In order to solve the problem of poor formability caused by different materials and properties in the process of tailor-welded sheets forming,a forming method was proposed to change the stress state of tailor-welded s...In order to solve the problem of poor formability caused by different materials and properties in the process of tailor-welded sheets forming,a forming method was proposed to change the stress state of tailor-welded sheets by covering the tailor-welded sheets with better plastic properties overlapping sheets.At the same time,the interface friction effect between the overlapping and tailor-welded sheets was utilized to control the stress magnitude and further improve the formability and quality of the tailor-welded sheets.In this work,the bulging process of the tailor-welded overlapping sheets was taken as the research object.Aluminum alloy tailor-welded overlapping sheets bulging specimens were studied by a combination of finite element analysis and experimental verification.The results show that the appropriate use of interface friction between tailor-welded and overlapping sheets can improve the formability of tailor-welded sheets and control the flow of weld seam to improve the forming quality.When increasing the interface friction coefficient on the side of tailor-welded sheets with higher strength and decreasing that on the side of tailor-welded sheets with lower strength,the deformation of the tailor-welded sheets are more uniform,the offset of the weld seam is minimal,the limit bulging height is maximal,and the forming quality is optimal.展开更多
The transformation of natural habitats into human-modified landscapes has far-reaching consequences for species distribution and abundance.As species adapt to these changing environments,shifts in distribution pattern...The transformation of natural habitats into human-modified landscapes has far-reaching consequences for species distribution and abundance.As species adapt to these changing environments,shifts in distribution patterns,niche dynamics,and interspecies interactions may occur,impacting biodiversity at multiple levels and potentially leading to ecosystem imbalances.This study aims to assess the impact of variations in vegetation composition and human disturbance on the distribution of sympatric breeding birds and to determine the extent of niche overlap or differentiation among these species.We conducted field surveys and collected data on bird distribution,vegetation composition,and level of human disturbance in eastern Inner Mongolian grasslands.We focused on the six most frequently co-occurring breeding birds,representing a mix of sparrows,larks,and corvids.Generalized Additive Models revealed varying responses of species occurrence along habitat gradients.Species like the Eurasian Skylark(Alauda arvensis),Mongolian Lark(Melanocorypha mongolica),and Asian Shorttoed Lark(Calandrella cheleensis),increased in larger and more connected habitats,while others,like the Tree Sparrow(Passer montanus),Eurasian Magpie(Pica pica),and Barn Swallow(Hirundo rustica),adapted to more fragmented habitats.Niche analysis indicated habitat generalists tended to occupy larger niches than grassland specialists.Substantial niche overlap was also found among the six co-occurring bird species.Conservation efforts should consider the specific needs of specialist species and strive to maintain or restore critical grassland habitats.Additionally,promoting sustainable agricultural practices that balance the needs of birds and human activities can contribute to the coexistence of generalist and specialist bird species in modified landscapes.展开更多
The deformation caused by tunnel excavation is quite important for safety,especially when it is adjacent to the existing tunnel.Nevertheless,the investigation of deformation characteristics in overlapped curved shield...The deformation caused by tunnel excavation is quite important for safety,especially when it is adjacent to the existing tunnel.Nevertheless,the investigation of deformation characteristics in overlapped curved shield tunneling remains inadequate.The analytical solution for calculating the deformation of the ground and existing tunnel induced by overlapped curved shield tunneling is derived by the Mirror theory,Mindlin solution and Euler-Bernoulli-Pasternak model,subsequently validated through both finite element simulation and field monitoring.It is determined that the overcutting plays a crucial role in the ground settlement resulting from curved shield tunneling compared to straight shield tunneling.The longitudinal settlement distribution can be categorized into five areas,with the area near the tunnel surface experiencing the most dramatic settlement changes.The deformation of the existing tunnel varies most significantly with turning radius compared to tunnel clearance and grouting pressure,especially when the turning radius is less than 30 times the tunnel diameter.The tunnel crown exhibits larger displacement than the tunnel bottom,resulting in a distinctive‘vertical egg'shape.Furthermore,an optimized overcutting mode is proposed,involving precise control of the extension speed and angular velocity of the overcutting cutter,which effectively mitigates ground deformation,ensuring the protection of the existing tunnel during the construction.展开更多
