Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports

BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.

The Mathematical and Physical Theory of Rational Human Intelligence: Complete Empirical-Digital Properties;Full Electrochemical-Mechanical Model (Part I: Mathematical Foundations)

The design of this paper is to present the first installment of a complete and final theory of rational human intelligence. The theory is mathematical in the strictest possible sense. The mathematics involved is strictly digital—not quantitative in the manner that what is usually thought of as mathematics is quantitative. It is anticipated at this time that the exclusively digital nature of rational human intelligence exhibits four flavors of digitality, apparently no more, and that each flavor will require a lengthy study in its own right. (For more information,please refer to the PDF.)

Effect of NaCl Concentration on the Cumulative Strain and Pore Distribution of Clay under Cyclic Loading

Clay,as the most common soil used for foundationfill,is widely used in various infrastructure projects.The phy-sical and mechanical properties of clay are influenced by the pore solution environment.This study uses a GDS static/dynamic triaxial apparatus and nuclear magnetic resonance experiments to investigate the effects of cyclic loading on clay foundations.Moreover,the development of cumulative strain in clay is analyzed,and afitting model for cumulative plastic strain is introduced by considering factors such as NaCl solution concentration,con-solidation stress ratio,and cycle number.In particular,the effects of the NaCl solution concentration and con-solidation stress ratio on the pore distribution of the test samples before and after cyclic loading are examined,and the relationship between microscopic pore size and macroscopic cumulative strain is obtained accordingly.Our results show that as the consolidation stress ratio grows,an increasing number of large pores in the soil samples are transformed into small pores.As the NaCl solution concentration becomes higher,the number of small pores gradually decreases,while the number of large pores remains unchanged.Cyclic loading causes the disappearance of the large pores in the samples,and the average pore size before cyclic loading is posi-tively correlated with the axial cumulative strain after cyclic loading.The cumulative strain produced by the soil under cyclic loading is inversely proportional to the NaCl solution concentration and consolidation stress ratio.

The “Dead Universe” Theory: Natural Separation of Galaxies Driven by the Remnants of a Supermassive Dead Universe

This article explores the dead universe theory as a novel interpretation for the origin and evolution of the universe, suggesting that our cosmos may have originated from the remnants of a preceding universe. This perspective challenges the conventional Big Bang theory, particularly concerning dark matter, the expansion of the universe, and the interpretation of phenomena such as gravitational waves.

A gated recurrent unit model to predict Poisson’s ratio using deep learning

Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.

Predictive Ability of Hypertriglyceridemic Waist,Hypertriglyceridemic Waist-to-Height Ratio,and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents

Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.

Insufficiency of Cellular Energy (ICE) May Precede Neurodegeneration in Alzheimer’s Disease and Be Treatable via the Alternative Cellular Energy (ACE) Pathway

The term neurodegeneration emphasizes the destruction of neuronal cells as the primary explanation of many major neurological illnesses, including Alzheimer’s disease. Specialized functioning of cells requires more cellular energy than is needed for basic cell survival. Cells can acquire energy both from the metabolism of food and from the alternative cellular energy (ACE) pathway. The ACE pathway is an added dynamic (kinetic) quality of the body’s fluids occurring from the absorption of an external force termed KELEA (Kinetic Energy Limiting Electrostatic Attraction). KELEA is attracted to separated electrical charges and is seemingly partially released as the charges become more closely linked. As suggested elsewhere, the fluctuating electrical activity in the brain may attract KELEA from the environment and, thereby, contribute to the body’s ACE pathway. Certain illnesses affecting the brain may impede this proposed antenna function of the brain, leading to a systemic insufficiency of cellular energy (ICE). Furthermore, individual neurons may derive some of the energy for their own activities from the repetitive depolarization of the cell. This may explain why hyper-excitability of neurons can occur in response to cell damage. This adaptive mechanism is unlikely to be sustainable, however, especially if there is a continuing need to synthesize neurotransmitters and membrane ion channels. The energy deficient neurons would then become quiescent and, although remaining viable, would not perform their intended specialized functions. Actual cell death would not necessarily occur till much later in the disease process. The distinction between quiescent and degenerated cells is important since the ACE pathway can be enhanced by several means, including the regular consumption of KELEA activated water. This, in turn, may improve the proposed antenna function of individual neurons, leading to a sustained restoration of specialized function via the ACE pathway. This paper explores this novel concept and provides a rationale for clinical testing of KELEA activated water in patients with neurological and psychiatric illnesses, including Alzheimer’s disease.

Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer:A meta-analysis and systematic review

Objective: To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic diseases.Methods: A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect model.Results: Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: −0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24).Conclusion: The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.

Expressions of ICAM-1 and its mRNA in sera and tissues of patients with hepatocellular carcinoma

INTRODUCTIONThe increased expression of ICAM-1 on a widerange of cells and in the sera of patients withmalignancies, chronic liver diseases andinflammation diseases has been described since thelate 1980s[1-22]. Recently rapid progress in studieson expression of ICAM-1 in patients withhepatocellular carcinoma ( HCC ) have beenachieved, including clinical and experimentalresearches[23-31].

Prediction of lime utilization ratio of dephosphorization in BOF steelmaking based on online sequential extreme learning machine with forgetting mechanism

The machine learning models of multiple linear regression(MLR),support vector regression(SVR),and extreme learning ma-chine(ELM)and the proposed ELM models of online sequential ELM(OS-ELM)and OS-ELM with forgetting mechanism(FOS-ELM)are applied in the prediction of the lime utilization ratio of dephosphorization in the basic oxygen furnace steelmaking process.The ELM model exhibites the best performance compared with the models of MLR and SVR.OS-ELM and FOS-ELM are applied for sequential learning and model updating.The optimal number of samples in validity term of the FOS-ELM model is determined to be 1500,with the smallest population mean absolute relative error(MARE)value of 0.058226 for the population.The variable importance analysis reveals lime weight,initial P content,and hot metal weight as the most important variables for the lime utilization ratio.The lime utilization ratio increases with the decrease in lime weight and the increases in the initial P content and hot metal weight.A prediction system based on FOS-ELM is applied in actual industrial production for one month.The hit ratios of the predicted lime utilization ratio in the error ranges of±1%,±3%,and±5%are 61.16%,90.63%,and 94.11%,respectively.The coefficient of determination,MARE,and root mean square error are 0.8670,0.06823,and 1.4265,respectively.The system exhibits desirable performance for applications in actual industrial pro-duction.

Novel therapeutic strategies targeting mitochondria as a gateway in neurodegeneration

In recent years, multiple disciplines have focused on mitochondrial biology and contributed to understanding its relevance towards adult-onset neurodegenerative disorders. These are complex dynamic organelles that have a variety of functions in ensuring cellular health and homeostasis. The plethora of mitochondrial functionalities confers them an intrinsic susceptibility to internal and external stressors(such as mutation accumulation or environmental toxins), particularly so in long-lived postmitotic cells such as neurons. Thus, it is reasonable to postulate an involvement of mitochondria in aging-associated neurological disorders, notably neurodegenerative pathologies including Alzheimer’s disease and Parkinson’s disease. On the other hand, biological effects resulting from neurodegeneration can in turn affect mitochondrial health and function, promoting a feedback loop further contributing to the progression of neuronal dysfunction and cellular death. This review examines state-of-the-art knowledge, focus on current research exploring mitochondrial health as a contributing factor to neuroregeneration, and the development of therapeutic approaches aimed at restoring mitochondrial homeostasis in a pathological setting.

Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Growth differentiation factor-15 serum concentrations reflect disease severity and anemia in patients with inflammatory bowel disease

BACKGROUND Population of patients with inflammatory bowel disease(IBD)is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality.Growth-differentiation factor-15(GDF-15)is often overexpressed under stress conditions,such as inflammation,malignancies,heart failure,myocardial ischemia,and many others.AIM To explore the association between GDF-15 and IBD as serum concentrations of GDF-15 were shown to be an independent predictor of poor outcomes in multiple diseases.An additional aim was to determine possible associations between GDF-15 and multiple clinical,anthropometric and laboratory parameters in patients with IBD.METHODS This cross-sectional study included 90 adult patients diagnosed with IBD,encompassing both Crohn’s disease(CD)and ulcerative colitis(UC),and 67 healthy age-and sex-matched controls.All patients underwent an extensive workup,including colonoscopy with subsequent histopathological analysis.Disease activity was assessed by two independent gastroenterology consultants specialized in IBD,employing well-established clinical and endoscopic scoring systems.GDF-15 serum concentrations were determined following an overnight fasting,using electrochemiluminescence immunoassay.RESULTS In patients with IBD,serum GDF-15 concentrations were significantly higher in comparison to the healthy controls[800(512-1154)pg/mL vs 412(407-424)pg/mL,P<0.001],whereas no difference in GDF-15 was found between patients with CD and UC[807(554-1451)pg/mL vs 790(509-956)pg/mL,P=0.324].Moreover,multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age,sex,and C-reactive protein levels(P=0.016 and P=0.049,respectively).Finally,an association between GDF-15 and indices of anemia was established.Specifically,negative correlations were found between GDF-15 and serum iron levels(r=-0.248,P=0.021),as well as GDF-15 and hemoglobin(r=-0.351,P=0.021).Accordingly,in comparison to IBD patients with normal hemoglobin levels,GDF-15 serum levels were higher in patients with anemia(1256(502-2100)pg/mL vs 444(412-795)pg/mL,P<0.001).CONCLUSION For the first time,we demonstrated that serum concentrations of GDF-15 are elevated in patients with IBD in comparison to healthy controls,and the results imply that GDF-15 might be involved in IBD pathophysiology.Yet,it remains elusive whether GDF-15 could serve as a prognostic indicator in these patients.

Application of Different Image Processing Techniques on Aster and ETM+ Images for Exploration of Hydrothermal Alteration Associated with Copper Mineralizations Mapping Kehdolan Area (Eastern Azarbaijan Province-Iran)

The Kehdolan area is located at 20 kilometers to the?south-east of Dozdozan Town (Eastern Azarbaijan Province). According to structural geology, volconic rocks are situated in Alborz-Azarbyjan zone, and faults?are?observed?in?the?same direction to this system with SE-NW trend. The results show that kaolinite alteration trend with Argilic and propylitic veins?is the?same direction with SW-NE faults in this area. Therefore, these faults with these trends can be considered as the mineralization control for determination of the alterations. Different image processing techniques,?such as false color composite?(FCC), band ratios, color ratio composite?(CRC), principal component?analysis?(PCA), Crosta technique, supervised spectral angle mapping?(SAM), are used for?identification of the alteration zones associated with copper mineralization. In this project ASTER?data are process and spectral analysis to fit for recognizing intensity and kind of argillic, propylitic,?philic, and ETM+ data?which?are process and to fit for iron oxide and relation to metal mineralization of the area. For recognizing different alterations of the study area, some chemical and mineralogical analysis data from the samples showed that ASTER data and ETM+ data were?capable of hydrothermal alteration mapping with copper mineralization.?Copper mineralization in the region is in agreement with argillic alteration. SW-NE trending faults controlled the mineralization process.

What Are the Current and Developing Treatments for Cotard’s Syndrome, Alice in Wonderland Syndrome, and Catatonic Schizophrenia?

