In this paper, one-state on-off intermittency and two-state on-off intermittency are generated in two five- dimensional continuum systems respectively. In each system, a two-dimensional subsystem is driven by the Ross...In this paper, one-state on-off intermittency and two-state on-off intermittency are generated in two five- dimensional continuum systems respectively. In each system, a two-dimensional subsystem is driven by the Rossler chaotic system. The parameter conditions under which the on-off intermittency occurs are discussed in detail. The statistical property of the intermittency is investigated. It is shown that the distribution of the laminar phase duration time follows a power law with an exponent of -3/2, which is a signature of on-off intermittency. Moreover, the phenomenon of intermingled basins is observed when attractors in the two symmetric invariant subspaces are stable. We provide an effective way to generate on-off intermittency based on a chaotic system, which is important for application and theoretical study.展开更多
Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensiona...Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters.Therefore,a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed.True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro.The effects of intermediate principal stress and amplitude on the strength characteristics,deformation characteristics,failure characteristics,and precursors of monzogabbro are analyzed,intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism.Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance.Based on the experimental result,the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed.A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established,and the model predicted results align well with the experimental results.The sensitivity of stress states and model parameters is further explored,and the intermittent disturbance behaviors at different f are predicted.This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.展开更多
Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bl...Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.展开更多
Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to...Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86.Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer.Results In total,143 patients were enrolled(NH group,n=49;NA group,n=47;P group,n=47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001.Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.展开更多
AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive p...AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.展开更多
Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years fol...Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.展开更多
BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymph...BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymphangiomas can give rise to complications such as abdominal pain,bleeding,volvulus,and intussusception.Here,we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.CASE SUMMARY A 66-year-old man presented with intermittent melena,fatigue and refractory anemia nine months prior.Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding.Conservative management,including transfusion,hemostasis,gastric acid secretion inhibition and symptomatic treatment,was performed,but the lesions tended to recur shortly after surgery.Ultimately,the patient underwent capsule endoscopy,which revealed a more than 10 cm lesion accompanied by active bleeding.After singleballoon enteroscopy and biopsy,a diagnosis of jejunal cavernous lymphangioma was confirmed,and the patient underwent surgical resection.No complications or recurrences were observed postoperatively.CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding.Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis.Surgical resection is an effective management method.展开更多
Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed ...Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed that two cycles of fasting treatment significantly inhibited breast tumor growth and lung tissue metastasis,as well as prolonged overall survival in mice bearing 4T1 and 4T07 breast cancer.During this process,both the immunosuppressive monocytic-(M-)and granulocytic-(G-)myeloid-derived suppressor cell(MDSC)decreased,accompanied by an increase in interleukin(IL)7R^(+)and granzyme B^(+)T cells in the tumor microenvironment.Interestingly,we observed that Ly6G^(low)G-MDSC sharply decreased after fasting treatment,and the cell surface markers and protein mass spectrometry data showed potential therapeutic targets.Mechanistic investigation revealed that glucose metabolism restriction suppressed the splenic granulocytemonocyte progenitor and the generation of colony-stimulating factors and IL-6,which both contributed to the accumulation of G-MDSC.On the other hand,glucose metabolism restriction can directly induce the apoptosis of Ly6G^(low)G-MDSC,but not Ly6G^(high)subsets.In summary,these results suggest that glucose metabolism restriction induced by fasting treatment attenuates the immune-suppressive milieu and enhances the activation of CD3^(+)T cells,providing potential solutions for enhancing immune-based cancer interventions.展开更多