This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with pa...This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.展开更多
BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and asse...BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related death.METHODS Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort study.Liver-related death or transplantation(liver-related mortality)was determined using a population-based data linkage system.Prognostic scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and AIH-PSC.LOS was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any group.CONCLUSION Survival in the rare,AILDOS is unclear.The current study supports the LOS as a predictor of liver-related mortality in AIH-PBC patients.Further trials investigating predictors of survival in AILDOS are required.展开更多
BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitor...BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.展开更多
The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the intera...The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the interaction among decision variables is intricate,leading to large group sizes and suboptimal optimization effects;hence a large-scale multi-objective optimization algorithm based on weighted overlapping grouping of decision variables(MOEAWOD)is proposed in this paper.Initially,the decision variables are perturbed and categorized into convergence and diversity variables;subsequently,the convergence variables are subdivided into groups based on the interactions among different decision variables.If the size of a group surpasses the set threshold,that group undergoes a process of weighting and overlapping grouping.Specifically,the interaction strength is evaluated based on the interaction frequency and number of objectives among various decision variables.The decision variable with the highest interaction in the group is identified and disregarded,and the remaining variables are then reclassified into subgroups.Finally,the decision variable with the strongest interaction is added to each subgroup.MOEAWOD minimizes the interactivity between different groups and maximizes the interactivity of decision variables within groups,which contributed to the optimized direction of convergence and diversity exploration with different groups.MOEAWOD was subjected to testing on 18 benchmark large-scale optimization problems,and the experimental results demonstrate the effectiveness of our methods.Compared with the other algorithms,our method is still at an advantage.展开更多
BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been v...BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.展开更多
BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune...BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.展开更多
Due to the network planning of subways and their surrounding structures,increasingly more overlapping shields with a small curve radius have been constructed. A newly constructed upper tunnel partly overlaps a lower o...Due to the network planning of subways and their surrounding structures,increasingly more overlapping shields with a small curve radius have been constructed. A newly constructed upper tunnel partly overlaps a lower one, leading to the extremely complex uplift of the lower tunnel caused by the construction of a new tunnel. Based on the shield-driven project that runs from the Qinghe Xiaoyingqiao Station to the Qinghe Station in Beijing, which adopts the reinforcement measures of interlayer soil grouting and steel supports on site, in this study, the uplift pattern of the lower tunnel and the stress characteristics of steel supports were investigated through numerical simulations and on-site monitoring.The study results show that among all tunnel segments, the first segment of the shield witnesses a maximum uplift displacement that increases with the horizontal space between tunnels. On using either interlayer soil grouting or steel-ring bracing reinforcement, the uplift of the tunnel lining exceeds the control value;by contrast,when these two measures are jointly applied, the uplift of the tunnel lining does not exceed a maximum value of 4.87 mm, which can satisfy the requirements of deformation control. Under these two joint measures, the soil strength between two stacked shield tunnels can be enhanced and the uplift deformation can be restricted with the interlayer soil grouting. Also, the segmental deformation and overall stability of the existing tunnel can be controlled with the temporary steel supports.The deformation of circumferential supports and segments is closely related to each other, and the segmental uplift is controlled by H-shaped steel supports. With the increase in the horizontal space between twin shields, the effect of the construction would gradually weaken, accompanied by a gradual reduction of the stresses of steel supports. These findings provide a valuable reference for the engineering design and safe construction of overlapping shield tunnels with a small curve radius.展开更多
