Flexural wave band-gaps in phononic metamaterial beam with hybrid shunting circuits

Periodic arrays of hybrid-shunted piezoelectric patches are used to control the band-gaps of phononic metamaterial beams. Passive resistive-inductive （RL） shunting circuits can produce a narrow resonant band-gap （RG）, and active negative capacitive （NC） shunting circuits can broaden the Bragg band-gaps （BGs）. In this article, active NC shunting circuits and passive resonant RL shunting circuits are connected to the same piezoelectric patches in parallel, which are usually called hybrid shunting circuits, to control the location and the extent of the band-gaps. A super-wide coupled band-gap is generated when the coupling between RG and the BG occurs. The attenuation constant of the infinite periodic structure is predicted by the transfer matrix method, which is compared with the vibration transmittance of a finite periodic structure calculated by the finite element method. Numerical results show that the hybrid-shunting circuits can make the band-gaps wider by appropriately selecting the inductances, negative capacitances, and resistances.

Effect of rapamycin on hepatic osteodystrophy in rats with portasystemic shunting

AIM： TO study if T-cell activation related to portasystemic shunting causes osteoclast-mediated bone loss through RANKL-dependent pathways. We also investigated if T-cell inhibition using rapamycin would protect against bone loss in rats. METHODS： Portasystemic shunting was performed in male Sprague-Dawley rats and rapamycin 0.1 mg/kg was administered for 15 wk by gavage. Rats received powderized chow and supplemental feeds to prevent the effects of malnutrition on bone composition. Weight gain and growth was restored after surgery in shunted animals. At termination, biochemical parameters of bone turnover and quantitative bone histology were assessed. Markers of T-cell activation, inflammatory cytokine production, and RANKL-dependent pathways were measured. In addition, the roles of IGF-1 and hypogonadism were investigated. RESULTS： Portasystemic shunting caused low turnover osteoporosis that was RANKL independent. Bone resorbing cytokine levels, including IL-1, IL-6 and TNFα, were not increased in serum and TNFα and RANKL expression were not upregulated in PBMC. Portasystemic shunting increased the circulating CD8＋ T-cell population. Rapamycin decreased the circulating CD8＋ T-cell population, increased CD8＋ CD25＋ T-regulatory cell population and improved all parameters of bone turnover. CONCLUSION： Osteoporosis caused by portasystemic shunting may be partially ameliorated by rapamycin in the rat model of hepatic osteodystrophy.

Wave propagation in beams with anti-symmetric piezoelectric shunting arrays

Piezoelectric shunting arrays are employed to control the wave propagation in flexible beams. Contrary to conven- tional symmetric configuration, a substrate beam with anti-symmetric shunting arrays is investigated by adapted transfer matrix method. Compared with symmetric scheme, the anti-symmetric one demonstrates some distinctive characteristics. Primarily, the longitudinal and fiexural waves are coupled, so they are correlated and must be considered simultaneously. Moreover, the attenuation of flexural wave is much stronger in anti-symmetric scenario, while the longitudinal wave demon- strates the converse side. As a result, the anti-symmetric scheme can be utilized to improve the vibration isolation capability of shunting arrays. Finally, the theoretical analyses are validated by finite element simulations.

WEIGHTED PSEUDO ALMOST-PERIODIC SOLUTIONS OF SHUNTING INHIBITORY CELLULAR NEURAL NETWORKS WITH MIXED DELAYS

In this paper, we prove the existence and the global exponential stability of the unique weighted pseudo almost-periodic solution of shunting inhibitory cellular neural networks with mixed time-varying delays comprising different discrete and distributed time delays. Some sufficient conditions are given for the existence and the global exponential stability of the weighted pseudo almost-periodic solution by employing fixed point theorem and differential inequality techniques. The results of this paper complement the previously known ones. Finally, an illustrative example is given to demonstrate the effectiveness of our results.

Research on Optimization of Selection of Train Passing Routes and Division of Shunting Work in Railway Hub

in this paper, a general integer prosramming model is set up, and its solution ispresented to optimize the organization of wagon flows and the determination ofthe train running route as well as division of shuntins work among stations in ahub. As application example is put forword, with some conclusions reached.

