Update in lean metabolic dysfunction-associated steatotic liver disease

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.

Heterostructured nickel-cobalt metal alloy and metal oxide nanoparticles as a polysulfide mediator for stable lithium-sulfur full batteries with lean electrolyte

Batteries that utilize low-cost elemental sulfur and light metallic lithium as electrodes have great potential in achieving high energy density.However,building a lithium-sulfur(Li-S)full battery by controlling the electrolyte volume generally produces low practical energy because of the limited electrochemical Li-S redox.Herein,the high energy/high performance of a Li-S full battery with practical sulfur loading and minimum electrolyte volume is reported.A unique hybrid architecture configured with Ni-Co metal alloy(NiCo)and metal oxide(NiCoO_(2))nanoparticles heterogeneously anchored in carbon nanotube-embedded selfstanding carbon matrix is fabricated as a host for sulfur.This work demonstrates the considerable improvement that the hybrid structure's high conductivity and satisfactory porosity promote the transport of electrons and lithium ions in Li-S batteries.Through experimental and theoretical validations,the function of NiCo and NiCoO_(2) nanoparticles as an efficient polysulfide mediator is established.These particles afford polysulfide anchoring and catalytic sites for Li-S redox reaction,thus improving the redox conversion reversibility.Even at high sulfur loading,the nanostructured Ni-Co metal alloy and metal oxide enable to have stable cycling performance under lean electrolyte conditions both in half-cell and full-cell batteries using a graphite anode.

Metal-free two-dimensional phosphorene-based electrocatalyst with covalent P-N heterointerfacial reconstruction for electrolyte-lean lithium-sulfur batteries

The use of lithium-sulfur batteries under high sulfur loading and low electrolyte concentrations is severely restricted by the detrimental shuttling behavior of polysulfides and the sluggish kinetics in redox processes.Two-dimensional(2D)few layered black phosphorus with fully exposed atoms and high sulfur affinity can be potential lithium-sulfur battery electrocatalysts,which,however,have limitations of restricted catalytic activity and poor electrochemical/chemical stability.To resolve these issues,we developed a multifunctional metal-free catalyst by covalently bonding few layered black phosphorus nanosheets with nitrogen-doped carbon-coated multiwalled carbon nanotubes(denoted c-FBP-NC).The experimental characterizations and theoretical calculations show that the formed polarized P-N covalent bonds in c-FBP-NC can efficiently regulate electron transfer from NC to FBP and significantly promote the capture and catalysis of lithium polysulfides,thus alleviating the shuttle effect.Meanwhile,the robust 1D-2D interwoven structure with large surface area and high porosity allows strong physical confinement and fast mass transfer.Impressively,with c-FBP-NC as the sulfur host,the battery shows a high areal capacity of 7.69 mAh cm^(−2) under high sulfur loading of 8.74 mg cm^(−2) and a low electrolyte/sulfur ratio of 5.7μL mg^(−1).Moreover,the assembled pouch cell with sulfur loading of 4 mg cm^(−2) and an electrolyte/sulfur ratio of 3.5μL mg^(−1) shows good rate capability and outstanding cyclability.This work proposes an interfacial and electronic structure engineering strategy for fast and durable sulfur electrochemistry,demonstrating great potential in lithium-sulfur batteries.

Effect of nano-CaO particle on the microstructure,mechanical properties and corrosion behavior of lean Mg-1Zn alloy

The effects of nano-CaO contents on the microstructure,mechanical properties and corrosion resistance of lean Mg-1Zn alloy were investigated.The results showed that the addition of nano-CaO significantly refined the grain size and improved mechanical properties of the Mg-1Zn alloy.At the same time,CaO reacted with molten Mg in situ to form nano-MgO,whose corrosion product in SBF solution was the same with the degradation product of Mg matrix,resulting in the enhanced compactness of the Mg(OH)_(2) layer and reduced corrosion rate of matrix.The Mg-1Zn alloy had lower corrosion resistance due to excessively large grain size and shedding of corrosion products.The composite with 0.5 wt.%CaO had the best corrosion resistance with a weight loss of 9.875 mg·y^(-1)·mm^(-2)due to the small number of Ca_(2)Mg_(6)Zn_(3) phase and suitable grain size.While for composites with high content of CaO(0.7 wt.%and 1.0 wt.%),they had lower corrosion resistance due to the coexistence of large number of Ca_(2)Mg_(6)Zn_(3) and Mg_(2)Ca at grain boundaries,especially for 1.0 wt.%CaO composite,resulting from the strong micro-galvanic corrosion.

