Pressure from surrounding rock of three shallow tunnels with large section and small spacing

With the increasing traffic demand, the closely built three or more tunnels with large section play a significant role in the tunnel construction. However, the interaction among tunnels has important influences on the security and economy of tunnel engineering, and the calculation of pressure from the surrounding rock during the excavation is one of the problems that need to be solved urgently. Based on the practical engineering of three tunnels, the load model of three tunnels was proposed in consideration of the interaction and excavation sequence between tunnels. In comparison with the load model of single tunnel, the construction mechanical characteristics of the three tunnels were analyzed. The results show that the rock pressure of three tunnels calculated by the current tunnel design code is not reliable, and the interaction force increases with the spacing between tunnels.

Heterogeneity across the murine small and large intestine

The small and large intestine of the gastrointestinal tract(GIT) have evolved to have discrete functions with distinct anatomies and immune cell composition.The importance of these differences is underlined when considering that different pathogens have uniquely adapted to live in each region of the gut.Furthermore,different regions of the GIT are also associated with differences in susceptibility to diseases such as cancer and chronic inflammation.The large and small intestine,given their anatomical and functional differences,should be seen as two separate immunological sites.However,this distinction is often ignored with findings from one area of the GIT being inappropriately extrapolated to the other.Focussing largely on the murine small and large intestine,this review addresses the literature relating to the immunology and biology of the two sites,drawing comparisons between them and clarifying similarities and differences.We also highlight the gaps in our understanding and where further research is needed.

Multiple metastases to the small bowel from large cell bronchial carcinomas

AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. METHODS: Formalin-fixed, paraffin-embedded tissues were cut into 5 urn thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. Antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. Immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.

Gas Holdups of Small and Large Bubbles in a Large-scale Bubble Column with Elevated Pressure

Gas holdups of large bubbles and small bubbles were measured by means of dynamic gas disengagement approach in the pressured bubble column with a diameter of 0.3 m and a height of 6.6 m. The effects of superficial gas velocity, liquid surface tension, liquid viscosity and system pressure on gas holdups of small bubbles and large bubbles were investigated. The holdup of large bubbles increases and the holdup of small bubbles decreases with an increase of liquid viscosity. Meanwhile, the holdup of large bubbles decreases with increasing the system pressure. A correlation for the holdup of small bubbles was obtained from the experimental data.

A New Large Scale Instability in Rotating Stratified Fluids Driven by Small Scale Forces

In this paper, we find a new large scale instability displayed by a stratified rotating flow in forced turbulence. The turbulence is generated by a small scale external force at low Reynolds number. The theory is built on the rigorous asymptotic method of multi-scale development. There is no other special constraint concerning the force. In previous papers, the force was either helical or violating parity invariance. The nonlinear equations for the instability are obtained at the third order of the perturbation theory. In this article, we explain a detailed study of the linear stage of the instability.

The Large Scale Instability in Rotating Fluid with Small Scale Force

In this paper, we find a new large scale instability in rotating flow forced turbulence. The turbulence is generated by a small scale external force at low Reynolds number. The theory is built on the rigorous asymptotic method of multi-scale development. The nonlinear equations for the instability are obtained at the third order of the perturbation theory. In this article, we explain the nonlinear stage of the instability and the generation vortex kinks.

Interdecadal Variability in Large and Small Warm Pools in Western Pacific and Their Association with Rainfall Anomalies

This study investigated interdecadal variability of June–October(JJASO) the large and small warm pools in western Pacific and their association with rainfall anomalies using station and reanalysis data from 1958 to 2008.The results indicated that the large and small warm pools in western Pacific showed an interdecadal shift around 1986.The large warm pool years over western Pacific were found after 1986,whereas the small warm pool years were often seen throughout the periods before 1986.The analysis results also showed that there were obvious interdecadal variability in JJASO rainfall in Southeast China and warm pool in western Pacific.During 1958–1985(small warm pool years),the decrease in rainfall was associated with tropospheric moisture divergence and sinking motion over Southeast China and warm pool in western Pacific.However,during 1986–2008(large warm pool years),the increase in rainfall was associated with tropospheric moisture convergence and ascending motion.Further analysis showed that large warm pool contributed to the increase in surface latent heat fluxes over warm pool in the western Pacific.Thus,there was an increase in the amount of water vapor over Southeast China and warm pool in western Pacific,which contributed to increased rainfall in these regions.