Shunt-E 4.0—Autonomous Zero Emission Shunting Processes in Port and Hinterland Railway Operations

The port railway operation in Germany and Europe is not least due to its long history of technological and regulatory developments characterized by a high number of players and a lack of comprehensive planning and optimization of all relevant processes.Innovative technologies and business processes are therefore useful and needed to achieve key steps on the way to an overall optimization of rail transport within global supply chains.A substantial part of the European rail freight transport has its origin or its destination in an inland or sea port.Considering the railway system,ports play a more important role for urgently needed innovations than the pure interfaces between sea and land transport.Especially ports with their own railway system have an own responsibility in this matter.Insofar the goal of the Bremen Port Railway—which already now has a leading share of railway in modal split in Europe—is to exploit the opportunities offered by digitalization.Significant steps for this are the optimization and gradually automatization of rail operational processes on the last mile including modern and transparent IT systems and the designing of autonomous shunting processes.Together with research partners ISL(Institute of Shipping Economics and Logistics Bremen),BIBA(Bremen Institute for Production and Logistics)and IVE(Institute for Transport,Railway Construction and Operation in Brunswick)and in connection with associated business partners the project Rang-E has been applied for at the Ministry of Transport in the funding initiative IHATEC(Innovated HArbour TEChnologies)—and had won a grant to perform the proposed work.Basic thoughts are outlined in the following.

New Results on Almost Periodic Solution of Shunting Inhibitory Cellular Neural Networks with Continuously Distributed Delays

In this paper,the existence,uniqueness and global attractivity are discussed on almost periodic solution of SICNNs（shunting inhibitory cellular neural networks）with continuously distributed delays.By using the fixed point theorem,differential inequality technique and Lyapunov functional method,giving the new ranges of parameters,several sufficient conditions are obtained to ensure the existence,uniqueness and global attractivity of almost periodic solution.Compared with the previous studies,our methods are more effective for almost periodic solution analysis of SICNNs with continuously distributed delays.Some existing results have been improved and extended.In order to show the effectiveness of the obtained results,an example is given in this paper.

The therapeutic strategies for the slit ventricle syndrome after cyst-peritoneal shunting for the temporal arachnoid cyst in children:six cases report and literatures review

Objective To investigate early diagnosis evidences,optimal therapeutic strategies and the prophylactic methods of the slit ventricle syndrome (SVS) in the temporal lobe arachnoid cysts patients who received the cyst-peritoneal(CP) shunting. Methods Six cases of SVS in the temporal lobe arachnoid cysts patients

Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt

AIM: To evaluate the effect of the shunting branch of the portal vein (PV) (left or right) and the initial stent position (optimal or suboptimal) of a transjugular intrahepatic portosystemic shunt (TIPS).

Vascular anomalies associated with hepatic shunting

Congenital vascular anomalies affecting the liver have been described in the scientific literature for decades.Understanding these malformations begins with knowledge of hepatic vascular embryology.Surgeons have applied numerous classification systems to describe both intrahepatic and extrahepatic shunts,which can confuse the reader and clinician.In our experience,focusing on one classification system for extrahepatic shunts and one for intrahepatic shunts is better.Today many patients with these shunts carry good long-term prognosis thanks to advances in imaging to better detect shunts earlier and classify them.Timely intervention by skilled radiologists and surgeons have also limited complications arising from dynamic shunts and can avoid a liver transplant.Congenital hepatic shunts are not the only vascular condition affecting the liver.Hereditary hemorrhagic telangiectasia,also known as Osler Weber Rendu syndrome,particularly type 2,may have varying severity of hepatic involvement which warrants longitudinal care from an experienced hepatologist.Lastly,congenital hemangiomas,often first identified on the skin and oral mucosa,also can affect the liver.While most will resolve in infancy and childhood,the pediatric hepatologist must understand how and when to treat persistent lesions and their complications.This article serves as a concise reference to help clinicians better care for patients with these rare conditions.

Could there be light at the end of the tunnel? Mesocaval shunting for refractory esophageal varices in patients with contraindications to transjugular intrahepatic portosystemic shunt

Cirrhotic patients with recurrent variceal bleeds who have failed prior medical and endoscopic therapies and are not transjugular intrahepatic portosystemic shunt candidates face a grim prognosis with limited options. We propose that mesocaval shunting be offered to this group of patients as it has the potential to decrease portal pressures and thus decrease the risk of recurrent variceal bleeding. Mesocaval shunts are stent grafts placed by interventional radiologists between the mesenteric system, most often the superior mesenteric vein, and the inferior vena cava. This allows flow to bypass the congested hepatic system, reducing portal pressures. This technique avoids the general anesthesia and morbidity associated with surgical shunt placement and has been successful in several case reports. In this paper we review the technique, candidate selection, potential pitfalls and benefits of mesocaval shunt placement.

