There is a perpetual pursuit for free-form glasses and ceramics featuring outstanding mechanical properties as well as chemical and thermal resistance.It is a promising idea to shape inorganic materials in three-dimen...There is a perpetual pursuit for free-form glasses and ceramics featuring outstanding mechanical properties as well as chemical and thermal resistance.It is a promising idea to shape inorganic materials in three-dimensional(3D)forms to reduce their weight while maintaining high mechanical properties.A popular strategy for the preparation of 3D inorganic materials is to mold the organic–inorganic hybrid photoresists into 3D micro-and nano-structures and remove the organic components by subsequent sintering.However,due to the discrete arrangement of inorganic components in the organic-inorganic hybrid photoresists,it remains a huge challenge to attain isotropic shrinkage during sintering.Herein,we demonstrate the isotropic sintering shrinkage by forming the consecutive–Si–O–Si–O–Zr–O–inorganic backbone in photoresists and fabricating 3D glass–ceramic nanolattices with enhanced mechanical properties.The femtosecond(fs)laser is used in two-photon polymerization(TPP)to fabricate 3D green body structures.After subsequent sintering at 1000℃,high-quality 3D glass–ceramic microstructures can be obtained with perfectly intact and smooth morphology.In-suit compression experiments and finite-element simulations reveal that octahedral-truss(oct-truss)lattices possess remarkable adeptness in bearing stress concentration and maintain the structural integrity to resist rod bending,indicating that this structure is a candidate for preparing lightweight and high stiffness glass–ceramic nanolattices.3D printing of such glasses and ceramics has significant implications in a number of industrial applications,including metamaterials,microelectromechanical systems,photonic crystals,and damage-tolerant lightweight materials.展开更多
Electrocardiogram(ECG)signal is one of the noninvasive physiological measurement techniques commonly usedin cardiac diagnosis.However,in real scenarios,the ECGsignal is susceptible to various noise erosion,which affec...Electrocardiogram(ECG)signal is one of the noninvasive physiological measurement techniques commonly usedin cardiac diagnosis.However,in real scenarios,the ECGsignal is susceptible to various noise erosion,which affectsthe subsequent pathological analysis.Therefore,the effective removal of the noise from ECG signals has becomea top priority in cardiac diagnostic research.Aiming at the problem of incomplete signal shape retention andlow signal-to-noise ratio(SNR)after denoising,a novel ECG denoising network,named attention-based residualdense shrinkage network(ARDSN),is proposed in this paper.Firstly,the shallow ECG characteristics are extractedby a shallow feature extraction network(SFEN).Then,the residual dense shrinkage attention block(RDSAB)isused for adaptive noise suppression.Finally,feature fusion representation(FFR)is performed on the hierarchicalfeatures extracted by a series of RDSABs to reconstruct the de-noised ECG signal.Experiments on the MIT-BIHarrhythmia database and MIT-BIH noise stress test database indicate that the proposed scheme can effectively resistthe interference of different sources of noise on the ECG signal.展开更多
The effect of urban shrinkage has gradually become a new topic.Theoretically,urban shrinkage may exert great influence on land use efficiency(LUE)through various urban subsystems,but there is currently limited researc...The effect of urban shrinkage has gradually become a new topic.Theoretically,urban shrinkage may exert great influence on land use efficiency(LUE)through various urban subsystems,but there is currently limited research examining these pathways.Using the Super-SBM-Undesirable model and the Structural Equation Model(SEM),this study calculates the LUE of shrinking cities in Northeast China and simulates the process of urban shrinkage affecting LUE.To quantify the process of urban shrinkage affecting LUE,three mediation variables,namely the economy,public services,and innovation,are used as latent variables to apply SEM.The results show that urban shrinkage will affect LUE through a direct path and indirect paths.In the direct path,urban shrinkage leads to an improvement in LUE.In the indirect paths,the economy and innovation will transmit the negative effect of urban shrinkage on LUE,while public services will reverse this effect.An important contribution of this study is that it quantifies the paths of urban shrinkage affecting LUE,thereby expanding the understanding of urban shrinkage effect and laying a foundation for the sustainable development of shrinking cities.展开更多
This paper explores the shrinkage of reinforced UHPC under high-temperature steam curing and natural curing conditions.The results are compared with the existing shrinkage prediction models.The results show that the m...This paper explores the shrinkage of reinforced UHPC under high-temperature steam curing and natural curing conditions.The results are compared with the existing shrinkage prediction models.The results show that the maximum shrinkage strain of reinforced UHPC after steam curing is 164μεand gradually becomes zero.As for natural curing,the maximum shrinkage strain is 173μεand the value stabilizes on the 10th day after pouring.This indicated that steam curing can significantly reduce shrinkage time.Compared with the plain UHPC tested in the previous literature,the structural reinforcement can significantly inhibit the UHPC shrinkage and greatly reduce the risk of cracking due to shrinkage.By comparing the results in this paper with the existing models for predicting the shrinkage strain development,it is found that the formula recommended in the French UHPC structural and technical specification is suitable for the shrinkage curve in the present paper.展开更多