The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition...The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition can be influenced.For addressing this issue,a method for extracting ship targets with overlaps via the expectation maximization(EM)algorithm is pro-posed.First,the scatterers of ship targets are obtained via the target detection technique.Then,the EM algorithm is applied to extract the scatterers of a single ship target with a single IPP.Afterwards,a novel image amplitude estimation approach is pro-posed,with which the radar image of a single target with a sin-gle IPP can be generated.The proposed method can accom-plish IPP selection and targets separation in the image domain,which can improve the image quality and reserve the target information most possibly.Results of simulated and real mea-sured data demonstrate the effectiveness of the proposed method.展开更多
Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive ...Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.展开更多
For addressing impulse noise in images, this paper proposes a denoising algorithm for non-convex impulse noise images based on the l_(0) norm fidelity term. Since the total variation of the l_(0) norm has a better den...For addressing impulse noise in images, this paper proposes a denoising algorithm for non-convex impulse noise images based on the l_(0) norm fidelity term. Since the total variation of the l_(0) norm has a better denoising effect on the pulse noise, it is chosen as the model fidelity term, and the overlapping group sparse term combined with non-convex higher term is used as the regularization term of the model to protect the image edge texture and suppress the staircase effect. At the same time, the alternating direction method of multipliers, the majorization–minimization method and the mathematical program with equilibrium constraints were used to solve the model. Experimental results show that the proposed model can effectively suppress the staircase effect in smooth regions, protect the image edge details, and perform better in terms of the peak signal-to-noise ratio and the structural similarity index measure.展开更多
基金Funded by the National Natural Science Foundation of China(Nos.52075347,51575364)and the Natural Science Foundation of Liaoning Provincial(No.2022-MS-295)。
文摘In order to solve the problem of poor formability caused by different materials and properties in the process of tailor-welded sheets forming,a forming method was proposed to change the stress state of tailor-welded sheets by covering the tailor-welded sheets with better plastic properties overlapping sheets.At the same time,the interface friction effect between the overlapping and tailor-welded sheets was utilized to control the stress magnitude and further improve the formability and quality of the tailor-welded sheets.In this work,the bulging process of the tailor-welded overlapping sheets was taken as the research object.Aluminum alloy tailor-welded overlapping sheets bulging specimens were studied by a combination of finite element analysis and experimental verification.The results show that the appropriate use of interface friction between tailor-welded and overlapping sheets can improve the formability of tailor-welded sheets and control the flow of weld seam to improve the forming quality.When increasing the interface friction coefficient on the side of tailor-welded sheets with higher strength and decreasing that on the side of tailor-welded sheets with lower strength,the deformation of the tailor-welded sheets are more uniform,the offset of the weld seam is minimal,the limit bulging height is maximal,and the forming quality is optimal.
基金supported by the National Natural Science Foundation of China (No.32201304)the Fundamental Research Funds for the Central Universities (No.2412022QD026)。
文摘The transformation of natural habitats into human-modified landscapes has far-reaching consequences for species distribution and abundance.As species adapt to these changing environments,shifts in distribution patterns,niche dynamics,and interspecies interactions may occur,impacting biodiversity at multiple levels and potentially leading to ecosystem imbalances.This study aims to assess the impact of variations in vegetation composition and human disturbance on the distribution of sympatric breeding birds and to determine the extent of niche overlap or differentiation among these species.We conducted field surveys and collected data on bird distribution,vegetation composition,and level of human disturbance in eastern Inner Mongolian grasslands.We focused on the six most frequently co-occurring breeding birds,representing a mix of sparrows,larks,and corvids.Generalized Additive Models revealed varying responses of species occurrence along habitat gradients.Species like the Eurasian Skylark(Alauda arvensis),Mongolian Lark(Melanocorypha mongolica),and Asian Shorttoed Lark(Calandrella cheleensis),increased in larger and more connected habitats,while others,like the Tree Sparrow(Passer montanus),Eurasian Magpie(Pica pica),and Barn Swallow(Hirundo rustica),adapted to more fragmented habitats.Niche analysis indicated habitat generalists tended to occupy larger niches than grassland specialists.Substantial niche overlap was also found among the six co-occurring bird species.Conservation efforts should consider the specific needs of specialist species and strive to maintain or restore critical grassland habitats.Additionally,promoting sustainable agricultural practices that balance the needs of birds and human activities can contribute to the coexistence of generalist and specialist bird species in modified landscapes.