Small Optical Product Breeds Large Industry

China is the world’s largest consumer market for eyeglasses,with the total market volume reaching 80billion yuan.Accordingly,the market has a group of 800 million consumers demanding eyeglasses.The consumers are from different ages。

Endoscopic papillary large balloon dilation alone or combined with small or complete sphincterotomy for the removal of large common bile duct stones

Background:Endoscopic papillary large balloon dilation(EPLBD)has been proposed as an alternative to manage large bile duct stones.However,EPLBD alone or combined with sphincterotomy remains controversial.Methods:Between Jan.2014 and Dec.2017,195 consecutive patients with proven large common bile duct stones(size≥10 mm)were retrospectively analyzed.We compared the baseline characteristics,procedure time,success rate of stone removal and morbidity outcomes in different groups.Results:There were no significant difference between baseline characteristics of the groups compared.A total of 89.2%,95.4%,and 93.8% of the patients in the EPLBD,EPLBD+small sphincterotomy(SES),and EPLBD+complete sphincterotomy(CES)groups had stones cleared(P=0.473),respectively.There was no difference in terms of procedure time(33.5±10.2,34.8±9.0,34.9±8.2,in the EPLBD,EPLBD+SES,and EPLBD+CES groups,respectively).However,when assigned to tvvo groups according to bile duct stones diameter(bile duct stones<13 mm,bile duct stones≥13 mm).in the bile duct stones<13 mm group,the procedure time was significantly less in the EPLBD group than the EPLBD+SES group and the EPLBD+CES group(P=0.028).In the bile duct stones≥13 mm group,the mechanical lithotripsy rate of EPLBD was significantly higher compared to EPLBD+SES or EPLBD+CES(P=0.032).The complication rates were similar among all groups.Conclusions:The diameter of bile duct stones should be taken into consideration when choosing EPLBD alone or combined with small sphincterotomy for the removal of common bile duct stones.

Hydrogen and steam distribution following a small-break LOCA in large dry containment

The hydrogen deflagration is one of the major risk contributors to threaten the integrity of the containment in a nuclear power plant, and hydrogen control in the case of severe accidents is required by nuclear regulations. Based on the large dry containment model developed with the integral severe-accident analysis tool, a small-break loss-of-coolant-accident (LOCA) without HPI, LPI, AFW and containment sprays, leading to the core degradation and large hydrogen generation, is calculated. Hydrogen and steam distribution in containment compartments is investi- gated. The analysis results show that significant hydrogen deflagration risk exits in the reactor coolant pump (RCP) compartment and the cavity during the early period, if no actions are taken to mitigate the effects of hydrogen accu- mulation.

Serum uric acid is a risk factor for large-artery atherosclerosis cerebral infarction

Using the Trial of Org 10172 in Acute Stroke Treatment （TOAST） classification for acute ischemic stroke, 371 patients with either acute large-artery atherosclerosis or small-artery oc-clusion cerebral infarction were recruited to investigate the potential impact of elevated serum uric acid on cerebrovascular disorders. The results showed that patients who have suffered from large-artery atherosclerosis, relative to small-artery occlusion patients, were characterized by elevated serum uric acid but reduced high-density lipoprotein cholesterol and triglyceride levels. Logistic regression showed that elevated uric acid and lower triglyceride levels were the main risk factors for patients with large-artery atherosclerosis. The findings of this study suggest that hyperuricemia may be a risk factor for stroke.

Effects of process parameters on numerical control bending process for large diameter thin-walled aluminum alloy tubes

Numerical control(NC) bending experiments with different process parameters were carried out for 5052O aluminum alloy tubes with outer diameter of 70 mm, wall thickness of 1.5 mm, and centerline bending radius of 105 mm. And the effects of process parameters on tube wall thinning and cross section distortion were investigated. Meanwhile, acceptable bending of the 5052O aluminum tubes was accomplished based on the above experiments. The results show that the effects of process parameters on bending process for large diameter thin-walled aluminum alloy tubes are similar to those for small diameter thin-walled tubes, but the forming quality of the large diameter thin-walled aluminum alloy tubes is much more sensitive to the process parameters and thus it is more difficult to form.

