Oxidation Kinetics of Aluminum Powders in a Gas Fluidized Bed Reactor in the Potential Application of Surge Arresting Materials

In this technical paper, the oxidation mechanism and kinetics of aluminum powders are discussed in great details. The potential applications of spherical aluminum powders after oxidation to be part of the surging arresting materials are discussed. Theoretical calculations of oxidation of spherical aluminum powders in a typical gas fluidization bed are demonstrated. Computer software written by the author is used to carry out the basic calculations of important parameters of a gas fluidization bed at different temperatures. A mathematical model of the dynamic system in a gas fluidization bed is developed and the analytical solution is obtained. The mathematical model can be used to estimate aluminum oxide thickness at a defined temperature. The mathematical model created in this study is evaluated and confirmed consistently with the experimental results on a gas fluidization bed. Detail technical discussion of the oxidation mechanism of aluminum is carried out. The mathematical deviations of the mathematical modeling have demonstrated in great details. This mathematical model developed in this study and validated with experimental results can bring a great value for the quantitative analysis of a gas fluidization bed in general from a theoretical point of view. It can be applied for the oxidation not only for aluminum spherical powders, but also for other spherical metal powders. The mathematical model developed can further enhance the applications of gas fluidization technology. In addition to the development of mathematical modeling of a gas fluidization bed reactor, the formation of oxide film through diffusion on both planar and spherical aluminum surfaces is analyzed through a thorough mathematical deviation using diffusion theory and Laplace transformation. The dominant defects and their impact to oxidation of aluminum are also discussed in detail. The well-controlled oxidation film on spherical metal powders such as aluminum and other metal spherical powders can potentially become an important part of switch devices of surge arresting materials, in general.

The assessment of time dependent flow of Williamson fluid with radiative blood flow against a wedge

The present pagination reports both Brownian diffusion and thermophoresis aspects subject to magneto hydrodynamic Williamson fluid model.Assuming the flow is unsteady and blood is treated as Williamson fluid over a wedge with radiation.The governing equations are transformed into ordinary differential equations by using similarity variables.The analytical solutions of the transformed governing equations are obtained by using the RK 4th order method along with shooting technique solver.The effects of various physical parameters such as Hartmann number,local Weissenberg number,radiation parameter,unsteadiness parameter,Prandtl number,Lewis number,Brownian diffusion,thermophoresis,wedge angle parameter,moving wedge parameter,on velocity,temperature,concentration,skin friction,heat transfer rate and mass transfer rate have been discussed in detail.The velocity and temperature profile deprives for larger We and an opposite trend is observed for concentration.The radiation parameter is propositional to temperature and a counter behaviour is observed for Pr.

Characteristics of Patients with Decreased Cognitive Function Undergoing Treatment for Acute Exacerbation of Chronic Heart Failure—Basic Survey for Standardization of Nursing to Prevent Discontinuation of Treatment

The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.

Cardioprotective effects of glucagon-like peptide 1 receptor agonists in heart failure: Myth or truth?

Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes.However,while evidence about atherosclerosis consistently suggests a cardioprotective potential with class effect,controversies remain on its impact on heart failure.GLP1 receptor agonists appear to prevent hospitalization for new-onset heart failure and reduce symptoms in heart failure with preserved ejection fraction(as demonstrated by the recent STEP-HFpEF Trial).Still,GLP1 agonism has resulted in neutral or even harmful effects in patients with established heart failure with reduced ejection fraction(the LIVE trial).GLP1 receptor agonists benefit the cardiovascular system indirectly through their marked metabolic effects(improved weight management,glycemic control,blood pressure,systemic and tissue inflammation),while direct effects on the heart have been questioned.Nonetheless,weight loss alone achieved through GLP1 receptor agonists has failed in improving left ventricular functions.Tirzepatide is a dual agonist of GLP1 and glucose-dependent insulinotropic polypeptide,representing an innovative treatment option in diabetes with a major impact on weight loss and promising cardiovascular benefits.Whether this class of therapies is going to change the history of heart failure is an ongoing debate.

