Overlapping approach Proton Pump Inhibitors/Nux vomica-Heel as new intervention for gastro-esophageal reflux management:Delphi consensus study

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.

Large-Scale Multi-Objective Optimization Algorithm Based on Weighted Overlapping Grouping of Decision Variables

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.

Overlapping infections of Mycobacterium canariasense and Nocardia farcinica in an immunocompetent patient:A case report

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.

The Practical Path of Labor Curriculum in Compulsory Education in China from the Perspective of Overlapping Influence Domain Theory

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.

High Order Total Variational Denoising Algorithm Based on l_(0) Overlapping Combination Sparse

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.

Analysis of bulging process of aluminum alloy by overlapping sheet metal and its formability

The influences of strength coefficient K, work hardening exponent n and thickness t of the overlapping sheet on bulging process are analyzed based on hardening material model. Also, bulging experiments are carried out by taking the aluminum alloy LF21 as formed sheet metal, and selecting overlapping sheet with different thicknesses and material properties, by which accuracy of the above analysis result is verified in the aspects of geometric shape, thickness distribution and limit bulging height. The results show that higher strength coefficient K, larger work hardening exponent n and proper thickness of the overlapping sheet are helpful to improve the formability and forming uniformity of formed sheet metal.

Overlap吻合与π吻合在全腹腔镜全胃切除术中的应用

目的:比较Overlap吻合与π吻合在全腹腔镜全胃切除术(TLTG)中的应用效果。方法:选择2019年2月至2022年2月在成都市第五人民医院行TLTG的胃癌患者98例,根据食管空肠吻合方式分为Overlap吻合组(n=56)和π吻合组(n=42)。比较两组围手术期指标(手术时间、吻合时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、术后拔除引流管时间、术后住院时间、肿瘤上缘至食管切缘距离),吻合口相关并发症(吻合口出血、吻合口狭窄、吻合口漏)与随访并发症(吻合口溃疡、倾倒综合征、反流性食管炎、营养不良)发生情况,以及术前与术后3个月整体营养状况主观评估量表(PG-SGA)评分与营养状况客观指标(血红蛋白、白蛋白、总蛋白)水平的变化。结果:Overlap吻合组手术时间[(230.36±25.12)min vs(205.58±20.43)min]、吻合时间[(43.22±6.15)min vs(27.45±5.36)min]均长于π吻合组(P<0.05);两组吻合口相关并发症、随访并发症发生率及术前、术后3个月PG-SGA量表评分与营养状况客观指标水平的变化差异均无统计学意义(P>0.05)。结论:Overlap吻合和π吻合在TLTG术中各有优势,π吻合可缩短手术时间和吻合时间。

Feature study for improving Chinese overlapping ambiguity resolution based on SVM

In order to improve Chinese overlapping ambiguity resolution based on a support vector machine, statistical features are studied for representing the feature vectors. First, four statistical parameters-mutual information, accessor variety, two-character word frequency and single-character word frequency are used to describe the feature vectors respectively. Then other parameters are tried to add as complementary features to the parameters which obtain the best results for further improving the classification performance. Experimental results show that features represented by mutual information, single-character word frequency and accessor variety can obtain an optimum result of 94. 39%. Compared with a commonly used word probability model, the accuracy has been improved by 6. 62%. Such comparative results confirm that the classification performance can be improved by feature selection and representation.

FEM SIMULATION OF RESIDUAL STRESSES INDUCED BY LASER SHOCK WITH OVERLAPPING LASER SPOTS

The finite element method is presented to attain the numerical simulation of the residual stresses field in the material treated by laser shock processing. The distribution of residual stresses generated by a single laser shock with square and round laser spot is predicted and validated by experimental results. With the Finite Element Method （FEM） model, effects of different overlapping rates and impact sequences on the distribution of residual stresses are simulated. The results indicate that： （1） Overlapping laser shock can increase the compressive residual stresses. However, it is not effective on the growth of plastically affected depth; （2） Overlapping rate should be optimized and selected carefully for the large area treatment. Appropriate overlapping rate is beneficial to obtain a homogeneous residual stress field; （3） The impact sequence has a great effect on the residual stress field. It can greatly attenuate the phenomenon of the “residual stress hole” to obtain a homogeneous residual stress field.

Detecting overlapping communities in networks via dominant label propagation

Community detection is an important methodology for understanding the intrinsic structure and function of a realworld network. In this paper, we propose an effective and efficient algorithm, called Dominant Label Propagation Algorithm（Abbreviated as DLPA）, to detect communities in complex networks. The algorithm simulates a special voting process to detect overlapping and non-overlapping community structure in complex networks simultaneously. Our algorithm is very efficient, since its computational complexity is almost linear to the number of edges in the network. Experimental results on both real-world and synthetic networks show that our algorithm also possesses high accuracies on detecting community structure in networks.

