms and shared their feedback. Patients were also asked detailed questions about the relevance of the items, response options and recall period. Verbatim interview transcripts were subject to thematic and content analysis.ResultsPatients were from the United States (n=20) and Germany (n=8), mean age was 52.8 years, and 57% (n=16) were male; mean time since diagnosis of axSpA was 9.5 years (range 0.3–31.3 years). The CE section identified 12 distinct signs and symptoms that characterised patients’ experience of axSpA: pain, sleep problems, fatigue/tiredness, stiffness, swelling, vision/eye issues, restricted body movements, headache/migraine, spasms, change in posture/stature, balance/coordination problems and numbness. Pain, sleep problems and fatigue/tiredness were all reported to be experienced by ≥90% of patients, occurring simultaneously and exacerbating one another. 78% (n=21/27) of patients reported pain to be the most bothersome symptom, and 88% (n=23/26) described it as the symptom they would most like treatment to improve. Patients reported axSpA to impact their lives across six health-related quality of life (HRQoL) domains: physical functioning (100%), emotional wellbeing (89%), work/volunteering (79%), social functioning (75%), activities of daily living (61%) and cognitive functioning (54%). Impacts were most frequently described as being associated with pain, stiffness and fatigue. The experiences of symptoms and impacts were consistent between the AS and nr-axSpA patients. CD showed all three PROMIS instruments are conceptually comprehensive and well understood by patients with axSpA. No patients reported misunderstanding of instructions and/or items of the sleep disturbance instrument, and only one and four items had a small number of instances of misunderstanding for the fatigue and pain interference instruments, respectively. Across each instrument, all items were relevant to at least half of patients, and almost all patients reported the instruments to be appropriate for measuring their experience of sleep problems, pain and fatigue due to axSpA. Both AS and nr-axSpA patients confirmed the three PROMIS Short Forms to be relevant and appropriate for assessing their disease experience.ConclusionPain, sleep problems and fatigue are pivotal symptoms of axSpA and associated with HRQoL impacts. Interpretability and content validity of the PROMIS customised Short Forms have been confirmed, with each deemed to adequately assess key impacts associated with axSpA, making them suitable for use in clinical trials of patients with axSpA.Funding: GSK [209770]AcknowledgementsMedical writing support was provided by Tony Reardon, of of Aura, a division of Spirit Medical Communications Group Limited (Manchester, UK), and was funded by GlaxoSmithKline.Disclosure of InterestsAmy Findley Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, Jessica Middlehurst Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, Chloe Howse Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, Molly Clifford Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, William Neill Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, Sophi Tatlock Grant/research support from: employee of Adelphi Values, who received fees from GlaxoSmithKline for the conduct of this study, Wen-Hung Chen Shareholder of: GlaxoSmithKline, Employee of: GlaxoSmithKline, Marguerite Bracher Shareholder of: GlaxoSmithKline, Employee of: GlaxoSmithKline, Dharm Patel Shareholder of: GlaxoSmithKline, Employee of: GlaxoSmithKline

Based on large data analysis method and automatic detection technology, this paper designs a test system, which can realize intelligent online monitoring of seawater. Based on the theory of large data, the data preprocessing method of large data is applied by relying on the information transmitted by integrated sensors. Using data cleaning, data integration, data conversion and data reduction technology, a large number of data collected by marine monitoring devices are processed accurately. An automatic seawater monitoring system is designed on a software platform. Finally, combined with the experimental data of a certain sea area, the test results are analyzed, which proves the feasibility and effectiveness of the designed seawater online monitoring system. It has achieved the effect of seawater environmental analysis and early warning.