Effect of Interface Form on Creep Failure and Life of Dissimilar Metal Welds Involving Nickel-Based Weld Metal and Ferritic Base Metal

For dissimilar metal welds(DMWs)involving nickel-based weld metal(WM)and ferritic heat resistant steel base metal(BM)in power plants,there must be an interface between WM and BM,and this interface suffers mechanical and microstructure mismatches and is often the rupture location of premature failure.In this study,a new form of WM/BM interface form,namely double Y-type interface was designed for the DMWs.Creep behaviors and life of DMWs containing double Y-type interface and conventional I-type interface were compared by finite element analysis and creep tests,and creep failure mechanisms were investigated by stress-strain analysis and microstructure characterization.By applying double Y-type interface instead of conventional I-type interface,failure location of DMW could be shifted from the WM/ferritic heat-affected zone(HAZ)interface into the ferritic HAZ or even the ferritic BM,and the failure mode change improved the creep life of DMW.The interface premature failure of I-type interface DMW was related to the coupling effect of microstructure degradation,stress and strain concentrations,and oxide notch on the WM/HAZ interface.The creep failure of double Y-type interface DMW was the result of Type IV fracture due to the creep voids and micro-cracks on fine-grain boundaries in HAZ,which was a result of the matrix softening of HAZ and lack of precipitate pinning at fine-grain boundaries.The double Y-type interface form separated the stress and strain concentrations in DMW from the WM/HAZ interface,preventing the trigger effect of oxide notch on interface failure and inhibiting the interfacial microstructure cracking.It is a novel scheme to prolong creep life and enhance reliability of DMW,by means of optimizing the interface form,decoupling the damage factors from WM/HAZ interface,and then changing the failure mechanism and shifting the failure location.

Rapid, Non-Destructive, Textile Classification Using SIMCA on Diffuse Near-Infrared Reflectance Spectra

Soft independent modeling of class analogy (SIMCA) was successful in classifying a large library of 758 commercially available, non-blended samples of acetate, cotton, polyester, rayon, silk and wool 89% - 98% of the time at the 95% confidence level (p = 0.05 significance level). In the present study, cotton and silk had a 62% and 24% chance, respectively, of being classified with their own group and also with rayon. SIMCA correctly identified a counterfeit “silk” sample as polyester. When coupled with diffuse NIR reflectance spectroscopy and a large sample library, SIMCA shows considerable promise as a quick, non-destructive, multivariate method for fiber identification. A major advantage is simplicity. No sample pretreatment of any kind was required, and no adjust-ments were made for fiber origin, manufacturing process residues, topical finishes, weave pattern, or dye content. Increasing the sample library should make the models more robust and improve identification rates over those reported in this paper.

Energy analysis of rock plug thickness in karst tunnels based on non-associated flow rule and nonlinear failure criterion

The geological hazards, such as water inrush and mud outburst, are easily induced by the high water pressure caverns ahead of a karst tunnel face. Therefore, it is a pivotal issue to determine the reserved thickness of rock plug during the construction of tunnels. The limit analysis principle is employed to analyze the safe thickness from the point of energy dissipation, and the nonlinear and non-associated characteristics of geotechnical materials are both considered. On the basis of a plane failure pattern of rock plug, the expressions of detaching curve and rock plug thickness are derived. The effect of each parameter on the safe thickness of rock plug is discussed in detail, which interprets the corresponding failure scope of rock plug. The obtained results indicate that the thickness of rock plug is highly influenced by the nonlinear dilatancy coefficient and the nonlinear coefficient. The proposed method is validated by a comparison of the calculated results with those of the engineering project of the "526 karst cavern" of Yunwushan tunnel. This proposed method can provide reference basis for the design and excavation of karst tunnels in the future.

