Glasses are known to possess low-frequency excess modes beyond the Debye prediction.For decades,it has been assumed that evolution of low-frequency density of excess modes D(ω) with frequency ω follows a power-law s...Glasses are known to possess low-frequency excess modes beyond the Debye prediction.For decades,it has been assumed that evolution of low-frequency density of excess modes D(ω) with frequency ω follows a power-law scaling:D(ω)~ω~γ.However,it remains debated on the value of γ at low frequencies below the first phonon-like mode in finitesize glasses.Early simulation studies reported γ=4 at low frequencies in two-(2D),three-(3D),and four-dimensional(4D)glasses,whereas recent observations in 2D and 3D glasses suggested γ=3.5 in a lower-frequency regime.It is uncertain whether the low-frequency scaling of D(ω)~ω^(3.5) could be generalized to 4D glasses.Here,we conduct numerical simulation studies of excess modes at frequencies below the first phonon-like mode in 4D model glasses.It is found that the system size dependence of D(ω) below the first phonon-like mode varies with spatial dimensions:D(ω) increases in2D glasses but decreases in 3D and 4D glasses as the system size increases.Furthermore,we demonstrate that the ω^(3.5)scaling,rather than the ω~4 scaling,works in the lowest-frequency regime accessed in 4D glasses,regardless of interaction potentials and system sizes examined.Therefore,our findings in 4D glasses,combined with previous results in 2D and 3D glasses,suggest a common low-frequency scaling of D(ω)~ ω^3.5) below the first phonon-like mode across different spatial dimensions,which would inspire further theoretical studies.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death a...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.展开更多
The Fourier series of the 2π-periodic functions tg(x2)and 1sin(x)and some of their relatives (first of their integrals) are investigated and illustrated with respect to their convergence. These functions are Generali...The Fourier series of the 2π-periodic functions tg(x2)and 1sin(x)and some of their relatives (first of their integrals) are investigated and illustrated with respect to their convergence. These functions are Generalized functions and the convergence is weak convergence in the sense of the convergence of continuous linear functionals defining them. The figures show that the approximations of the Fourier series possess oscillations around the function which they represent in a broad band embedding them. This is some analogue to the Gibbs phenomenon. A modification of Fourier series by expansion in powers cosn(x)for the symmetric part of functions and sin(x)cosn−1(x)for the antisymmetric part (analogous to Taylor series) is discussed and illustrated by examples. The Fourier series and their convergence behavior are illustrated also for some 2π-periodic delta-function-like sequences connected with the Poisson theorem showing non-vanishing oscillations around the singularities similar to the Gibbs phenomenon in the neighborhood of discontinuities of functions. .展开更多
Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and in...Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.展开更多
Perovskite solar cells(PSCs)have attracted much attention due to their low cost,high efficiency and easy processing.Recently,You et al.achieved a record efficiency of 26.1%(certified 25.6%)in PSCs with excellent stabi...Perovskite solar cells(PSCs)have attracted much attention due to their low cost,high efficiency and easy processing.Recently,You et al.achieved a record efficiency of 26.1%(certified 25.6%)in PSCs with excellent stability[1].Excess PbI_(2) in perovskite films was converted into inactive(PbI_(2))2RbCl to avoid its detrimental effect to device stability,while maintaining its positive effect to device efficiency.展开更多
BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatmen...BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.展开更多
In discussing the policy effects of environmental regulation,we should focus not only on whether environmental regulation helps improve the environmental and economic performance of firms,but also on how such improvem...In discussing the policy effects of environmental regulation,we should focus not only on whether environmental regulation helps improve the environmental and economic performance of firms,but also on how such improvement is materialized,i.e.whether the obsolete mode of production is reversed.After matching the database of China’s industrial enterprises with that of pollution emissions from these industrial enterprises,this paper identifies the asymmetric scope of clean production standards to