The shrinkage of the Aral Sea,which is closely related to the Amu Darya River,strongly affects the sustainability of the local natural ecosystem,agricultural production,and human well-being.In this study,we used the B...The shrinkage of the Aral Sea,which is closely related to the Amu Darya River,strongly affects the sustainability of the local natural ecosystem,agricultural production,and human well-being.In this study,we used the Bayesian Estimator of Abrupt change,Seasonal change,and Trend(BEAST)model to detect the historical change points in the variation of the Aral Sea and the Amu Darya River and analyse the causes of the Aral Sea shrinkage during the 1950–2016 period.Further,we applied multifractal detrend cross-correlation analysis(MF-DCCA)and quantitative analysis to investigate the responses of the Aral Sea to the runoff in the Amu Darya River,which is the main source of recharge to the Aral Sea.Our results showed that two significant trend change points in the water volume change of the Aral Sea occurred,in 1961 and 1974.Before 1961,the water volume in the Aral Sea was stable,after which it began to shrink,with a shrinkage rate fluctuating around 15.21 km3/a.After 1974,the water volume of the Aral Sea decreased substantially at a rate of up to 48.97 km3/a,which was the highest value recorded in this study.In addition,although the response of the Aral Sea's water volume to its recharge runoff demonstrated a complex non-linear relationship,the replenishment of the Aral Sea by the runoff in the lower reaches of the Amu Darya River was identified as the dominant factor affecting the Aral Sea shrinkage.Based on the scenario analyses,we concluded that it is possible to slow down the retreat of the Aral Sea and restore its ecosystem by increasing the efficiency of agricultural water use,decreasing agricultural water use in the middle and lower reaches,reducing ineffective evaporation from reservoirs and wetlands,and increasing the water coming from the lower reaches of the Amu Darya River to the 1961–1973 level.These measures would maintain and stabilise the water area and water volume of the Aral Sea in a state of ecological restoration.Therefore,this study focuses on how human consumption of recharge runoff affects the Aral Sea and provides scientific perspective on its ecological conservation and sustainable development.展开更多
This paper examines national urban agglomerations by taking factor flows as the focal point as the research subject.By dividing the stages of urban agglomeration development,a comprehensive framework of urban shrinkag...This paper examines national urban agglomerations by taking factor flows as the focal point as the research subject.By dividing the stages of urban agglomeration development,a comprehensive framework of urban shrinkage is constructed,encompassing economic,population,and social shrinkage.The study explores the spatial distribution characteristics of urban shrinkage during different stages of urban agglomeration and investigates the influencing factors using a geographic detector model.The findings reveal that urban shrinkage within urban agglomerations is widely spread,predominantly in peripheral areas.During the diffusion stage,urban shrinkage is scattered,with population shrinkage concentrated in peripheral regions,economic shrinkage concentrated on old industrial cities,and social shrinkage concentrated on the northeast.The outcomes of the geographic detector model indicate that traffic flow,capital flow,information flow,node importance,network connectivity,government investment,openness,and environmental regulations all play significant roles in shaping the spatial distribution of urban shrinkage.展开更多
Recycling solid waste in cement-based materials cannot only ease its load on the natural environment but also reduce the carbon emissions of building materials.This study aims to investigate the effect of recycled gla...Recycling solid waste in cement-based materials cannot only ease its load on the natural environment but also reduce the carbon emissions of building materials.This study aims to investigate the effect of recycled glass powder(RGP)on the early-age mechanical properties and autogenous shrinkage of cement pastes,where cement is replaced by 10%,20%and 30%of RGP.In addition,the microstructure and nano-mechanical properties of cement paste with different RGP content and water to binder(W/B)ratio were also evaluated using SEM,MIP and nanoindentation techniques.The results indicate that the early-age autogenous shrinkage decreases with the increase of RGP content and W/B ratio.While the mechanical strength deteriorates due to the addition of RGP,it can be compensated by reducing the W/B ratio.Although the addition of RGP increases the total porosity of the hardened paste,it reduces the small size porosity(<50 nm).In addition,the proportions of different types of C-S-H are changed,and the volume fraction of porosity is increased,but that of hydration products of cement paste is reduced due to the incorporation of RGP.Besides its pozzolanic activity,the mitigated shrinkage deformation that RGP is generating in cement pastes is encouraging for its use as a novel supplementary cementitious material that reduces the early-age cracking risk of cement-based materials.Meanwhile,the life cycle assessments indicate that the RGP-cement component is an economical and eco-friendly novel engineering material.展开更多
Steel slag is characterized by high strength,good wear resistance and micro-expansion.This study aims at exploring the potential of steel slag in cement stabilized aggregates,mainly including mechanical properties,shr...Steel slag is characterized by high strength,good wear resistance and micro-expansion.This study aims at exploring the potential of steel slag in cement stabilized aggregates,mainly including mechanical properties,shrinkage and compensation mechanisms.For this purpose,the compressive strength and compressive resilient modulus of cement stabilized aggregates with different steel slag contents(CSMS)were initially investigated.Subsequently,the effects of steel slag and cement on dry shrinkage,temperature shrinkage,and total shrinkage were analyzed through a series of shrinkage test designs.Additionally,in combination with X-ray diffraction(XRD)and Scanning electron microscope(SEM),the characteristic peaks and microscopic images of cement,steel slag and cement-steel slag at different hydration ages were analyzed to identify the chemical substances causing the expansion volume of steel slag and reveal the compensation mechanism of CSMS.The results show that the introduction of 20%steel slag improved the mechanical properties of CSMS by 16.7%,reduced dry shrinkage by 21%,increased temperature shrinkage by 5.8%and reduced its total shrinkage by 19.2%.Compared with the hydration reaction of cement alone,the composite hydration reaction of steel slag with cement does not produce new hydrates.Furthermore,it is noteworthy that the volume expansion of the f-CaO hydration reaction in steel slag can compensate for the volume shrinkage of cement-stabilized macadam.This research can provide a solid theoretical basis for the application and promotion of steel slag in cement-stabilized macadam and reduce the possibility of shrinkage cracking.展开更多
