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To investigate the prognostic value of metabolic syndrome (MetS) and its relationship with renal structure changes in patients with type 2 diabetes and associated diabetic nephropathy (DN).411 Chinese patients with type 2 diabetes and biopsy-confirmed DN were enrolled in this retrospective study. MetS was defined according to the modified criteria of the 2005 International Diabetes Federation. Baseline demographics and clinical information at the time of renal biopsy were extracted from the hospital's electronic medical records system. Renal pathological findings were assessed according to Renal Pathology Society system. Univariate and multivariate logistic regression analyses were performed to define the pathological covariates associated with MetS. A competing risk model, with death as the competing risk, was used to estimate the sub-distribution hazard ratio (SHR) of MetS for end-stage kidney disease (ESKD).224 (55%) patients had MetS. Patients with MetS had poor renal function and more severe interstitial fibrosis tubular atrophy scores (IFTA) than those without MetS. Multivariate logistic regression analysis revealed that IFTA was significantly associated with MetS (odds ratio per score increase 1.45, 95% confidence interval [CI] 1.02-2.05). Of the patients with DN at risk, 40% of patients progressed to ESKD. After adjusting for renal function and pathological parameters, the presence of MetS was an independent predictor for progression to ESKD (SHR 1.93, 95% CI 1.34-2.79). The SHRs for progression to ESKD also increased as the number of MetS components increased. Additionally, adding the IFTA scores improved the prognostic power of a model that only contained MetS and clinical covariates for predicting future ESKD.MetS is an independent prognostic predictor of ESKD in patients with T2D and DN, while adding the IFTA scores increased the prognostic value of MetS for renal outcome.

Chunmei Qin,1– 3 Yiting Wang,1,2 Lijun Zhao,1,2 Junlin Zhang,1,2 Honghong Ren,1,2 Yutong Zou,1,2 Yucheng Wu,1,2 Tingli Wang,1,2 Yuancheng Zhao,1,2 Rui Zhang,1,2 Huan Xu,4 Jie Zhang,5 Mark E Cooper,6 Fang Liu1,2 1Division of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 3Department of Nephrology, Luzhou People’s Hospital, Luzhou, People’s Republic of China; 4Division of Pathology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 5Key Laboratory of Transplant Engineering and Immunology, Chengdu, People’s Republic of China; 6Department of Diabetes, Central Clinical School, Monash University, Melbourne, AustraliaCorrespondence: Fang Liu, Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People’s Republic of China, Tel +86-28-18980601214, Fax +86-28-85422335, Email liufangfh@163.comObjective: The rate of kidney function decline in patients with diabetic kidney disease (DKD) is known to differ. This study analyzed the clinicopathologic features and related risk factors affecting long-term renal survival in Chinese type 2 diabetic patients with rapid estimated glomerular filtration rate (eGFR) decline.Methods: In this retrospective descriptive study, 191 DKD patients were first classified as rapid eGFR decliners and slow eGFR decliners on the basis of the median eGFR slope value (− 8.0 mL/min/1.73 m2/year). In total, 96 patients with rapid eGFR decline were included in the analyses and subsequently allocated to end-stage renal disease (ESRD) and non-ESRD groups. Baseline clinicopathological data of rapid eGFR decliners were collected. Cox proportional hazard analysis was performed to calculate the hazard ratios (HRs) for progression to ESRD.Results: During a median follow-up of 25 months, 52 (54.2%) rapid eGFR decliners progressed to ESRD. These 52 rapid eGFR decliners had poorer renal function, lower hemoglobin and albumin concentrations, higher total cholesterol and baseline proteinuria levels, and more severe interstitial inflammation than those who did not progress to ESRD. After adjustment for age, gender, baseline eGFR, proteinuria, hemoglobin level, serum albumin concentration, and histopathologic parameters, multivariate Cox proportional hazard analysis revealed that eGFR (HR 0.973, 95% CI 0.956– 0.989) and proteinuria (HR 1.125, 95% CI 1.030– 1.228) were associated with the increased risk of progression to ESRD.Conclusion: Higher proteinuria and lower eGFR were independent risk factors for renal progression in Chinese patients with type 2 diabetes and rapid eGFR decline.Keywords: diabetic kidney disease, rapid eGFR decline, clinical, pathological, type 2 diabetes