Overview of the Theoretical Exploration and Application of Lean Six Sigma

In contemporary contexts,Lean Six Sigma(LSS)is extensively utilized and has evolved across various sectors due to its substantial benefits.This paper aims to explore the definition,origin,and development of LSS,as well as its key tools,methods,theoretical research,and future prospects.Furthermore,it analyzes the theoretical foundations and practical applications of LSS in-depth,with an emphasis on anticipating future development trends.The goal is to provide readers with a comprehensive overview of LSS and offer insights for enterprises seeking to implement LSS for process improvement and innovation.

Boosting Lean Electrolyte Lithium-Sulfur Battery Performance with Transition Metals: A Comprehensive Review

Lithium–sulfur(Li–S) batteries have received widespread attention, and lean electrolyte Li–S batteries have attracted additional interest because of their higher energy densities. This review systematically analyzes the effect of the electrolyte-to-sulfur(E/S) ratios on battery energy density and the challenges for sulfur reduction reactions(SRR) under lean electrolyte conditions. Accordingly, we review the use of various polar transition metal sulfur hosts as corresponding solutions to facilitate SRR kinetics at low E/S ratios(< 10 μL mg~(-1)), and the strengths and limitations of different transition metal compounds are presented and discussed from a fundamental perspective. Subsequently, three promising strategies for sulfur hosts that act as anchors and catalysts are proposed to boost lean electrolyte Li–S battery performance. Finally, an outlook is provided to guide future research on high energy density Li–S batteries.

基于Lean管理理念的门诊医疗服务质量提升研究

目的分析在Lean管理理念基础上实施门诊护理管理对门诊医疗服务质量提升的影响。方法选取2021年1月—2022年12月在南京医科大学附属逸夫医院门诊工作的34名护理人员作为研究对象,2021年1—12月实施常规管理(实施前组),2022年1—12月实施Lean管理理念(实施后组)。比较实施前后护理质量、不良事件发生率及交接班质量评分。结果实施后组护理质量评分高于实施前组,差异有统计学意义(P<0.05)。实施后组护理差错、缺陷、纠纷发生率均低于实施前组,差异有统计学意义(P均<0.05)。实施后组护理人员交接班质量评分高于实施后组,差异有统计学意义(P<0.05)。结论Lean管理理念在门诊护理管理中的应用能有效提升护理质量,降低护理差错发生率,减少护患纠纷和投诉发生率,对提升门诊医疗服务质量具有积极意义。

Design Strategies for Leaning-Type Arch Bridges

This paper presents a study on the design strategy of leaning-type arch bridges.The main characteristics of leaning-type arch bridges are first introduced;Kunshan Yufeng Bridge is taken as an example to discuss different aspects of a design strategy,which includes self-system optimization,selection of beam length and bridge deck position,and other aspects.This paper can be used as a reference to further improve and develop bridge design.

NO reduction by CO over TiO_2-γ-Al_2O_3 supported In/Ag catalyst under lean burn conditions

TiO2/γ-Al2O3 supported In/Ag catalysts were prepared by impregnation method,and investigated for NO reduction with CO as the reducing agent under lean burn conditions.The microscopic structure and surface properties of the catalysts were studied by N2 adsorption-desorption,X-ray diffraction,transmission electron microscopy,X-ray photoelectron spectroscopy,ultraviolet-visible spectroscopy,H2 temperature-programmed reduction and Fourier transform infrared spectroscopy.TiO2/γ-Al2O3 supported In/Ag is a good catalyst for the reduction of NO to N2.It displayed high dispersion,large amounts of surface active components and high NO adsorption capacity,which gave good catalytic performance and stability for the reduction of NO with CO under lean burn conditions.The silver species stabilized and improved the dispersion of the indium species.The introduction of TiO2 into the γ-Al2O3 support promoted NO adsorption and improved the dispersion of the indium species and silver species.

Metabolic-associated fatty liver disease and sarcopenia:A double whammy

The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.

