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.

基于MQTT协议的营运车辆安全预警提示装置

随着智慧交通、车联网及车路协同技术的发展,交通管理装置作为智慧交通系统的重要组成部分,将发挥越来越重要的作用,为城市交通的安全、高效、便捷做出更大的贡献。本文旨在研究与设计一种在物联网(IoT)环境下实现营运车辆判别、对驾驶员提醒预警的装置。系统基于Wio Terminal单片机进行嵌入式开发,采用开源的Eclipse Mosquitto环境搭建消息代理服务器,并通过MQTT协议通信;本文详细探讨了其功能和技术特点以及其在交通安全管理场景中的应用,以期为物联网交通管理领域的应用提供参考和借鉴。

Adaptive optimisation of explosive reactive armour for protection against kinetic energy and shaped charge threats

We evaluate an adaptive optimisation methodology,Bayesian optimisation(BO),for designing a minimum weight explosive reactive armour(ERA)for protection against a surrogate medium calibre kinetic energy(KE)long rod projectile and surrogate shaped charge(SC)warhead.We perform the optimisation using a conventional BO methodology and compare it with a conventional trial-and-error approach from a human expert.A third approach,utilising a novel human-machine teaming framework for BO is also evaluated.Data for the optimisation is generated using numerical simulations that are demonstrated to provide reasonable qualitative agreement with reference experiments.The human-machine teaming methodology is shown to identify the optimum ERA design in the fewest number of evaluations,outperforming both the stand-alone human and stand-alone BO methodologies.From a design space of almost 1800 configurations the human-machine teaming approach identifies the minimum weight ERA design in 10 samples.

Recent advances and perspectives in MXene-based cathodes for aqueous zinc-ion batteries

Aqueous zinc-ion batteries(AZIBs)show great potential for applications in grid-scale energy storage,given their intrinsic safety,cost effectiveness,environmental friendliness,and impressive electrochemical performance.However,strong electrostatic interactions exist between zinc ions and host materials,and they hinder the development of advanced cathode materials for efficient,rapid,and stable Zn-ion storage.MXenes and their derivatives possess a large interlayer spacing,excellent hydrophilicity,outstanding electronic conductivity,and high redox activity.These materials are considered“rising star”cathode candidates for AZIBs.This comprehensive review discusses recent advances in MXenes as AZIB cathodes from the perspectives of crystal structure,Zn-storage mechanism,surface modification,interlayer engineering,and conductive network design to elucidate the correlations among their composition,structure,and electrochemical performance.This work also outlines the remaining challenges faced by MXenes for aqueous Zn-ion storage,such as the urgent need for improved toxic preparation methods,exploration of potential novel MXene cathodes,and suppression of layered MXene restacking upon cycling,and introduces the prospects of MXene-based cathode materials for high-performance AZIBs.

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.

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.

考虑混合工艺的自动化码头多设备资源协同调度优化模型和算法设计

Considering the uncertainty of the speed of horizontal transportation equipment,a cooperative scheduling model of multiple equipment resources in the automated container terminal was constructed to minimize the completion time,thus improving the loading and unloading efficiencies of automated container terminals.The proposed model integrated the two loading and unloading processes of“double-trolley quay crane+AGV+ARMG”and“single-trolley quay crane+container truck+ARMG”and then designed the simulated annealing particle swarm algorithm to solve the model.By comparing the results of the particle swarm algorithm and genetic algorithm,the algorithm designed in this paper could effectively improve the global and local space search capability of finding the optimal solution.Furthermore,the results showed that the proposed method of collaborative scheduling of multiple equipment resources in automated terminals considering hybrid processes effectively improved the loading and unloading efficiencies of automated container terminals.The findings of this study provide a reference for the improvement of loading and unloading processes as well as coordinated scheduling in automated terminals.

BET inhibitors potentiate melanoma ferroptosis and immunotherapy through AKR1C2 inhibition

Dear Editor,Ferroptosis,an iron-dependent form of cell death driven by overwhelming lipid peroxidation,represents a vulnerability in cancers,and therapeutic strategies to further potentiate ferroptosis hold great potential for melanoma treatment.