Biomathematical study of time-dependent flow of a Carreau nanofluid through inclined catheterized arteries with overlapping stenosis

This work is concerned with the analysis of blood flow through inclined catheterized arteries having a balloon(angioplasty) with time-variant overlapping stenosis. The nature of blood in small arteries is analyzed mathematically by considering it as a Carreau nanofluid. The highly nonlinear momentum equations of nanofluid model are simplified by considering the mild stenosis case. The formulated problem is solved by a homotopy perturbation expansion in terms of a variant of the Weissenberg number to obtain explicit forms for the axial velocity, the stream function, the pressure gradient, the resistance impedance and the wall shear stress distribution. These solutions depend on the Brownian motion number, thermophoresis number, local temperature Grashof number G_r and local nanoparticle Grash of number B_r. The results were also studied for various values of the physical parameters, such as the Weissenberg number W_i, the power law index n, the taper angle φ, the maximum height of stenosis δ~*, the angle of inclination α, the maximum height of balloon σ~*, the axial displacement of the balloon z_d~*,the flow rate F and the Froud number Fr. The obtained results show that the transmission of axial velocity curves through a Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) is substantially lower than that through a Carreau nanofluid near the wall of balloon while the inverse occurs in the region between the balloon and stenosis. The streamlines have a clearly distinguished shifting toward the stenotic region and this shifting appears near the wall of the balloon, while it has almost disappeared near the stenotic wall and the trapping bolus in the case of horizontal arteries and Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) does not appear but for the case of Carreau nanofluid bolus appears.

EFFECT OF OVERLAPPING TREATMENT ON MICROSTRUCTURE OF LASER-CLAD WC/Ni60A COMPOSITE COATING

The effect of overlapping treatment on microstructure of laser clad WC/Ni60A composite coating was studied with XRD, SEM, TEM and SAED etc. The results show that during the overlapping treatment the existence of the residual heat and edge angle effect on the substrate has changed the composition and microstructure of the coating by raising the fusion temperature and increasing the dilution degree of the coating.

Effect of Interface Friction on Overlapping Sheets Bulging Formability and Microstructure of 5A02 Aluminum Alloy

Aluminum alloy 5 A02 with low plasticity was used as target sheet, and stainless steel SUS304 with good plasticity was used as overlapping sheet to investigate the effect of interface friction on bulging formability and microstructure of target sheet in overlapping sheets bulging process. Sheet sliding experiment was performed to measure interface friction coefficient of 5 A02/SUS304 in different lubricating conditions and normal pressure. Overlapping sheets bulging experiment of 5 A02/SUS304 was carried out to investigate the influence of interface friction on limit bulging height, wall thickness distribution, microstructure and fracture morphology of 5 A02 bulging specimens. The results showed that increase of the interface friction coefficient of 5 A02/SUS304 could effectively improve the limit bulging height and deformation uniformity of 5 A02. And the fracture style of 5 A02 transformed from toughness fracture of dimples-micropores gathered to fault slip separation fracture. Therefore, target sheet bulging formability is improved with the increase of interface friction coefficient.

Quantitative Analysis and Affecting Factors of the Overlapping Degree of Interfacial Transition Zone between Neighboring Aggregates in Concrete

Based on the nearest surface function formula, a quantitative formula to measure the overlapping degree between the interfacial transition zone （ITZ） of neighboring aggregate particles was put forward. The formula was further deduced to quantitatively analyze the influence of the volume fraction of aggregate, ITZ thickness and the maximum aggregate diameter on the overlapping degree between neighboring ITZ. The volume of ITZ was quantitatively calculated in actual concrete by comparing the nearest surface function formula with an approximate method, that is the surface area of the aggregates multiplied by the uniform thickness of the ITZ layers. The results showed that the influencing order of these three factors on the overlapping degree between neighboring ITZ in turn was the interface thickness, aggregate volume fraction and the maximum aggregate diameter; As long as the interface thickness 50 μm and the aggregate volume fraction 50%, the calculated error between two methods mentioned above is about 10 %.

Overlapping Grid Technique for Numerical Simulation of a Fast-Cruising Catamaran Fitted with Active T-Foils

In marine engineering,appendages such as fin stabilizers and/or T-foils are made to rotate and to reduce the motion of ships.Research on the hydrodynamics of ships fitted with active appendages has significantly improved the design and control of such ships.However,most studies focus on fixed rather than rotating appendages,thereby ignoring the hydrodynamic unsteadiness of active appendages.To enhance the reliability and precision of the numerical simulations,we propose the use of overlapping grids for simulating advanced catamarans fitted with a pair of rotating T-foils under each bow.The fundamental purpose of the overlapping grid technique is to realize information exchange via regional overlap sharing in each subdomain of the computing domain,instead of using the method of boundary sharing,thus greatly alleviating the difficulty of generating the subdomain grid;moreover,the technique guarantees the quality of the subdomain grid.Within the main computational domain,a subdomain was allocated to accommodate the T-foil.Overlapping meshes near the interface between the two domains enable information flow during the simulation;the overlapping grids are updated at every iteration step because the subdomain rotates.The instantaneous trim and sinkage responses of the catamaran to the T-foil rotation were reproduced.From the moment the active T-foil stopped moving,there was no change in the ship’s sailing attitude,indicating that the response was in real time.By comparing with EFD data,the numerical results showed reasonable agreement,indicating the feasibility and effectiveness of the technique in simulating the hydrodynamics of ships fitted with active appendages.