In this article, we study the nonlinear stochastic heat equation in the spatial domain R^d subject to a Gaussian noise which is white in time and colored in space. The spatial correlation can be any symmetric, nonnega...In this article, we study the nonlinear stochastic heat equation in the spatial domain R^d subject to a Gaussian noise which is white in time and colored in space. The spatial correlation can be any symmetric, nonnegative and nonnegative-definite function that satisfies Dalang's condition. We establish the existence and uniqueness of a random field solution starting from measure-valued initial data. We find the upper and lower bounds for the second moment. With these moment bounds, we first establish some necessary and sufficient conditions for the phase transition of the moment Lyapunov exponents, which extends the classical results from the stochastic heat equation on Z^d to that on R^d.Then, we prove a localization result for the intermittency fronts, which extends results by Conus and Khoshnevisan [9] from one space dimension to higher space dimension. The linear case has been recently proved by Huang et al [17] using different techniques.展开更多
This paper presents a non-autonomous hyper-chaotic system, which is formed by adding a periodic driving signal to a four-dimensional chaotic model extended from the Lorenz system. The resulting non-autonomous hyper-ch...This paper presents a non-autonomous hyper-chaotic system, which is formed by adding a periodic driving signal to a four-dimensional chaotic model extended from the Lorenz system. The resulting non-autonomous hyper-chaotic system can display any dynamic behaviour among the periodic orbits, intermittency, chaos and hyper-chaos by controlling the frequency of the periodic signal. The phenomenon has been well demonstrated by numerical simulations, bifurcation analysis and electronic circuit realization. Moreover, the system is concrete evidence for the presence of Pomeau- Manneville Type-I intermittency and crisis-induced intermittency. The emergence of a different type of intermittency is similarly subjected to the frequency of periodic forcing. By statistical analysis, power scaling laws consisting in different intermittency are obtained for the lifetime in the laminar state between burst states.展开更多
A stroboscopic map for voltage-controlled single ended primary inductor converter (SEPIC) with pulse width modulation (PWM) is presented, where low-frequency oscillating phenomena such as quasi-periodic and interm...A stroboscopic map for voltage-controlled single ended primary inductor converter (SEPIC) with pulse width modulation (PWM) is presented, where low-frequency oscillating phenomena such as quasi-periodic and intermittent quasi-periodic bifurcations occurring in the system are captured by numerical and experimental methods. According to bifurcation diagrams and nonlinear dynamical theory, the characteristics of the low-frequency oscillation and the mechanism for the appearance of the low-frequency oscillation are investigated. It is shown that as the controller parameter varies, the change in the conduction mode takes place from the continuous conduction mode (CCM) under the originally stable period one and high periodic orbits to the intermittent changes between CCM and discontinuous conduction mode (DCM), which may be related to the losing stability of the system and brought the system to exhibiting low-frequency oscillating behaviour in the time domain. Moreover, the occurrence of the intermittent quasi-periodic oscillation reflects that the system undergoes a Neimark-Sacker bifurcation.展开更多
Both the velocity and temperature measurements taken in turbulent Rayleigh-B'enard convection experiments have been analyzed. It is found that both the velocity and temperature fluctuations are intermittent and ca...Both the velocity and temperature measurements taken in turbulent Rayleigh-B'enard convection experiments have been analyzed. It is found that both the velocity and temperature fluctuations are intermittent and can be well-described by the She-Leveque hierarchical structure. A positive correlation between the vertical velocity and the temperature differences is found both at the center, near the sidewall and near the bottom of the convection cell, supporting that buoyancy is significant in the Bolgiano regime. Moreover, the intermittent nature of the temperature fluctuations in the Bolgiano regime can be attributted to the variations in the temperature dissipation rate. However, the relations between the velocity and temperature structure functions and their correlations implied by the Bolgiano-Obukhov scaling are not supported by experimental measurements.展开更多
The intermittency effect has been studied for an interaction of 3.7 A GeV ^16O with emulsion using the distributions of both the pseudorapidity intervals and the azimuthal angle intervals of the shower particles emitt...The intermittency effect has been studied for an interaction of 3.7 A GeV ^16O with emulsion using the distributions of both the pseudorapidity intervals and the azimuthal angle intervals of the shower particles emitted in a central rapidity region. The scaled factorial moments, reduced scaled factorial moments and multifractal moments as functions of the bin size in pseudorapidity and in azimuthal angle have been calculated and have revealed the presence of an intermittent behaviour which may be due to the random cascading property of the reaction. The anomalous fractal dimension has been found to increase with the increase of rank of the moment.展开更多
A sequence of periodic attractors has been observed in a two-dimensional discontinuous map, which canbe considered as a model of impact oscillator. The so-called 'transfer number', which is defined as the mean...A sequence of periodic attractors has been observed in a two-dimensional discontinuous map, which canbe considered as a model of impact oscillator. The so-called 'transfer number', which is defined as the mean numberof transfer from non-impact state to impact state per iteration, is locked onto a lot of rational values to form a curveconsisting of many steps. Our numerical investigation confirms that every step is confined by conditions created by thecollision between the periodic orbit and the discontinuous boundary of the system. After the last collision the systemshows a chaotic motion with intermittent characteristics. Therefore the staircase can be addressed as a 'prelude staircaseto type V intermittency'. The similar phenomenon has also been observed in a model of electric circuit. These resultsof our study suggest that this kind of staircases is common in two (or even higher) dimensional discontinuous maps.展开更多