test the effect of environmental regulation on the total factor productivity(TFP)of the industrial enterprises.Our empirical research finds that the implementation of clean production standards may induce TFP improvement.However,such improvement only occurs for polluters who cannot or who barely meet clean production standards and does little to improve the production standards of polluters with low pollution emission,reflecting the yardstick phenomenon of the asymmetric environmental regulation policy effect:While polluters are forced to improve,clean enterprises that pollute less are more likely to take no action.Further research finds that such TFP improvement is materialized primarily by means of overall firm optimization;the compensation effect is insignificant and does not reverse the backward mode of production.Polluters cope with the implementation of clean production standards by purchasing more equipment and expanding capacity,which adds to the tension between the expansion of capacity and the abatement of pollution emission.展开更多
Heat-killed Bifidobacterium longum CLA8013 has been demonstrated to improve the frequency of defecation, straining, and pain during defecation in human placebo-controlled, double-blind, parallel-group studies. We cond...Heat-killed Bifidobacterium longum CLA8013 has been demonstrated to improve the frequency of defecation, straining, and pain during defecation in human placebo-controlled, double-blind, parallel-group studies. We conducted a randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety of both long-term and excessive intakes of heat-killed B. longum CLA8013, when used as a food with functional claims. In both tests, 30 healthy volunteers were divided into two groups: an active group that ingested heat-killed B. longum CLA8013 and a placebo group. In the long-term intake safety study, participants in the active group ingested 25 billion cells/day for 12 weeks. In the excessive intake safety study, participants in the active group ingested 125 billion cells/day for 4 weeks. Physical, hematological, biochemical, and urine examinations were conducted, and adverse events were evaluated in both studies. The studies revealed no abnormalities in any of the safety tests. In conclusion, no safety-related issues were identified with long-term or excessive intake of heat-killed B. longum CLA8013.展开更多
The osmium tetroxide catalyzed asymmetric dihydroxylation of the(22E)- steroidal sidechain is described and an unexpected 8:1 ratio of(22R,23R)and (22S,23S)was obtained from the(22E,24S)-24-ethyl substituted sidechain.
Background: Blood pH and bicarbonate estimations are basal acid-base laboratory tests that are performed in infants with infantile hypertrophic pyloric stenosis (IHPS). This study aimed to define the clinical value of...Background: Blood pH and bicarbonate estimations are basal acid-base laboratory tests that are performed in infants with infantile hypertrophic pyloric stenosis (IHPS). This study aimed to define the clinical value of pCO<sub>2</sub> and BE in infants suspected to have IHPS. Methods: We collected data from 80 “surgical” infants younger than 100 days with prolonged nonbilious vomiting who were suspected to have IHPS. In 65 infants, pyloric stenosis was confirmed, and 15 infants had nonsurgical conditions. Capillary blood was tested for standard acid-base parameters and lactate. The two groups were compared. Results: Eighty-eight percent of the IHPS infants had elevated standard bicarbonate levels (st bicarb) > 25 mmol/l, and 60% had BE > 3.5 mmol/l;12% of the infants showed hypercapnia (pCO<sub>2</sub> ≥ 50 mmHg) associated with markedly increased standard bicarbonate and BE. Infants with nonsurgical vomiting were older at admission (p = 0.002), had a longer duration of vomiting (p < 0.001), were older (p = 0.002) and weighted more at admission (p = 0.004), had lower pCO<sub>2</sub> (p = 0.021), lower st bicarb (p < 0.001) and lower BE (p = 0.001). In addition, nonsurgical infants showed a trend to anemia (p = 0.002). Conclusions: In infants with IHPS/nonbilious vomiting, acid-base analysis (ABA) is equivocal or inconclusive. These findings may be misleading and could result in a false clinical decision. Nonsurgical vomiting is associated with a lower degree of alkalosis, normocapnia to slight hypercapnia and a base deficit. However, even infants with IHPS may present with a negative BE. In infants with IHPS and severe alkalosis, hypercapnia carries a risk for respiratory depression. Monitoring the infant’s respiration allows for the early detection of respiratory deterioration.展开更多