An Efficient Plant Regeneration System for Different Explants of Rare and Endangered Plants in Mussaenda anomala

To establish an efficient regeneration method for the rare and endangered plant Mussaenda anomala to address problems regarding its reproductive obstacles and scarce populations.In this study,the terminal buds,axillary buds,stem segments with two axillary buds,stem segments with two axillary buds and one terminal bud,and leaves of M.anomala were used as explants.The effects of different explants and disinfection methods,plant growth regulators and substrates on plant regeneration were explored.The following results were obtained:(1)The terminal bud was a suitable explant for M.anomala tissue culture,and the disinfection method utilized was treatment with 0.2%HgCl2 for 8 min.(2)Initiate medium:MS basic medium supplemented with 0.5 mg/L 6-BA and 0.2 mg/L IBA for the high germination rate(100%)and the maximum bud height(1.70 cm)of the terminal bud.(3)Proliferation medium:MS basic medium supplemented with 3.0 mg/L 6-BA and 0.2 mg/L IBA for a high proliferation rate(96%)and proliferation time(6.0)of terminal buds.(4)Proliferation medium supplemented with 0.7 mg/L GA3 significantly increased the bud heights of multiple buds.(5)Rooting medium:MS basic medium supplemented with 0.5 mg/L IBA and 0.5 mg/L IAA for a high rooting rate(88%),root number(12.0)and root length(5.07 cm).(6)The optimal substrate for seedling acclimation and transplanting was perlite:vermiculite(1:1),which resulted in the highest survival rate(97%)and plant height(5.89 cm),as well as better growth potential for seedlings.The surfaces of M.anomala explants are densely covered with trichome,which increased the difficulty of disinfection;the plant growth regulators directly affected the growth and development in the regeneration process of M.anomala,and the substrate significantly affected the survival rate and height growth for seedling acclimation.

A Pre-Selection-Based Ant Colony System for Integrated Resources Scheduling Problem at Marine Container Terminal

Marine container terminal(MCT)plays a key role in the marine intelligent transportation system and international logistics system.However,the efficiency of resource scheduling significantly influences the operation performance of MCT.To solve the practical resource scheduling problem(RSP)in MCT efficiently,this paper has contributions to both the problem model and the algorithm design.Firstly,in the problem model,different from most of the existing studies that only consider scheduling part of the resources in MCT,we propose a unified mathematical model for formulating an integrated RSP.The new integrated RSP model allocates and schedules multiple MCT resources simultaneously by taking the total cost minimization as the objective.Secondly,in the algorithm design,a pre-selection-based ant colony system(PACS)approach is proposed based on graphic structure solution representation and a pre-selection strategy.On the one hand,as the RSP can be formulated as the shortest path problem on the directed complete graph,the graphic structure is proposed to represent the solution encoding to consider multiple constraints and multiple factors of the RSP,which effectively avoids the generation of infeasible solutions.On the other hand,the pre-selection strategy aims to reduce the computational burden of PACS and to fast obtain a higher-quality solution.To evaluate the performance of the proposed novel PACS in solving the new integrated RSP model,a set of test cases with different sizes is conducted.Experimental results and comparisons show the effectiveness and efficiency of the PACS algorithm,which can significantly outperform other state-of-the-art algorithms.

Advancing the predictive accuracy of PNTML in rectal prolapse:An ongoing quest

Fecal incontinence is a common symptom among patients with rectal prolapse.Pudendal nerve terminal motor latency(PNTML)testing can serve as a reference indicator for predicting the outcomes of rectal prolapse surgery,thereby assisting surgeons in formulating more appropriate surgical plans.The direct correlation between preoperative PNTML testing results and postoperative fecal incontinence in patients with rectal prolapse remains a contentious issue,necessitating further clarification.Thus,we analyze the existing publications from both clinical and statistical perspectives to comprehensively evaluate the accuracy of preoperative PNTML testing in rectal prolapse and provide some feasible statistical solutions.

Comparison of mismatch repair and immune checkpoint protein profile with histopathological parameters in pancreatic,periampullary/ampullary,and choledochal adenocarcinomas

BACKGROUND Pancreatic,periampullary/ampullary,and choledochal adenocarcinomas are aggressive malignancies with a poor prognosis.Immune checkpoint blockade is a promising treatment option for several tumor types.H long terminal repeatassociating 2(HHLA2),which is analogous to programmed death-ligand 1(PDL1),is a recently discovered member of the B7/cluster of differentiation 28 family and is expressed in many malignancies.AIM To analyze the expression of HHLA2 and its association with the pathologic biomarkers that predict sensitivity to immunotherapy.METHODS Ninety-two adenocarcinoma cases located in the pancreas,ampulla,and distal common bile duct were identified.This study assessed 106 pancreaticoduodenectomy and distal/total pancreatectomy samples that were delivered to Ankara City Hospital between 2019 and 2021.Immunohistochemistry was conducted to examine the expression of DNA mismatch repair(MMR),PD-L1,and HHLA2 proteins.RESULTS Patients with high HHLA2 expression had a higher mean age than those with low expression.Low HHLA2 expression was associated with high perineural invasion.HHLA2 expression was low in pathological stage T3(pT)3 cases and high in pathological stage T1,T2,and T4 cases.There was no correlation between HHLA2 expression and the expression of MMR proteins and PD-L1.CONCLUSION Evaluation of HHLA2 expression in microsatellite stable and PD-L1-negative tumors may be useful for predicting the response of individuals to immunotherapy and may serve as a novel therapeutic target for immunotherapy in advanced-stage disease.