Coexistence of diffuse large B-cell lymphoma,acute myeloid leukemia,and untreated lymphoplasmacytic lymphoma/waldenström macroglobulinemia in a same patient:A case report

BACKGROUND The Coexistence of myeloid and lymphoid malignancies is rare.Myeloid leukemia occurs more frequently as a secondary event in patients receiving chemotherapy agents for lymphoid malignancies.Synchronous diagnoses of diffuse large B-cell lymphoma(DLBCL),acute myeloid leukemia(AML),and untreated lymphoplasmacytic lymphoma/Waldenström macroglobulinemia(LPL/WM)in the same patient have not been reported.Here we report one such case.CASE SUMMARY An 89-year-old man had a chest wall mass histopathologically diagnosed as DLBCL.The bone marrow and peripheral blood contained two groups of cells.One group of cells fulfilled the criteria of AML,and the other revealed the features of small B lymphocytic proliferative disorder,which we considered LPL/WM.Multiple chromosomal or genetic changes were detected in bone marrow mononuclear cells,including ATM deletion,CCND1 amplification,mutations of MYD88(L265P)and TP53,WT1 overexpression,and fusion gene of BIRC2-ARAP1,as well as complex chromosomal abnormalities.The patient refused chemotherapy because of old age and died of pneumonia 1 mo after the final diagnosis.CONCLUSION The coexistence of DLBCL,AML,and untreated LPL/WM in the same patient is extremely rare,which probably results from multiple steps of genetic abnormalities.Asymptomatic LPL/WM might have occurred first,then myelodysplastic syndromerelated AML developed,and finally aggressive DLBCL arose.Therefore,medical staff should pay attention to this rare phenomenon to avoid misdiagnoses.

The Influence of Weakly-Nonlinear Vertical Advection on the Wind Field of PBL with Large-Scale Orography

The analytical solutions of the PBL wind distribution under the equilibrium of four forces including both horizontal and vertical advections are obtained in this paper using small parameter method. Utilizing this simple PBL model, we also compute the wind spirals of a certain circular vortex over level ground and over a west-east ranged mountain, respectively. The results show that when there exsits large-scale orographic forcing,vertical advection may exert considerable influence on the wind distribution of PBL, the angle between geostrophic flow and surface wind, and the height of the top of PBL.

A Summary of the Large-Scale Access Convergence Network Structure

Under the requirement of everything over IP, network service shows the following characteristics:(1) network service increases its richness;(2) broadband streaming media becomes the mainstream. To achieve unified multi-service bearing in the IP network, the largescale access convergence network architecture is proposed. This flat access convergence structure with ultra-small hops, which shortens the service transmission path, reduces the complexity of the edge of the network, and achieves IP strong waist model with the integration of computation, storage and transmission. The key technologies are also introduced in this paper, including endto-end performance guarantee for real time interactive services, fog storing mechanism, and built-in safety transmission with integration of aggregation and control.

Evaluating the accuracy and reproducibility of ChatGPT-4 in answering patient questions related to small intestinal bacterial overgrowth

BACKGROUND Small intestinal bacterial overgrowth(SIBO)poses diagnostic and treatment challenges due to its complex management and evolving guidelines.Patients often seek online information related to their health,prompting interest in large language models,like GPT-4,as potential sources of patient education.AIM To investigate ChatGPT-4's accuracy and reproducibility in responding to patient questions related to SIBO.METHODS A total of 27 patient questions related to SIBO were curated from professional societies,Facebook groups,and Reddit threads.Each question was entered into GPT-4 twice on separate days to examine reproducibility of accuracy on separate occasions.GPT-4 generated responses were independently evaluated for accuracy and reproducibility by two motility fellowship-trained gastroenterologists.A third senior fellowship-trained gastroenterologist resolved disagreements.Accuracy of responses were graded using the scale:(1)Comprehensive;(2)Correct but inadequate;(3)Some correct and some incorrect;or(4)Completely incorrect.Two responses were generated for every question to evaluate reproducibility in accuracy.RESULTS In evaluating GPT-4's effectiveness at answering SIBO-related questions,it provided responses with correct information to 18/27(66.7%)of questions,with 16/27(59.3%)of responses graded as comprehensive and 2/27(7.4%)responses graded as correct but inadequate.The model provided responses with incorrect information to 9/27(33.3%)of questions,with 4/27(14.8%)of responses graded as completely incorrect and 5/27(18.5%)of responses graded as mixed correct and incorrect data.Accuracy varied by question category,with questions related to“basic knowledge”achieving the highest proportion of comprehensive responses(90%)and no incorrect responses.On the other hand,the“treatment”related questions yielded the lowest proportion of comprehensive responses(33.3%)and highest percent of completely incorrect responses(33.3%).A total of 77.8%of questions yielded reproducible responses.CONCLUSION Though GPT-4 shows promise as a supplementary tool for SIBO-related patient education,the model requires further refinement and validation in subsequent iterations prior to its integration into patient care.