Although,dietary proteins play a crucial role in poultry profit maximization,through the sustenance of birds`welfare,growth and development,yet metabolic excesses from crude protein(CP)degradation is detrimental to br...Although,dietary proteins play a crucial role in poultry profit maximization,through the sustenance of birds`welfare,growth and development,yet metabolic excesses from crude protein(CP)degradation is detrimental to broiler chickens(BC)affected by heat stress.This study evaluated the effect of dietary protein levels on blood profile of heat-stressed BC at starter phase(SP)and finisher phase(FP).Arbor Acre BC(n=288)were randomly allotted to four dietary treatments(T1-23%CP;T2-21%CP;T3-19%CP;and T4-17%CP)with six replicate groups in a completely randomized design.Data were subjected to descriptive analysis,analysis of variance(p=0.05)and correlation statistics.Protein intake(PI)was not significantly affected by varying CP in diets at SP,but not at FP,where PI significantly increased with increasing dietary CP.PER had a negative correlation with PCV(r=-0.89,p<0.01),Hb(r=-0.88,p<0.01),RBC(r=-0.93,p<0.01)and PI(r=-0.78,p<0.01).Metabolic excesses including heat dissipation from dietary proteins influenced PCV,Hb,platelets and glucose of heat-stressed broilers.展开更多
Dynamic tensile failure is a common phenomenon in deep rock practices,and thus accurately evaluating the dynamic tensile responses of rocks under triaxial pressures is of great significance.The Brazilian disc(BD)test ...Dynamic tensile failure is a common phenomenon in deep rock practices,and thus accurately evaluating the dynamic tensile responses of rocks under triaxial pressures is of great significance.The Brazilian disc(BD)test is the suggested method by the International Society for Rock Mechanics and Rock Engineering(ISRM)for measuring both the static and dynamic tensile strengths of rock-like materials.However,due to the overload phenomenon and the complex preloading conditions,the dynamic tensile strengths of rocks measured by the BD tests tend to be overestimated.To address this issue,the dynamic BD tensile strength(BTS)of Fangshan marble(FM)under different preloading conditions were measured through a triaxial split Hopkinson pressure bar(SHPB).The fracture onset in BD specimen was captured through a strain gage around the disc center.The discrepancy between the traditional tensile strength(TTS,determined by the peak load P_(f) of the BD specimen)and the nominal tensile strength(NTS,obtained from the load P_(i) when the diametral fracture commences in the tested BD specimen)was applied to quantitatively evaluating the overload phenomenon.The Griffith criterion was used to rectify the calculation of the tensile stress at the disc center under triaxial stress states.The results demonstrate that the overload ratio(s)increases with the loading rate(σ)and decreases with the hydrostatic pressure(σ_(s)).The TTS corrected by the Griffith criterion is independent of theσ_(s)due to the overload phenomenon,while the NTS corrected by the Griffith criterion is sensitive to both the andσ.Therefore,it is essential to modify the tensile stress in dynamic confined BD tests using both the overload correction and the Griffith criterion rectification to obtain the accurate dynamic BTS of rocks.展开更多
An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including...An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including transfusion of blood products and clotting factors,were administered to reverse fatal disseminated intravascular coagulation and acute hemolysis.The glucocorticoid dose was tapered slowly,and sirolimus was added to treat the hemangiomas.The patient subsequently underwent interventional therapy.After 6 months of medical and interventional therapy,the patient was doing well with a normal platelet count,the tumor volume was markedly reduced,and the primary cutaneous lesion became pale pink.Currently,the patient remains on sirolimus,and no recurrence of thrombocytopenia or further growth of the mass was observed after six months of follow-up.展开更多
