Acute suppurative terminal cholangitis:Clinical characteristics of a new subtype of acute cholangitis

Background:Acute suppurative terminal cholangitis(ASTC)is rarer than acute obstructive cholangitis and is not well studied.To explore this subtype of acute cholangitis,we described our clinical experience with ASTC.Methods:We performed a retrospective review of patients with ASTC admitted to our center from September 2014 to August 2020.We analyzed their clinical characteristics,including etiology,clinical manifestations,imaging features,treatment and prognosis.Results:A total of 32 ASTC patients were included in the analysis.The majority of the patients had a history of biliary operations,and clinical manifestations were occult and atypical.The positive rate of bacterial culture was 46.9%.All the patients had typical imaging features on computed tomography and magnetic resonance imaging.Treatment with effective antibiotics was provided as soon as diagnosis was established.After treatment,most patients had a good outcome.Elevated levels of total bilirubin,aspartate aminotransferase,procalcitonin and gamma-glutamyltransferase were the characteristics of critically ill patients and were associated with relatively poor prognosis.Conclusions:Our results demonstrated that ASTC should be recognized as a new subtype of acute cholangitis,and that earlier diagnosis and more personalized treatments are needed.

Machine learning for predicting the outcome of terminal ballistics events

Machine learning(ML) is well suited for the prediction of high-complexity,high-dimensional problems such as those encountered in terminal ballistics.We evaluate the performance of four popular ML-based regression models,extreme gradient boosting(XGBoost),artificial neural network(ANN),support vector regression(SVR),and Gaussian process regression(GP),on two common terminal ballistics’ problems:(a)predicting the V50ballistic limit of monolithic metallic armour impacted by small and medium calibre projectiles and fragments,and(b) predicting the depth to which a projectile will penetrate a target of semi-infinite thickness.To achieve this we utilise two datasets,each consisting of approximately 1000samples,collated from public release sources.We demonstrate that all four model types provide similarly excellent agreement when interpolating within the training data and diverge when extrapolating outside this range.Although extrapolation is not advisable for ML-based regression models,for applications such as lethality/survivability analysis,such capability is required.To circumvent this,we implement expert knowledge and physics-based models via enforced monotonicity,as a Gaussian prior mean,and through a modified loss function.The physics-informed models demonstrate improved performance over both classical physics-based models and the basic ML regression models,providing an ability to accurately fit experimental data when it is available and then revert to the physics-based model when not.The resulting models demonstrate high levels of predictive accuracy over a very wide range of projectile types,target materials and thicknesses,and impact conditions significantly more diverse than that achievable from any existing analytical approach.Compared with numerical analysis tools such as finite element solvers the ML models run orders of magnitude faster.We provide some general guidelines throughout for the development,application,and reporting of ML models in terminal ballistics problems.

Mixed Integer Robust Programming Model for Multimodal Fresh Agricultural Products Terminal Distribution Network Design

The low efficiency and high cost of fresh agricultural product terminal distribution directly restrict the operation of the entire supply network.To reduce costs and optimize the distribution network,we construct a mixed integer programmingmodel that comprehensively considers tominimize fixed,transportation,fresh-keeping,time,carbon emissions,and performance incentive costs.We analyzed the performance of traditional rider distribution and robot distribution modes in detail.In addition,the uncertainty of the actual market demand poses a huge threat to the stability of the terminal distribution network.In order to resist uncertain interference,we further extend the model to a robust counterpart form.The results of the simulation show that the instability of random parameters will lead to an increase in the cost.Compared with the traditional rider distribution mode,the robot distribution mode can save 12.7%on logistics costs,and the distribution efficiency is higher.Our research can provide support for the design of planning schemes for transportation enterprise managers.

Improved STNModels and Heuristic Rules for Cooperative Scheduling in Automated Container Terminals

Improving the cooperative scheduling efficiency of equipment is the key for automated container terminals to copewith the development trend of large-scale ships. In order to improve the solution efficiency of the existing spacetimenetwork (STN) model for the cooperative scheduling problem of yard cranes (YCs) and automated guidedvehicles (AGVs) and extend its application scenarios, two improved STN models are proposed. The flow balanceconstraints in the original model are decomposed, and the trajectory constraints of YCs and AGVs are added toacquire the model STN_A. The coupling constraint in STN_A is updated, and buffer constraints are added toSTN_A so that themodel STN_B is built.As the size of the problem increases, the solution speed of CPLEX becomesthe bottleneck. So a heuristic method containing three groups of heuristic rules is designed to obtain a near-optimalsolution quickly. Experimental results showthat the computation time of STN_A is shortened by 49.47% on averageand the gap is reduced by 1.69% on average compared with the original model. The gap between the solution ofthe heuristic rules and the solution of CPLEX is less than 3.50%, and the solution time of the heuristic rules is onaverage 99.85% less than the solution time of CPLEX. Compared with STN_A, the computation time for solvingSTN_B increases by 58.93% on average.

Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

An Improved Bounded Conflict-Based Search for Multi-AGV Pathfinding in Automated Container Terminals

As the number of automated guided vehicles(AGVs)within automated container terminals(ACT)continues to rise,conflicts have becomemore frequent.Addressing point and edge conflicts ofAGVs,amulti-AGVconflict-free path planning model has been formulated to minimize the total path length of AGVs between shore bridges and yards.For larger terminalmaps and complex environments,the grid method is employed to model AGVs’road networks.An improved bounded conflict-based search(IBCBS)algorithmtailored to ACT is proposed,leveraging the binary tree principle to resolve conflicts and employing focal search to expand the search range.Comparative experiments involving 60 AGVs indicate a reduction in computing time by 37.397%to 64.06%while maintaining the over cost within 1.019%.Numerical experiments validate the proposed algorithm’s efficacy in enhancing efficiency and ensuring solution quality.

Transformation of marginal zone lymphoma into high-grade B-cell lymphoma expressing terminal deoxynucleotidyl transferase:A case report

BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and HGBL-not otherwise specific(HGBL-NOS),which are morphologically characteristic of HGBL but lack MYC,BCL-2,or BCL-6 rearrangements.HGBL is partially transformed by follicular lymphoma and other indolent lymphoma,with few cases of marginal zone lymphoma(MZL)transformation.HGBL often has a poor prognosis and intensive therapy is currently mainly advocated,but there is no good treatment for these patients who cannot tolerate chemotherapy.CASE SUMMARY We reported a case of MZL transformed into HGBL-NOS with TP53 mutation and terminal deoxynucleotidyl transferase expression.Gene analysis revealed the gene expression profile was identical in the pre-and post-transformed tissues,suggesting that the two diseases are homologous,not secondary tumors.The chemotherapy was ineffective and the side effect was severe,so we tried combination therapy including venetoclax and obinutuzumab.The patient tolerated treatment well,and reached partial response.The patient had recurrence of hepatocellular carcinoma and died of multifunctional organ failure.He survived for 12 months after diagnosis.CONCLUSION Venetoclax combined with obinutuzumab might improve the survival in some HGBL patients,who are unsuitable for chemotherapy.

Investigation on Breakdown Characteristics of Various Surface Terminal Structures for GaN-Based Vertical P-i-N Diodes

GaN-based vertical P-i-N diode with mesa edge terminal structure due to electric field crowding effect, the breakdown voltage of the device is significantly reduced. This work investigates three terminal structures, including deeply etched, bevel, and stepped-mesas terminal structures, to suppress electric field crowding effects at the device and junction edges. Deeply-etched mesa terminal yields a breakdown voltage of 1205 V, i.e., 89% of the ideal voltage. The bevel-mesa terminal achieves about 89% of the ideal breakdown voltage, while the step-mesa terminal is less effective in mitigating electric field crowding, at about 32% of the ideal voltage. This work can provide an important reference for the design of high-power, high-voltage GaN-based P-i-N power devices, finding a terminal protection structure suitable for GaNPiN diodes to further enhance the breakdown performance of the device and to unleash the full potential of GaN semiconductor materials.

Terminal Blend橡胶泡沫沥青制备及性能评价

为弥补传统泡沫沥青高温稳定性和黏附性的不足,解决传统橡胶沥青发泡效果不理想的缺陷,对terminal blend(TB)橡胶泡沫沥青进行了研究,探究了TB橡胶泡沫沥青发泡效果的影响规律,对其微观形貌与特征进行了表征,同时评估了TB橡胶泡沫沥青的高温性能、温度敏感性和黏度.结果表明:采用TB橡胶沥青制备泡沫沥青具备可行性;相比传统泡沫沥青,TB橡胶泡沫沥青在温度敏感性降低的同时,还显著提升了高温性能和黏度;微观结果显示TB橡胶泡沫沥青的发泡过程仅为物理过程,而且受发泡温度和发泡用水量的影响,其中后者对整体发泡效果的影响更加明显;TB橡胶泡沫沥青的最佳发泡温度为160°C、发泡用水量为2.7%.

