Nomogram for overall survival in ampullary adenocarcinoma using the surveillance,epidemiology,and end results database and external validation

BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.

Research into the Application of Cooperative Learning to English Reading Teaching of Art Majors in Independent Colleges

This paper first stated some related theories of cooperative learning and English reading teaching.And then an applicationof cooperative learning in English reading teaching of art majors in independent college is implemented based on these literature re-views.The aim of the experiment is to explore the impact of the application of cooperative learning strategies.It mainly discussedthe following questions:(1)Can the group cooperative learning improve students'reading achievement?(2)What factors contributeto the success/failure of cooperative learning?(3)What are the favorite cooperative learning models in reading classes?The experi-ment proved that cooperative learning does not truly improve art students’reading achievement in independent college,but it real-ly has a positive role in promoting the students'learning interest,motivation and emotional attitude.The experiment also indicatesthat cooperative learning is still a valuable teaching strategy for applying,and GI,LT,TGT and other cooperative learning modelare welcomed by classmates.

“liberal arts”的源与流——古今之变中的审视

“古今之变”是审视liberal arts流变的中心线索。古典liberal arts是具有内在统一性并指向完满品格的整全性知识体系。欧洲三次文艺复兴对liberal arts的再造展现了其历史流变中的不变逻辑,即为特定时代的受教育者提供共同价值。德国古典大学赋予了liberal arts在古典意义上的完美形态,而新人文主义的自我塑造观念孕育了博雅教育的现代转向。科学革命终结了古典学术的内在统一性与道德理想,瓦解了古典liberal arts。美国现代大学则借助古典资源,经由三次改革浪潮重建了liberal arts。然而,古典教育凝聚文明精华的共同价值、塑造意义与学术整合力量,同现代科学的智识自由、价值分殊与学科分化特性相冲突,这是古今之变为现代大学再造liberal arts所深植的困境,liberal arts只能在钟摆的两端之间不断权衡。

Current Controversies and the State of the Art in Endovascular Treatment of Vascular Malformations

Vascular anomalies constitute some of the most difficult diagnostic and therapeutic enigmas that can be encountered in the practice of medicine. The clinical presentations are extremely protean and can range from an asymptomatic birthmark to fulminant。

医护-社会组织一体化模式对HIV/AIDS患者ART及自我管理能力的影响

探究接受高效抗反转录病毒治疗确诊HIV/AIDS患者接受医护-社会组织一体化模式干预价值。方法 从2022年1月至2022年12月南昌市某定点医院接受抗病毒治疗及随访管理的新确诊HIV/AIDS患者100例,50例接受传统医护合作模式对照组、50例接受医护-社会组织一体化模式观察组,两组各项临床指标差异进行分析对比(从HIV抗体初筛阳性到启动ART治疗时间、抗病毒治疗一年后HIV病毒载量的指标及病毒抑制率、抗病毒治疗一年后自我管理能力)。结果 干预后与对照组比较,观察组HIV抗体初筛阳性到启动ART治疗时间显著偏低,HIV病毒载量指标水平显著偏低,病毒抑制率显著偏高,一年后自我管理能力评分显著偏高,用药依从性显著偏高(P<0.05)。结论 接受抗病毒治疗及随访管理的确诊HIV/AIDS患者接受医护-社会组织一体化模式干预后,可显著提高患者自我管理能力。此外,还能保障高病毒抑制率,缩短患者治疗时间,提升患者用药依从性。

Finite element analysis of the end cutting process for U-section parts with high-strength steel

This paper presents a constitutive framework for finite element analysis of the truck beam end cutting process.For this purpose,a finite strain anisotropic elasto-plastic model,which takes nonlinear kinematic and isotropic hardening into account,is presented.Three factors are investigated to determine the effect on cutting quality:radius of cutting tools,strength of materials and relative clearance in cutting.The recommendations made herein are based on the simulation results.