Thermal alkaline hydrolysis is a common pretreatment method for the utilization of excess activated sludge(EAS).Owing to strict environment laws and need for better energy utilization,new methods were developed in thi...Thermal alkaline hydrolysis is a common pretreatment method for the utilization of excess activated sludge(EAS).Owing to strict environment laws and need for better energy utilization,new methods were developed in this study to improve the efficiency of pretreatment method.Direct thermal hydrolysis(TH),pasteurized thermal hydrolysis(PTH),and alkaline pasteurized thermal hydrolysis(PTH+CaO and PTH+NaOH)methods were used to treat EAS.Each method was compared and analyzed in terms of dissolution in ammonium nitrogen(NH_(4)^(+)-N)and soluble COD(SCOD)in EAS.Furthermore,the removal of tetracycline resistance genes(TRGs)and class 1 transposon gene intI1 from EAS was investigated.The NH_(4)^(+)-N and SCOD concentrations in EAS treated by PTH were 1.24 and 2.58 times higher than those of TH.However,the removal efficiency of total TRGs and intI1 between the groups was comparable.The SCOD concentration of the PTH+NaOH group was 4.37 times higher than that of the PTH group,and the removal efficiency of total TRGs was increased by 9.52%compared with that by PTH.The NH_(4)^(+)-N and SCOD concentrations of the PTH+CaO group could reach 85.04%and 92.14%of the PTH+NaOH group,but the removal efficiency of total TRGs by PTH+CaO was 19.78%lower than that by PTH+NaOH.Thus,to reduce the financial cost in actual operation,lime(CaO)can be used instead of a strong alkali(NaOH),and pasteurized steam at 70℃ instead of conventional high-temperature heating to treat EAS.This study provides a reference for the development of alkaline hydrolysis under moderate temperatures along with the removal of TRGs in EAS.展开更多
BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudde...BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.展开更多
Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in ...Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in the method were from the Physical Examination Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the 60 rheumatoid arthritis patients included were from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The disease activity score of patients with rheumatoid arthritis was evaluated using VAS score and DAS28 score,joint symptoms and spleen deficiency syndrome score were evaluated using graded quantification method,immune inflammation indicators were detected using relevant instruments,inflammatory cytokines were detected using ELISA method,macrophage markers were detected using FCM method,and pathway gene expression was detected using RT-qPCR;Evaluate the predictive effect of circ-CBLB and miR-486-5p on disease activity in rheumatoid arthritis using ROC curves.Results:(1)miR-486-5p,CD14^(+)CD86^(+),ESR,CRP,RF,Anti CCP Ab,IL-6,TNF in patients with rheumatoid arthritis-αThe levels of circ-CBLB,CD14^(+)CD163^(+),IL-4,and IL-10 were significantly higher than those of healthy individuals;(2)The expression level of circ-CBLB in patients with rheumatoid arthritis is positively correlated with CD14^(+)CD163^(+),and negatively correlated with miR-486-5p and CD14^(+)CD86^(+);The expression level of miR-486-5p is negatively correlated with CD14^(+)CD163^(+)and positively correlated with CD14^(+)CD86^(+);There is a negative correlation between CD14^(+)CD86^(+)and CD14^(+)CD163^(+);ESR is negatively correlated with circ-CBLB,and positively correlated with miR-486-5p,CD14^(+)CD86^(+),CRP;CRP is negatively correlated with circ-CBLB,CD14^(+)CD163^(+),and positively correlated with CD14^(+)CD86^(+),ESR;(3)The expression level of circ-CBLB in patients with rheumatoid arthritis is negatively correlated with joint tenderness,morning stiffness,lack of qi and lazy speech,and postprandial abdominal distension score;The expression level of miR-486-5p is positively correlated with the scores of joint tenderness and decreased appetite.(4)The ROC curve shows that in terms of circ-CBLB,ESR,CRP,VAS,and DAS28 AUC are 0.662(P=0.032),0.658(P=0.035),0.516(P=0.830),and 0.791(P=0.000),respectively.In terms of miR-486-5p,ESR,CRP,VAS,and DAS28 AUC were 0.566(P=0.385),0.511(P=0.883),0.592(P=0.223),and 0.727(P=0.003),respectively.Conclusion:The abnormal expression of circ CBLB and miR-486-5p in peripheral blood mononuclear cell of patients with rheumatoid arthritis of spleen deficiency and dampness excess type is related to inflammatory polarization markers,immune inflammation,disease activity,joint symptoms and spleen deficiency syndrome of rheumatoid arthritis,and the low expression of circ CBLB and high expression of miR-486-5p have certain predictive value for disease activity of rheumatoid arthritis.展开更多
基金the support from the National Natural Science Foundation of China(Grant Nos.12374202 and 12004001)Anhui Projects(Grant Nos.2022AH020009,S020218016,and Z010118169)Hefei City(Grant No.Z020132009)。