Urban shrinkage is a global phenomenon,and it will coexist with urban growth for many years.At the same time,the network connection between cities continuously improved due to the construction of the transportation an...Urban shrinkage is a global phenomenon,and it will coexist with urban growth for many years.At the same time,the network connection between cities continuously improved due to the construction of the transportation and information networks.However,the relationship between urban network externalities and urban population growth/shrinkage remains unclear.Therefore,based on high-speed railway(HSR)flow data,a spatial econometric model is used to explore the mechanism behind urban population growth and shrinkage from the perspective of network externalities in China.The results indicate that:1)the urban network experiences a certain clubbing effect.Growing cities that are strongly connected are concentrated along China’s main railway lines and the southeastern coastal areas,while shrinking cities that are weakly connected are distributed at the periphery of the network.2)Moreover,the network externality disregards spatial distance and together with the agglomeration externality influences the growth and shrinking of cities.3)Urban economic development still promotes the development of Chinese cities.However,the improvement of the urban economy has a negative cross-regional spillover effect on neighboring cities due to urban competition.4)Lastly,Local spillovers of urban network externalities are positive,while cross-regional ones are negative.Consequently,the government needs to promote the construction of multi-dimensional network connections between cities to promote cities’sustainable development.This study reveals the relationship between urban network externalities and urban development,enriches the theories of network externalities and urban growth/shrinkage,and provides a reference for regional coordinated development.展开更多
The study explores the asymptotic consistency of the James-Stein shrinkage estimator obtained by shrinking a maximum likelihood estimator. We use Hansen’s approach to show that the James-Stein shrinkage estimator con...The study explores the asymptotic consistency of the James-Stein shrinkage estimator obtained by shrinking a maximum likelihood estimator. We use Hansen’s approach to show that the James-Stein shrinkage estimator converges asymptotically to some multivariate normal distribution with shrinkage effect values. We establish that the rate of convergence is of order and rate , hence the James-Stein shrinkage estimator is -consistent. Then visualise its consistency by studying the asymptotic behaviour using simulating plots in R for the mean squared error of the maximum likelihood estimator and the shrinkage estimator. The latter graphically shows lower mean squared error as compared to that of the maximum likelihood estimator.展开更多
With the rapid development of deep learning methods, the data-driven approach has shown powerful advantages over the model-driven one. In this paper, we propose an end-to-end autoencoder communication system based on ...With the rapid development of deep learning methods, the data-driven approach has shown powerful advantages over the model-driven one. In this paper, we propose an end-to-end autoencoder communication system based on Deep Residual Shrinkage Networks (DRSNs), where neural networks (DNNs) are used to implement the coding, decoding, modulation and demodulation functions of the communication system. Our proposed autoencoder communication system can better reduce the signal noise by adding an “attention mechanism” and “soft thresholding” modules and has better performance at various signal-to-noise ratios (SNR). Also, we have shown through comparative experiments that the system can operate at moderate block lengths and support different throughputs. It has been shown to work efficiently in the AWGN channel. Simulation results show that our model has a higher Bit-Error-Rate (BER) gain and greatly improved decoding performance compared to conventional modulation and classical autoencoder systems at various signal-to-noise ratios.展开更多
In the current scenario,Lake Urmia,one of the vastest hyper saline lakes on the Earth,has been affected by serious environmental degradation.Using different satellite images and observational data,this study investiga...In the current scenario,Lake Urmia,one of the vastest hyper saline lakes on the Earth,has been affected by serious environmental degradation.Using different satellite images and observational data,this study investigated the changes in the lake for the period 1970–2020 based on the effects of climate change and several human-induced processes on Lake Urmia,such as population growth,excessive dam construction,low irrigation water use efficiency,poor water resources management,increased sediment flow into the lake,and lack of political and legal frameworks.The results indicated that between 1970 and 1997,the process of change in Lake Urmia was slow;however;the shrinkage was faster between 1998 and 2018,with about 30.00%of the lake area disappearing.As per the findings,anthropogenic factors had a much greater impact on Lake Urmia than climate change and prolonged drought;the mismanagement of water consumption in the agricultural sector and surface and underground water withdrawals in the basin have resulted in a sharp decrease in the lake's surface.These challenges have serious implications for water resources management in Lake Urmia Basin.Therefore,we provided a comprehensive overview of anthropogenic factors on the changes in Lake Urmia along with existing opportunities for better water resources management in Lake Urmia Basin.This study serves as a guideline framework for climate scientists and hydrologists in order to assess the effects of different factors on lake water resources and for decision-makers to formulate strategies and plans according to the management task.展开更多
Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicult...Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.展开更多
