Generalized granuloma annulare in an infant clinically manifested as papules and atrophic macules:A case report

BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations including papules,plaques,and nodules on the extremities that are skin-colored,pink,or purple.Approximately 15%of all GA cases are considered generalized GA.CASE SUMMARY Herein,we describe the case of a pediatric patient who initially presented with papules and later developed generalized atrophic macules.Upon examination,two different morphologic lesions were histopathologically confirmed:Epithelioid nodular GA and scattered histiocytic infiltrative GA.This patient exhibited rare clinical manifestations that differed throughout the course of the disease.The varying histopathological types and clinical manifestations of GA may be linked to the different stages of the disease.CONCLUSION This rare case demonstrates the different histopathological features of different stages and clinical manifestations of granuloma annulare in an infant.

Elastic fiber degradation in the development of pediatric granuloma annulare:Report of 39 cases

BACKGROUND Granuloma annulare(GA)has diverse clinical manifestations,multiple subtypes,and unknown etiology and pathogenesis.Existing studies regarding GA in children are scarce.AIM To examine the correlation between clinical manifestation and histopathology of pediatric GA.METHODS A total of 39 patients under 18 years of age with both a clinical and pathological diagnosis of GA at Kunming Children's Hospital from 2017 to 2022 were retrieved.Their medical records were consulted,and clinical data of the children were recorded and summarized,including gender,age,disease site,etc.Existing wax blocks of skin lesion specimens of children and pathological films were retrieved for further study and relevant histology,including hematoxylin-eosin,Alcian blue,elastic fiber(Victoria blue-Lichon red method),and antacid staining.Finally,the children’s clinical manifestations,histopathological results,and special staining characteristics were analyzed.RESULTS The clinical manifestations of granuloma annulare in children were diverse:11 cases presented with a single lesion,25 with multiple lesions,and 3 with generalized lesions.The pathological typing comprised histiocytic infiltration,palisading granuloma,epithelioid nodular,and mixed types in 4,11,9,and 15 cases,respectively.Thirty-nine cases were negative for antacid staining.The positive rate of Alcian blue staining was 92.3%,and that of elastic fiber staining was 100%.The degree of elastic fiber dissolution and granuloma annulare histopathological typing were positively correlated(r=0.432,P<0.05).No correlation was found between clinical presentation and histopathological typing of the granuloma annulare in children.In the pathological diagnosis of granuloma annulare,the positive elastic fiber staining rate was higher than that of Alcian blue staining.A correlation was found between elastic fiber dissolution degree and histopathological staging.However,the differences in pathological staging may have been related to the pathological manifestation of granuloma annulare at different periods.CONCLUSION Elastic fiber degradation may be a critical step in the pathogenesis of pediatric granuloma annulare.This is also one of the first studies focused on granuloma annulare in children.

Annulare With Tuberculosis and Cutis Laxa: A Rare Case Report

Introduction:Granuloma annulare(GA)is a benign,noninfectious granulomatous disorder of unknown etiology,characterized by an annular arrangement of erythematous small nodules and plaques,classically localized on dorsal surfaces of the hands and feet.GA shows palisading granulomas with a central zone of necrobiotic collagen and mucin deposition surrounded by a palisade of histiocytes.Here,we reported a 24-year-old man with GA combined with tuberculosis and cutis laxa.Case presentation:A 24-year-old man was presented with skin annular lesions on the trunk and extremities without subjective symptoms for three years.The annular lesions first arose in the trunk that slowly progressed to most parts of the body and cutis laxa-like lesions appeared on the left inguinal region with inguinal hernia two years ago.At the same time,the patient was diagnosed with pulmonary tuberculosis due to the hemoptysis for two years and the sputum culture for tuberculosis bacillus was positive.He was treated with triple anti-tuberculosis drugs regularly.Partial remission of the skin lesions was noted since then.Pathological examination showed similar histological changes in the interstitial pattern of GA.Discussion:Tuberculosis was a possible etiologic factor in GA because of the coincidental occurrence,granulomatous histologic features,and positive tuberculin skin tests.In fact,some cases of GA with chronic pulmonary tuberculosis responding to a specific anti-tuberculosis therapy were reported.It is worth noting that tuberculids,generalized exanthems in the skin of tuberculous patients possibly resulting from hypersensitivity reactions to the tubercle bacillus,may mimic GA.Furthermore,our patient also showed extremely characteristic slack skin in posterior lumbar and groin,which was deemed to be related to reduction and destruction of elastic fibers.Conclusion:Generalized interstitial GA with tuberculosis and cutis laxa is vary rare,which is worth being aware of the possibility of such a occurrence.