文摘Glasses are known to possess low-frequency excess modes beyond the Debye prediction.For decades,it has been assumed that evolution of low-frequency density of excess modes D(ω) with frequency ω follows a power-law scaling:D(ω)~ω~γ.However,it remains debated on the value of γ at low frequencies below the first phonon-like mode in finitesize glasses.Early simulation studies reported γ=4 at low frequencies in two-(2D),three-(3D),and four-dimensional(4D)glasses,whereas recent observations in 2D and 3D glasses suggested γ=3.5 in a lower-frequency regime.It is uncertain whether the low-frequency scaling of D(ω)~ω^(3.5) could be generalized to 4D glasses.Here,we conduct numerical simulation studies of excess modes at frequencies below the first phonon-like mode in 4D model glasses.It is found that the system size dependence of D(ω) below the first phonon-like mode varies with spatial dimensions:D(ω) increases in2D glasses but decreases in 3D and 4D glasses as the system size increases.Furthermore,we demonstrate that the ω^(3.5)scaling,rather than the ω~4 scaling,works in the lowest-frequency regime accessed in 4D glasses,regardless of interaction potentials and system sizes examined.Therefore,our findings in 4D glasses,combined with previous results in 2D and 3D glasses,suggest a common low-frequency scaling of D(ω)~ ω^3.5) below the first phonon-like mode across different spatial dimensions,which would inspire further theoretical studies.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.
文摘The Fourier series of the 2π-periodic functions tg(x2)and 1sin(x)and some of their relatives (first of their integrals) are investigated and illustrated with respect to their convergence. These functions are Generalized functions and the convergence is weak convergence in the sense of the convergence of continuous linear functionals defining them. The figures show that the approximations of the Fourier series possess oscillations around the function which they represent in a broad band embedding them. This is some analogue to the Gibbs phenomenon. A modification of Fourier series by expansion in powers cosn(x)for the symmetric part of functions and sin(x)cosn−1(x)for the antisymmetric part (analogous to Taylor series) is discussed and illustrated by examples. The Fourier series and their convergence behavior are illustrated also for some 2π-periodic delta-function-like sequences connected with the Poisson theorem showing non-vanishing oscillations around the singularities similar to the Gibbs phenomenon in the neighborhood of discontinuities of functions. .
文摘Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.
基金the National Key Research and Development Program of China (2022YFB3803300)National Natural Science Foundation of China (62274062, 52173161, 62104070, and 61974150)+2 种基金Shanghai Science and Technology Innovation Action Plan (22dz1205200)the open research fund of Songshan Lake Materials Laboratory (2021SLABFK02)the National Natural Science Foundation of China (21961160720)
文摘Perovskite solar cells(PSCs)have attracted much attention due to their low cost,high efficiency and easy processing.Recently,You et al.achieved a record efficiency of 26.1%(certified 25.6%)in PSCs with excellent stability[1].Excess PbI_(2) in perovskite films was converted into inactive(PbI_(2))2RbCl to avoid its detrimental effect to device stability,while maintaining its positive effect to device efficiency.
文摘BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.
文摘In discussing the policy effects of environmental regulation,we should focus not only on whether environmental regulation helps improve the environmental and economic performance of firms,but also on how such improvement is materialized,i.e.whether the obsolete mode of production is reversed.After matching the database of China’s industrial enterprises with that of pollution emissions from these industrial enterprises,this paper identifies the asymmetric scope of clean production standards to test the effect of environmental regulation on the total factor productivity(TFP)of the industrial enterprises.Our empirical research finds that the implementation of clean production standards may induce TFP improvement.However,such improvement only occurs for polluters who cannot or who barely meet clean production standards and does little to improve the production standards of polluters with low pollution emission,reflecting the yardstick phenomenon of the asymmetric environmental regulation policy effect:While polluters are forced to improve,clean enterprises that pollute less are more likely to take no action.Further research finds that such TFP improvement is materialized primarily by means of overall firm optimization;the compensation effect is insignificant and does not reverse the backward mode of production.Polluters cope with the implementation of clean production standards by purchasing more equipment and expanding capacity,which adds to the tension between the expansion of capacity and the abatement of pollution emission.
