Proton pump inhibitors and all-cause mortality risk among cancer patients

BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.

Development of a Drilling and Coring Test-bed for Lunar Subsurface Exploration and Preliminary Experiments

Drill sampling has been widely employed as an effective way to acquire deep samples in extraterrestrial exploration. A novel sampling method, namely, flexible-tube coring, was adopted for the Chang＇e mission to acquire drilling cores without damaging stratification information. Since the extraterrestrial environment is uncertain and different from the terrestrial environment, automated drill sampling missions are at risk of failure. The principles of drilling and coring for the lunar subsurface should be fully tested and verified on earth before launch. This paper proposes a test-bed for conducting the aforementioned experiments on earth. The test-bed comprises a rotary-percussive drilling mechanism, penetrating mechanism, drilling medium container, and signal acquisition and control system. For granular soil, coring experiments indicate that the sampling method has a high coring rate greater than 80%. For hard rock, drilling experiments indicate that the percussive frequency greatly affects the drilling efficiency. A multi-layered simulant composed of granular soil and hard rock is built to test the adaptability of drilling and coring. To tackle complex drilling media, an intelligent drilling strategy based on online recognition is proposed to improve the adaptability of the sampling drill. The primary features of this research are the proposal of a scheme for drilling and coring a test-bed for validation on earth and the execution of drilling experiments in complex media.

Design and Test of the Semi-Automatic Test-Bed with Inclined Belt of Garlic Transplanting Machine

In order to verify the feasibility of semi-automatic garlic planter with inclined belt program and determine its reasonable operating parameters, the semi-automatic test-bed with inclined belt of garlic transplanting machine was designed, and the garlic box experiments were conducted. The angle of inclined belt on the test-bed and its running speed were adjustable. Single factor test results showed that the program of the semi-automatic garlic planter with inclined belt was feasible, and the angle of inclined belt and the test bed running speed affected the indicators. Orthogonal experiment results showed that the angle of inclined belt was the main factor affecting the test indicators. It is also found that the best angle was 30 degrees, while the most reasonable running speed was 0.75 Km/h.

Simplified Removable Ground Test-Bed for Testing Turbofan Engine

A new simplified removable ground test-bed was designed for testing a certainturbofan engine. The facilities are 5.5 m long, 1.5 m wide, 2.2 m high and not more than 4. 5 t ofits empty weight. There are four rubber wheels that could be towed. There is an independentelectrical measurement and control system to test the rotational speed of rotors, the gas pressureof the compressor, the exhaust gas temperature, etc. Cooperated with the oil truck and the electricpower supply truck, the turbofan engine could be preserved on the ground and started to the idlingregime. While running, the parameter of the engine could be recorded, disposed and displayed. Inaddition, the facilities were successfully applied to the plateau experiment in order to researchhow the atmosphere pressure affects the start of engines. Some data are given in the paper.

Effects of proton pump inhibitors on inflammatory bowel disease:An updated review

Inflammatory bowel disease(IBD)is believed to be caused by various factors,including abnormalities in disease susceptibility genes,environmental factors,immune factors,and intestinal bacteria.Proton pump inhibitors(PPIs)are the primary drugs used to treat acid-related diseases.They are also commonly prescribed to patients with IBD.Recent studies have suggested a potential association between the use of certain medications,such as PPIs,and the occurrence and progression of IBD.In this review,we summarize the potential impact of PPIs on IBD and analyze the underlying mechanisms.Our findings may provide insights for conducting further investigations into the effects of PPIs on IBD and serve as an important reminder for physicians to exercise caution when prescribing PPIs to patients with IBD.

Ultra-Robust and High-Performance Rotational Triboelectric Nanogenerator by Bearing Charge Pumping

As an emerging technology to convert environmental high-entropy energy into electrical energy,triboelectric nanogenerator(TENG)has great demands for further enhancing the service lifetime and output performance in practical applications.Here,an ultra-robust and high-performance rotational triboelectric nanogenerator(R-TENG)by bearing charge pumping is proposed.The R-TENG composes of a pumping TENG(P-TENG),an output TENG(O-TENG),a voltage-multiplying circuit(VMC),and a buffer capacitor.The P-TENG is designed with freestanding mode based on a rolling ball bearing,which can also act as the rotating mechanical energy harvester.The output low charge from the P-TENG is accumulated and pumped to the non-contact O-TENG,which can simultaneously realize ultralow mechanical wear and high output performance.The matched instantaneous power of R-TENG is increased by 32 times under 300 r/min.Furthermore,the transferring charge of R-TENG can remain 95%during 15 days(6.4×10^(6)cycles)continuous operation.This work presents a realizable method to further enhance the durability of TENG,which would facilitate the practical applications of high-performance TENG in harvesting distributed ambient micro mechanical energy.