基金financially supported by the National Natural Science Foundation of China(Grant No.52078334)the National Key Research and Development Program of China(Grant No.2017YFC0805402)the Tianjin Research Innovation Project for Postgraduate Students(Grant No.2021YJSB141).
文摘The deformation caused by tunnel excavation is quite important for safety,especially when it is adjacent to the existing tunnel.Nevertheless,the investigation of deformation characteristics in overlapped curved shield tunneling remains inadequate.The analytical solution for calculating the deformation of the ground and existing tunnel induced by overlapped curved shield tunneling is derived by the Mirror theory,Mindlin solution and Euler-Bernoulli-Pasternak model,subsequently validated through both finite element simulation and field monitoring.It is determined that the overcutting plays a crucial role in the ground settlement resulting from curved shield tunneling compared to straight shield tunneling.The longitudinal settlement distribution can be categorized into five areas,with the area near the tunnel surface experiencing the most dramatic settlement changes.The deformation of the existing tunnel varies most significantly with turning radius compared to tunnel clearance and grouting pressure,especially when the turning radius is less than 30 times the tunnel diameter.The tunnel crown exhibits larger displacement than the tunnel bottom,resulting in a distinctive‘vertical egg'shape.Furthermore,an optimized overcutting mode is proposed,involving precise control of the extension speed and angular velocity of the overcutting cutter,which effectively mitigates ground deformation,ensuring the protection of the existing tunnel during the construction.
文摘This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.
文摘BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is unclear.AIM To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related death.METHODS Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort study.Liver-related death or transplantation(liver-related mortality)was determined using a population-based data linkage system.Prognostic scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and AIH-PSC.LOS was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any group.CONCLUSION Survival in the rare,AILDOS is unclear.The current study supports the LOS as a predictor of liver-related mortality in AIH-PBC patients.Further trials investigating predictors of survival in AILDOS are required.
文摘BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.
基金supported in part by the Central Government Guides Local Science and TechnologyDevelopment Funds(Grant No.YDZJSX2021A038)in part by theNational Natural Science Foundation of China under(Grant No.61806138)in part by the China University Industry-University-Research Collaborative Innovation Fund(Future Network Innovation Research and Application Project)(Grant 2021FNA04014).
文摘The large-scale multi-objective optimization algorithm(LSMOA),based on the grouping of decision variables,is an advanced method for handling high-dimensional decision variables.However,in practical problems,the interaction among decision variables is intricate,leading to large group sizes and suboptimal optimization effects;hence a large-scale multi-objective optimization algorithm based on weighted overlapping grouping of decision variables(MOEAWOD)is proposed in this paper.Initially,the decision variables are perturbed and categorized into convergence and diversity variables;subsequently,the convergence variables are subdivided into groups based on the interactions among different decision variables.If the size of a group surpasses the set threshold,that group undergoes a process of weighting and overlapping grouping.Specifically,the interaction strength is evaluated based on the interaction frequency and number of objectives among various decision variables.The decision variable with the highest interaction in the group is identified and disregarded,and the remaining variables are then reclassified into subgroups.Finally,the decision variable with the strongest interaction is added to each subgroup.MOEAWOD minimizes the interactivity between different groups and maximizes the interactivity of decision variables within groups,which contributed to the optimized direction of convergence and diversity exploration with different groups.MOEAWOD was subjected to testing on 18 benchmark large-scale optimization problems,and the experimental results demonstrate the effectiveness of our methods.Compared with the other algorithms,our method is still at an advantage.
基金Supported by The Guangxi TCM Suitable Technology Development and Promotion Project,No.GZSY20-20.
文摘BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.
基金Supported by National Natural Science Foundation of China,No.82060123National Health Commission of Guizhou Province,No.gzwjk2019-1-082.
文摘BACKGROUND Autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.Autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.