精益生产在工业数字化中落地的应用与规划研究

精益生产是贯穿智能工厂、数字化工厂建设的核心内容之一,随着市场需求的发展,工业生产的要求由“零缺陷”转变为“尽一切可能缩短产品交付周期”。精益生产在现场的落地应用,除了通过管理手段,还要依靠技术作为载体进行实现,让精益生产在具体业务场景中进行应用,本文称为LEAN系统。本文结合制造行业场景需求,对LEAN系统进行系统性的详细设计,为精益生产在工业场景的落地提供一定的借鉴意义;尤其是通过配置改变PLC中I/O点的对应关系,突破了PLC的传统应用,使得系统应用更加灵活多变,能适应更加柔性、复杂的场景。通过LEAN系统积累到的数据,结合质量数据,通过人工智能技术为构建行业质量大模型奠定了较为可靠的基础。

Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors:The iBoneFIT project

Background Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density(aBMD).However,the prevalence of muscle strength deficits is not well documented,and the associations of muscle strength with aBMD are unknown in this population.Therefore,this study aimed to investigate the prevalence of upper-and lower-body muscle strength deficits and to examine the associations of upper-and lower-body muscle strength with age-,sex,and race-specific aBMD Z-scores at the total body,total hip,femoral neck,and lumbar spine.Methods This cross-sectional study included 116 pediatric cancer survivors(12.1±3.3 years old,mean±SD;42.2%female).Upper-and lower-body muscle strength were assessed by handgrip and standing long jump test,respectively.Dual‑energy X‑ray absorptiometry was used to measure aBMD(g/cm2).Associations between muscle strength and aBMD were evaluated in multivariable linear regression models.Logistic regression was used to evaluate the contribution of muscle strength(1-decile lower)to the odds of having low aBMD(Z-score≤1.0).All analyses were adjusted for time from treatment completion,radiotherapy exposure,and body mass index.Results More than one-half of survivors were within the 2 lowest deciles for upper-(56.9%)and lower-body muscle strength(60.0%)in comparison to age-and sex-specific reference values.Muscle strength deficits were associated with lower aBMD Z-scores at all sites(B=0.133–0.258,p=0.001–0.032).Each 1-decile lower in upper-body muscle strength was associated with 30%–95%higher odds of having low aBMD Z-scores at all sites.Each 1-decile lower in lower-body muscle strength was associated with 35%–70%higher odds of having low aBMD Z-scores at total body,total hip,and femoral neck.Conclusion Muscle strength deficits are prevalent in young pediatric cancer survivors,and such deficits are associated with lower aBMD Z-scores at all sites.These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added benefit of improving aBMD.

Solution of idle LBO problem for high FAR aero combustor

The paper sheds light on the idle lean blow off(LBO)problem for high fuel air ratio(FAR)com⁃bustor,which is impossible to be addressed with traditional aero combustor design.A significant improvement in aero combustor design is required to resolve the idle LBO issue.The authors detailed a practical and efficient solu⁃tion,which not only solved the idle LBO issue but also defined the aero-thermal design for high-FAR combustor.The design will usher in a new era of aero combustor.

Epileptic brain network mechanisms and neuroimaging techniques for the brain network

Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.

基于E-leaning的体育课程网络化教学改革

E-leaning可以优化教育资源、提高学习效率、降低学习成本,对于体育课程教学而言,其灵活便捷的教学方式能够解决"学训矛盾",方便学生自主学习。学习过程记录方便、教学管理和课程资源及时有效的更新,既方便了教学管理,也为体育远程教育创造了条件。E-leaning借助网络跨越了校园空间的限制,给学习者提供了一个全新的学习环境,促使了学校与学习者之间距离的缩短,让学校教育向更广泛的地区辐射。借助E-leaning进行体育精品课程和网络课程整合,开展体育远程教育有助于现有体育精品课程和网络课程的可持续发展,有利于体育教育资源共享,是未来学校体育教育和终身体育教育的重要途径。

《Leaning to do》的启示:把价值观教育与TVET结合起来

这几个模块相关联的核心价值是健康,与自然和谐,达到人的身体、智力、情感、社会和精神的全面发展,实现一种人与人、人与自然环境和谐的状态.要对自身健康负责,对所有形态的生命关爱,成为一个环境的看护者.