This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled ...This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled from the Three Gorges Dam.The mechanical properties of the laboratory dam concrete,whether cured in natural or standard environments,continued to improve over time.Furthermore,the laboratory dam concrete exhibited good resistance to diffusion and a refined microstructure after 17 years.However,curing and long-term exposure to the local natural environment reduced the frost resistance.Microstructural analyses of the laboratory concrete samples demonstrated that moderate-heat cement and fine fly ash(FA)particles were almost fully hydrated to form compact micro structures consisting of large quantities of homogeneous calcium(alumino)silicate hydrate(C-(A)-S-H)gels and a few crystals.No obvious interfacial transition zones were observed in the microstructure owing to the longterm pozzolanic reaction.This dense and homogenous microstructure was the crucial reason for the excellent long-term performance of the dam concrete.A high FA volume also played a significant role in the microstructural densification and performance growth of dam concrete at a later age.The concrete drilled from the dam surface exhibited a loose microstructure with higher microporosity,indicating that concrete directly exposed to the actual service environment suffered degradation caused by water and wind attacks.In this study,both macro-performance and microstructural analyses revealed that the application of moderate-heat cement and FA resulted in a dense and homogenous microstructure,which ensured the excellent long-term performance of concrete from the Three Gorges Dam after 17 years.Long-term exposure to an actual service environment may lead to microstructural degradation of the concrete surface.Therefore,the retained long-term dam concrete samples need to be further researched to better understand its microstructural evolution and development of its properties.展开更多
Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have no...Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.展开更多
BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis an...BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.展开更多
BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there hav...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there have been no specific studies on predicting long-term survival after TIPS placement.AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.METHODS A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS implantation.Through univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after TIPS.Consequently,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)level.Furthermore,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing models.RESULTS The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement.The NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation cohorts.Additionally,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients and guide follow-up management after TIPS implantation.展开更多
Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitte...Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.展开更多
The application of reclaimed asphalt pavement(RAP)and reclaimed asphalt shingles(RAS)on asphalt pavement can reduce the asphalt paving cost,conserve energy and protect the environment.However,the use of high contents ...The application of reclaimed asphalt pavement(RAP)and reclaimed asphalt shingles(RAS)on asphalt pavement can reduce the asphalt paving cost,conserve energy and protect the environment.However,the use of high contents of RAP and RAS in asphalt pavement may lead to durability issues,especially the fatigue cracking and thermal cracking.It is necessary to conduct a series of analyses on asphalt mixtures containing high RAP and RAS,and seek methods to enhance their long-term performance.This paper provides a comprehensive over-view of the long-term performance of recycled asphalt mixtures containing high contents of RAP and RAS.The findings in this research show that rutting resistance of high recycled asphalt mixtures is not a concern,whereas their resistance to fatigue and thermal cracking is not conclusive.Recycling agents can be used to improve the thermal cracking resistance of high recycled asphalt mixtures.An optimum decision on recycling agents will improve the durability properties of high recycled asphalt mixtures.It is recommended that to use a balanced mixture design approach with testing of the blended asphalt binders will provide better understanding of long-term performance of recycled asphalt mixtures containing high RAP and RAS.展开更多
基金supported by the National Key Research and Development Program of China(2020YFA0715000)the Hainan Provincial Joint Project of Sanya Yazhou Bay Science and Technology City(2021JJLH0058)the Guangdong Basic and Applied Basic Research Foundation(2021B1515120041)。
文摘There is a perpetual pursuit for free-form glasses and ceramics featuring outstanding mechanical properties as well as chemical and thermal resistance.It is a promising idea to shape inorganic materials in three-dimensional(3D)forms to reduce their weight while maintaining high mechanical properties.A popular strategy for the preparation of 3D inorganic materials is to mold the organic–inorganic hybrid photoresists into 3D micro-and nano-structures and remove the organic components by subsequent sintering.However,due to the discrete arrangement of inorganic components in the organic-inorganic hybrid photoresists,it remains a huge challenge to attain isotropic shrinkage during sintering.Herein,we demonstrate the isotropic sintering shrinkage by forming the consecutive–Si–O–Si–O–Zr–O–inorganic backbone in photoresists and fabricating 3D glass–ceramic nanolattices with enhanced mechanical properties.The femtosecond(fs)laser is used in two-photon polymerization(TPP)to fabricate 3D green body structures.After subsequent sintering at 1000℃,high-quality 3D glass–ceramic microstructures can be obtained with perfectly intact and smooth morphology.In-suit compression experiments and finite-element simulations reveal that octahedral-truss(oct-truss)lattices possess remarkable adeptness in bearing stress concentration and maintain the structural integrity to resist rod bending,indicating that this structure is a candidate for preparing lightweight and high stiffness glass–ceramic nanolattices.3D printing of such glasses and ceramics has significant implications in a number of industrial applications,including metamaterials,microelectromechanical systems,photonic crystals,and damage-tolerant lightweight materials.