An NMOS output-capacitorless low-dropout regulator with dynamic-strength event-driven charge pump

In this paper,an NMOS output-capacitorless low-dropout regulator(OCL-LDO)featuring dual-loop regulation has been proposed,achieving fast transient response with low power consumption.An event-driven charge pump(CP)loop with the dynamic strength control(DSC),is proposed in this paper,which overcomes trade-offs inherent in conventional structures.The presented design addresses and resolves the large signal stability issue,which has been previously overlooked in the event-driven charge pump structure.This breakthrough allows for the full exploitation of the charge-pump structure's poten-tial,particularly in enhancing transient recovery.Moreover,a dynamic error amplifier is utilized to attain precise regulation of the steady-state output voltage,leading to favorable static characteristics.A prototype chip has been fabricated in 65 nm CMOS technology.The measurement results show that the proposed OCL-LDO achieves a 410 nA low quiescent current(IQ)and can recover within 30 ns under 200 mA/10 ns loading change.

Preface:Development and utilization of pumped storage in closed/abandoned mines

China has embarked on an extensive and sustained endeavor to harness its coal resources for a substantial period.However,the depletion of coal reserves in mining regions has necessitated the closure or abandonment of numerous mines,resulting in a marked increase in the number of such facilities.Parallel to this,China is vigorously advancing the development of a novel energy power system,aimed at transitioning the power sector from a high-carbon,fossil fuel-dependent paradigm to a low-carbon,clean energy footing.

An LED-Side-Pumped Intracavity Frequency-Doubled Nd,Ce:YAG Laser Producing a 2W Q-Switched Red Beam

We report a high-average-power acousto-optic(AO)Q-switched intracavity frequency-doubled red laser based on a high-efficiency light-emitting-diode(LED)pumped two-rod Nd,Ce:YAG laser module.Under quasi-continuous wave operation conditions,a maximum output power of 1319.08 nm wavelength was achieved at 11.26 W at a repetition rate of 100 Hz.

Wear dependent virtual flow rate sensor for progressing cavity pumps with deformable stator

This contribution presents a novel wear dependent virtual flow rate sensor for single stage single lobe progressing cavity pumps. We study the wear-induced material loss of the pump components and the impact of this material loss on the volumetric efficiency. The results are combined with an established backflow model to implement a backflow calculation procedure that is adaptive to wear. We use a laboratory test setup with a highly abrasive fluid and operate a pump from new to worn condition to validate our approach. The obtained measurement data show that the presented virtual sensor is capable of calculating the flow rate of a pump being subject to wear during its regular operation.

Dual-wavelength pumped latticed Fermi-Pasta-Ulam recurrences in nonlinear Schrödinger equation

We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated heteroclinic structure of instability unveils all possible dynamic trajectories of nonlinear waves.Significantly,the latticed-Fermi-Pasta-Ulam recurrences on the modulated-wave background in NLSE are also investigated and their dynamic trajectories run along the Hamiltonian contours of the heteroclinic structure.It is demonstrated that there has much richer dynamic behavior,in contrast to the nonlinear waves reported before.This novel nonlinear wave promises to inject new vitality into the study of MI.

Dynamic response characteristics of muddy sandstone in pumped storage mine under action of high-stress dynamic disturbance