Trust evaluation model of power terminal based on equipment portrait

As the number of power terminals continues to increase and their usage becomes more widespread,the security of power systems is under great threat.In response to the lack of effective trust evaluation methods for terminals,we propose a trust evaluation model based on equipment portraits for power terminals.First,we propose an exception evaluation method based on the network flow order and evaluate anomalous terminals by monitoring the external characteristics of network traffic.Second,we propose an exception evaluation method based on syntax and semantics.The key fields of each message are extracted,and the frequency of keywords in the message is statistically analyzed to obtain the keyword frequency and time-slot threshold for evaluating the status of the terminal.Thus,by combining the network flow order,syntax,and semantic analysis,an equipment portrait can be constructed to guarantee security of the power network terminals.We then propose a trust evaluation method based on an equipment portrait to calculate the trust values in real time.Finally,the experimental results of terminal anomaly detection show that the proposed model has a higher detection rate and lower false detection rate,as well as a higher real-time performance,which is more suitable for power terminals.

Terminal Blend(TB)胶粉/SBS复合改性沥青性能研究

采用Terminal Blend(TB)技术制备了基质沥青牌号和SBS含量不同的6种TB复合改性沥青,并对它们的常规指标、感温性能、黏温特性和力学性能进行了评价。结果表明:TB复合改性沥青各项性能均显著优于基质沥青。TB复合改性沥青的性能与SBS含量和基质沥青的牌号有关。除温度敏感性外,其他各项性能均随SBS含量增加而得到改善。中油AH-70有助于改善软化点、针入度、针入度指数PI值、弹性恢复、峰值拉力Fmax、屈服应变能E、黏韧性面积S和黏韧性指标,中海AH-90则有助于改善延度、黏温曲线方程斜率、拉伸柔量f。

A review of the etched terminal structure of a 4H-SiC PiN diode

The comparison of domestic and foreign studies has been utilized to extensively employ junction termination extension(JTE)structures for power devices.However,achieving a gradual doping concentration change in the lateral direction is difficult for SiC devices since the diffusion constants of the implanted aluminum ions in SiC are much less than silicon.Many previously reported studies adopted many new structures to solve this problem.Additionally,the JTE structure is strongly sensitive to the ion implantation dose.Thus,GA-JTE,double-zone etched JTE structures,and SM-JTE with modulation spacing were reported to overcome the above shortcomings of the JTE structure and effectively increase the breakdown voltage.They provided a theoretical basis for fabricating terminal structures of 4H-SiC PiN diodes.This paper summarized the effects of different terminal structures on the electrical properties of SiC devices at home and abroad.Presently,the continuous development and breakthrough of terminal technology have significantly improved the breakdown voltage and terminal efficiency of 4H-SiC PiN power diodes.

Study of the Akouedo Landfill (Abidjan) Using the Electrical Resistivity Method: Implications for the Risk of Contamination of the Continental Terminal Water Table

An electrical resistivity survey was carried out on the household and industrial waste disposal site (landfill) of Akouédo (Central Abidjan) with a view to searching for a possible layer of clay in the stratification which could constitute a protective screen of the aquifer of the Continental Terminal of Abidjan against the migration of leachate. Electrical surveys (SE) carried out according to the Schlumberger configuration showed that the stratigraphy of the area is composed of three to four geoelectric layers depending on the SE positions. The correlation with the lithology of two piezometric boreholes carried out indicates that the lithology of the study area is dominated by clayey sand, sand, sandy clay and clay. The average thickness of accumulated waste varies between 30 and 40 m. The virtual absence of a continuous layer of clay under the waste exposes the Continental Terminal aquifer to contamination by leachate from waste accumulated over several decades in the Akouedo area.

Metallogeny and Emplacement Conditions of Continental Terminal 3 (Ct3) Iron Formations of the Niamey Region (Western Niger)