The connection of phytoplankton biomass in the Marguerite Bay polynya of the western Antarctic Peninsula to the Southern Annular Mode

Antarctic coastal polynyas are biological hotspots in the Southern Ocean that support the abundance of hightrophic-level predators and are important for carbon cycling in the high-latitude oceans.In this study,we examined the interannual variation of summertime phytoplankton biomass in the Marguerite Bay polynya(MBP)in the western Antarctic Peninsula area,and linked such variability to the Southern Annular Mode(SAM)that dominated the southern hemisphere extratropical climate variability.Combining satellite data,atmosphere reanalysis products and numerical simulations,we found that the interannual variation of summer chlorophyll-a(Chl-a)concentration in the MBP is significantly and negatively correlated with the spring SAM index,and weakly correlated with the summer SAM index.The negative relation between summer Chl-a and spring SAM is due to weaker spring vertical mixing under a more positive SAM condition,which would inhibit the supply of iron from deep layers into the surface euphotic layer.The negative relation between spring mixing and spring SAM results from greater precipitation rate over the MBP region in positive SAM phase,which leads to lower salinity in the ocean surface layer.The coupled physical-biological mechanisms between SAM and phytoplankton biomass revealed in this study is important for us to predict the future variations of phytoplankton biomasses in Antarctic polynyas under climate change.

Dynamic Response of A Group of Cylindrical Storage Tanks with Baffles Considering the Effect of Soil Foundation

The sloshing in a group of rigid cylindrical tanks with baffles and on soil foundation under horizontal excitation is studied analytically.The solutions for the velocity potential are derived out by the liquid subdomain method.Equivalent models with mass-spring oscillators are established to replace continuous fluid.Combined with the least square technique,Chebyshev polynomials are employed to fit horizontal,rocking and horizontal-rocking coupling impedances of soil,respectively.A lumped parameter model for impedance is presented to describe the effects of soil on tank structures.A mechanical model for the soil-foundation-tank-liquid-baffle system with small amount of calculation and high accuracy is proposed using the substructure technique.The analytical solutions are in comparison with data from reported literature and numerical codes to validate the effectiveness and correctness of the model.Detailed dynamic properties and seismic responses of the soil-tank system are given for the baffle number,size and location as well as soil parameter.

A Novel Method for Determining the Void Fraction in Gas-Liquid Multi-Phase Systems Using a Dynamic Conductivity Probe

Conventional conductivity methods for measuring the void fraction in gas-liquid multiphase systems are typically affected by accuracy problems due to the presence of fluid flow and salinity.This study presents a novel approach for determining the void fraction based on a reciprocating dynamic conductivity probe used to measure the liquid film thickness under forced annular-flow conditions.The measurement system comprises a cyclone,a conductivity probe,a probe reciprocating device,and a data acquisition and processing system.This method ensures that the flow pattern is adjusted to a forced annular flow,thereby minimizing the influence of complex and variable gas-liquid flow patterns on the measurement results;Moreover,it determines the liquid film thickness solely according to circuit connectivity rather than specific conductivity values,thereby mitigating the impact of salinity.The reliability of the measurement system is demonstrated through laboratory experiments.The experimental results indicate that,in a range of gas phase superficial velocities 5–20 m/s and liquid phase superficial velocities 0.079–0.48 m/s,the maximum measurement deviation for the void fraction is 4.23%.

Circulation Pattern Controls of Summer Temperature Anomalies in Southern Africa

This study investigates the relationship between circulation patterns and austral summer temperature anomalies in southern Africa. The results show that the formation of continental lows tends to increase the thickness of the lower atmosphere. Further, the distinct variabilities of high and low pressure under the circulation types, influence air mass advection from the adjacent oceans, as well as atmospheric stability over land. Stronger anticyclonic circulation at the western branch of the Mascarene high-pressure system enhances the low-level cold air advection by southeast winds,decreases the thickness, and lowers the temperature over a majority of the land in southern Africa. Conversely, a weaker Mascarene High, coupled with enhanced cyclonic activity in the southwest Indian Ocean increases low-level warm air advection and increases temperature anomalies over vast regions in southern Africa. The ridging of a closed South Atlantic anticyclone at the southern coast of southern Africa results in colder temperatures near the tip of southern Africa due to enhanced low-level cold air advection by southeast winds. However, when the ridge is weak and westerly winds dominate the southern coast of southern Africa, these areas experience temperature increases. The northward track of the Southern Hemisphere mid-latitude cyclone, which can be linked to the negative Southern Annular Mode, reduces the temperature in the southwestern part of southern Africa. Also, during the analysis period, El Ni?o was associated with temperature increases over the central parts of southern Africa;while the positive Indian Ocean dipole was linked to a temperature increase over the northeastern, northwestern, and southwestern parts of southern Africa.