Purpose: Cotard’s syndrome, Alice in Wonderland Syndrome, and Catatonia are all rare psychiatric disorders that have relatively little research regarding their treatments. The aim of this article is to highlight any gaps in knowledge regarding represented demographics in these treatment studies, and to discuss the current and upcoming treatment options. Background: This literature review explores under-researched psychiatric conditions: Cotard’s syndrome, Alice in Wonderland syndrome, and Catatonic Schizophrenia. Understanding psychiatric disorders requires basic knowledge of brain anatomy. These conditions are often result of or associated with neurological issues, such as migraines or tumors. The brain has eight lobes, two of four kinds: frontal, parietal, occipital, and temporal lobes, which all govern different functions and abilities. Frontal lobes control judgment, decision-making, personality traits, and fine motor movements. Parietal lobes interpret pain and temperature, occipital lobes handle visual stimuli, and temporal lobes enable hearing. The pre-frontal cortex is associated with high intelligence, psychotic traits, and psychosis. The Broca’s Area in the frontal lobes controls expressive language. These areas and divisions of the brain contribute to the complexity of the psychiatric disorders discussed in this review. Introduction: Cotard’s syndrome is a psychiatric disorder characterized by delusions of being dead or not having certain limbs or organs. It is believed that there is a disconnect between their fusiform face area and the amygdala, causing a lack of familiarity between one’s mind and body. Alice in Wonderland Syndrome (AIWS) is another psychiatric disorder which is characterized by visual hallucinations, such as distorted perceptions of color, size, distance, and speed. The most common symptoms include micropsia and macropsia. Catatonia/Catatonic Schizophrenia is an uncommon type of schizophrenia. This type of schizophrenia is characterized by motor rigidity, verbal rigidity, the flat effect, psychomotor retardation, waxy flexibility, and overall negative symptoms. Thus, these people may come off as emotionally detached, and able to stay frozen in odd positions for periods on end. Treatments and Results: Cotard’s syndrome seemed to be most effectively treated by ECT (electroconvulsive therapy). Alice in Wonderland Syndrome (AIWS) had the highest positive responses to treatment by Valproate (an anti-epileptic drug), as well as intervention to treat the associated neurological conditions they had. Catatonia/Catatonic Schizophrenia seemed to be most effectively treated with a combination of benzodiazepines and ECT. Discussion and Demographics: In all 3 disorders, the Latino and African communities were underrepresented. There also seemed to be an underrepresentation of men in Cotard’s syndrome, and of women in Alice in Wonderland Syndrome. Japan and India seemed to have the highest density of treatment studies in all 3 disorders.

Alterations in gut microbiota are related to metabolite profiles in spinal cord injury

Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To investigate the correlation between gut microbiota and metabolites and the possible mechanism underlying the effects of gut microbiota on secondary injury after spinal cord injury, in this study, we established mouse models of T8–T10 traumatic spinal cord injury. We used 16 S rRNA gene amplicon sequencing and metabolomics to reveal the changes in gut microbiota and metabolites in fecal samples from the mouse model. Results showed a severe gut microbiota disturbance after spinal cord injury, which included marked increases in pro-inflammatory bacteria, such as Shigella, Bacteroides, Rikenella, Staphylococcus, and Mucispirillum and decreases in anti-inflammatory bacteria, such as Lactobacillus, Allobaculum, and Sutterella. Meanwhile, we identified 27 metabolites that decreased and 320 metabolites that increased in the injured spinal cord. Combined with pathway enrichment analysis, five markedly differential amino acids(L-leucine, L-methionine, L-phenylalanine, L-isoleucine and L-valine) were screened out, which play a pivotal role in activating oxidative stress and inflammatory responses following spinal cord injury. Integrated correlation analysis indicated that the alteration of gut microbiota was related to the differences in amino acids, which suggests that disturbances in gut microbiota might participate in the secondary injury through the accumulation of partial metabolites that activate oxidative stress and inflammatory responses. Findings from this study provide a new theoretical basis for improving the secondary injury after spinal cord injury through fecal microbial transplantation.