Essentials Sinus thrombosis may play a crucial role in development of dural arteriovenous fistula (DAVF). Little is known about the association between gene polymorphism and the development of DAVF. MMP-2-1306 C/T showed a higher prevalence rate in DAVF cases with sinus thrombosis. MMP-2-1306C/T polymorphism is likely a potential risk factor for sinus thrombosis in DAVF. SUMMARY Background Dural arteriovenous fistula (DAVF) is a rare but important cerebrovascular disorder in adults. Little is known about the molecular genetic pathogenesis underlying DAVF development. Objectives To investigate the associations of gene polymorphisms and DAVF. Materials and Methods By the use of real-time PCR genotyping, seven single-nucleotide polymorphisms (SNPs) of angiogenesis-related genes were analyzed in 72 DAVF patients. Pertinent clinical and imaging data were subgrouped on the basis of location (cavernous sinus versus lateral sinus), lesions (single versus multiple), cerebral venous reflux (CVR) grading (Borden I versus Borden II/III), and sinus thrombosis (with versus without). Results We found that individuals carrying the polymorphic allele of matrix metalloproteinase (MMP)-2-1306 C/T (rs243865) had a significantly increased risk of sinus thrombosis in DAVF (odds ratio 6.2; 95% confidence interval 1.7-22.9). There was a weak difference in associations of tissue inhibitor of metalloproteinase (TIMP)-2 (rs2277698) gene polymorphism and DAVF patients subgrouped by CVR grading. Conclusions These preliminary results indicate that MMP-2-1306 C/T, but not MMP-9, TIMP-1, TIMP-2, and vascular endothelial growth factor A SNP variants, is a risk factor for the development of sinus thrombosis in DAVF patients.

Phytoremediation is an environmentally friendly green rehabilitation technology that is often incorporated with an application to improve phytohormones required for the growth of agricultural plants with the expectation to improve the effectiveness of plant rehabilitation. This study adopts phytoremediation, a green remediation technology, for the sake of restoring soil fertility and ensuring environmental sustainability, and adds ethylenediaminedisuccinic acid (EDDS) and the plant growth regulator (GA3) to examine the overall efficiency of phytoremediation. The experiments using pots in this study finds that environmentally sustainable phytoremediation achieves the greatest efficacy regarding the remediation of soil polluted by copper, zinc and nickel. The best combination of operational factors is the addition of the EDDS and GA3. The environment where the EDDS is added shows a poorer performance in the remediation of the heavy metal lead. In addition, the PCR(Polymerase chain reaction)-DGGE analysis results of bacterial flora change show that the combination “heavy metal + EDDS + GA3” brings about the richest bacterial flora, indicating that the addition of EDDS and GA3 can stimulate microbial growth, thereby achieving richer bacterial flora.

The study aims to estimate the stress-strain constitutive behavior of intermetallic compounds (IMCs) observed in a solder interconnect from experimental nanoindentation responses through a modified analysis procedure for improved solution robustness based on Cheng and Cheng's and Dao et al.'s models. On the basis of parametric finite element nanoindentation simulation and dimensional analysis together with the concept of representative strain, a set of universal dimensionless functions are established, by which a forward and reverse analysis algorithm are created to predict nanoindentation responses from given elastoplastic properties and vice versa, respectively. The proposed analysis procedure is validated through comparison with the experimental nanoindentation responses and limited literature data. The results show that the proposed analysis procedure is an effective means for plastic property characterization of micro/nanoscale IMCs. The representative strain is found to be 0.056, which differs from the Dao et al.'s and Giannakopoulos and Suresh's estimate. Besides, though generally brittle and hard in nature, the IMCs in a micro/nanoscale thickness show high plasticity, and comprise a yield strength surpassing most typical engineering metals.

鼻窦胆脂瘤在临床上较为罕见，本文介绍了1例上颌窦胆脂瘤病例，总结其病例特点，并介绍了经泪前隐窝入路切除的治疗效果及经验。发现经泪前隐窝入路切除上颌窦胆脂瘤优势明显，可最大程度地暴露上颌窦窦腔，便于手术操作，彻底清除病变，治疗效果好，创伤小，具有一定的临床应用价值。.