基金the National Natural Science Foundation of China under Grant 62172059 and 62072055Hunan Provincial Natural Science Foundations of China under Grant 2022JJ50318 and 2022JJ30621Scientific Research Fund of Hunan Provincial Education Department of China under Grant 22A0200 and 20K098。
文摘Electrocardiogram(ECG)signal is one of the noninvasive physiological measurement techniques commonly usedin cardiac diagnosis.However,in real scenarios,the ECGsignal is susceptible to various noise erosion,which affectsthe subsequent pathological analysis.Therefore,the effective removal of the noise from ECG signals has becomea top priority in cardiac diagnostic research.Aiming at the problem of incomplete signal shape retention andlow signal-to-noise ratio(SNR)after denoising,a novel ECG denoising network,named attention-based residualdense shrinkage network(ARDSN),is proposed in this paper.Firstly,the shallow ECG characteristics are extractedby a shallow feature extraction network(SFEN).Then,the residual dense shrinkage attention block(RDSAB)isused for adaptive noise suppression.Finally,feature fusion representation(FFR)is performed on the hierarchicalfeatures extracted by a series of RDSABs to reconstruct the de-noised ECG signal.Experiments on the MIT-BIHarrhythmia database and MIT-BIH noise stress test database indicate that the proposed scheme can effectively resistthe interference of different sources of noise on the ECG signal.
基金Under the auspices of the National Natural Science Foundation of China(No.42071219,42171198)。
文摘The effect of urban shrinkage has gradually become a new topic.Theoretically,urban shrinkage may exert great influence on land use efficiency(LUE)through various urban subsystems,but there is currently limited research examining these pathways.Using the Super-SBM-Undesirable model and the Structural Equation Model(SEM),this study calculates the LUE of shrinking cities in Northeast China and simulates the process of urban shrinkage affecting LUE.To quantify the process of urban shrinkage affecting LUE,three mediation variables,namely the economy,public services,and innovation,are used as latent variables to apply SEM.The results show that urban shrinkage will affect LUE through a direct path and indirect paths.In the direct path,urban shrinkage leads to an improvement in LUE.In the indirect paths,the economy and innovation will transmit the negative effect of urban shrinkage on LUE,while public services will reverse this effect.An important contribution of this study is that it quantifies the paths of urban shrinkage affecting LUE,thereby expanding the understanding of urban shrinkage effect and laying a foundation for the sustainable development of shrinking cities.
基金financial support received from the National Natural Science Foundation of China(No.52108211)Hunan Provincial Department of Education(No.21B0188)+1 种基金Natural Science Foundation of Hunan Province(No.2022JJ40186)Water Resources Science and Technology Program of Hunan Province(No.XSKJ2023059-44).
文摘This paper explores the shrinkage of reinforced UHPC under high-temperature steam curing and natural curing conditions.The results are compared with the existing shrinkage prediction models.The results show that the maximum shrinkage strain of reinforced UHPC after steam curing is 164μεand gradually becomes zero.As for natural curing,the maximum shrinkage strain is 173μεand the value stabilizes on the 10th day after pouring.This indicated that steam curing can significantly reduce shrinkage time.Compared with the plain UHPC tested in the previous literature,the structural reinforcement can significantly inhibit the UHPC shrinkage and greatly reduce the risk of cracking due to shrinkage.By comparing the results in this paper with the existing models for predicting the shrinkage strain development,it is found that the formula recommended in the French UHPC structural and technical specification is suitable for the shrinkage curve in the present paper.