This study aims to characterize the different lithofacies of the Ct3 formation in the Niamey region, and to determine the distribution of major and trace elements, in order to highlight the conditions for the establishment of iron mineralization. A lithological column, synthesizing sections of selected outcrops in the vicinity of Niamey, was produced. The chemical compositions of the selected samples were determined by X-ray fluorescence (XRF) spectrometry. Microscopic analysis of the thin sections determined the gœthitic nature of the oolitic iron ore. The oolites show a quartz, limonitic or gœthitic nucleus. Sometimes the nucleus is absent. From a morphoscopic point of view, two types of oolites have been distinguished: spherical-shaped and ellipsoidal-shaped oolites. The oolites are either contiguous or disseminated, as the case may be, in a limonitic to goethitic cement or in a fine sandstone matrix. The larger oolites (pisolites) are relatively friable. They reflect the influence of a relatively turbulent to submerged environment. The hardground of the iron mineralized horizons are covered by quartz grains. They are indicative of a submerged or emergent environment. X-ray fluorescence analysis shows high Fe2O3 contents (50% to 80%) and variable contents of major elements SiO2, Al2O3, TiO2, MnO, MgO, CaO, K2O and P2O5 associated with certain trace elements such as Th, U, V, Y, Zn, Zr and As. The results of the study are an important tool for decision-makers to adopt effective prevention/remediation measures for groundwater contamination in the Continental terminal aquifer systems.

Modelling Dry Port Systems in the Framework of Inland Waterway Container Terminals

Overcoming the global sustainability challenges of logistics requires applying solutions that minimize the negative effects of logistics activities.The most efficient way of doing so is through intermodal transportation(IT).Current IT systems rely mostly on road,rail,and sea transport,not inland waterway transport.Developing dry port(DP)terminals has been proven as a sustainable means of promoting and utilizing IT in the hinterland of seaport container terminals.Conventional DP systems consolidate container flows from/to seaports and integrate road and rail transportation modes in the hinterland which improves the sustainability of the whole logistics system.In this article,to extend literature on the sustainable development of different categories of IT terminals,especially DPs,and their varying roles,we examine the possibility of developing DP terminals within the framework of inland waterway container terminals(IWCTs).Establishing combined road–rail–inland waterway transport for observed container flows is expected to make the IT systems sustainable.As such,this article is the first to address the modelling of such DP systems.After mathematically formulating the problem of modelling DP systems,which entailed determining the number and location of DP terminals for IWCTs,their capacity,and their allocation of container flows,we solved the problem with a hybrid metaheuristic model based on the Bee Colony Optimisation(BCO)algorithmand themeasurement of alternatives and ranking according to compromise solution(i.e.,MARCOS)multi-criteria decision-making method.The results from our case study of the Danube region suggest that planning and developingDP terminals in the framework of IWCTs can indeed be sustainable,as well as contribute to the development of logistics networks,the regionalisation of river ports,and the geographic expansion of their hinterlands.Thus,the main contributions of this article are in proposing a novel DP concept variant,mathematically formulating the problems of its modelling,and developing an encompassing hybrid metaheuristic approach for treating the complex nature of the problem adequately.

Improved RF power performance of InAlN/GaN HEMT by optimizing rapid thermal annealing process for high-performance low-voltage terminal applications

Improved radio-frequency(RF)power performance of InAlN/GaN high electron mobility transistor(HEMT)is achieved by optimizing the rapid thermal annealing(RTA)process for high-performance low-voltage terminal applications.By optimizing the RTA temperature and time,the optimal annealing condition is found to enable low parasitic resistance and thus a high-performance device.Besides,compared with the non-optimized RTA HEMT,the optimized one demonstrates smoother ohmic metal surface morphology and better heterojunction quality including the less degraded heterojunction sheet resistance and clearer heterojunction interfaces as well as negligible material out-diffusion from the barrier to the channel and buffer.Benefiting from the lowered parasitic resistance,improved maximum output current density of 2279 mA·mm^(-1)and higher peak extrinsic transconductance of 526 mS·mm^(-1)are obtained for the optimized RTA HEMT.In addition,due to the superior heterojunction quality,the optimized HEMT shows reduced off-state leakage current of 7×10^(-3)mA·mm^(-1)and suppressed current collapse of only 4%,compared with those of 1×10^(-1)mA·mm^(-1)and 15%for the non-optimized one.At 8 GHz and V_(DS)of 6 V,a significantly improved power-added efficiency of 62%and output power density of 0.71 W·mm^(-1)are achieved for the optimized HEMT,as the result of the improvement in output current,knee voltage,off-state leakage current,and current collapse,which reveals the tremendous advantage of the optimized RTA HEMT in high-performance low-voltage terminal applications.