In this paper, a coupled electric-thermal model is proposed to estimate the power loss and thermal performance of power module and three-phase inverter. First, the electrical extraction software is used to obtain parasitic parameters of the package. Then, the temperature field of the package is simulated under certain power by using computational fluid dynamics (CFD). Finally, the results of the electrical extraction and the CFD model are imported into the circuit simulation software to establish an equivalent circuit model for coupled calculation of conduction loss and switching loss under certain boundary condition. The results of the power loss and temperature field are also compared with the experimental data.

Background:Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease resulting in increased morbidity and mortality and reduced health-related quality of life (HRQoL). Patients with SLE are at risk of developing irreversible long-term organ damage (LTOD) caused by both disease activity and cumulative medication toxicities. Data regarding the overall disease burden and impact of LTOD in patients with SLE are limited.Objectives:The primary objective of this qualitative study was to develop a conceptual model to describe the burden experienced by patients with SLE and LTOD.Methods:This study (GSK Study 209754) was conducted in three phases. First, a targeted literature review was performed to aid the development of an initial draft conceptual model. Key opinion leaders (KOLs) with experience in SLE and LTOD were then interviewed to assess the clarity, language, comprehensibility, and potential use of the conceptual model, and to help shape the patient interview materials. Finally, one-on-one interviews were performed with patients with SLE and LTOD in any of the 12 organ areas (defined by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI]), to gather patient perspectives on the common symptoms, functional impacts, treatment experiences, and HRQoL factors associated with LTOD. Data from the interviews were coded and analysed using NVivo software to identify patterns in responses concerning the key concepts of the overall patient burden of LTOD, and used to identify concepts to include in the model.Results:The literature review produced the preliminary conceptual model of LTOD. Results of the KOL interviews (n=5 clinicians and n=1 patient advocate) indicated that the preliminary conceptual model broadly captured the patient experience of LTOD. KOLs emphasised the difference between SLE activity (flares) and LTOD; the conceptual model was subsequently updated in accordance with these recommendations. Interviews conducted with patients with confirmed single (n=9) and multiple LTOD (n=31) indicated that the burden of LTOD associated with SLE was more severe, debilitating, and life threatening than that caused by SLE flares. Almost all patients (39/40) reported aspects of their lives that were more severely affected since their LTOD diagnosis. All 40 patients reported LTOD-related physical impacts, which often affected patients’ ability to perform everyday tasks. The most frequent physical impacts reported were a loss of vitality (39/40), long-term complications (e.g. unstable blood pressure, extreme pain, poor mobility, inflammation, dialysis, infection; 36/40), and severe fatigue (29/40). Cognitive impairments that became more pronounced after their LTOD diagnosis were reported by 27/40 of patients. Typically characterised as “brain fog”, these impairments were described as slower cognitive processing, forgetfulness, confusion, and aphasia. Economic impacts associated with LTOD included patients’ inability to work (31/40), costs of care (33/40), and non-medical-related costs (17/30). Psychosocial impacts reported by patients with LTOD affected their emotional state (39/40), ability to socialise (40/40) and relationships (30/40). Additionally, 30/40 patients reported symptoms as more severe since their LTOD diagnosis, including pain (14/40), fatigue (9/40), and oedema (8/40). Patients’ treatment goals were largely aligned with their experienced impacts of LTOD, including managing the disease and symptoms (25/40), limiting further organ damage (15/40), and improving HRQoL (11/40).Conclusion:The findings from this research clearly indicate that the patient burden of LTOD far surpasses that of SLE without LTOD. These data were incorporated and refined into a conceptual model that fully represents the patient experience of LTOD. The model will help researchers, clinicians, and patients to better understand the impact of SLE-related LTOD progression.Funding:GSKAcknowledgements:Medical writing assistance was provided by Casmira Brazaitis, PhD, Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.Disclosure of Interests:Lynne Broderick Consultant of: GSK, Wen-Hung Chen Shareholder of: GSK, Employee of: GSK, Roger Levy Shareholder of: GSK, Employee of: GSK, April Foster Consultant of: GSK, Cindy Umanzor Consultant of: GSK, Deven Chauhan Shareholder of: GSK, Employee of: GSK