高效节能化工塑料管材生产工艺优化研究

化工塑料管材在现代工业中得到了广泛应用,但是如何进行高效节能的生产却成为了当前亟待解决的问题。本研究致力于化工塑料管材的生产工艺进行优化设计,以提高生产效率以及减少能耗。通过引入LEAN生产理念,综合运用运筹学和流程图分析方法,分析了化工塑料管材生产全过程并对关键流程环节进行了优化,旨在减少不必要的投入,降低浪费,提升生产效率并有效降低能耗。研究结果表明,经过优化后的生产线比原生产线节省了约15%的能耗,而且产品合格率提高了10%,显著提升了生产效率和产品质量。同时,采用节能材料,收集利用浪费的热能,通过调度优化减少设备空载运行等方法,对于化工塑料管材生产能耗进行了有效的节能减排。本研究的结果对于化工塑料管材行业生产效率的提升和节能减排具有重要的参考意义。

IPD模式下基于VisiLean的施工生产计划与控制研究

为完善IPD模式实践应用的操作系统,引入集成精益建造与BIM技术的施工生产管理系统VisiLean,构建IPD模式下基于VisiLean的施工生产计划与控制系统的基本框架,并对系统框架下的操作流程进行详细的阐述,该体系可以有效提高施工生产计划的可靠性,维护生产流的稳定性,对于IPD模式下建造流程的持续改进具有一定的指导意义。

Prevalence,clinical characteristics,risk factors,and indicators for lean Chinese adults with nonalcoholic fatty liver disease

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is one of the most common chronic diseases in the world.Nowadays,the percentage of non-obese or lean patients with NAFLD is increasing.NAFLD in non-obese populations,especially the lean subgroup with a normal waist circumference(WC),might lead to more problems than obese individuals,as these individuals may not visit clinics for NAFLD diagnosis or ignore the diagnosis of NAFLD.If the precise characteristics of these populations,especially the lean subgroup,are identified,the clinicians would be able to provide more appropriate advice and treatment to these populations.AIM To investigate the prevalence,clinical characteristics,risk factors,and possible indicators for NAFLD in lean Chinese adults with a normal WC.METHODS People without diabetes mellitus or significant alcohol consumption who underwent routine health examinations were included.Their fatty liver index(FLI),abdominal ultrasonography results,and controlled attenuation parameter were all assessed.Genotyping for single-nucleotide polymorphisms associated with NAFLD was performed in another small group consisting of biopsy-proven NAFLD subjects and healthy controls.RESULTS A total of 2715 subjects who underwent routine health examinations were included in the study.Among 810 lean participants with a normal WC,142(17.5%)fulfilled the diagnostic criteria for NAFLD.Waist-height ratio,hemoglobin,platelets,and triglycerides were significant factors associated with the presence of NAFLD in these participants.The appropriate cut-off value of the FLI score in screening for NAFLD in the lean subjects with a normal WC was 25.15,which had a 77.8%sensitivity and 75.9%specificity.There was no significant difference in the single-nucleotide polymorphisms in the SIRT1,APOC3,PNPLA3,AGTR1,and PPARGC1A genes between lean subjects with and without NAFLD(P<0.05).CONCLUSION NAFLD is not uncommon in lean Chinese adults even with a normal WC.Metabolic factors,rather than genetic factors,may play important roles in the development of NAFLD in this population.A lower cut-off value of the FLI score in screening for NAFLD should be used for lean Chinese adults with a normal WC.

Electrolyte solvation chemistry for lithium-sulfur batteries with electrolyte-lean conditions

Lithium-sulfur(Li-S)batteries possess overwhelming energy density of 2654 Wh kg-1,and are considered as the next-generation battery technology for energy demanding applications.Flooded electrolytes are ubiquitously employed in cells to ensure sufficient redox kinetics and preclude the interference of the electrolyte depletion due to side reactions with the lithium metal anode.This strategy is capable of enabling long-lasting,high-capacity and excellent-rate battery performances,but it mask the requirements of practical Li-S batteries,where high-sulfur-loading/content and lean electrolyte are prerequisite to realize the energy-dense Li-S batteries.Sparingly and highly solvating electrolytes have emerged as effective yet simple approaches to decrease the electrolyte/sulfur ratio through altering sulfur species and exerting new reaction pathways.Sparingly solvating electrolytes are characterized by few free solvents to solvate lithium polysulfides,rendering a quasi-solid sulfur conversion and decoupling the reaction mechanisms from electrolyte quantity used in cells;while highly solvating electrolytes adopt highdonicity or high-permittivity solvents and take their advantages of strong solvation ability toward polysulfide intermediates,thereby favoring the polysulfide formation and stabilizing unique radicals,which subsequently accelerate redox kinetics.Both solvation chemistry approaches have their respective features to allow the operation of cells under electrolyte-starved conditions.This Review discusses their unique features and basic physicochemical properties in the working Li-S batteries,presents remaining technical and scientific issues and provides future directions for the electrolyte chemistry to attain highenergy Li-S batteries.