To improve the understanding of the turbulence intermittency, a detailed investigation of the intermittency of the density fluctuations has been performed in the boundary of J-TEXT. The intermittency of the density fl...To improve the understanding of the turbulence intermittency, a detailed investigation of the intermittency of the density fluctuations has been performed in the boundary of J-TEXT. The intermittency of the density fluctuations and its influence on the radial transport are reported. The probability distribution functions of the density fluctuations are not scale-invariant, being inconsistent with the self-organized criticality hypothesis. The underlying dynamics of the intermittency are detected using the quiet-time statistical method. The probability distribution function of the quiet times shows double-power-law regions, indicating the existence of correlations between the successive burst events.展开更多
This paper investigates the impact of the intermittency of the photovoltaic (PV) power plants on the electric grid frequency management and the consequences that can occur. To meet these purposes, three years data of ...This paper investigates the impact of the intermittency of the photovoltaic (PV) power plants on the electric grid frequency management and the consequences that can occur. To meet these purposes, three years data of the Senegalese grid frequency are used, combined with three PV power plants data since their starting-up. Using these data, we analyzed two days of heavily disturbed operation of the Senegalese grid in order to emphasize the real impact of the presence of PV power plants on the electrical grid. Our study has highlighted that how the intermittency of photovoltaic power plants affects frequency management. It obviously appears that the PV production curves follow the irradiation variations. Instantaneous variations of PV production make it difficult to manage the grid frequency leading to more frequent load shedding as we have shown with the data after the commissioning of the PV power plants. We also estimate the power then energy losses during the load shedding induced by the PV integration on the power grid by comparing a period corresponding to one month before (February 2017) and one month after (February 2018) the integration of variable PV production.展开更多
This paper proposes a passive methodology for detecting a class of stealthy intermittent integrity attacks in cyberphysical systems subject to process disturbances and measurement noise.A stealthy intermittent integri...This paper proposes a passive methodology for detecting a class of stealthy intermittent integrity attacks in cyberphysical systems subject to process disturbances and measurement noise.A stealthy intermittent integrity attack strategy is first proposed by modifying a zero-dynamics attack model.The stealthiness of the generated attacks is rigorously investigated under the condition that the adversary does not know precisely the system state values.In order to help detect such attacks,a backward-in-time detection residual is proposed based on an equivalent quantity of the system state change,due to the attack,at a time prior to the attack occurrence time.A key characteristic of this residual is that its magnitude increases every time a new attack occurs.To estimate this unknown residual,an optimal fixed-point smoother is proposed by minimizing a piece-wise linear quadratic cost function with a set of specifically designed weighting matrices.The smoother design guarantees robustness with respect to process disturbances and measurement noise,and is also able to maintain sensitivity as time progresses to intermittent integrity attack by resetting the covariance matrix based on the weighting matrices.The adaptive threshold is designed based on the estimated backward-in-time residual,and the attack detectability analysis is rigorously investigated to characterize quantitatively the class of attacks that can be detected by the proposed methodology.Finally,a simulation example is used to demonstrate the effectiveness of the developed methodology.展开更多
A new extendable method for the simulation of atmospheric wave-fronts with turbulence intermittency is reported. The purpose is to generate simulations consistent with the distributions observed for the turbulence par...A new extendable method for the simulation of atmospheric wave-fronts with turbulence intermittency is reported. The purpose is to generate simulations consistent with the distributions observed for the turbulence parameters and the seeing, not available with standard methods. The intermittency is included by entering log-normal distributed arrays for the Fried parameter and the spatial coherence outer scale length into an extended form of the phase spectrum. The method is tested on large samples of simulated long-exposure point-source images. The tests show the agreement of the simulations with literature data. The simulations show that the intermittency affects negligibly the long-term median image size but breaks the symmetry of the wave-front phase spectrum, scatters the phase structure function and changes the image profile.展开更多