To investigate the relationship between metabolic-associated fatty liver disease (MAFLD) and end-stage renal disease (ESRD) in patients with biopsy-confirmed diabetic nephropathy (DN).A total of 316 participants with biopsy-confirmed DN between January 2008 and December 2019 were retrospectively assessed. Kaplan-Meier curve and Cox proportional hazard models were used to compare the risk of incident ESRD in 50 patients with MAFLD and 50 patients without MAFLD, after using propensity score matching (PSM) to address the imbalances of sex, age, baseline-estimated glomerular filtration rate, serum albumin, 24-h urine protein, hemoglobin and systolic blood pressure.During the median follow-up period of 3 years, there were 19 ESRD outcome events (19%) in PSM cohort. Kaplan-Meier curve analysis suggested that renal survival significantly deteriorated in patients with MAFLD versus those without MAFLD (p = 0.021). Additionally, the hazard ratios (95% confidence interval) of MAFLD were 3.12 (1.09-8.95, p = 0.035), 3.36 (1.09-10.43, p = 0.036), 3.66 (1.22-10.98, p = 0.021), 4.25 (1.34-13.45, p = 0.014), 3.11 (1.08-8.96, p = 0.035) and 5.84 (1.94-18.5, p = 0.003) after adjustment for six models, including demographic, clinical and pathological characteristics as well as medication use at the time of renal biopsy, respectively. Besides, patients with higher liver fibrosis score had a greater possibility of ESRD, comparing to those with lower liver fibrosis score (p = 0.002).MAFLD increases the risk of incident ESRD in patients with biopsy-proven DN. Further research is needed to determine whether treatment targeting MAFLD improves the prognosis of DN.

Several studies show that patients with early-onset diabetes have higher risk of diabetic complications than those diagnosed in middle age. However, whether early-onset of type 2 diabetes mellitus (T2DM) is a risk factor for diabetic nephropathy (DN) progression remains unclear, especially a lack of data in biopsy-confirmed cohort. In This study, we enrolled 257 patients with T2DM and biopsy-confirmed DN to investigate the role of early-onset T2DM in DN progression. Participants were divided into two groups according to the age of T2DM diagnosis: early-onset group (less than 40 years) and later-onset group (40 years or older). We found that patients with early-onset T2DM had higher glomerular grades and arteriolar hyalinosis scores than those in later-onset group. After adjusted for confounding factors, early-onset of T2DM remained an independent predictor of end-stage renal disease (ESRD) for patients with DN. In conclusion, although with the comparable renal function and proteinuria, patients with early-onset T2DM and DN had worse renal pathological changes than those with later-onset. Early-onset of T2DM might be an important predictor of ESRD for patients with DN, which called more attention to early supervision and prevention for patients with early-onset T2DM and DN.

Electronic data forensics is the process of obtaining, preserving, analyzing and presenting evidence for computer invasion, destruction, fraud, attack and other criminal acts. Some key digital evidence of cybercrime exists in physical memory or stored in page exchange files, so memory forensics is an important part of electronic data forensics. This paper studies RAM-based electronic data forensics with the use of the memory forensics tool Volatility. By obtaining the memory data of real equipment, cloud computing, virtual machine or virtual devices, performing the extraction and analysis of process information, registry, network connection, strings, access records and other contents, and extracting the digital evidence related to network attack or network crime.