Strain concentration caused by the closed end contributes to cartridge case failure at the bottom

Ruptures at the bottom of cartridges are a common cause of failure of ammunitions,which directly threatens the safety of weapons and shooters.Based on plastic tube theory,this study analyses the radial and axial deformation of a cartridge,considering the radial constraint of the closed end at the bottom of the cartridge.Owing to the influence of the closed end,the bottom of a cartridge does not establish complete contact with the chamber.Owing to strain concentration in the non-contact area,this area is more amenable to the occurrence of cartridge rupture.This theory predicts the location of the fracture more accurately than the traditional theory.The maximum axial deformation of a cartridge comprises bending and friction deformation.The maximum strain at the bottom of the cartridge increased by 135%owing to the introduction of bending strain caused by the closed end.The strain distribution of a cartridge was measured using digital image correlation technology,and the measured result was consistent with the predicted results of the bending deformation theory and rupture case.The effects of wall thickness,radial clearance,friction coefficient,and axial clearance on the axial deformation of the cylinder were studied.Increasing the wall thickness and reducing radial clearance were found to reduce bending deformation;furthermore,lubrication and reduction in axial clearance reduce frictional deformation,which in turn reduce cartridge rupture.

Efficient and Stable Optimization of Multi‑pass End Milling Using a Cloud Drop‑Enabled Particle Swarm Optimization Algorithm

Optimization of machining parameters is of great importance for multi-pass end milling because machining parameters adversely or positively affect the time and quality of production.This paper develops a second-order fulldiscretization method(2ndFDM)-based 3-D stability prediction model for simultaneous optimization of spindle speed,axial cutting depth and radial cutting depth.The optimal machining parameters in each pass are obtained to achieve the minimum production time comprehensive considering constraints of 3-D stability,machine tool performance,tool life and machining requirements.A cloud drop-enabled particle swarm optimization(CDPSO)algorithm is proposed to solve the developed machining parameter optimization,and 13 benchmark problems are used to evaluate CDPSO algorithm.Numerical results show that CDPSO algorithm has a certain advantage in computational cost as well as comparable search quality and robustness.A demonstrative example is provided.

Correlation between soluble receptor for advanced glycation end products levels and coronary artery disease in postmenopausal nondiabetic women

BACKGROUND The established cardiovascular risk factors cannot explain the overall risk of coronary artery disease(CAD),especially in women.Therefore,there is a growing need for the assessment of novel biomarkers to identify women at risk.The receptor for advanced glycation end products(RAGE)and its interaction with the advanced glycation end product(AGE)ligand have been associated with atherogenesis.The soluble fraction of RAGE(sRAGE)antagonizes RAGE signaling and exerts an antiatherogenic effect.AIM The study aim was to explore the association between plasma levels of sRAGE and CAD in nondiabetic postmenopausal women.METHODS This case-control study included 110 nondiabetic postmenopausal women who were enrolled in two groups.Group I included 55 angiographically proven CAD subjects with>50%stenosis in at least one of the major coronary arteries and Group II included 55 healthy control women who did not have CAD or had<50%stenosis of the coronary arteries.Stenosis was confirmed by invasive angiography.Plasma sRAGE was determined by an enzyme-linked immunosorbent assay.RESULTS We observed significantly lower plasma sRAGE concentrations in subjects with CAD vs healthy controls(P<0.05).Univariate and multivariate logistic regression analysis also revealed a significant correlation between plasma sRAGE levels and CAD(P=0.01).Multivariate odds ratios for CAD revealed that subjects with sRAGE concentrations below 225 pg/mL(lowest quartile)had a 6-fold increase in CAD prevalence independent of other risk factors.CONCLUSION Our findings indicated that low sRAGE levels were independently associated with CAD in nondiabetic postmenopausal women.Risk assessment of CAD in postmenopausal women can be improved by including sRAGE along with other risk factors.

An Interpretation of Danto’s the End-of-Art Thesis from the Perspective of Gadamerian Hermeneutics

Ontology of art,philosophy of art history,and aesthetics make up Danto’s integrated philosophy of art.The end-of-art thesis is the essence of Danto’s philosophy of art history.As an analytical philosopher,Danto’s philosophy resembles Hans-Georg Gadamer’s philosophical hermeneutics in the viewpoints concerning art and history in some ways but differs in others.Danto’s concepts of history show different tendencies in analytical philosophy of history and philosophy of art history.On the one hand,his philosophy of history conforms to Gadamer’s history of effect for the denial of the objectivity and certainty of historical truth.On the other hand,his philosophy of art history fundamentally differs from Gadamer’s relativism by asserting“the end of art”therefore generating a Hegelian law in art history.By using the strategy of“historical narrative”in his philosophy of art history,which is also in accordance with Gadamerian tradition,Danto aims to reconcile his self-contradictory historical views and to justify his philosophical position both as an“essentialist”and a“historicist”.