基金supported by the National Natural Science Foundation of China (42230708)the Joint CAS (Chinese Academy of Sciences) & MPG (Max-Planck-Gesellschaft) Research Project (HZXM20225001MI)the Tianshan Talent Project of Xinjiang Uygur Autonomous Region, China (2022TSYCLJ0056)。
文摘The shrinkage of the Aral Sea,which is closely related to the Amu Darya River,strongly affects the sustainability of the local natural ecosystem,agricultural production,and human well-being.In this study,we used the Bayesian Estimator of Abrupt change,Seasonal change,and Trend(BEAST)model to detect the historical change points in the variation of the Aral Sea and the Amu Darya River and analyse the causes of the Aral Sea shrinkage during the 1950–2016 period.Further,we applied multifractal detrend cross-correlation analysis(MF-DCCA)and quantitative analysis to investigate the responses of the Aral Sea to the runoff in the Amu Darya River,which is the main source of recharge to the Aral Sea.Our results showed that two significant trend change points in the water volume change of the Aral Sea occurred,in 1961 and 1974.Before 1961,the water volume in the Aral Sea was stable,after which it began to shrink,with a shrinkage rate fluctuating around 15.21 km3/a.After 1974,the water volume of the Aral Sea decreased substantially at a rate of up to 48.97 km3/a,which was the highest value recorded in this study.In addition,although the response of the Aral Sea's water volume to its recharge runoff demonstrated a complex non-linear relationship,the replenishment of the Aral Sea by the runoff in the lower reaches of the Amu Darya River was identified as the dominant factor affecting the Aral Sea shrinkage.Based on the scenario analyses,we concluded that it is possible to slow down the retreat of the Aral Sea and restore its ecosystem by increasing the efficiency of agricultural water use,decreasing agricultural water use in the middle and lower reaches,reducing ineffective evaporation from reservoirs and wetlands,and increasing the water coming from the lower reaches of the Amu Darya River to the 1961–1973 level.These measures would maintain and stabilise the water area and water volume of the Aral Sea in a state of ecological restoration.Therefore,this study focuses on how human consumption of recharge runoff affects the Aral Sea and provides scientific perspective on its ecological conservation and sustainable development.
基金National Social Science Fund Project(22BZ039)Henan Province Science and Technology Tackling Key Problems Soft Science Project(222400410186)。
文摘This paper examines national urban agglomerations by taking factor flows as the focal point as the research subject.By dividing the stages of urban agglomeration development,a comprehensive framework of urban shrinkage is constructed,encompassing economic,population,and social shrinkage.The study explores the spatial distribution characteristics of urban shrinkage during different stages of urban agglomeration and investigates the influencing factors using a geographic detector model.The findings reveal that urban shrinkage within urban agglomerations is widely spread,predominantly in peripheral areas.During the diffusion stage,urban shrinkage is scattered,with population shrinkage concentrated in peripheral regions,economic shrinkage concentrated on old industrial cities,and social shrinkage concentrated on the northeast.The outcomes of the geographic detector model indicate that traffic flow,capital flow,information flow,node importance,network connectivity,government investment,openness,and environmental regulations all play significant roles in shaping the spatial distribution of urban shrinkage.
基金the Natural Science Foundation of Zhejiang Province(Grant No.LY20E020006)the International Scientific and Technological Cooperation Project of Shaoxing University(Grant No.2019LGGH1009)+1 种基金National Natural Science Foundation of China(Grant No.51602198)Science and Technology R&D Project of Zhejiang Yongjian New Material Technology Co.,Ltd.(Grant No.RD202008)for their financial support to the work present in this paper.
文摘Recycling solid waste in cement-based materials cannot only ease its load on the natural environment but also reduce the carbon emissions of building materials.This study aims to investigate the effect of recycled glass powder(RGP)on the early-age mechanical properties and autogenous shrinkage of cement pastes,where cement is replaced by 10%,20%and 30%of RGP.In addition,the microstructure and nano-mechanical properties of cement paste with different RGP content and water to binder(W/B)ratio were also evaluated using SEM,MIP and nanoindentation techniques.The results indicate that the early-age autogenous shrinkage decreases with the increase of RGP content and W/B ratio.While the mechanical strength deteriorates due to the addition of RGP,it can be compensated by reducing the W/B ratio.Although the addition of RGP increases the total porosity of the hardened paste,it reduces the small size porosity(<50 nm).In addition,the proportions of different types of C-S-H are changed,and the volume fraction of porosity is increased,but that of hydration products of cement paste is reduced due to the incorporation of RGP.Besides its pozzolanic activity,the mitigated shrinkage deformation that RGP is generating in cement pastes is encouraging for its use as a novel supplementary cementitious material that reduces the early-age cracking risk of cement-based materials.Meanwhile,the life cycle assessments indicate that the RGP-cement component is an economical and eco-friendly novel engineering material.
基金National Natural Science Foundation of China(Grant No.52078051)Fundamental Research Funds for the Central Universities(Grant No.310821163502)+1 种基金Technology Innovation Project of Shandong Department of Industry and Information(Grant No.Lugongxinji 2020-8)the Transportation Department of Shandong Province(Grant No.Lujiaokeji 2017-28).