We report that assimilating total electron content (TEC) into a coupled thermosphere-ionosphere model by using the ensemble Kalman filter results in improved specification and forecast of eastward pre-reversal enhancement (PRE) electric field (E-field). Through data assimilation, the ionospheric plasma density, thermospheric winds, temperature and compositions are adjusted simultaneously. The improvement of dusk-side PRE E-field calculation over the prior state is achieved primarily by intensification of eastward neutral wind. The improved E-field calculation promotes a stronger plasma fountain and deepens the equatorial trough. As a result, the horizontal gradients of Pedersen conductivity and eastward wind are increased due to greater zonal electron density gradient and smaller ion drag at dusk, respectively. Such modifications provide preferable conditions and obtain a strengthened PRE magnitude closer to the observation. The adjustment of PRE E-field is enabled through self-consistent thermosphere and ionosphere coupling processes captured in the model. This study suggests that the PRE E-field that is critical in driving the evening equatorial plasma instability could be better forecasted by assimilation of TECs in the 10 minutes cycling.

The reaction of (p-cymene)Ru2(μ-S2)(S2C2B10H10)2 (I) with HC≡CCH(OH)(CH3)2 in dichloromethane led to addition complexes, (p-cymene)Ru2(μ-S2)(S2C2B10H10)2(R1C=CR2) (R1 = H, R2 = C(OH)(CH3)2 (II); R1 = C(OH)(CH3)2, R2 = H (III)). In boiling chloroform both complexes II and III spontaneously lose water to generate two geometrical isomers (p-cymene)Ru2(μ-S2)(S2C2B10H10)2(R1C=CR2) (R1 = H, R2 = C(CH3)=CH2 (IV); R1 = C(CH3)=CH2, R2 = H (V)), respectively. Complexes IV and V could be interconverted in boiling toluene. All these complexes were characterized by elemental analysis, mass spectrometry, and NMR spectroscopy. The molecular structure of complex IV has been determined by X-ray crystallography (CIF file CCDC no. 1443964). Complex IV crystallizes in monoclinic system, space group P21/c with a = 10.3717(9), b = 20.3982(17), c = 18.6428(13) A, β = 111.096(4)°, C19H40B20Ru2S6, M r = 879.27, V = 3679.8(5) A3, ρ c = 1.587 g/cm3, Z = 4, F(000) = 1752, μ(MoK α) = 1.179 mm–1, R = 0.0416 and wR = 0.0848 for 4602 observed reflections (I > 2σ(I)).

Improving the steam reforming of ethanol by Ni/Al2O3/CaO composite was investigated in this work. The CO2 sorbent plays a key role in the catalytic reaction enhancement. The reforming catalysts were prepared by the as-prepared 10 wt.% Ni/Al2O3 physical mixing with CaO sorbents (from Ca(OH)2 conversion). All reforming experiments were performed under 873K condition. In addition, the suitable parameters of mass ratio of Ni catalyst/CO2 sorbent (20 : 80 w/w) and steam / ethanol molar ratio of five were adjusted in this work. The results indicate that the steam reforming of ethanol via CO2 sorption enhancement obviously produced ∼95% H2 greater than common steam reforming of ethanol (∼72% H2). Other by-products involving CO2, CO and CH4 can be also obviously suppressed during reaction. For the sorption-enhanced steam reforming, the recyclability of CO2 sorbent is an important issue. The 10 cycles of reaction/regeneration at 873K and 1023K for the steam reforming of ethanol were tested. The results reveal the H2 concentration of products stably keeps above 90% during the cycles test. The performance of CO2 sorbent was insignificant change after 10 cycles. The average capture capacity of CO2 around 17.8 wt.% can be determined during cycles.