During the construction and operation of the abandoned mine pumped storage power station,the underground space surrounding rock body faces the complex stress environment under the action of mining disturbance,frequent pumping,water storage and other dynamic disturbances.The stability of the abandoned mine surrounding rock body is the basis for guaranteeing the safety and effectiveness of water storage in the underground space of the abandoned mine.By considering the two main factors of different stress levels and disturbance amplitudes,the mechanical properties,damage characteristics and acoustic emission characteristics of the abandoned mine perimeter rock body under dynamic disturbance were investigated using a creep-disturbed dynamic impact loading system.The experimental results show that:1)The stress level is considered to be the major contributing factor of the failure of muddy sandstone,followed by the amplitude of the disturbances;2)The time required for the destruction of muddy sandstone decreases with the increase of amplitude.When the stress level is 80%,the sandstone specimens have a decreasing number of cycles as the disturbance amplitude increases.The disturbance amplitude is sequentially increased from 4 MPa to 5,6,7,and 8 MPa,the number of cycles required for specimen destruction decreases significantly by 96.71%,99.13%,99.60%,and 99.93%,respectively;3)Disturbance amplitude and stress level have a significant effect on muddy sandstone damage and damage occurs only after a certain threshold is reached.With the increase of stress level and disturbance amplitude,the macroscopic damage of muddy sandstone is mainly conical,with obvious flake spalling and poor damage integrity;4)According to the time-dependent changes in AE energy and ringing counts,the acoustic emission activity during the failure process could be divided into three phases,namely,weakening period,smooth period,and surge period,corresponding to the compaction phase,elastic rise phase and post-peak damage phase.The research results are of reference significance for the damage evolution analysis of muddy sandstone under dynamic disturbance and the safety and stability of abandoned mine perimeter rock body.

In-phase and out-of-phase spin pumping effects in Py/Ru/Pysynthetic antiferromagnetic structures

The spin pumping effect in magnetic heterostructures and multilayers is a highly effective method for the generationand transmission of spin currents. In the increasingly prominent synthetic antiferromagnetic structures, the two ferromagneticlayers demonstrate in-phase and out-of-phase states, corresponding to acoustic and optical precession modes. Withinthis context, our study explores the spin pumping effect in Py/Ru/Py synthetic antiferromagnetic structures across differentmodes. The heightened magnetic damping resulting from the spin pumping effect in the in-phase state initially decreaseswith increasing Py thickness before stabilizing. Conversely, in the out-of-phase state, the amplified damping exceeds thatof the in-phase state, suggesting a greater spin relaxation within this configuration, which demonstrates sensitivity to alterationsin static exchange interactions. These findings contribute to advancing the application of synthetic antiferromagneticstructures in magnonic devices.

Research on pumped storage and complementary energy development models for abandoned mines in China

Within the framework of achieving carbon neutrality,various industries are confronted with fresh challenges.The ongoing process of downsizing coal industry operations has evolved into a new phase,with the burgeoning proliferation of abandoned mines posing a persistent issue.Addressing the challenges and opportunities presented by these abandoned mines,this paper advocates for a scientific approach centered on the advancement of pumped storage energy alongside gas-oil complementary energy.Leveraging abandoned mine tunnels to establish pumped storage power stations holds significant ecological and economic importance for repurposing these sites.This initiative not only serves as an effective means to restore the ecological balance in mining regions but also provides an environmentally friendly approach to repurposing abandoned mine tunnels,offering a blueprint for economically viable pumped storage power stations.This article delineates five crucial scientific considerations and outlines seven primary models for the utilization of abandoned mine sites,delineating a novel,comprehensive pathway for energy and power development that emphasizes multi-energy complementarity and synergistic optimization within abandoned mines.

Transient Experiments on a Prototype Pump with an Atypical Open Impeller for Different Discharge Valve Openings

In order to obtain the transient characteristics of a low-speed centrifugal pump during the start-up and shutdown stages,dedicated experimental tests were conducted with eight different valve opening conditions.The Pearson correlation coefficient was used to reveal the linear correlation between variables.According to the results,the stable rotational speed decreases with increasing valve opening(rotational speed decreases from approximately 1472 to 1453 r/min),while the stable shaft power exhibits an increasing trend(shaft power increases from approximately 0.242 to 0.390 kW).The stable time and zeroing time of each parameter during start-up and shutdown processes vary,with the flow zeroing time significantly increasing with the relative flow,reaching up to 10.468 s,while the shaft power zeroing time is roughly between 1.219 and 1.375 s.The results demonstrate that with increasing valve opening,the stable and zeroing time of flow significantly increase(|r|greater than 0.95),while the stable and zeroing time of rotational speed,power,and head display a smaller sensitivity on the valve opening(|r|less than 0.6).