Cardiac myxoma (CM) is the most common benign cardiac tumor which is mostly sporadic. Increasing evidence show that protein-coding genes (PCGs) and long noncoding RNAs (lncRNAs) play important roles in the pathology processes of multiple cancers. However, the functional roles and regulatory mechanisms of RNAs interaction in CM are still unclear. In this study, we investigated three pairs of surgically excised CM by high throughput sequencing and screened a set of PCGs and lncRNAs which were differentially expressed and could serve as expression markers in CM. By constructing protein-protein interactions (PPI) and lncRNA-mRNA coexpressing network, we screened out a CM-related hub lncRNA-mRNA modules, which were enriched in different pathways such as MAPK and TGF-beta whose imbalance were validated by q-PCR. In addition, we identified a specific dysregulated competing endogenous RNA (ceRNA) network in CM by integrating lncRNA-miRNA-mRNA interactions. These results will help us to understand the interaction mechanisms of RNAs in CM and provide novel PCGs and lncRNAs as potential therapeutic targets for CM.

As urban power grid is getting more and more complex, it is necessary to improve the original evaluation method and also a more convenient and accurate vulnerability assessment of urban power grid is needed. Firstly, the evaluating vulnerability index system of urban power grid is established by Analytic Hierarchy Process (AHP) from four aspects of composition of power supply, grid structure, grid operation and important transmission channels. Secondly, according to the effect and position of index in evaluation system, the weights of different indexes are calculated by using the Artificial Neural Network (ANN). Thirdly, aiming at the problem of different dimensions of input indexes, a nondimensionalized scoring standard is proposed to form a complete assessment system. Finally, the vulnerability assessment of urban power grid is carried out by taking a city as an example. The paper puts forward the weaknesses and defects of the urban power grid after analyzing the results, which lays a theoretical foundation for further optimization and upgrading.

The Minjiang Fault belt on the eastern edge of the Tibetan Plateau is the boundary between the Motianling block and the Songpan-Ganzi fold belt. It has recently been a focus of many geological and geophysical studies. In this paper, a NW-SE trending magnetotelluric (MT) sounding profile which crossed the Minjiang Fault and adjacent regions was used to study the deep structure of this region. The dimensionality analysis results indicate that the structure of the research area is 3-D. This is because most of the Swift and Bahr skew values are larger than 0.2 in the long period data. In contrast, impedance tensor decomposition results show a poorly-defined strike angle of N20°E with the 90° ambiguity removed with regional geological information. A similar strike angle was given by phase tensor analysis as well. Thus, both 2-D and 3-D approaches were applied to produce resistivity models. The resistivity model can be divided into three parts which are the Ruoergai basin, the Maerkang block and the Minshan block from west to east. These three parts are separated by the Longriba Fault in the west and the Minjiang Fault in the east. The Ruoergai block and Maerkang block are characterized by highly resistive upper crust and less resistive middle to lower crust. The low resistivity layer is located beneath the Minjiang Fault and connects with the shallow low resistivity body in the upper crust of the Minshan block. The shallow conductor beneath the Minshan block may be caused by fluid and partial melt. In contrast, the widespread low resistivity middle to lower crust beneath the Minshan block, is interpreted as partial melt and can be related to the northeastward channel flow of the weakened Tibetan crust. The channel flow is interpreted to travel through the Longriba Fault in the eastern margin of the Tibetan plateau and was blocked by the rigid Motianling block east of the Minshan block. This blockage caused the upwelling of partial melt in the middle and lower crust, leading to crustal deformation in the weak Minshan uplift zone. As a result, the Minshan uplift was formed as a result of an eastward-thrusting nappe, whereas the left-lateral, strike-slip movement of the Minjiang Faults and Huya fracture accelerates the uplift of the Minshan block. The other portion of the channel flow is blocked by the Motianling block and turns to the southeast, resulting in the Maerkang block moving to the south; this phenomenon corresponds to the dextral strike-slip movement of the Longriba Fault and the sinistral strike-slip movement of the Minjiang Fault.