Risk factors for small intestinal adenocarcinomas that are common in the proximal small intestine

The frequency of primary small intestinal adenocarcinoma is increasing but is still low.Its frequency is approximately 3%of that of colorectal adenocarcinoma.Considering that the small intestine occupies 90%of the surface area of the gastrointestinal tract,small intestinal adenocarcinoma is very rare.The main site of small intestinal adenocarcinoma is the proximal small intestine.Based on this characteristic,dietary animal proteins/lipids and bile concentrations are implicated and reported to be involved in carcinogenesis.Since most nutrients are absorbed in the proximal small intestine,the effect of absorbable intestinal content is a suitable explanation for why small intestinal adenocarcinoma is more common in the proximal small intestine.The proportion of aerobic bacteria is high in the proximal small intestine,but the absolute number of bacteria is low.In addition,the length and density of villi are greater in the proximal small intestine.However,the involvement of villi is considered to be low because the number of small intestinal adenocarcinomas is much smaller than that of colorectal adenocarcinomas.On the other hand,the reason for the low incidence of small intestinal adenocarcinoma in the distal small intestine may be that immune organs reside there.Genetic and disease factors increase the likelihood of small intestinal adenocarcinoma.In carcinogenesis experiments in which the positions of the small and large intestines were exchanged,tumors still occurred in the large intestinal mucosa more often.In other words,the influence of the intestinal contents is small,and there is a large difference in epithelial properties between the small intestine and the large intestine.In conclusion,small intestinal adenocarcinoma is rare compared to large intestinal adenocarcinoma due to the nature of the epithelium.It is reasonable to assume that diet is a trigger for small intestinal adenocarcinoma.

Small Signal Stability Analysis with Penetration of Grid-connected Wind Farm of PMSG Type

The impacts of large-scale grid-connected wind farm on direct-driven permanent magnet synchronous generator(PMSG)type are discussed on the small signal stability performances of power systems.Firstly,a simplified practical model of wind farm of PMSG type is derived for analyzing small signal stability.The rotor-fluxoriented control strategy is applied to the modelling of PMSG.Secondly,the framework of small signal stability analysis incorporating wind farm of PMSG type is built.Finally,the different simulation scenarios based on the IEEE 3-generator-9-bus test system as benchmark are designed to conduct the eigenvalue analysis and to assess the impacts of wind farm of PMSG type on power system small signal stability.Some conclusions are drawn with simulation results.

AN APPLICATION OF THEORETICAL SOLUTIONS ABOUT CYLINDRICAL SHELLS WITH SMALL OPENINGS

Stress concentrations about thin cylindrical shells with small openings are reconsidered front a nerv angle. There is a sort of special internal relation between theoretical solutions about cylindrical shells,vith large openings and one,with small openings. Using this relation, the extent of applying the theory about small openings to engineering practice is estimated again, thus an idea of how to use this theory and a nerv appraisal of the application of theoretical solutions about cylindrical shells with small openings to engineering practice are given.

Rosuvastatin Reduces Plasma Small Dense Ldl-Cholesterol Predominantly in Non-Diabetic Hypercholesterolemic Patients

Aims: Small dense LDL (sdLDL) cholesterol is considered a cardiovascular risk. Our purpose in this study was to evaluate the efficacy of rosuvastatin in reducing sdLDL and large buoyant LDL (lbLDL-C) in hypercholesterolemia. Methods: Fifty-six patients with a mean baseline LDL-cholesterol (LDL-C) concentration of 173.9 ± 40.5 mg/dL were treated with rosuvastatin 2.5 mg/day for 12 weeks. LDL-C, sdLDL-C, and apolipoprotein (apo) B were assessed and l lbLDL-C was calculated (LDL-C minus sdLDL-C). Results: After 12-week treatment with rosuvastatin 2.5mg, sdLDL-C and lbLDL-C were significantly reduced from 62.1 ± 23.8 mg/dL to 34.0 ± 13.4 mg/dL, p <0.001 and 112.7 ± 34.9 mg/dL to 77.2± 29.2 mg/dL, p < 0.001 respectively, and sdLDL-C/lbLDL-C ratio and apo B also decreased significantly, from 0.36 ± 0.02 to 0.32 ± 0.02, p < 0.005 and 134.2 ± 4.3 to 93.6 ± 3.5 mg/dl, p < 0.001, respectively. In diabetic subjects there was significant correlation between percent reductions in the plasma triglyceride and sdLDL-C/ lbLDL-C ratio (r = 0.58, p < 0.005), but not between the percentage decrease in plasma triglyceride and sdLDL-C. Conclusions: Treatment with rosuvastatin is associated with significant reduction in sdLDL, lbLDL and sdLDL/lbLDL ratio.