Multisensory mechanisms of gait and balance in Parkinson’s disease:an integrative review

Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have on our aging population.Posture and gait control does not happen automatically,as previously believed,but rather requires continuous involvement of central nervous mechanisms.To effectively exert control over the body,the brain must integrate multiple streams of sensory information,including visual,vestibular,and somatosensory signals.The mechanisms which underpin the integration of these multisensory signals are the principal topic of the present work.Existing multisensory integration theories focus on how failure of cognitive processes thought to be involved in multisensory integration leads to falls in older adults.Insufficient emphasis,however,has been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions that occur between the sensory modalities in relation to gait and balance.In the present work,we review the contributions of somatosensory,visual,and vestibular modalities,along with their multisensory intersections to gait and balance in older adults and patients with Parkinson’s disease.We also review evidence of vestibular contributions to multisensory temporal binding windows,previously shown to be highly pertinent to fall risk in older adults.Lastly,we relate multisensory vestibular mechanisms to potential neural substrates,both at the level of neurobiology(concerning positron emission tomography imaging)and at the level of electrophysiology(concerning electroencephalography).We hope that this integrative review,drawing influence across multiple subdisciplines of neuroscience,paves the way for novel research directions and therapeutic neuromodulatory approaches,to improve the lives of older adults and patients with neurodegenerative diseases.

Optimal scheduling of a township integrated-energy system using the adjustable heat-electricity ratio model

With the expansion and implementation of rural revitalization strategies,there is a constant need for new energy sources for the construction of new townships.Consequently,integrated energy systems with the interconnection and interaction of multiple energy sources are developing rapidly.Biomass energy,a renewable green energy source with low pollution and wide distribution,has significant application potential in integrated energy systems.Considering the application of biomass energy in townships,this study established an integrated biomass energy system and proposed a model to optimize its operation.Lowest economic cost and highest clean energy utilization rate were considered as the objective functions.In addition,a plan was suggested to adjust the heat-electricity ratio based on the characteristics of the combined heat and power of the biomass.Finally,a simulation analysis conducted for a town in China was discussed,demonstrating that the construction of a township integrated-energy system and the use of biomass can significantly reduce operating costs and improve the energy utilization rate.Moreover,by adjusting the heat-electricity ratio,the economic cost was further reduced by 6.70%,whereas the clean energy utilization rate was increased by 5.14%.

Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis

BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.

Elliptical vibration chiseling:a novel process for texturing ultra-high-aspect-ratio microstructures on the metallic surface

High-aspect-ratio metallic surface microstructures are increasingly demanded in breakthrough applications,such as high-performance heat transfer enhancement and surface plasmon devices.However,the fast and cost-effective fabrication of high-aspect-ratio microstructures on metallic surfaces remains challenging for existing techniques.This study proposes a novel cutting-based process,namely elliptical vibration chiseling(EV-chiseling),for the high-efficiency texturing of surface microstructures with an ultrahigh aspect ratio.Unlike conventional cutting,EV-chiseling superimposes a microscale EV on a backward-moving tool.The tool chisels into the material in each vibration cycle to generate an upright chip with a high aspect ratio through material deformation.Thanks to the tool’s backward movement,the chip is left on the material surface to form a microstructure rather than falling off.Since one microstructure is generated in one vibration cycle,the process can be highly efficient using ultrafast(>1 kHz)tool vibration.A finite element analysis model is established to explore the process mechanics of EV-chiseling.Next,a mechanistic model of the microstructured surface generation is developed to describe the microstructures’aspect ratio dependency on the process parameters.Then,surface texturing tests are performed on copper to verify the efficacy of EV-chiseling.Uniformed micro ribs with a spacing of 1–10μm and an aspect ratio of 2–5 have been successfully textured on copper.Compared with the conventional EV-cutting that uses a forward-moving tool,EV-chiseling can improve the aspect ratio of textured microstructure by up to 40 times.The experimental results also verify the accuracy of the developed surface generation model of microstructures.Finally,the effects of elliptical trajectory,depth of cut,tool shape,and tool edge radius on the surface generation of micro ribs have been discussed.