Through a systematically developed theory,we demonstrate that the motion of Instanton identified in Zhang et al(2017 Phys.Plasmas 24122304)is highly correlated to the intermittent excitation and propagation of geodesi...Through a systematically developed theory,we demonstrate that the motion of Instanton identified in Zhang et al(2017 Phys.Plasmas 24122304)is highly correlated to the intermittent excitation and propagation of geodesic acoustic mode(GAM)that is observed in tokamaks.While many numerical simulations have observed the phenomena,it is the first theory that reveals the physical mechanism behind GAM intermittent excitation and propagation.The preceding work is based on the micro-turbulence associated with toroidal ion temperature gradient mode,and slab-based phenomenological model of zonal flow.When full toroidal effect is introduced into the system,two branches of zonal flow emerge:the torus-modified low frequency zonal flow(TLFZF),and GAM,necessitating a unified exploration of GAM and TLFZF.Indeed,we observe that the transition from the Caviton to Instanton is triggered by a rapid zero-crossing of radial group velocity of drift wave and is found to be strongly correlated with the GAM onset.Many features peculiar to intermittent GAMs,observed in real machines,are thus identified in the numerical experiment.The results will be displayed in figures and in a movie;first for single central rational surface,and then with coupled multiple central rational surfaces.The periodic bursting first shown disappears as being replaced by irregular one,more similar to the intermittent characteristics observed in GAM experiments.展开更多
文摘In this paper, one-state on-off intermittency and two-state on-off intermittency are generated in two five- dimensional continuum systems respectively. In each system, a two-dimensional subsystem is driven by the Rossler chaotic system. The parameter conditions under which the on-off intermittency occurs are discussed in detail. The statistical property of the intermittency is investigated. It is shown that the distribution of the laminar phase duration time follows a power law with an exponent of -3/2, which is a signature of on-off intermittency. Moreover, the phenomenon of intermingled basins is observed when attractors in the two symmetric invariant subspaces are stable. We provide an effective way to generate on-off intermittency based on a chaotic system, which is important for application and theoretical study.
基金the financial support from the National Natural Science Foundation of China(No.52109119)the Guangxi Natural Science Foundation(No.2021GXNSFBA075030)+2 种基金the Guangxi Science and Technology Project(No.Guike AD20325002)the Chinese Postdoctoral Science Fund Project(No.2022 M723408)the Open Research Fund of State Key Laboratory of Simulation and Regulation of Water Cycle in River Basin(China Institute of Water Resources and Hydropower Research)(No.IWHR-SKL-202202).
文摘Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters.Therefore,a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed.True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro.The effects of intermediate principal stress and amplitude on the strength characteristics,deformation characteristics,failure characteristics,and precursors of monzogabbro are analyzed,intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism.Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance.Based on the experimental result,the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed.A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established,and the model predicted results align well with the experimental results.The sensitivity of stress states and model parameters is further explored,and the intermittent disturbance behaviors at different f are predicted.This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.
文摘Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.
基金supported by the National Key Research and Development Program[2022YFC2603500,2022YFC2603505]Capital Clinical Diagnostic Techniques and Translational Application Projects(Z211100002921059)+2 种基金Capital’s Funds for Health Improvement and Research[2022-1-2172]Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support[XMLX 202127]National Science and Technology Major Project of China[2017ZX10203202-003]。
文摘Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86.Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer.Results In total,143 patients were enrolled(NH group,n=49;NA group,n=47;P group,n=47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001.Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.
基金the Nature and Science of Science Technology Department of Fujian Province(No.2020J01233).
文摘AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.
文摘Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.
文摘BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymphangiomas can give rise to complications such as abdominal pain,bleeding,volvulus,and intussusception.Here,we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.CASE SUMMARY A 66-year-old man presented with intermittent melena,fatigue and refractory anemia nine months prior.Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding.Conservative management,including transfusion,hemostasis,gastric acid secretion inhibition and symptomatic treatment,was performed,but the lesions tended to recur shortly after surgery.Ultimately,the patient underwent capsule endoscopy,which revealed a more than 10 cm lesion accompanied by active bleeding.After singleballoon enteroscopy and biopsy,a diagnosis of jejunal cavernous lymphangioma was confirmed,and the patient underwent surgical resection.No complications or recurrences were observed postoperatively.CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding.Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis.Surgical resection is an effective management method.