Mass transfer mechanism and relationship of gas–liquid annular flow in a microfluidic cross-junction device

Mass transfer performance of gas–liquid two-phase flow at microscale is the basis of application of microreactor in gas–liquid reaction systems.At present,few researches on the mass transfer property of annular flow have been reported.Therefore,the mass transfer mechanism and relationship of gas–liquid annular flow in a microfluidic cross-junction device are studied in the present study.We find that the main factors,i.e.,flow pattern,liquid film thickness,liquid hydraulic retention time,phase interface fluctuation,and gas flow vorticity,which influence the flow mass transfer property,are directly affected both by gas and liquid flow velocities.But the influences of gas and liquid velocities on different mass transfer influencing factors are different.Thereout,the fitting relationships between gas and liquid flow velocities and mass transfer influencing factors are established.By comparing the results from calculations using fitting equations and simulations,it shows that the fitting equations have relatively high degrees of accuracy.Finally,the Pareto front,namely the Pareto optimal solution set,of gas and liquid velocity conditions for the best flow mass transfer property is obtained using the method of multi-objective particle swarm optimization.It is proved that the mass transfer property of the gas–liquid two-phase flow can be obviously enhanced under the guidance of the obtained Pareto optimal solution set through experimental verification.

Optimal Design of Aperture Illuminations for Microwave Power Transmission with Annular Collection Areas

This work presents an optimal design method of antenna aperture illumination for microwave power transmission with an annular collection area.The objective is to maximize the ratio of the power radiated on the annular collection area to the total transmitted power.By formulating the aperture amplitude distribution through a summation of a special set of series,the optimal design problem can be reduced to finding the maximum ratio of two real quadratic forms.Based on the theory of matrices,the solution to the formulated optimization problem is to determine the largest characteristic value and its associated characteristic vector.To meet security requirements,the peak radiation levels outside the receiving area are considered to be extra constraints.A hybrid grey wolf optimizer and Nelder–Mead simplex method is developed to deal with this constrained optimization problem.In order to demonstrate the effectiveness of the proposed method,numerical experiments on continuous apertures are conducted;then,discrete arrays of isotropic elements are employed to validate the correctness of the optimized results.Finally,patch arrays are adopted to further verify the validity of the proposed method.

Mechanical properties and microstructural evolution of rheocast A356 semi-solid slurry prepared by annular electromagnetic stirring

Nowadays,having an effective technique in preparing semi-solid slurries for rheocasting process seems to be an essential requirement.In this study,semi-solid slurry of A356 aluminum alloy was prepared by three-phase annular electromagnetic stirring(A-EMS)technique under different conditions.The effects of stirring current,pouring temperature and stirring time on microstructural evolution,mean particle size,shape factor and solid fraction were investigated.The rheocasting process was carried out by using a drop weight setup and to inject the prepared semi-solid slurry in optimal conditions into the step-die cavity.The filling behavior and mechanical properties of parts were studied.Microstructural evolution showed that the best semi-solid slurry which had fine spherical particles with the average size of~27μm and a shape factor of~0.8 was achieved at the stirring current of 70 A,melt pouring temperature of 670℃,and stirring time of 30 s.Under these conditions,the step-die cavity was completely filled at die preheating temperature of 470℃.The hardness increases by decreasing step thickness as well as die preheating temperature.Moreover,the tensile properties are improved at lower die preheating temperatures.The fracture surface,which consists of a complex topography,indicates a typical ductile fracture.