基金National Natural Science Foundation of China,Grant/Award Number:52168059Program for Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region,Grant/Award Number:NJYT23103Fundamental Research Funds in Universities of Inner Mongolia Autonomous Region,Grant/Award Number:2023QNJS159。
文摘Due to the network planning of subways and their surrounding structures,increasingly more overlapping shields with a small curve radius have been constructed. A newly constructed upper tunnel partly overlaps a lower one, leading to the extremely complex uplift of the lower tunnel caused by the construction of a new tunnel. Based on the shield-driven project that runs from the Qinghe Xiaoyingqiao Station to the Qinghe Station in Beijing, which adopts the reinforcement measures of interlayer soil grouting and steel supports on site, in this study, the uplift pattern of the lower tunnel and the stress characteristics of steel supports were investigated through numerical simulations and on-site monitoring.The study results show that among all tunnel segments, the first segment of the shield witnesses a maximum uplift displacement that increases with the horizontal space between tunnels. On using either interlayer soil grouting or steel-ring bracing reinforcement, the uplift of the tunnel lining exceeds the control value;by contrast,when these two measures are jointly applied, the uplift of the tunnel lining does not exceed a maximum value of 4.87 mm, which can satisfy the requirements of deformation control. Under these two joint measures, the soil strength between two stacked shield tunnels can be enhanced and the uplift deformation can be restricted with the interlayer soil grouting. Also, the segmental deformation and overall stability of the existing tunnel can be controlled with the temporary steel supports.The deformation of circumferential supports and segments is closely related to each other, and the segmental uplift is controlled by H-shaped steel supports. With the increase in the horizontal space between twin shields, the effect of the construction would gradually weaken, accompanied by a gradual reduction of the stresses of steel supports. These findings provide a valuable reference for the engineering design and safe construction of overlapping shield tunnels with a small curve radius.
基金This work was supported by the National Science Fund for Distinguished Young Scholars(62325104).
文摘The quality of synthetic aperture radar(SAR)image degrades in the case of multiple imaging projection planes(IPPs)and multiple overlapping ship targets,and then the performance of target classification and recognition can be influenced.For addressing this issue,a method for extracting ship targets with overlaps via the expectation maximization(EM)algorithm is pro-posed.First,the scatterers of ship targets are obtained via the target detection technique.Then,the EM algorithm is applied to extract the scatterers of a single ship target with a single IPP.Afterwards,a novel image amplitude estimation approach is pro-posed,with which the radar image of a single target with a sin-gle IPP can be generated.The proposed method can accom-plish IPP selection and targets separation in the image domain,which can improve the image quality and reserve the target information most possibly.Results of simulated and real mea-sured data demonstrate the effectiveness of the proposed method.
文摘Since the new curriculum reform,labor education has gradually shed its marginalized position in the“five educations,”and the labor curriculum has become an independent course officially separated from comprehensive practical activity courses.Exploring the practical path of labor curriculum in compulsory education in China has become the primary task of labor education in China.Based on the practical situation of labor curriculum in compulsory education in China,drawing on the theory of overlapping influence domains,and from the perspective of collaborative education among family,school,and community,this paper proposes a curriculum practical path of“school-led”family-school-community collaboration and a curriculum practical path guided by“student-centered”sentiment,in order to provide references for the practice of labor curriculum in compulsory education in China.
基金funded by National Nature Science Foundation of China,grant number 61302188。
文摘For addressing impulse noise in images, this paper proposes a denoising algorithm for non-convex impulse noise images based on the l_(0) norm fidelity term. Since the total variation of the l_(0) norm has a better denoising effect on the pulse noise, it is chosen as the model fidelity term, and the overlapping group sparse term combined with non-convex higher term is used as the regularization term of the model to protect the image edge texture and suppress the staircase effect. At the same time, the alternating direction method of multipliers, the majorization–minimization method and the mathematical program with equilibrium constraints were used to solve the model. Experimental results show that the proposed model can effectively suppress the staircase effect in smooth regions, protect the image edge details, and perform better in terms of the peak signal-to-noise ratio and the structural similarity index measure.