基金supported by the Postdoctoral Research Funds of Hebei Medical University(30705010016-3759)Natural Science Foundation of China(32272328)+4 种基金Natural Science Foundation of Hebei Province(B2022321001)National Key Research Project of Hebei Province(20375502D)Postdoctoral Research Project of Hebei Province(B2022003031)Science and Technology Research Program of Hebei Provincial Colleges(QN2023229)Hebei Provincial Key Laboratory of Nutrition and Health(2023YDYY-KF05)。
文摘Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed that two cycles of fasting treatment significantly inhibited breast tumor growth and lung tissue metastasis,as well as prolonged overall survival in mice bearing 4T1 and 4T07 breast cancer.During this process,both the immunosuppressive monocytic-(M-)and granulocytic-(G-)myeloid-derived suppressor cell(MDSC)decreased,accompanied by an increase in interleukin(IL)7R^(+)and granzyme B^(+)T cells in the tumor microenvironment.Interestingly,we observed that Ly6G^(low)G-MDSC sharply decreased after fasting treatment,and the cell surface markers and protein mass spectrometry data showed potential therapeutic targets.Mechanistic investigation revealed that glucose metabolism restriction suppressed the splenic granulocytemonocyte progenitor and the generation of colony-stimulating factors and IL-6,which both contributed to the accumulation of G-MDSC.On the other hand,glucose metabolism restriction can directly induce the apoptosis of Ly6G^(low)G-MDSC,but not Ly6G^(high)subsets.In summary,these results suggest that glucose metabolism restriction induced by fasting treatment attenuates the immune-suppressive milieu and enhances the activation of CD3^(+)T cells,providing potential solutions for enhancing immune-based cancer interventions.
基金supported by the National Research Foundation of Korea (NRF-2017R1C1B1005436)the TJ Park Science Fellowship of POSCO TJ Park Foundation
文摘In this article, we study the nonlinear stochastic heat equation in the spatial domain R^d subject to a Gaussian noise which is white in time and colored in space. The spatial correlation can be any symmetric, nonnegative and nonnegative-definite function that satisfies Dalang's condition. We establish the existence and uniqueness of a random field solution starting from measure-valued initial data. We find the upper and lower bounds for the second moment. With these moment bounds, we first establish some necessary and sufficient conditions for the phase transition of the moment Lyapunov exponents, which extends the classical results from the stochastic heat equation on Z^d to that on R^d.Then, we prove a localization result for the intermittency fronts, which extends results by Conus and Khoshnevisan [9] from one space dimension to higher space dimension. The linear case has been recently proved by Huang et al [17] using different techniques.
基金supported in part by the National Natural Science Foundation of China(Grant Nos 60774088 and 10772135)the Program for New Century Excellent Talents in University of China(NCET)+1 种基金the Foundation of the Application Base and Frontier Technology Research Project of Tianjin of China(Grant No 08JCZDJC21900)the Science and Technology Research Key Project of Education Ministry of China(Grant No 107024)
文摘This paper presents a non-autonomous hyper-chaotic system, which is formed by adding a periodic driving signal to a four-dimensional chaotic model extended from the Lorenz system. The resulting non-autonomous hyper-chaotic system can display any dynamic behaviour among the periodic orbits, intermittency, chaos and hyper-chaos by controlling the frequency of the periodic signal. The phenomenon has been well demonstrated by numerical simulations, bifurcation analysis and electronic circuit realization. Moreover, the system is concrete evidence for the presence of Pomeau- Manneville Type-I intermittency and crisis-induced intermittency. The emergence of a different type of intermittency is similarly subjected to the frequency of periodic forcing. By statistical analysis, power scaling laws consisting in different intermittency are obtained for the lifetime in the laminar state between burst states.