Inverter air conditioners (ACs) account for a large proportion of air conditioning loads in many countries and, thus, contribute significantly to the peak loads in these areas, especially in summer. On the other hand, as an important category of thermostatically controlled load with thermal energy storage capability, inverter ACs also have the potential to provide considerable flexibility for electric power systems that are faced with increasing challenges posed by high penetration of renewable power generation. This paper focuses on the demand response from the control of the aggregated inverter ACs for load reduction. A virtual energy storage system (VESS) model that encapsulates the room with an inverter AC was established based on the electric model of an inverter AC and the thermodynamic model of a room. Based on the VESS model, a virtual state of charge (VSOC) priority-based load reduction control method with temperature holding and linear recovery strategies was proposed. The VSOC priority based control was designed to decrease the negative impact of load reduction on customers’ thermal comfort from the perspective of the whole AC population. The temperature holding strategy was designed to reduce the electric power of an AC while ensuring that the indoor temperature is always below the allowable limit. The linear recover strategy was proposed to reduce the load rebound after load reduction. Four cases were studied regarding the operation and load reduction of the 100 inverter ACs, and the simulation results verified the models established and the effectiveness and advantages of the proposed load reduction control method.

Background To address the prognostic value of combining tubular basement membrane (TBM) and glomerular basement membrane (GBM) thickness in diabetic nephropathy (DN). Methods This retrospective study enrolled 110 patients with type 2 diabetes and biopsy‐proven DN from 2011 to 2018. The pathological findings were confirmed according to the Renal Pathology Society classifications. GBM and TBM thicknesses were determined using the Haas' direct measurement/arithmetic mean method and orthogonal intercept method, respectively. Cox proportional hazard models were used to investigate the hazard ratios (HRs) for the influence of combined GBM and TBM thickness for predicting end‐stage renal disease (ESRD). Results Patients were assigned to three groups according to the median GBM and TBM thickness: GBMloTBMlo (GBM, Highlights The prognostic value of combining tubular basement membrane (TBM) and glomerular basement membrane (GBM) in diabetic nephropathy (DN) was lacking.TBM thickness was strongly correlated with GBM thickness, baseline estimated glomerular filtration rate, and proteinuria.The degree of TBM thickness provided additional value to GBM thickness for predicting end‐stage renal disease progression in patients with type 2 diabetes and biopsy‐proven DN.

The More Electric Aircraft (MEA) stands for the direction of aviation development in the new era, and the reliability of power systems on the MEA has attracted widespread attention. Based on the characteristics of MEA power systems, an equivalent method of electrical topology structure is presented in this article, and evaluation method is proposed which shows the reliability of the overall system with the reliability of specific nodes. Firstly, electrical topology structure of a MEA power system is converted into a network node diagram according to the proposed equivalent method. Then, the minimal path sets of specific nodes are obtained by the adjacent matrix algorithm, and the low-order minimal cut sets of disjointed are obtained. After that, the actual failure rate of components is converted to node failure rate, and the reliability of the overall system is evaluated by operational reliability indexes of specific nodes. Finally, taking the MEA A380 as an example, this paper compares and analyzes the reliability of AC loads, DC loads, and key loads to verify the validity and feasibility of the proposed evaluation method. This evaluation system can predict the weak points existing in the MEA power system, as well as providing theoretical support for maintenance schedule.

Large signal stability means that a system can be a transition to a new stable state without losing synchronism after a large disturbance. The large signal stability problem brought by large capacity electrical loads in ac/dc independent power system is prominent, which seriously affects the dynamic security of the system. In view of modeling characteristics of ac/dc system, a generalized state space average large signal modeling method for the ac/dc independent power system in dq-coordinates is proposed. A large signal model of the ac/dc independent power system is constructed, which includes generators, inverter units, rectifying units, and dc/dc converters. The simulation results indicate that the large signal model constructed in this paper can accurately reflect the dynamic characteristics of the system under large disturbances, such as startup and sudden change in load, which is helpful to understand and improve the dynamic performance of the system under large disturbance. Furthermore, with feasibility and effectiveness, the large signal model provides convenience and possibility for the theoretical analysis of large signal stability of ac/dc independent power systems in the future.