Implicit Shape Reconstruction of Unorganized Points Using PDE-Based Deformable 3D Manifolds

In this work we consider the problem of shape reconstruction from an unorganized data set which has many important applications in medical imaging, scientific computing, reverse engineering and geometric modelling. The reconstructed surface is obtained by continuously deforming an initial surface following the Partial Differential Equation (PDE)-based diffusion model derived by a minimal volume-like variational formulation. The evolution is driven both by the distance from the data set and by the curvature analytically computed by it. The distance function is computed by implicit local interpolants defined in terms of radial basis functions. Space discretization of the PDE model is obtained by finite co-volume schemes and semi-implicit approach is used in time/scale. The use of a level set method for the numerical computation of the surface reconstruction allows us to handle complex geometry and even changing topology,without the need of user-interaction. Numerical examples demonstrate the ability of the proposed method to produce high quality reconstructions. Moreover, we show the effectiveness of the new approach to solve hole filling problems and Boolean operations between different data sets.

Study on Sinking-Sliding Failure Mechanism of Perilous Rock at Wangxia in Three Gorges of the Yangtze River, China

The giant perilous rock at Wangxia (named Wangxia perilous rock) is representative in Three Gorges of the Yangtze River, China, has threatened badly the navigation of the Yangtze River channel for a long period. The giant perilous rock is composed of siliceous limestone and argillaceous limestone, and includes two elements marking by W1 and W2, respectively. The W1 is an isolated pillar while the W2 is in clintheriform. The linking segment of dominant fissure in the W2 is composed by moniliform solution funnels at its back, and the locked segment of the dominant fissure at the base of the W2 is composed by two parts. For the locked part of the dominant fissure of the W2, the upper segment shows the same lithology with the perilous rock and it can be simplified as an elastic medium, for the lower segment composed by argillaceous shale and mudstone can be simplified as a strain-softening medium. Introducing the water-softened function, the constitutive curves with two kinds of medium materials for the locked segment in the dominant fissure of the W2 have been proposed. Based on energy principle, the cusp catastrophe model for perilous rock rupture is built and formulas for the transient elastic and impulsive acceleration and the elastic-impulsive velocity of perilous rock catastrophe rupture have been established. By the calculation, the elastic-impulsive acceleration for the catastrophe rupture of the W2 is 531.4 m/s2, while the average elastic-impulsive velocity is 2.608 m/s. Further, it is deduced that the elastic-impulsive velocity at the base of the W2 is about 5.2 m/s. For the transient ruture of the W2, there is a greater speed difference between the top and the base of the W2, which impels the giant perilous rock to be retroverted sliding rupture, coinciding with the fact. Undoubtedly, studies in this paper must play an important role to analyze the catastrophe rupture mechanism of giant perilous rocks at both banks in Three Gorges of the Yangtze River, China.

Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality worldwide.Cardiac rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients.Physical activity,lifestyle,and psychological support are core components of a successful CR program.CR has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of participating.An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients.The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency.It is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR program.There are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or activity.In the present editorial,we present all the updated knowledge and recommendations in CR programs.

Establishing delivery route-dependent safety and efficacy of living biodrug mesenchymal stem cells in heart failure patients

BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.

荧光相关光谱单分子检测系统的研究

基于激光共焦构型,构建了一套高灵敏度和高稳定性的荧光相关光谱单分子检测系统。采用高数值孔径物镜使激光束高度聚焦,并用同一物镜收集样品的荧光,单光子计数器用于实时记录荧光信号。优化系统保持物镜焦点、针孔以及单光子计数器光敏区高度同轴。采用60×1.2(NA)的水浸物镜及直径为160μm的针孔得到的检测系统结构参数为ω0和z0分别为0.42μm和1.33μm,照射微区的体积为1.3fL。单个RhodamineGreen分子可获得13倍的信噪比。用该系统获得了小分子和生物大分子(DNA片段和蛋白质)的高质量荧光相关图谱,成功实现了单个分子的检测。