基金Project supported by the Natural Science Foundation of Ningxia Autonomous Region,China(Grant No.NZ0954)
文摘A stroboscopic map for voltage-controlled single ended primary inductor converter (SEPIC) with pulse width modulation (PWM) is presented, where low-frequency oscillating phenomena such as quasi-periodic and intermittent quasi-periodic bifurcations occurring in the system are captured by numerical and experimental methods. According to bifurcation diagrams and nonlinear dynamical theory, the characteristics of the low-frequency oscillation and the mechanism for the appearance of the low-frequency oscillation are investigated. It is shown that as the controller parameter varies, the change in the conduction mode takes place from the continuous conduction mode (CCM) under the originally stable period one and high periodic orbits to the intermittent changes between CCM and discontinuous conduction mode (DCM), which may be related to the losing stability of the system and brought the system to exhibiting low-frequency oscillating behaviour in the time domain. Moreover, the occurrence of the intermittent quasi-periodic oscillation reflects that the system undergoes a Neimark-Sacker bifurcation.
文摘Both the velocity and temperature measurements taken in turbulent Rayleigh-B'enard convection experiments have been analyzed. It is found that both the velocity and temperature fluctuations are intermittent and can be well-described by the She-Leveque hierarchical structure. A positive correlation between the vertical velocity and the temperature differences is found both at the center, near the sidewall and near the bottom of the convection cell, supporting that buoyancy is significant in the Bolgiano regime. Moreover, the intermittent nature of the temperature fluctuations in the Bolgiano regime can be attributted to the variations in the temperature dissipation rate. However, the relations between the velocity and temperature structure functions and their correlations implied by the Bolgiano-Obukhov scaling are not supported by experimental measurements.
基金Project supported by the National Natural Science Foundation of China (Grant No 10475054), the Key Program of Ministry of Education, China (Grant No 205026), the Natural Science Foundation of Shanxl Province, China (Grant No 20021007) and Shanxi Provincial Foundation for Returned Scholars, China (Grant No 20031046). We are thankful to Lund University in Sweden plates. Professor 0tterlund I of for supplying the emulsion
文摘The intermittency effect has been studied for an interaction of 3.7 A GeV ^16O with emulsion using the distributions of both the pseudorapidity intervals and the azimuthal angle intervals of the shower particles emitted in a central rapidity region. The scaled factorial moments, reduced scaled factorial moments and multifractal moments as functions of the bin size in pseudorapidity and in azimuthal angle have been calculated and have revealed the presence of an intermittent behaviour which may be due to the random cascading property of the reaction. The anomalous fractal dimension has been found to increase with the increase of rank of the moment.
文摘A sequence of periodic attractors has been observed in a two-dimensional discontinuous map, which canbe considered as a model of impact oscillator. The so-called 'transfer number', which is defined as the mean numberof transfer from non-impact state to impact state per iteration, is locked onto a lot of rational values to form a curveconsisting of many steps. Our numerical investigation confirms that every step is confined by conditions created by thecollision between the periodic orbit and the discontinuous boundary of the system. After the last collision the systemshows a chaotic motion with intermittent characteristics. Therefore the staircase can be addressed as a 'prelude staircaseto type V intermittency'. The similar phenomenon has also been observed in a model of electric circuit. These resultsof our study suggest that this kind of staircases is common in two (or even higher) dimensional discontinuous maps.
基金supported in part by the National Basic Research Program of China (Grant No. 2008CB717805)the National Natural Science Foundation of China (Grant No. 50907029)
文摘To improve the understanding of the turbulence intermittency, a detailed investigation of the intermittency of the density fluctuations has been performed in the boundary of J-TEXT. The intermittency of the density fluctuations and its influence on the radial transport are reported. The probability distribution functions of the density fluctuations are not scale-invariant, being inconsistent with the self-organized criticality hypothesis. The underlying dynamics of the intermittency are detected using the quiet-time statistical method. The probability distribution function of the quiet times shows double-power-law regions, indicating the existence of correlations between the successive burst events.
文摘This paper investigates the impact of the intermittency of the photovoltaic (PV) power plants on the electric grid frequency management and the consequences that can occur. To meet these purposes, three years data of the Senegalese grid frequency are used, combined with three PV power plants data since their starting-up. Using these data, we analyzed two days of heavily disturbed operation of the Senegalese grid in order to emphasize the real impact of the presence of PV power plants on the electrical grid. Our study has highlighted that how the intermittency of photovoltaic power plants affects frequency management. It obviously appears that the PV production curves follow the irradiation variations. Instantaneous variations of PV production make it difficult to manage the grid frequency leading to more frequent load shedding as we have shown with the data after the commissioning of the PV power plants. We also estimate the power then energy losses during the load shedding induced by the PV integration on the power grid by comparing a period corresponding to one month before (February 2017) and one month after (February 2018) the integration of variable PV production.