DYNAMIC OBSERVATION ON THE CHANGES OF PLASMA SOMATOSTATIN AND GLUCAGON DURING THE DEVELOPMENT OF CIRRHOSIS AND AFTER PORTACAVAL SHUNTING IN THE CIRRHOTIC RATS

In the present study we observed dynamically and systemically the changes of plasma somatostatin and glucagon in the peripheral and portal vein, and the changes of pancreatic immunopathology in the course of development of cirrhosis induced by CCl4 and after portacaval shunt （PCS） in the cirrhotic rats as well as investigated their causes and correlationship. The results showed that hyperglucagonemia was caused by spontaneous portosystemic shunting and surgically induced portacaval anastomosis. Moreover, there was much higher level of glucagon in the portal vein with corresponding increase of A cells in PCS rats than those in the controls, indicating that another cause for elevation of glucagon was hypersecretion of pancreatic A cells. Our data demonstrated that both deterioration of liver function and portosystemic shunting might not be responsible for the elevated level of somatostatin in the cirrhotic rats with PCS. However, there was a closed positive correlation between plasma glucagon and somatostatin. Thus it was concluded that hyperglucagonemia stimulated the release of somatostatin. In view of the fact the elevated level of glucagon was much higher than that of somatostatin, there was probably a relative lack of somatostatin in cirrhosis with portal hypertension.

Early fault prediction and detection of hydrocephalus shunting system

Trends of various intracranial pressure (ICP) parameters for high pressure hydrocephalus patients are utilized to detect various shunt faults in their early stages, as well as, to monitor the effect of such faults on shunt performance. A method was proposed to predict the time required for ICP to be abnormal and for the valve to reach full blockage condition. Furthermore, an auto valve schedule updating method is proposed and used to temporarily deal with detected faults until the patient is checked up by his/her physician. The proposed algorithms were evaluated using numerical simulation.

Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment.AIM To analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS(sTIPS)placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic intervention.METHODS Baseline risk scores for the Acute Physiology and Chronic Health Evaluation(APACHE)II,Bonn TIPS early mortality(BOTEM),Child-Pugh,Emory,FIPS,model for end-stage liver disease(MELD),MELD-Na,and a novel 5 category CABIN score incorporating Creatinine,Albumin,Bilirubin,INR and Na,were calculated before sTIPS.Concordance(C)statistics for predictive accuracy of inhospital mortality of the eight scores were compared using area under the receiver operating characteristic curve(AUROC)analysis.RESULTS Thirty-four patients(29 men,5 women),median age 52 years(range 31-80)received sTIPS for uncontrolled(11)or refractory(23)bleeding between August 1991 and November 2020.Salvage TIPS controlled bleeding in 32(94%)patients with recurrence in one.Ten(29%)patients died in hospital.All scoring systems had a significant association with in-hospital mortality(P<0.05)on multivariate analysis.Based on in-hospital survival AUROC,the CABIN(0.967),APACHE II(0.948)and Emory(0.942)scores had the best capability predicting mortality compared to FIPS(0.892),BOTEM(0.877),MELD Na(0.865),Child-Pugh(0.802)and MELD(0.792).CONCLUSION The novel CABIN score had the best prediction capability with statistical superiority over seven other risk scores.Despite sTIPS,hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores>10.Survival was 100%in CABIN A patients while mortality was 75%for CABIN B,87.5%for CABIN C,and 83%for CABIN scores>10.

Genome mining combined metabolic shunting and OSMAC strategy of an endophytic fungus leads to the production of diverse natural products

Endophytic fungi are promising producers of bioactive small molecules.Bioinformatic analysis of the genome of an endophytic fungus Penicillium dangeardii revealed 43 biosynthetic gene clusters,exhibited its strong ability to produce numbers of secondary metabolites.However,this strain mainly produce rubratoxins alone with high yield in varied culture conditions,suggested most gene clusters are silent.Efforts for mining the cryptic gene clusters in P.dangeardii,including epigenetic regulation and one-strain-many-compounds(OSMAC)approach were failed probably due to the high yield of rubratoxins.A metabolic shunting strategy by deleting the key gene for rubratoxins biosynthesis combining with optimization of culture condition successfully activated multiple silent genes encoding for other polyketide synthases(PKSs),and led to the trace compounds detectable.As a result,a total of 23 new compounds including azaphilone monomers,dimers,turimers with unprecedented polycyclic bridged heterocycle and spiral structures,as well as siderophores were identified.Some compounds showed significant cytotoxicities,anti-inflammatory or antioxidant activities.The attractive dual PKS s gene clusters for azaphilones biosynthesis were mined by bioinformatic analysis and overexpression of a pathway specific transcription factor.Our work therefor provides an efficient approach to mine the chemical diversity of endophytic fungi.

Effect of arterioportal shunting in radical resection of hilar cholangiocarcinoma

Background The resection and reconstruction of the hepatic artery is often required in radical surgery for hilar cholangiocarcinoma. In this study, we report our experience in performing arterioportal shunting as an alternative for the arterial reconstruction. Methods Four patients with hilar cholangiocarcinoma underwent extended left hepatectomy and caudate Iobectomy combined with en bloc resection of the hepatic artery and arterioportal shunting with restriction of the arterial caliber. The efficacy of arterioportal shunting was assessed by computed tomography angiography （CTA）. Results All the four patients recovered uneventfully without any complications. CTA showed a patent shunt and normal liver regeneration. No signs of portal hypertension were found at one year of follow-up. Conclusions Arterioportal shunting with restriction of the arterial caliber appears to be a feasible and safe alternative for the microvascular reconstruction after hepatic artery resection in radical surgery for hilar cholangiocarcinoma.