With the development of DC distribution system within the isolated power system of a ship or an aircraft, more constant frequency loads will be supplied by inverters connected to DC main bus. In the operating mode conversion process of an isolated power system, inverters will inevitably suffer from serious disturbance and affect the stability of the system. Therefore, it is important to establish a model of the inverter that reflects its dynamic characteristics and based on which to conduct the stability analysis. This paper proposes a 12-pulse inverter model based on the generalized state space averaging (GSSA) method. This model can overcome the limitations of 12-pulse inverter state space averaging (SSA) model in transient analysis with good accuracy and fast analysis ability effectively. Three kinds of models for a 12-pulse aircraft inverter are built in MATLAB, namely GSSA model, SSA model and detail device model. The simulation results show the high accuracy of GSSA model in stability analysis. This study provides an effective analytical tool for stability analysis of 12-pulse inverter and also provides a reference for inverter modeling research of isolated power system such as in aircraft or ship.

As an emerging architecture, mobile edge computing (MEC) extends cloud computing services to network edges close to users through MEC servers, satisfying the application needs of real-time control and real-time data analysis. However, due to the limited computing power of MEC server, the task has a long delay-time. In order to improve the current situation, this paper proposes a scheduling algorithm of minimum total delay-time (MTD), in which the server determines the optimal order of task computation to MTD. In addition, this paper proposes an incentive mechanism for users to submit tasks with reasonable computation and expected completion time, while reducing the number and computation of submitted tasks when server computing resources are insufficient. The results show that the performance of the algorithm is close to that of the traditional scheduling algorithm, and total delay-time and average delay-time have improved by 17% to 200%.

Minimal cut sets are the basis of reliability analysis using analytical techniques. At the present stage, minimal cut sets are mainly obtained by dealing with minimal path sets, which involves cumbersome steps and slower operational speed. The speed of reliability analysis is limited by that of calculating minimal cut sets. In consideration of the characteristics of microgrid, a hierarchical approach for fast calculating minimal cut sets is proposed in this paper. Firstly, an equivalent principle is proposed to convert topology structure into network node diagram; then grades of nodes are designated based on their original connection and the breadth-first search approach; afterwards, root-leaf matrices and selected matrix are created to specify the direction and order of the search. Next, all possible combinations of minimal cut sets are vertically traversed out by replacing root nodes with leaf nodes to achieve a more rapid access to minimal cut sets. Finally, taking the electrical structure of type A380 more electric aircraft as an example, mainstream methods are compared to show the correctness and advantage of our proposed method.

Air conditioning loads are important resources for demand response. With the help of thermal energy storage capacity, they can reduce peak load, improve the reliability of power grid operations, and enhance the emergency capacity of a power grid, without affecting the comfort of the users. In this paper, a virtual energy storage model for inverter air conditioning loads, which reflects their operating characteristics and is more conducive to practical application, is established. Two parts are involved in the virtual energy storage model: An electrical parameter part, based on the operating characteristics, and a thermal parameter part, based on the equivalent thermal parameter model. The control function and restrictive conditions of the virtual energy storage are analyzed and a control strategy, based on virtual state-of-charge ranking, is proposed. The strategy controls the inverter air conditioners through re-assigning indoor temperature set-points within the pre-agreed protocol interval and gives priority those with a higher virtual state of charge. As a result, electric power consumption is reduced while the temperature remains unchanged, so that a shortage in the power system can be compensated for as much as possible, while the comfort of users is guaranteed. Simulation and example analyses show that the strategy is effective in controlling air conditioning loads. Additionally, the influences of load reduction target magnitude and communication time-step on the performance of the control strategy are analyzed.