急性肾功能衰竭兔血小板聚集功能、PGI_2、TXA_2、ET的变化

目的:探讨实验性急性肾功能衰竭 (Acuterenalfailure, ARF)兔血小板聚集功能、PGI2、TXA2、内皮素(Endothelins,ET)的变化与心肌组织形态学变化的关系。方法:实验分为 2组。对照组 (8只 ):用生理盐水 10ml/ 行后肢肌肉内加压注射。ARF组(12只):用 50%甘油 10mg/kg后肢肌肉内加压注射。检测各组不同时相血小板聚集功能等指标。结果: 2h、24hARF组与对照组比较:ARF组血小板聚集性明显增高(P<0. 01),TXA2、ET明显升高(P<0. 01), 6 Keto PGF1a明显降低(P<0. 01)。心肌组织出现严重的缺血性损害,主要为:心肌细胞弥漫性变性、心肌纤维间质水肿、血管周围水肿等。结论: ARF时血小板聚集性改变以及血管活性物质和氧自由基增高可能是造成心肌组织缺血性损害的直接原因之一。

Advances in Research on Treatment of Heart Failure with Yangxinshi Tablet

The advances in the treatment of heart failure with Yangxinshi tablet are reviewed in this paper.Yangxinshi tablet has effects of nourishing myocardia,improving myocardial metabolism,reducing myocardial oxygen consumption,dilating coronary artery,improving cardiac blood supply,reducing blood viscosity and improving microcirculation,and it can improve the functions of heart and curative effect of heart failure.

Application of Optical Methods in Blood Studies upon Evaluation of Severity Rate of Diffuse Liver Pathology

Possible early diagnostic application of optical methods (dielectrophoresis, spectral and imaging ellipsometry, Fourier-transform infrared spectroscopy, Raman spectroscopy) in studies of red blood cells and serum of patients with diffuse liver disease with varying degrees of fibrosis has been evaluated. Application of combined optical methods was confirmed to significantly improve the performance of sensitivity, specificity, and accuracy index as well as to achieve the reliable results in diagnosis of both severe fibrosis and slight ulterior liver fibrosis. Identified diagnostic potential of optical methods can be effectively utilized in noninvasive screening evaluation of stages of diffuse liver disease of various geneses.

Restoring the Treg cell to Th17 cell ratio may alleviate HBV-related acute-on-chronic liver failure

AIM: To investigate the role of T helper 17 cells (Th17) and regulatory T cells (Treg) in hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).METHODS: We enrolled 79 patients with HBV infection into the study, 50 patients with HBV-related ACLF and 29 patients with chronic hepatitis B (CHB), from the First Affiliated Hospital of Medical College from January 2009 to June 2012. The ACLF patients were diagnosed according to the criteria recommended by The 19th Conference of the Asian Pacific Association for the Study of the Liver in 2009. Twenty healthy individuals with a similar gender and age structures to the two patient groups were also included as the normal controls (NC). Of the 50 ACLF patients, 28 were subsequently classified as non-survivors: 19 patients died from multiorgan failure, 3 underwent liver transplantation, and 6 discontinued therapy during follow-up because of financial reasons. The remaining 22 ACLF patients whose liver and anticoagulation function recovered to nearly normal levels within the next 6 mo were classified as survivors. The number of circulating Treg and Th17 cells was determined upon diagnosis and during the 8th week of follow-up through flow cytometry. RESULTS: The percentage of circulating Treg cells in the ACLF group was significantly higher than that in the CHB group (5.50% ± 1.15% vs 3.30% ± 1.13%, P < 0.01). The percentages of circulating Th17 cells in the ACLF and the CHB groups were significantly higher than that in the NC group (6.32% ± 2.22% vs 1.56% ± 0.44%, P < 0.01; 3.53% ± 1.65% vs 1.56% ± 0.44%, P < 0.01). No significant difference in Treg cell to Th17 cell ratio was observed between the ACLF group and the CHB group (0.98 ± 0.44 vs 1.12 ± 0.64, P = 0.991), whereas those in the two HBV infection groups were significantly lower than that in the NC group (1.85 ± 1.22; both P < 0.01). The percentage of Treg cells in the survivors during the 8th week of follow-up was significantly lower than that during peak ACLF severity [total bilirubin (TBIL) peak] (3.45% ± 0.97% vs 5.18% ± 1.02%, P < 0.01). The percentage of Th17 cells in survivors during the 8th week of follow-up was significantly lower than that during the peak TBIL (2.89% ±0.60% vs 5.24% ± 1.46%; P < 0.01). The Treg cell to Th17 cell ratio during the 8 th week of follow-up was significantly higher than that during the TBIL peak (1.22 ± 0.36 vs 1.10 ± 0.54; P < 0.05). CONCLUSION: Restoring the Treg cell to Th17 cell ratio during the follow-up phase of ACLF could maintain the immune system at a steady state, which favours good prognosis.

Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure

AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV) use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortality Ⅲ(PRIsM-Ⅲ) scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV) were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%) failed treatment and required MV.The majority of the patients(74%) had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P = 0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲ scores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P < 0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.

End-stage liver disease score and future liver remnant volume predict post-hepatectomy liver failure in hepatocellular carcinoma

BACKGROUND Hepatocellular carcinoma(HCC)is the world’s sixth most common malignant tumor and the third cause of cancer death.Although great progress has been made in hepatectomy,it is still associated with a certain degree of risk of posthepatectomy liver failure(PHLF),which extends the length of hospital stay and remains the leading cause of postoperative death.Studies have shown that assessment of hepatic functional reserve before hepatectomy is beneficial for reducing the incidence of PHLF.AIM To assess the value of model for end-stage liver disease(MELD)score combined with standardized future liver remnant(sFLR)volume in predicting PHLF in patients undergoing hepatectomy for HCC.METHODS This study was attended by 238 patients with HCC who underwent hepatectomy between January 2015 and January 2018.Discrimination of sFLR volume,MELD score,and sFLR/MELD ratio to predict PHLF was evaluated according to the area under the receiver operating characteristic curve.RESULTS The patients were divided into two groups according to whether PHLF occurred after hepatectomy.The incidence of PHLF was 8.4%in our research.The incidence of PHLF increased with the decrease in sFLR volume and the increase in MELD score.Both sFLR volume and MELD score were considered independent predictive factors for PHLF.Moreover,the cut-off value of the sFLR/MELD score to predict PHLF was 0.078(P<0.001).This suggests that an sFLR/MELD≥0.078 indicates a higher incidence of PHLF than an sFLR/MELD<0.078.CONCLUSION MELD combined with sFLR is a reliable and effective PHLF predictor,which is superior to MELD score or sFLR volume alone.

A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and HF.Methods A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group technique.The group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across China.Consensus was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent facilitator.Results A total of 150 responses from 21 provinces across China were recruited in the survey.Respondents were comprised of an even split(n=75,50%)between cardiologists and nephrologists.All 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

Seismic-induced surficial failure of cohesive slopes using three-dimensional limit analysis:A case study of the Wangjiayan landslide in Beichuan, China

A seismic-induced landslide is a common geological catastrophe that occurs in nature.The Wangjiayan landslide,which was triggered by the Wenchuan earthquake,is a typical case in point.The Wanjiayan landslide caused many casualties and resulted in enormous property loss.This study constructs a simple surficial failure model based on the upper bound approach of three-dimensional(3D)limit analysis to evaluate the slope stability of the Wangjiayan case,while a traditional two-dimensional(2D)analysis is also conducted as a reference for comparison with the results of the 3D analysis.A quasi-static calculation is used to study the effect of the earthquake in terms of horizontal ground acceleration,while a parametric study is conducted to evaluate the critical cohesion of slopes.Rather than employing a 3D analysis,using the 2D analysis yields an underestimation regarding the safety factor.In the Wangjiayan landslide,the difference in the factors of safety between the 3D and 2D analyses can reach 20%.The sliding surface morphology as determined by the 3D method is similar to actual morphology,and the parameters of both are also compared to analyze the reliability of the proposed 3D method.