Low-Strain Damage Imaging Detection Experiment for Model Pile Integrity Based on HHT

With the advancement of computer and mathematical techniques,significant progress has been made in the 3D modeling of foundation piles.Existing methods include the 3D semi-analytical model for non-destructive low-strain integrity assessment of large-diameter thin-walled pipe piles and the 3D soil-pile dynamic interaction model.However,these methods have complex analysis procedures and substantial limitations.This paper introduces an innovative and streamlined 3D imaging technique tailored for the detection of pile damage.The approach harnesses the power of an eight-channel ring array transducer to capture internal reflection signals within foundation piles.The acquired signals are subsequently processed using the Hilbert-Huang Transform(HHT),a robust analytical tool known for its effectiveness in handling non-stationary signals.Through the development of a sophisticated multi-channel ring array imaging algorithm,this technique empowers engineers and researchers to identify various pile defects,including their specific type,precise location,and obtain detailed 3D imaging representations.The findings of this research offer a valuable blend of theoretical insights and practical guidance,significantly advancing the state-of-the-art in the realm of concrete pile integrity inspection.By simplifying and enhancing the assessment process,this innovative approach not only addresses the complexities of existing methods but also contributes to the overall safety and reliability of concrete engineering structures.

Lithium mapping in a Mg-9Li-4Al-1Zn alloy using electron energy-loss spectroscopy

Magnesium-lithium alloys with high lithium content have been attracting significant attention because of their low density,high formability and corrosion resistance.These properties are dependent on the distribution of lithium,which is difficult to map in the presence of magnesium.In this work,a ratio spectrum-imaging method with electron energy-loss spectroscopy(EELS)is demonstrated,which enables the mapping of lithium.In application to LAZ941(Mg-9Li-4Al-1Zn in wt.%),this technique revealed that a key precipitate in the microstructure,previously thought by some to be Mg_(17)Al_(12),is in fact rich in lithium.This result was corroborated with a structural investigation by high-angle annular dark-field scanning transmission electron microscopy(HAADF-STEM),showing this phase to be Al_(1-x)Zn_(x)Li,with x<<1.This work indicates the potential offered by this technique for mapping lithium in materials.

Delayed dislocation of the radial head associated with malunion of distal radial fracture: A case report

BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.

Variability of Northeast China River Break-up Date

This paper investigates the variability of the break-up dates of the rivers in Northeast China from their icebound states for the period of 1957-2005 and explores some potential explanatory mechanisms. Results show that the break-up of the two major rivers （the Heilongjiang River and Songhuajiang River） was about four days earlier, and their freeze-up was about 4-7 days delayed, during 1989 2005 as compared to 1971 1987. This interdecadal variation is evidently associated with the warming trend over the past 50 years. In addition, the break-up and freeze-up dates have large interannual variability, with a standard deviation of about 10-15 days. The break-up date is primarily determined by the January February-March mean surface air temperature over the Siberian-Northeast China region via changes in the melting rate, ice thickness, and snow cover over the ice cover. The interannual variability of the break-up date is also significantly connected with the Northern Annular Mode （NAM）, with a correlation coefficient of 0.35-0.55 based on the data from four stations along the two rivers. This relationship is attributed to the fact that the NAM can modulate the East Asian winter monsoon circulation and Siberian-Northeast China surface air temperature in January February-March.

Pathophysiology, diagnosis, and treatment of discogenic low back pain

Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.

Annular multiphase flow behavior during deep water drilling and the effect of hydrate phase transition

It is very important to understand the annular multiphase flow behavior and the effect of hydrate phase transition during deep water drilling. The basic hydrodynamic models, including mass, momentum, and energy conservation equations, were established for annular flow with gas hydrate phase transition during gas kick. The behavior of annular multiphase flow with hydrate phase transition was investigated by analyzing the hydrate-forming region, the gas fraction in the fluid flowing in the annulus, pit gain, bottom hole pressure, and shut-in casing pressure. The simulation shows that it is possible to move the hydrate-forming region away from sea floor by increasing the circulation rate. The decrease in gas volume fraction in the annulus due to hydrate formation reduces pit gain, which can delay the detection of well kick and increase the risk of hydrate plugging in lines. Caution is needed when a well is monitored for gas kick at a relatively low gas production rate, because the possibility of hydrate presence is much greater than that at a relatively high production rate. The shut-in casing pressure cannot reflect the gas kick due to hydrate formation, which increases with time.