文摘Heat-killed Bifidobacterium longum CLA8013 has been demonstrated to improve the frequency of defecation, straining, and pain during defecation in human placebo-controlled, double-blind, parallel-group studies. We conducted a randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety of both long-term and excessive intakes of heat-killed B. longum CLA8013, when used as a food with functional claims. In both tests, 30 healthy volunteers were divided into two groups: an active group that ingested heat-killed B. longum CLA8013 and a placebo group. In the long-term intake safety study, participants in the active group ingested 25 billion cells/day for 12 weeks. In the excessive intake safety study, participants in the active group ingested 125 billion cells/day for 4 weeks. Physical, hematological, biochemical, and urine examinations were conducted, and adverse events were evaluated in both studies. The studies revealed no abnormalities in any of the safety tests. In conclusion, no safety-related issues were identified with long-term or excessive intake of heat-killed B. longum CLA8013.
文摘The osmium tetroxide catalyzed asymmetric dihydroxylation of the(22E)- steroidal sidechain is described and an unexpected 8:1 ratio of(22R,23R)and (22S,23S)was obtained from the(22E,24S)-24-ethyl substituted sidechain.
文摘Background: Blood pH and bicarbonate estimations are basal acid-base laboratory tests that are performed in infants with infantile hypertrophic pyloric stenosis (IHPS). This study aimed to define the clinical value of pCO<sub>2</sub> and BE in infants suspected to have IHPS. Methods: We collected data from 80 “surgical” infants younger than 100 days with prolonged nonbilious vomiting who were suspected to have IHPS. In 65 infants, pyloric stenosis was confirmed, and 15 infants had nonsurgical conditions. Capillary blood was tested for standard acid-base parameters and lactate. The two groups were compared. Results: Eighty-eight percent of the IHPS infants had elevated standard bicarbonate levels (st bicarb) > 25 mmol/l, and 60% had BE > 3.5 mmol/l;12% of the infants showed hypercapnia (pCO<sub>2</sub> ≥ 50 mmHg) associated with markedly increased standard bicarbonate and BE. Infants with nonsurgical vomiting were older at admission (p = 0.002), had a longer duration of vomiting (p < 0.001), were older (p = 0.002) and weighted more at admission (p = 0.004), had lower pCO<sub>2</sub> (p = 0.021), lower st bicarb (p < 0.001) and lower BE (p = 0.001). In addition, nonsurgical infants showed a trend to anemia (p = 0.002). Conclusions: In infants with IHPS/nonbilious vomiting, acid-base analysis (ABA) is equivocal or inconclusive. These findings may be misleading and could result in a false clinical decision. Nonsurgical vomiting is associated with a lower degree of alkalosis, normocapnia to slight hypercapnia and a base deficit. However, even infants with IHPS may present with a negative BE. In infants with IHPS and severe alkalosis, hypercapnia carries a risk for respiratory depression. Monitoring the infant’s respiration allows for the early detection of respiratory deterioration.
文摘Although,dietary proteins play a crucial role in poultry profit maximization,through the sustenance of birds`welfare,growth and development,yet metabolic excesses from crude protein(CP)degradation is detrimental to broiler chickens(BC)affected by heat stress.This study evaluated the effect of dietary protein levels on blood profile of heat-stressed BC at starter phase(SP)and finisher phase(FP).Arbor Acre BC(n=288)were randomly allotted to four dietary treatments(T1-23%CP;T2-21%CP;T3-19%CP;and T4-17%CP)with six replicate groups in a completely randomized design.Data were subjected to descriptive analysis,analysis of variance(p=0.05)and correlation statistics.Protein intake(PI)was not significantly affected by varying CP in diets at SP,but not at FP,where PI significantly increased with increasing dietary CP.PER had a negative correlation with PCV(r=-0.89,p<0.01),Hb(r=-0.88,p<0.01),RBC(r=-0.93,p<0.01)and PI(r=-0.78,p<0.01).Metabolic excesses including heat dissipation from dietary proteins influenced PCV,Hb,platelets and glucose of heat-stressed broilers.