文摘Steel slag is characterized by high strength,good wear resistance and micro-expansion.This study aims at exploring the potential of steel slag in cement stabilized aggregates,mainly including mechanical properties,shrinkage and compensation mechanisms.For this purpose,the compressive strength and compressive resilient modulus of cement stabilized aggregates with different steel slag contents(CSMS)were initially investigated.Subsequently,the effects of steel slag and cement on dry shrinkage,temperature shrinkage,and total shrinkage were analyzed through a series of shrinkage test designs.Additionally,in combination with X-ray diffraction(XRD)and Scanning electron microscope(SEM),the characteristic peaks and microscopic images of cement,steel slag and cement-steel slag at different hydration ages were analyzed to identify the chemical substances causing the expansion volume of steel slag and reveal the compensation mechanism of CSMS.The results show that the introduction of 20%steel slag improved the mechanical properties of CSMS by 16.7%,reduced dry shrinkage by 21%,increased temperature shrinkage by 5.8%and reduced its total shrinkage by 19.2%.Compared with the hydration reaction of cement alone,the composite hydration reaction of steel slag with cement does not produce new hydrates.Furthermore,it is noteworthy that the volume expansion of the f-CaO hydration reaction in steel slag can compensate for the volume shrinkage of cement-stabilized macadam.This research can provide a solid theoretical basis for the application and promotion of steel slag in cement-stabilized macadam and reduce the possibility of shrinkage cracking.
基金Under the auspices of the National Natural Science Foundation of China (No.41971167)Fundamental Scientific Research Funds of Central China Normal University (No.CCNU22JC0262022CXZZ005)。
文摘Urban shrinkage is a global phenomenon,and it will coexist with urban growth for many years.At the same time,the network connection between cities continuously improved due to the construction of the transportation and information networks.However,the relationship between urban network externalities and urban population growth/shrinkage remains unclear.Therefore,based on high-speed railway(HSR)flow data,a spatial econometric model is used to explore the mechanism behind urban population growth and shrinkage from the perspective of network externalities in China.The results indicate that:1)the urban network experiences a certain clubbing effect.Growing cities that are strongly connected are concentrated along China’s main railway lines and the southeastern coastal areas,while shrinking cities that are weakly connected are distributed at the periphery of the network.2)Moreover,the network externality disregards spatial distance and together with the agglomeration externality influences the growth and shrinking of cities.3)Urban economic development still promotes the development of Chinese cities.However,the improvement of the urban economy has a negative cross-regional spillover effect on neighboring cities due to urban competition.4)Lastly,Local spillovers of urban network externalities are positive,while cross-regional ones are negative.Consequently,the government needs to promote the construction of multi-dimensional network connections between cities to promote cities’sustainable development.This study reveals the relationship between urban network externalities and urban development,enriches the theories of network externalities and urban growth/shrinkage,and provides a reference for regional coordinated development.
文摘The study explores the asymptotic consistency of the James-Stein shrinkage estimator obtained by shrinking a maximum likelihood estimator. We use Hansen’s approach to show that the James-Stein shrinkage estimator converges asymptotically to some multivariate normal distribution with shrinkage effect values. We establish that the rate of convergence is of order and rate , hence the James-Stein shrinkage estimator is -consistent. Then visualise its consistency by studying the asymptotic behaviour using simulating plots in R for the mean squared error of the maximum likelihood estimator and the shrinkage estimator. The latter graphically shows lower mean squared error as compared to that of the maximum likelihood estimator.
文摘With the rapid development of deep learning methods, the data-driven approach has shown powerful advantages over the model-driven one. In this paper, we propose an end-to-end autoencoder communication system based on Deep Residual Shrinkage Networks (DRSNs), where neural networks (DNNs) are used to implement the coding, decoding, modulation and demodulation functions of the communication system. Our proposed autoencoder communication system can better reduce the signal noise by adding an “attention mechanism” and “soft thresholding” modules and has better performance at various signal-to-noise ratios (SNR). Also, we have shown through comparative experiments that the system can operate at moderate block lengths and support different throughputs. It has been shown to work efficiently in the AWGN channel. Simulation results show that our model has a higher Bit-Error-Rate (BER) gain and greatly improved decoding performance compared to conventional modulation and classical autoencoder systems at various signal-to-noise ratios.