Existence and Global Exponential Stability of Periodic Solutions for General Shunting Inhibitory Cellular Neural Networks with Delays

By using the Leray-Schauder fixed point theorem,differential inequality techniques and constructing suitable Lyapunov functional,several sufficient conditions are obtained for the existence and global exponential stability of periodic solutions for general shunting inhibitory cellular neural networks with delays.Some new results are obtained and some previously known results are improved.An example is employed to illustrate our feasible results.

Gut microbiota shifts in hepatitis B-related portal hypertension after transjugular intrahepatic portosystemic shunt:Mechanistic and clinical implications

In this article,we provide commentary on the recent article by Zhao et al.We focus on the shifts in the gut microbiota of patients with hepatitis B virus(HBV)-associated cirrhosis/portal hypertension(PH)following transjugular intrahepatic portosystemic shunt(TIPS)and the implications for understanding the mechanisms,diagnosis,and treatment.By comparing the gut microbiota composition and dynamic changes before and after TIPS in patients with and without hepatic encephalopathy,the authors found an increase in non-probiotic bacteria in those who developed hepatic encephalopathy post-TIPS,with Morganella species present only in the hepatic encephalopathy group.The gut microbiota changes post-TIPS among patients without the occurrence of hepatic encephalopathy suggest potential therapeutic benefits through prophylactic microbiome therapies.Furthermore,the specific gut microbiota alterations may hold promise to predict the risk of hepatic encephalopathy in individuals undergoing TIPS for HBVrelated PH.Despite these promising findings,future studies are needed to address limitations,including a small sample size,a relatively short evaluation period for gut microbiota alterations,the absence of data on dynamic alterations in gut microbiota post-TIPS and their correlation with blood ammonia levels,and the lack of validation in animal models.In conclusion,Zhao et al's study has shed new light on the link of gut microbiota with post-TIPS hepatic encephalopathy,potentially through the intricate gut-liver axis,and has important clinical implications for improving the management of patients with HBV-related PH.

The anti-periodic oscillations of shunting inhibitory cellular neural networks with time-varying delays and continuously distributed delays

Purpose – The purpose of this paper is to study the existence and exponential stability of anti-periodicsolutions of a class of shunting inhibitory cellular neural networks (SICNNs) with time-varying delays andcontinuously distributed delays.Design/methodology/approach – The inequality technique and Lyapunov functional method are applied.Findings – Sufficient conditions are obtained to ensure that all solutions of the networks convergeexponentially to the anti-periodic solution, which are new and complement previously known results.Originality/value – There are few papers that deal with the anti-periodic solutions of delayed SICNNs withthe form negative feedback – aij(t)αij(xij(t)).

Management of chylous ascites after liver cirrhosis: A case report

BACKGROUND Chylous ascites is an uncommon condition,occurring in less than 1%of ascites cases.It results from traumatic or obstructive disruption of the lymphatic system,causing the leakage of thoracic or intestinal lymph into the abdominal cavity.This leads to the accumulation of a milky,triglyceride-rich fluid.In adults,malignancy and cirrhosis are the primary causes of chylous ascites.Notably,chylous ascites accounts for only 0.5%to 1%of all cirrhosis-related ascites cases.At present,there is a limited understanding of this condition,and effective timely management in clinical practice remains challenging.CASE SUMMARY This case report presents a patient with hepatic cirrhosis complicated by chylous ascites,who had experienced multiple hospitalizations due to abdominal distension.Upon admission,comprehensive examinations and assessments were conducted.The treatment strategy focused on nutritional optimization through a low-sodium,low-fat,and high-protein diet supplemented with medium-chain triglycerides,therapeutic paracentesis,and diuretics.Following a multidiscip-linary discussion and thorough evaluation of the patient’s condition,surgical indications were confirmed.After informing the patient about the benefits and risks,and obtaining consent,a transjugular intrahepatic portosystemic shunt procedure was performed,successfully alleviating the abdominal swelling symptoms.This article details the clinical characteristics and treatment approach for this uncommon case,summarizing current management methods for hepatic cirrhosis complicated by chylous ascites.The aim is to provide valuable insights for clinicians encountering similar situations.CONCLUSION Optimizing nutrition and addressing the underlying cause are essential in the treatment of chylous ascites.When conservative approaches prove ineffective,alternative interventions such as transjugular intrahepatic portosystemic shunt may be considered.