Study on Recognition Method of Similar Weather Scenes in Terminal Area

Weather is a key factor affecting the control of air traffic.Accurate recognition and classification of similar weather scenes in the terminal area is helpful for rapid decision-making in air trafficflow management.Current researches mostly use traditional machine learning methods to extract features of weather scenes,and clustering algorithms to divide similar scenes.Inspired by the excellent performance of deep learning in image recognition,this paper proposes a terminal area similar weather scene classification method based on improved deep convolution embedded clustering(IDCEC),which uses the com-bination of the encoding layer and the decoding layer to reduce the dimensionality of the weather image,retaining useful information to the greatest extent,and then uses the combination of the pre-trained encoding layer and the clustering layer to train the clustering model of the similar scenes in the terminal area.Finally,term-inal area of Guangzhou Airport is selected as the research object,the method pro-posed in this article is used to classify historical weather data in similar scenes,and the performance is compared with other state-of-the-art methods.The experi-mental results show that the proposed IDCEC method can identify similar scenes more accurately based on the spatial distribution characteristics and severity of weather;at the same time,compared with the actualflight volume in the Guangz-hou terminal area,IDCEC's recognition results of similar weather scenes are con-sistent with the recognition of experts in thefield.

Novel Radiation-Adjustable Heating Terminal Based on Flat Heat Pipe Combined with Air Source Heat Pump

The electrification of building heating is an effective way to meet the global carbon target. As a clean and sustainable electrified heating technology, air-source heat pumps (ASHPs) are widely used in areas lacking central heating. However, as a major component of space heating, heating terminals might not fit well with ASHP in order to achieve both intermittency and comfort. Therefore, this study proposes a novel radiation-adjustable heating terminal combined with an ASHP to achieve electrification, intermittency, and better thermal comfort. Radiant terminals currently suffer from three major problems: limited maximum heating capacity, inability to freely adapt, and difficulty with combining them with ASHPs. These problems were solved by improving the structural design of the novel terminal (Improvement A–E). Results showed that the maximum heating capacity increased by 23.6% and radiation heat transfer ratio from 10.1% to 30.9% was provided for users with the novel terminal. Further, new flat heat pipe (FHP) design improved stability (compressor oil return), intermittency (refrigerant thermal inertia), and safety (refrigerant leakage risk) by reducing the length of exposed refrigerant pipes. Furthermore, a new phased operation strategy was proposed for the novel terminal, and the adjustability of the terminal was improved. The results can be used as reference information for decarbonizing buildings by electrifying heating terminals.

Palliative oral care in terminal cancer patients:Integrated review

BACKGROUND Palliative care(PC)aims to improve quality of life in patients and its families against life threatening diseases,through suffering’s prevention and relief.It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span,in order to establish an adequate treatment plan for each situation.AIM To synthesize the published evidence on oral conditions,impact,management and challenges in managing oral conditions among palliative patients.METHODS Articles were selected from PubMed and Scopus electronic platforms,using a research strategy with diverse descriptors related to“palliative care”,“cancer”and“oral health”.The article’s selection was done in two phases.The first one was performed by the main researcher through the reading of the abstracts.In the second phase two researchers selected eligible articles after reading in full those previous selected.Data was tabulated and analyzed,obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC.RESULTS As results,the total of 15 articles were eligible,being one a qualitative analysis,13(92.8%)clinical trials and one observational study.Of the 15 articles,8(53.4%)involved questionnaires,while the rest involved:one systematic review about oral care in a hospital environment,2 oral exams and oral sample collection,one investigation of terminal patient’s(TP)oral assessment records,2 collection of oral samples and their respective analysis and one treatment of the observed oral complications.CONCLUSION It can be concluded that the oral manifestations in oncologic patients in terminal stage are,oral candidiasis,dry mouth,dysphagia,dysgeusia,oral mucositis and orofacial pain.Determining a protocol for the care of these and other complications of cancer–or cancer therapy–based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC.To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member.It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer.Other complications in terminal patients and their treatments still need to have further studying.

Hydrogeological Characterization of Continental Terminal and Oligo-Miocene Aquifers in the Tambacounda-Kaffrine Zone(Senegal)

This study aims to make a hydrogeological characterization of the aquifers of the Continental Terminal and the Oligo-Miocene.To do so,an analysis is conducted on the basis of hydrogeological parameters from 172 boreholes,10 of which are used for groundwater levels and flows analysis.The results of the statistical analysis of the hydrogeological parameters show that the average flow rate is 42.29 m^(3)/h,the average specific flow rate is 5.96 m^(3)/h/m,and the average transmissivity is 0.024 m^(2)/s.These values highlight the high productivity of aquifers from the Continental Terminal and the Oligo-Miocene.The results of piezometry showed that water flows from the south center to the northwest of Tambacounda where the largest depression is located and could even be the outlet of the system.The groundwater fluctuations between low water level and high water level seasons reveal a rise in the piezometric surface of the aquifers at the scale of the study area.