文摘In the current scenario,Lake Urmia,one of the vastest hyper saline lakes on the Earth,has been affected by serious environmental degradation.Using different satellite images and observational data,this study investigated the changes in the lake for the period 1970–2020 based on the effects of climate change and several human-induced processes on Lake Urmia,such as population growth,excessive dam construction,low irrigation water use efficiency,poor water resources management,increased sediment flow into the lake,and lack of political and legal frameworks.The results indicated that between 1970 and 1997,the process of change in Lake Urmia was slow;however;the shrinkage was faster between 1998 and 2018,with about 30.00%of the lake area disappearing.As per the findings,anthropogenic factors had a much greater impact on Lake Urmia than climate change and prolonged drought;the mismanagement of water consumption in the agricultural sector and surface and underground water withdrawals in the basin have resulted in a sharp decrease in the lake's surface.These challenges have serious implications for water resources management in Lake Urmia Basin.Therefore,we provided a comprehensive overview of anthropogenic factors on the changes in Lake Urmia along with existing opportunities for better water resources management in Lake Urmia Basin.This study serves as a guideline framework for climate scientists and hydrologists in order to assess the effects of different factors on lake water resources and for decision-makers to formulate strategies and plans according to the management task.
基金supported by the National Natural Science Foundation of China (Grant Nos.41701296 and 42277481)the Natural Science Foundation of Gansu Province (GrantNo.22JR5RA058)the Youth Science and Technology Fund Program of Gansu Province (Grant No.22JR5RA087).
文摘Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.
基金the financial supports provided by the National Natural Science Foundation of China(U2040222,52293431,and 52278259)。
文摘This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled from the Three Gorges Dam.The mechanical properties of the laboratory dam concrete,whether cured in natural or standard environments,continued to improve over time.Furthermore,the laboratory dam concrete exhibited good resistance to diffusion and a refined microstructure after 17 years.However,curing and long-term exposure to the local natural environment reduced the frost resistance.Microstructural analyses of the laboratory concrete samples demonstrated that moderate-heat cement and fine fly ash(FA)particles were almost fully hydrated to form compact micro structures consisting of large quantities of homogeneous calcium(alumino)silicate hydrate(C-(A)-S-H)gels and a few crystals.No obvious interfacial transition zones were observed in the microstructure owing to the longterm pozzolanic reaction.This dense and homogenous microstructure was the crucial reason for the excellent long-term performance of the dam concrete.A high FA volume also played a significant role in the microstructural densification and performance growth of dam concrete at a later age.The concrete drilled from the dam surface exhibited a loose microstructure with higher microporosity,indicating that concrete directly exposed to the actual service environment suffered degradation caused by water and wind attacks.In this study,both macro-performance and microstructural analyses revealed that the application of moderate-heat cement and FA resulted in a dense and homogenous microstructure,which ensured the excellent long-term performance of concrete from the Three Gorges Dam after 17 years.Long-term exposure to an actual service environment may lead to microstructural degradation of the concrete surface.Therefore,the retained long-term dam concrete samples need to be further researched to better understand its microstructural evolution and development of its properties.
基金supported by the National Science Foundation of China(No.31770672 and 3137062)the National Basic Research Program of China(No.2010CB950602)。
文摘Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022 and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.2021-1-I2M-003+1 种基金Undergraduate Innovation Program,No.2023-zglc-06034National Key Clinical Specialty Construction Project,No.ZK108000。
文摘BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.
基金Supported by the Talent Training Plan during the"14th Five-Year Plan"period of Beijing Shijitan Hospital Affiliated to Capital Medical University,No.2023LJRCLFQ.
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there have been no specific studies on predicting long-term survival after TIPS placement.AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.METHODS A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS implantation.Through univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after TIPS.Consequently,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)level.Furthermore,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing models.RESULTS The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement.The NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation cohorts.Additionally,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients and guide follow-up management after TIPS implantation.
文摘Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.
基金supported by National Natural Science Fund for Excellent Young Scientists Fund Program (Overseas) (Grant No.22FAA02811)Pearl River Talent Plan for the Introduction of High-level Talents (Young Top-notch Talents) (Grant No.2021QN02G744)+1 种基金National Natural Science Foundation of China (Grant No.52178426)the Fundamental Research Funds for the Central Universities (Grant No.SCUT 2022ZYGXZR066 and 2023ZYGXZR001).
文摘The application of reclaimed asphalt pavement(RAP)and reclaimed asphalt shingles(RAS)on asphalt pavement can reduce the asphalt paving cost,conserve energy and protect the environment.However,the use of high contents of RAP and RAS in asphalt pavement may lead to durability issues,especially the fatigue cracking and thermal cracking.It is necessary to conduct a series of analyses on asphalt mixtures containing high RAP and RAS,and seek methods to enhance their long-term performance.This paper provides a comprehensive over-view of the long-term performance of recycled asphalt mixtures containing high contents of RAP and RAS.The findings in this research show that rutting resistance of high recycled asphalt mixtures is not a concern,whereas their resistance to fatigue and thermal cracking is not conclusive.Recycling agents can be used to improve the thermal cracking resistance of high recycled asphalt mixtures.An optimum decision on recycling agents will improve the durability properties of high recycled asphalt mixtures.It is recommended that to use a balanced mixture design approach with testing of the blended asphalt binders will provide better understanding of long-term performance of recycled asphalt mixtures containing high RAP and RAS.