基金We acknowledge the funding support from the National Natural Science Foundation of China(Grant Nos.42141010,51879184 and 12172253).
文摘Dynamic tensile failure is a common phenomenon in deep rock practices,and thus accurately evaluating the dynamic tensile responses of rocks under triaxial pressures is of great significance.The Brazilian disc(BD)test is the suggested method by the International Society for Rock Mechanics and Rock Engineering(ISRM)for measuring both the static and dynamic tensile strengths of rock-like materials.However,due to the overload phenomenon and the complex preloading conditions,the dynamic tensile strengths of rocks measured by the BD tests tend to be overestimated.To address this issue,the dynamic BD tensile strength(BTS)of Fangshan marble(FM)under different preloading conditions were measured through a triaxial split Hopkinson pressure bar(SHPB).The fracture onset in BD specimen was captured through a strain gage around the disc center.The discrepancy between the traditional tensile strength(TTS,determined by the peak load P_(f) of the BD specimen)and the nominal tensile strength(NTS,obtained from the load P_(i) when the diametral fracture commences in the tested BD specimen)was applied to quantitatively evaluating the overload phenomenon.The Griffith criterion was used to rectify the calculation of the tensile stress at the disc center under triaxial stress states.The results demonstrate that the overload ratio(s)increases with the loading rate(σ)and decreases with the hydrostatic pressure(σ_(s)).The TTS corrected by the Griffith criterion is independent of theσ_(s)due to the overload phenomenon,while the NTS corrected by the Griffith criterion is sensitive to both the andσ.Therefore,it is essential to modify the tensile stress in dynamic confined BD tests using both the overload correction and the Griffith criterion rectification to obtain the accurate dynamic BTS of rocks.
文摘An infant with Kasabach-Merritt Phenomenon(KMP)presented with a giant subcutaneous mass in the right lower limb,severe hypofibrinogenemia,and thrombocytopenia.Glucocorticoids,along with supportive treatments including transfusion of blood products and clotting factors,were administered to reverse fatal disseminated intravascular coagulation and acute hemolysis.The glucocorticoid dose was tapered slowly,and sirolimus was added to treat the hemangiomas.The patient subsequently underwent interventional therapy.After 6 months of medical and interventional therapy,the patient was doing well with a normal platelet count,the tumor volume was markedly reduced,and the primary cutaneous lesion became pale pink.Currently,the patient remains on sirolimus,and no recurrence of thrombocytopenia or further growth of the mass was observed after six months of follow-up.
基金supported by the Key R&D Projects of the Sichuan Provincial Department of Science and Technology in 2022 (No.2022YFS0457)Innovation and Entrepreneurship Training Program for College Students (No.202210649050).
文摘Thermal alkaline hydrolysis is a common pretreatment method for the utilization of excess activated sludge(EAS).Owing to strict environment laws and need for better energy utilization,new methods were developed in this study to improve the efficiency of pretreatment method.Direct thermal hydrolysis(TH),pasteurized thermal hydrolysis(PTH),and alkaline pasteurized thermal hydrolysis(PTH+CaO and PTH+NaOH)methods were used to treat EAS.Each method was compared and analyzed in terms of dissolution in ammonium nitrogen(NH_(4)^(+)-N)and soluble COD(SCOD)in EAS.Furthermore,the removal of tetracycline resistance genes(TRGs)and class 1 transposon gene intI1 from EAS was investigated.The NH_(4)^(+)-N and SCOD concentrations in EAS treated by PTH were 1.24 and 2.58 times higher than those of TH.However,the removal efficiency of total TRGs and intI1 between the groups was comparable.The SCOD concentration of the PTH+NaOH group was 4.37 times higher than that of the PTH group,and the removal efficiency of total TRGs was increased by 9.52%compared with that by PTH.The NH_(4)^(+)-N and SCOD concentrations of the PTH+CaO group could reach 85.04%and 92.14%of the PTH+NaOH group,but the removal efficiency of total TRGs by PTH+CaO was 19.78%lower than that by PTH+NaOH.Thus,to reduce the financial cost in actual operation,lime(CaO)can be used instead of a strong alkali(NaOH),and pasteurized steam at 70℃ instead of conventional high-temperature heating to treat EAS.This study provides a reference for the development of alkaline hydrolysis under moderate temperatures along with the removal of TRGs in EAS.