End-to-end Delay Analysis for Mixed-criticality WirelessHART Networks

WirelessHART, as a robust and reliable wireless protocol, has been widely-used in industrial wireless sensoractuator networks. Its real-time performance has been extensively studied, but limited to the single criticality case. Many advanced applications have mixed-criticality communications, where different data flows come with different levels of importance or criticality. Hence, in this paper, we study the real-time mixedcriticality communication using WirelessHART protocol, and propose an end-to-end delay analysis approach based on fixed priority scheduling. To the best of our knowledge, this is the first work that introduces the concept of mixed-criticality into wireless sensor-actuator networks. Evaluation results show the effectiveness and efficacy of our approach. © 2014 Chinese Association of Automation.

D-dimer level and long-term outcome in patients with end-stage heart failure secondary to idiopathic dilated cardiomyopathy

Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognostic significance in patients with compatible or acute decompensated HF. However, the impact of D-dimer on the outcome in patients with end-stage HF remains unclear. Methods A total of 244 consecutive patients with end-stage HF due to idiopathic dilated cardiomyopathy (DCM) were prospectively enrolled from February 2011 to September 2014. D-dimer levels were measured and its prognostic value was assessed. Primary endpoint was all-cause mortality during the follow-up period. Secondary endpoints were stroke, bleeding, occurrence of sustained ventricular tachycardia or ventricular fibrillation, and major adverse cardiovascular events (MACE). Results D-dimer was significantly elevated in the non-survivors (median: 0.8 vs. 1.1 mg/L, P < 0.001). Traditional markers including B-type natriuretic peptide, troponin I, left ventricular ejection fraction, and left ventricular end-diastolic dimension provided limited prognostic value;but the addition of D-dimer refined the risk stratification. The optimal cut-off value of D-dimer to predict all-cause mortality was 0.84 mg/L by receiver operator characteristic analysis. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (HR = 2.315, 95% CI: 1.570–3.414, P < 0.001) and MACE (HR = 1.256, 95% CI: 1.058–1.490, P = 0.009), and the predictive value was independent of age, sex, atrial fibrillation and anticoagulation status. Conclusions Elevated D-dimer level was independently associated with poor long-term outcome in patients with end-stage HF secondary to idiopathic DCM, and the predictive value was superior to that of traditional prognostic markers.

Giorgio Vasari’s Fine Arts From the Vite of 1550:The Splendor of Creativity and Design

Giorgio Vasari’s conception of artistic creativity is related to his theory of painting. He proposes two alternatives in a painter’s development or achievement of artistic creativity: imitation (imitazione) and invention (invenzione).Imitation is the copying of art as a method of learning, whereas invention is independent of imitation and constitutes the means for conceiving artistic ideas. Imitation serves to guide and teach the artist in composing and creating perfection. Vasari maintains that artists must study antiquity and the masters, so that they may learn how others acquired the experience of imitating nature. For Vasari, imitation draws upon three different sources: the first two are copying from nature (copia dal vero) and the third one is selecting from one’s work (imitare se stessi). He emphasizes that copying from nature is important for the artist so that he may learn to create forms that are alive as visualized in the Fine Arts.

基于ART的集装箱运输防损策略优化探究

本论文结合人工智能运输机器人在港口应用的案例,从问题现象入手,分析急停可能导致的损失,通过对ART急停原因分析,制定出急停改缓停的解决方案,结果显示缓停策略大大地降低了ART急停概率,可为其他自动化集装箱码头水平运输作业或使用自动化车辆的工程项目提供借鉴。

Analysis of Cutting Force by End Milling Using Artificial ntelligence

The cutting forces during end milling process by using Genetic Algorithm are investigated in this paper. However, automated CNC （computer numerical control） programming by milling machine is intended to use for special required conditions of programming of tool path length, and analysis of cutting force and optimization of main parameters are presented. Some effective simplification of automated programming is done for cutting force. The cutting force is modelled and analyzed into mathematical simulations in order to optimize the main cutting parameters, also in this case tool path length, it is get as free trajectory. Optimization is carried out by using the Matlab/Genetic Algorithm method that excessively reduce the time and to optimize the main cutting parameters of machining. The number of experiments, measurements and results of cutting force （F~）, are presented in 3D as well as in tables. In order to verify the accuracy of the 3 D simulation with optimization method, the results are compared in experimental and theoretical way. In other word, these results indicate directly that the optimized parameters are capable of machining the workpiece. Achieved results that are presented in this paper may in general help the new researcher as well as manufacturing industries of metal cutting.