With the development of demand response technology, it is possible to reduce power shortages caused by loads participating in power grid dispatching. Based on the equivalent thermal parameter model, and taking full account of the virtual energy storage characteristics presented during electro-thermal conversion, a virtual energy storage model suitable for electric heating loads with different electrical and thermal parameters is proposed in this paper. To avoid communication congestion and simplify calculations, the model is processed by discretization and linearization. To simplify the model, a control strategy for electric heating load, based on the virtual state ofcharge priority list, is proposed. This paper simulates and analyzes a control example, explores the relevant theoretical basis affecting the control effect, and puts forward an optimization scheme for the control strategy. The simulation example proved that the proposed method in this paper can reduce power storage in the grid over a long period of time and can realize a power response in the grid.

As typical thermostatically controlled loads (TCL) driven by constant-speed compressor, constant-speed air-conditioners play important roles in demand-side response for their abilities of energy conversion and storage. Their great potential for load regulation can be incorporated into power system scheduling through demand response. In view of their operating characteristics, a virtual energy storage (VES) model of thermostatically controlled loads with electrical and thermal parameters is established. This model is discretized and linearized to simplify calculation. By analyzing the control function and constraints of the VES model, the control strategy of VES of constant-speed air-conditioners load with virtual charging state priority is proposed. Example analysis shows that this strategy can solve and alleviate power shortage problem of the system by participating in demand response, which provides methodological support for constant-speed compressor temperature-control load to participate in the system operation.

Purpose – The purpose of this paper is to introduce a method of the bottleneck detection for Emergency Department (ED) improvement using benchmarking and design of experiments (DOE) in simulation model. Design/methodology/approach – Four procedures of treatments are used to represent ED activities of the patient flow. Simulation modeling is applied as a cost-effective tool to analyze the ED operation. Benchmarking provides the achievable goal for the improvement. DOE speeds up the process of bottleneck search. Findings – It is identified that the long waiting time is accumulated by previous arrival patients waiting for treatment in the ED. Comparing the processing time of each treatment procedure with the benchmark reveals that increasing the treatment time mainly happens in treatment in progress and emergency room holding (ERH) procedures. It also indicates that the to be admitted time caused by the transfer delay is a common case. Research limitations/implications – The current research is conducted in the ED only. Activities in the ERH require a close cooperation of several medical teams to complete patients’ condition evaluations. The current model may be extended to the related medical units to improve the model detail. Practical implications – ED overcrowding is an increasingly significant public healthcare problem. Bottlenecks that affect ED overcrowding have to be detected to improve the patient flow. Originality/value – Integration of benchmarking and DOE in simulation modeling proposed in this research shows the promise in time-saving for bottleneck detection of ED operations.

Different strategies have been proposed to reduce patient waiting time in hospitals. Previous investigations indicate that up to 50% or more patients can be treated in a “fast track” process compared to the standard procedure in some emergency departments. However most studies on emergency department (ED) fast tracks were based on evidence without using an efficient decision tool to show applicability of the results. An agent-based simulation tool is proposed in this research to evaluate fast track treatment (FTT) in an ED. The tool can study the behavior change of entities and resources in a complex ED system. Static and dynamic FTT processes are evaluated. The static process uses a fixed duration in the daily ED operation. In the dynamic process, FTT is triggered based on the current patient waiting time and the state of ED operations. The simulation results provide details and information for the process of the FTT implementation at the ED to reduce patient waiting time.

In Constant speed constant frequency (CSCF) AC power supply system, generator output constant frequency and constant voltage AC power by connecting engine with constant speed transmission device (CSD). However, CSCF has many disadvantages, such as complex structure, heavy weight, high cost and low energy conversion efficiency. By eliminating CSD in CSCF and taking output voltage and output frequency as feedback quantities, this paper proposes a dual excitation control method to achieve the same effect as CSCF power source. From the perspective of engineering applications, this improved method can greatly reduce the weight of aviation power generation system. It has a simple structure and can cut down the cost of power system operation and maintenance. Simulation results show that the method of dual excitation control presented in this paper is effective, and it also provides a new idea for the improvement in aviation power generation system.