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.

半主动升沉补偿系统的预测控制与联合仿真分析

针对半主动升沉补偿系统响应滞后和非线性时变的特点,提出半主动升沉补偿系统的预测控制与联合仿真分析。以PSO-BiLSTM模型预测的船舶升沉位移作为控制信号输入,Terminal滑模控制器控制复合液压缸,补偿负载因船舶运动产生的升沉位移。建立AMESim-Simulink联合仿真系统,对比有无预测模型下的3种控制补偿性能,验证了采用PSO-BiLSTM预测算法的Terminal滑模控制半主动升沉补偿系统效果良好,补偿率可达95.63%,比PID控制和普通滑模控制分别提高11.07%和5.51%。仿真结果表明,精确的预测数据作为控制输入,可以有效地缩短响应时滞,提高位移补偿精度。

Hydrogeophysical and Structural Investigations Using VES: A Case Study of Dosso Region in the Southwestern Part of the Meso-Cenozoic Iullemmeden Basin (Southwestern Niger)

A regional study connecting geolelectrical surveys with geology and hydrogeology was carried out in the western part of the Iullemmeden basin, precisely in the Dosso region in Niger. One hundred and four (104) vertical electrical sounds have been realized, among them nineteen representative were thus be used as parametric surveys. The local resistivity values of the geological formations of Quaternary range from 100 Ω⋅m to 1000 Ω⋅m (sands and lateritic sandstones). The Oligo-Miocene formation of the Continental terminal (Ct) shows resistivity values ranging from 1 to 5 Ω⋅m (brackish groundwaters) to 1500 Ω⋅m (clay sandstones) while the Upper Cretaceous formation of the Continental “hamadien” (Ch) indicates values ranging from 20 Ω⋅m (sandy clay) to 5000 Ω⋅m (clayey sandstones). The geological formations of Paleocene have values from 2 Ω⋅m (marls) to 60 Ω⋅m (calcareous marl), while the Precambrian basement exhibits values of granite around 300 Ω⋅m to 60,000 Ω⋅m. The update of the structural settings reveals many faults in the study area which explain both the shape of the basin and the geometry of the aquifers. Tectonics is also consistent with the hydraulic characteristics of aquifers. In addition, brackish groundwaters were identified as perched aquifer groundwaters in different depths in Dosso region. They probably come from the marine brines during the regression of the Paleocene Sea.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

The Impact of Privatization on Terminal Efficiency: A Case Study of Tema Port

Port and terminal efficiency are of utmost importance to the container shipping industry due to their significance in enhancing the competitive advantage of ports within a region. Consequently, there have always been notable variations of studies around it. This paper analyzes the impact of privatization on terminal efficiency using the Port of Tema as a Case Study. The main objective of this paper is to analyze the efficiency trends of the public and private terminals in the port over the years. To achieve this objective, DEA-CCR methodology was employed to calculate the annual technical efficiency trends of the private and public terminals using four input variables and three output variables. The main results of the paper indicated that the public and private terminals were efficient for multiple years. However, the efficiency scores over the years demonstrated inconsistency, exhibiting notable fluctuations. The findings of this study will aid policymakers across the region on policies relating to the efficiency and ownership structure of ports and terminals.

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.

Simulation of Air Flow along Human Lung for Cylindrical Channel of Porous Medium

The steady flow behavior in terminal bronchus of human lung for cylindrical channel of porous medium has been studied. The governing equations have been solved analytically and numerically for cylindrical channel. Finite difference method is incorporated to simulate the problem. The numerical results are compared with square duct channel for different parametric effect. It is observed that the flow rate is increased in cylindrical channel compared to square duct channel for the increasing value of pressure gradient, porosity and permeability. On the contrary, the flow rate is decreased in square duct channel compared to cylindrical channel for increasing value of viscosity. Flow rate in both channels is analyzed and compared for non-porous medium also. It is observed that flow rate is increased very high in cylindrical channel compared to square duct channel for both medium.