A DIAGONAL SPLIT-CELL MODEL FOR THE OVERLAPPING YEE FDTD METHOD

In this paper, we present a nonorthogonal overlapping Yee method for solv- ing Maxwell＇s equations using the diagonal split-cell model. When material interface is presented, the diagonal split-cell model does not require permittivity averaging so that better accuracy can be achieved. Our numerical results on optical force computation show that the standard FDTD method converges linearly, while the proposed method achieves quadratic convergence and better accuracy.

A Genetic Algorithm for Identifying Overlapping Communities in Social Networks Using an Optimized Search Space

There are currently many approaches to identify the community structure of a network, but relatively few specific to detect overlapping community structures. Likewise, there are few networks with ground truth overlapping nodes. For this reason,we introduce a new network, Pilgrim, with known overlapping nodes, and a new genetic algorithm for detecting such nodes. Pilgrim is comprised of a variety of structures including two communities with dense overlap,which is common in real social structures. This study initially explores the potential of the community detection algorithm LabelRank for consistent overlap detection;however, the deterministic nature of this algorithm restricts it to very few candidate solutions. Therefore, we propose a genetic algorithm using a restricted edge-based clustering technique to detect overlapping communities by maximizing an efficient overlapping modularity function. The proposed restriction to the edge-based representation precludes the possibility of disjoint communities, thereby, dramatically reducing the search space and decreasing the number of generations required to produce an optimal solution. A tunable parameterr allows the strictness of the definition of overlap to be adjusted allowing for refinement in the number of identified overlapping nodes. Our method, tested on several real social networks, yields results comparable to the most effective overlapping community detection algorithms to date.

Dynamic interaction of twin vertically overlapping lined tunnels in an elastic half space subjected to incident plane waves

The scattering of plane harmonic P and SV waves by a pair of vertically overlapping lined tunnels buried in an elastic half space is solved using a semi-analytic indirect boundary integration equation method. Then the effect of the distance between the two tunnels, the stiffness and density of the lining material, and the incident frequency on the seismic response of the tunnels is investigated. Numerical results demonstrate that the dynamic interaction between the twin tunnels cannot be ignored and the lower tunnel has a significant shielding effect on the upper tunnel for high-frequency incident waves, resulting in great decrease of the dynamic hoop stress in the upper tunnel; for the low-frequency incident waves, in contrast, the lower tunnel can lead to amplification effect on the upper tunnel. It also reveals that the frequency-spectrum characteristics of dynamic stress of the lower tunnel are significantly different from those of the upper tunnel. In addition, for incident P waves in low-frequency region, the soft lining tunnels have significant amplification effect on the surface displacement amplitude, which is slightly larger than that of the corresponding single tunnel.

Bayesian method for system reliability assessment of overlapping pass/fail data

For high reliability and long life systems, system pass/fail data are often rare. Integrating lower-level data, such as data drawn from the subsystem or component pass/fail testing,the Bayesian analysis can improve the precision of the system reliability assessment. If the multi-level pass/fail data are overlapping,one challenging problem for the Bayesian analysis is to develop a likelihood function. Since the computation burden of the existing methods makes them infeasible for multi-component systems, this paper proposes an improved Bayesian approach for the system reliability assessment in light of overlapping data. This approach includes three steps： fristly searching for feasible paths based on the binary decision diagram, then screening feasible points based on space partition and constraint decomposition, and finally simplifying the likelihood function. An example of a satellite rolling control system demonstrates the feasibility and the efficiency of the proposed approach.

Detecting overlapping communities based on vital nodes in complex networks

Detection of community structures in the complex networks is significant to understand the network structures and analyze the network properties. However, it is still a problem on how to select initial seeds as well as to determine the number of communities. In this paper, we proposed the detecting overlapping communities based on vital nodes algorithm（DOCBVA）, an algorithm based on vital nodes and initial seeds to detect overlapping communities. First, through some screening method, we find the vital nodes and then the seed communities through the pretreatment of vital nodes. This process differs from most existing methods, and the speed is faster. Then the seeds will be extended. We also adopt a new parameter of attribution degree to extend the seeds and find the overlapping communities. Finally, the remaining nodes that have not been processed in the first two steps will be reprocessed. The number of communities is likely to change until the end of algorithm. The experimental results using some real-world network data and artificial network data are satisfactory and can prove the superiority of the DOCBVA algorithm.