Analysis on the development trend of environmental art design model from the perspective of cultural heritage and classical reconstruction

Environmental art design originated in the middle of the eighteenth Century, it affects people＇ s life and art. In this paper, the basic concept of environmental art design is discussed, and the content and the important position of environmental art design are described in detail. Environmental art is a branch of design art, which meets the aesthetic needs of people＇ s spiritual field and is an indispensable part of human beings. Environmental art design is closely linked with people＇ s life and social development and promotes the development of social civilization, which is of great significance to the progress of social civilization.

Art of Nourishing Life According to the Kidney Meridian in Zhenjiu Dacheng(The Great Compendium of Acupuncture and Moxibustion)

“Daoyin Benjing”(Art of Nourishing Life)discusses the kidney meridian in depth.It is a dense and heterogeneous text that is heavily influenced by Daoism.The text proposes rules for the maintenance of life using language that is often cryptic and under-standable only to the initiated.This language is closely interwoven with the classical terms of traditional Chinese medicine.The kidney is the home of vital energy,which is a type of sexual energy and the root of life.Engagement in moderate sexual activity nourishes life and leads to a long life.This is the goal of every Daoist follower and the goal of every doctor.

Research on the Developmental Trend of Modern Film Art under Perspectives of Scene Color and Aesthetic

In this paper, we conduct research on the developmental trend of modern fi lm art under perspectives of scene color and aesthetic.Modern movie space have already walked out of the studio, camera to record the real world, more is the fl eeting moments. And constructionspace scene as one of the most straightforward language, fi lm is often shows these bright spots mean to force. Generally speaking, the scene isfully able to meet the need of fi lm narrative, in some music in the movie was also involved in promoting the development of the plot. Music is theart of can directly evokes the emotional reaction, fi lm music in the fi lm’s narrative should properly appear in the process, in order to show thecharacters emotions and feelings. This paper starts from analyzing the general features of the trend of modern fi lm art under perspectives of scenecolor and aesthetic that could serve as the basis of the further research that will be meaningful.

High glucose reduces Nrf2-dependent cRAGE release and enhances inflammasome-dependent IL-1βproduction in monocytes:the modulatory effects of EGCG

Soluble receptor for advanced glycation end products(sRAGE)acts as a decoy sequestering of RAGE ligands,thus preventing the activation of the ligand-RAGE axis linking human diseases.However,the molecular mechanisms underlying sRAGE remain unclear.In this study,THP-1 monocytes were cultured in normal glucose(NG,5.5 mmol/L)and high glucose(HG,15 mmol/L)to investigate the effects of diabetesrelevant glucose concentrations on sRAGE and interleukin-1β(IL-1β)secretion.The modulatory effects of epigallocatechin gallate(EGCG)in response to HG challenge were also evaluated.HG enhanced intracellular reactive oxygen species(ROS)generation and RAGE expression.The secretion of sRAGE,including esRAGE and cRAGE,was reduced under HG conditions,together with the downregulation of a disintegrin and metallopeptidase 10(ADAM10)and nuclear factor erythroid 2-related factor 2(Nrf2)nuclear translocation.Mechanistically,the HG effects were counteracted by siRAGE and exacerbated by siNrf2.Chromatin immunoprecipitation results showed that Nrf2 binding to the ADAM10 promoter and HG interfered with this binding.Our data reinforce the notion that RAGE and Nrf2 might be sRAGE-regulating factors.Under HG conditions,the treatment of EGCG reduced ROS generation and RAGE activation.EGCG-stimulated cRAGE release was likely caused by the upregulation of the Nrf2-ADAM10 pathway.EGCG inhibited HG-mediated NLRP3 inflammasome activation at least partly by stimulating sRAGE,thereby reducing IL-1βrelease.

Actresses, Gender, and 1920s Theater in China： A Discussion Concerning ＂Female Involvement in Art Performances＂

In 1923, Wu Ruiyan, a schoolgirl at the Beijing People＇s Art Drama School, starred in a play titled Hero and Beauty, written by Chert Dabei. This was the first joint performance of male and female performers in the history of Chinese drama. The incident immediately triggered a debate in the Morning Newspaper Supplement between a group of middle-class intellectuals concerning ＂female involvement in art performances＂. This paper sees the boom in female participation in politics in the 1920s, as well as the ＂improvement in traditional drama＂ during the early republican period in China as the reasons behind the discussion. This incident shows how the New Cultural Movement shaped intellectuals＇ views on females and art performances.