基金This work was supported by the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skodowska-Curie(101027980(CSPCPS-A-ICA),739551(KIOS CoE-TEAMING))the Italian Ministry for Research in the Framework of the 2017 Program for Research Projects of National Interest(PRIN)(2017YKXYXJ)+3 种基金the National Natural Science Foundation of China(61903188,62073165,62020106003)the Natural Science Foundation of Jiangsu Province(BK20190403)the 111 Project(B20007)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘This paper proposes a passive methodology for detecting a class of stealthy intermittent integrity attacks in cyberphysical systems subject to process disturbances and measurement noise.A stealthy intermittent integrity attack strategy is first proposed by modifying a zero-dynamics attack model.The stealthiness of the generated attacks is rigorously investigated under the condition that the adversary does not know precisely the system state values.In order to help detect such attacks,a backward-in-time detection residual is proposed based on an equivalent quantity of the system state change,due to the attack,at a time prior to the attack occurrence time.A key characteristic of this residual is that its magnitude increases every time a new attack occurs.To estimate this unknown residual,an optimal fixed-point smoother is proposed by minimizing a piece-wise linear quadratic cost function with a set of specifically designed weighting matrices.The smoother design guarantees robustness with respect to process disturbances and measurement noise,and is also able to maintain sensitivity as time progresses to intermittent integrity attack by resetting the covariance matrix based on the weighting matrices.The adaptive threshold is designed based on the estimated backward-in-time residual,and the attack detectability analysis is rigorously investigated to characterize quantitatively the class of attacks that can be detected by the proposed methodology.Finally,a simulation example is used to demonstrate the effectiveness of the developed methodology.
文摘A new extendable method for the simulation of atmospheric wave-fronts with turbulence intermittency is reported. The purpose is to generate simulations consistent with the distributions observed for the turbulence parameters and the seeing, not available with standard methods. The intermittency is included by entering log-normal distributed arrays for the Fried parameter and the spatial coherence outer scale length into an extended form of the phase spectrum. The method is tested on large samples of simulated long-exposure point-source images. The tests show the agreement of the simulations with literature data. The simulations show that the intermittency affects negligibly the long-term median image size but breaks the symmetry of the wave-front phase spectrum, scatters the phase structure function and changes the image profile.
基金supported in part by the National MCF Energy R&D Program of China(Nos.2018YFE0311200 and 2017YFE0301204)National Natural Science Foundation of China(Nos.U1967206,11975231,11805203 and 11775222)+1 种基金Key Research Program of Frontier Science CAS(QYZDB-SSW-SYS004)the US Dept.of Energy(No.DE-FG02-04ER-54742)。
文摘Through a systematically developed theory,we demonstrate that the motion of Instanton identified in Zhang et al(2017 Phys.Plasmas 24122304)is highly correlated to the intermittent excitation and propagation of geodesic acoustic mode(GAM)that is observed in tokamaks.While many numerical simulations have observed the phenomena,it is the first theory that reveals the physical mechanism behind GAM intermittent excitation and propagation.The preceding work is based on the micro-turbulence associated with toroidal ion temperature gradient mode,and slab-based phenomenological model of zonal flow.When full toroidal effect is introduced into the system,two branches of zonal flow emerge:the torus-modified low frequency zonal flow(TLFZF),and GAM,necessitating a unified exploration of GAM and TLFZF.Indeed,we observe that the transition from the Caviton to Instanton is triggered by a rapid zero-crossing of radial group velocity of drift wave and is found to be strongly correlated with the GAM onset.Many features peculiar to intermittent GAMs,observed in real machines,are thus identified in the numerical experiment.The results will be displayed in figures and in a movie;first for single central rational surface,and then with coupled multiple central rational surfaces.The periodic bursting first shown disappears as being replaced by irregular one,more similar to the intermittent characteristics observed in GAM experiments.