Research on Cavitation Characteristics and Influencing Factors of Herringbone Gear Pump

Cavitation is a common issue in pumps,causing a decrease in pump head,a fall in volumetric efficiency,and an intensification of outlet flow pulsation.It is one of the main hazards that affect the regular operation of the pump.Research on pump cavitation mainly focuses on mixed flow pumps,jet pumps,external spur gear pumps,etc.However,there are few cavitation studies on external herringbone gear pumps.In addition,pumps with different working principles significantly differ in the flow and complexity of the internal flow field.Therefore,it is urgent to study the cavitation characteristics of external herringbone gear pumps.Compared with experimentalmethods,visual research and cavitation area identification are achieved through computation fluid dynamic(CFD),and changing the boundary conditions and shape of the gear rotor is easier.The simulation yields a head error of only 0.003%under different grid numbers,and the deviation between experimental and simulation results is less than 5%.The study revealed that cavitation causes flow pulsation at the outlet,and the cavitation serious area is mainly distributed in the meshing gap and meshing area.Cavitation can be inhibited by reducing the speed,increasing the inlet pressure,and changing the helix angle can be achieved.For example,when the inlet pressure is 5 bar,the maximumgas volume fraction in themeshing area is less than 50%.These results provide a reference for optimizing the design and finding the optimal design parameters to reduce or eliminate cavitation.

Evaluation of development potential of pumped hydroelectric storage and geothermal utilization system in abandoned coal mine

Every year in China,a significant number of mines are closed or abandoned.The pumped hydroelectric storage(PHS)and geothermal utilization are vital means to efficiently repurpose resources in abandoned mine.In this work,the development potentials of the PHS and geothermal utilization systems were evaluated.Considering the geological conditions and meteorological data available of Jiahe abandoned mine,a simple evaluation model for PHS and geothermal utilization was established.The average efficiency of the PHS system exceeds 70%and the regulatable energy of a unit volume is over 1.53 kW·h/m^(3).The PHS system achieves optimal performance when the wind/solar power ratio reaches 0.6 and 0.3 in daily and year scale,respectively.In the geothermal utilization system,the outlet temperature and heat production are significantly affected by the injection flow rate.The heat production performance is more stable at lower rate flow,and the proportion of heat production is higher in the initial stage at greater flow rate.As the operating time increases,the proportion of heat production gradually decreases.The cyclic heat storage status has obvious advantages in heat generation and cooling.Furthermore,the energy-saving and emission reduction benefits of PHS and geothermal utilization systems were calculated.

Overlapping approach Proton Pump Inhibitors/Nux vomica-Heel as new intervention for gastro-esophageal reflux management:Delphi consensus study

BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.

A Numerical Study on the Effect of the Backflow Hole Position on the Performances of a Self-Priming Pump

A self-priming pump is a centrifugal pump that has the ability to prime itself. Typically, its performance dependson the configuration of its reflux hole. In this study, the ANSYS FLUENT software is used to investigate the effectsof three different radial positions of the reflux hole on gas-liquid two-phase distribution, pressure pulsation, andimp during self-priming. The research results indicate that: (1) The effective channel size for the reflux liquid toenter the volute varies depending on the location of the reflux hole. The effect of the impeller rotation on thereflux liquid becomes more obvious as the setting distance of the reflux aperture decreases. (2) The position ofthe reflux hole significantly affects the gas phase mass fraction inside the impeller, resulting in a significant reductionin the time it takes for the mass fraction to exceed 80%. (3) The position of the reflux hole significantly affectsthe average pressure on each monitoring surface. (4) Placing the reflux hole at a excessively distant radial distancecan result in an excessive vertical component. (5) The self-priming performance of the pump can be improved tosome extent by placing the return hole at a small radial distance.

Optimal Design of High-Speed Partial Flow Pumps using Orthogonal Tests and Numerical Simulations

To investigate the influence of structural parameters on the performances and internal flow characteristics of partial flow pumps at a low specific speed of 10000 rpm,special attention was paid to the first and second stage impeller guide vanes.Moreover,the impeller blade outlet width,impeller inlet diameter,blade inclination angle,and number of blades were considered for orthogonal tests.Accordingly,nine groups of design solutions were formed,and then used as a basis for the execution of numerical simulations(CFD)aimed at obtaining the efficiency values and heads for each design solution group.The influence of impeller geometric parameters on the efficiency and head was explored,and the“weight”of each factor was obtained via a range analysis.Optimal structural parameters were finally chosen on the basis of the numerical simulation results,and the performances of the optimized model were verified accordingly(yet by means of CFD).Evidence is provided that the increase in the efficiency and head of the optimized model was 12.11%and 23.5 m,respectively,compared with those of the original model.