文摘BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.
基金the Seventh Batch of Inheritance Project of Academic Experience of National Veteran TCM Experts of the National Administration of Traditional Chinese Medicine (GZYYRJH[2022]No. 76)National Natural Science Foundation General Project (No.81973655)+4 种基金National Natural Science Foundation General Project (No.82274501)Anhui Provincial Excellent Youth Talent Support Program for Universities (Anhui Education Secretary [2022]No. 11)Key Laboratory of Xin'an Medical Education Department (No.2020xayx04)Natural Science Research Project of Universities in Anhui Province (No.KJ2020A0397)Anhui NewEra Education Quality Engineering Project (No.2022xscx103)。
文摘Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in the method were from the Physical Examination Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the 60 rheumatoid arthritis patients included were from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The disease activity score of patients with rheumatoid arthritis was evaluated using VAS score and DAS28 score,joint symptoms and spleen deficiency syndrome score were evaluated using graded quantification method,immune inflammation indicators were detected using relevant instruments,inflammatory cytokines were detected using ELISA method,macrophage markers were detected using FCM method,and pathway gene expression was detected using RT-qPCR;Evaluate the predictive effect of circ-CBLB and miR-486-5p on disease activity in rheumatoid arthritis using ROC curves.Results:(1)miR-486-5p,CD14^(+)CD86^(+),ESR,CRP,RF,Anti CCP Ab,IL-6,TNF in patients with rheumatoid arthritis-αThe levels of circ-CBLB,CD14^(+)CD163^(+),IL-4,and IL-10 were significantly higher than those of healthy individuals;(2)The expression level of circ-CBLB in patients with rheumatoid arthritis is positively correlated with CD14^(+)CD163^(+),and negatively correlated with miR-486-5p and CD14^(+)CD86^(+);The expression level of miR-486-5p is negatively correlated with CD14^(+)CD163^(+)and positively correlated with CD14^(+)CD86^(+);There is a negative correlation between CD14^(+)CD86^(+)and CD14^(+)CD163^(+);ESR is negatively correlated with circ-CBLB,and positively correlated with miR-486-5p,CD14^(+)CD86^(+),CRP;CRP is negatively correlated with circ-CBLB,CD14^(+)CD163^(+),and positively correlated with CD14^(+)CD86^(+),ESR;(3)The expression level of circ-CBLB in patients with rheumatoid arthritis is negatively correlated with joint tenderness,morning stiffness,lack of qi and lazy speech,and postprandial abdominal distension score;The expression level of miR-486-5p is positively correlated with the scores of joint tenderness and decreased appetite.(4)The ROC curve shows that in terms of circ-CBLB,ESR,CRP,VAS,and DAS28 AUC are 0.662(P=0.032),0.658(P=0.035),0.516(P=0.830),and 0.791(P=0.000),respectively.In terms of miR-486-5p,ESR,CRP,VAS,and DAS28 AUC were 0.566(P=0.385),0.511(P=0.883),0.592(P=0.223),and 0.727(P=0.003),respectively.Conclusion:The abnormal expression of circ CBLB and miR-486-5p in peripheral blood mononuclear cell of patients with rheumatoid arthritis of spleen deficiency and dampness excess type is related to inflammatory polarization markers,immune inflammation,disease activity,joint symptoms and spleen deficiency syndrome of rheumatoid arthritis,and the low expression of circ CBLB and high expression of miR-486-5p have certain predictive value for disease activity of rheumatoid arthritis.