Distribution characteristics of dissolved organic carbon in annular wetland soil-water solutions through soil profiles in the Sanjiang Plain,Northeast China

Overwhelming evidence reveals that concentrations of dissolved organic carbon （DOC） have increased in streams which brings negative environmental impacts. DOC in stream flow is mainly originated from soil-water solutions of watershed. Wetlands prove to be the most sensitive areas as an important DOC reserve between terrestrial and fluvial biogeosystems. This reported study was focused on the distribution characteristics and the controlling factors of DOC in soil-water solutions of annular wetland, i.e., a dishing wetland and a forest wetland together, in the Sanjiang Plain, Northeast China. The results indicate that DOC concentrations in soilwater solutions decreased and then increased with increasing soil depth in the annular wetland. In the upper soil layers of 0-10 cm and 10-20 cm, DOC concentrations in soil-water solutions linearly increased from edge to center of the annular wetland （R^2 = 0.3122 and R^2 = 0.443）. The distribution variations were intimately linked to DOC production and utilization and DOC transport processes in annular wetland soil-water solutions. The concentrations of total organic carbon （TOC）, total carbon （TC） and Fe（II）, DOC mobility and continuous vertical and lateral flow affectext the distribution variations of DOC in soil-water solutions. The correlation coefficients between DOC concentrations and TOC, TC and Fe（II） were 0.974, 0.813 and 0.753 respectively. These distribution characteristics suggested a systematic response of the distribution variations of DOC in annular wetland soil-water solutions to the geometry of closed depressions on a scale of small catchments. However, the DOC in soil pore water of the annular wetland may be the potential source of DOC to stream flow on watershed scale. These observations also implied the fragmentation of wetland landscape could bring the spatial-temporal variations of DOC distribution and exports, which would bring negative environmental impacts in watersheds of the Sanjiang Plain.

Annular electromagnetic stirring——a new method for the production of semi-solid A357 aluminum alloy slurry

A new method for producing semisolid slurry, annular electromagnetic stirring （AEMS）, to refine and spheroidize grains was exploited. Experimental work was undertaken to investigate the effects of cooling rate, stirring power and stirring time on the solidification behavior of A357 alloy using A-EMS. It was found that increasing the cooling rate and stirring power gave rise to substantial grain refinement, which could be attributed to the increase of effective nucleation rate caused by the extremely uniform temperature and composition fields in the bulk liquid during the initial stage of solidification. Results showed that a fully grain refined spherical structure could be obtained using proper processing conditions within 10 s.

Comparisons of microstructure homogeneity,texture and mechanical properties of AZ80 magnesium alloy fabricated by annular channel angular extrusion and backward extrusion

This paper provided an efficient single pass severe plastic deformation(SPD)method,annular channel angular extrusion(ACAE),for fabricating AZ80 magnesium alloy shell part.The effect of ACAE process on the microstructure homogeneity,texture,and mechanical properties of extruded part was experimentally investigated.For comparison,conventional backward extrusion(BE)was also conducted on processing AZ80 part with same specification.The results showed that ACAE process has a better capacity to refine the microstructure and dramatic improve the deformation homogeneity of the extruded part than BE process.Due to two strong shear deformations were implemented,ACAE process could also concurrently modify the basal texture more notably than BE process.In particular,a bimodal texture was found in ACAE extruded part,which was greatly related to the enhanced synergetic action of basal slip and secondary<c+a>slip caused by the effective shear stress.More uniform and superior hardness along the thickness and height of part were achieved via ACAE process.Further surveying of tensile tests also showed that the part fabricated by ACAE process exhibited significantly higher and far more homogeneous tensile properties with an excellent balance of strength and ductility.The remarkable enhanced tensile properties of ACAE extruded part could be primarily attributed to the significant grain refinement,which provided a powerful grain boundary strengthening effect and meaningfully suppressed the development of twin-sized cracks during tensile deformation.It was established that ACAE process seemed to be a very promising single pass SPD method for manufacturing Mg-based alloy shell parts with more homogeneous microstructure and superior performance.

The Possible Influence of Stratospheric Sudden Warming on East Asian Weather

By analyzing the linkage of the Northern Annular Mode （NAM） anomaly to the East Asian jet and the East Asian trough during Stratospheric Sudden Warming （SSW）, the influence of SSW on East Asian weather is studied. The results show that the East Asian jet is strengthened and the East Asian trough is deepened during SSW. With the downward propagation of SSW, the strengthened East Asian jet and the East Asian trough would move southward, expand westward and gradually influence the area of north and northeastern China. This implies that the winter monsoon tends to be enhanced over East Asia during SSW.