Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable...Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable to society.Consequently,there is a pressing need for swift identification of potential threats to preemptively alert law enforcement and security forces,thereby preventing potential attacks or violent incidents.Recent advancements in big data analytics and deep learning have significantly enhanced the capabilities of computer vision in object detection,particularly in identifying firearms.This paper introduces a novel automatic firearm detection surveillance system,utilizing a one-stage detection approach named MARIE(Mechanism for Realtime Identification of Firearms).MARIE incorporates the Single Shot Multibox Detector(SSD)model,which has been specifically optimized to balance the speed-accuracy trade-off critical in firearm detection applications.The SSD model was further refined by integrating MobileNetV2 and InceptionV2 architectures for superior feature extraction capabilities.The experimental results demonstrate that this modified SSD configuration provides highly satisfactory performance,surpassing existing methods trained on the same dataset in terms of the critical speedaccuracy trade-off.Through these innovations,MARIE sets a new standard in surveillance technology,offering a robust solution to enhance public safety effectively.展开更多
BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasi...BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasis are unclear.AIM To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe AC.METHODS We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July 2023.The outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later,employing a propensity score(PS)frame-work.Our primary outcomes were intensive care unit(ICU)admission rates,ICU length of stay,and duration of antibiotic use.RESULTS In total,we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention:The urgent group(≤24 h,n=102)and the elective group(>24 h,n=152).Ninety-three pairs of patients with similar characteristics were selected by PS matching.The urgent ERCP group had more ICU admissions(34.4%vs 21.5%,P=0.05),shorter ICU stays(3 d vs 9 d,P<0.001),fewer antibiotic use(6 d vs 9 d,P<0.001),and shorter hospital stays(9 d vs 18.5 d,P<0.001).There were no significant differences observed in adverse events,in-hospital mortality,recurrent cholangitis occurrence,30-d readmission rate or 30-d mortality.CONCLUSION Urgent one-stage ERCP provides the advantages of a shorter ICU stay,a shorter duration of antibiotic use,and a shorter hospital stay.展开更多
Recent reports suggest that aging is not solely a physiological process in living beings;instead, it should be considered a pathological process or disease(Amorim et al., 2022). Consequently, this process involves a w...Recent reports suggest that aging is not solely a physiological process in living beings;instead, it should be considered a pathological process or disease(Amorim et al., 2022). Consequently, this process involves a wide range of factors, spanning from genetic to environmental factors, and even includes the gut microbiome(GM)(Mayer et al., 2022). All these processes coincide at some point in the inflammatory process, oxidative stress, and apoptosis, at different degrees in various organs and systems that constitute a living organism(Mayer et al., 2022;AguilarHernández et al., 2023).展开更多
Sinter is the core raw material for blast furnaces.Flue pressure,which is an important state parameter,affects sinter quality.In this paper,flue pressure prediction and optimization were studied based on the shapley a...Sinter is the core raw material for blast furnaces.Flue pressure,which is an important state parameter,affects sinter quality.In this paper,flue pressure prediction and optimization were studied based on the shapley additive explanation(SHAP)to predict the flue pressure and take targeted adjustment measures.First,the sintering process data were collected and processed.A flue pressure prediction model was then constructed after comparing different feature selection methods and model algorithms using SHAP+extremely random-ized trees(ET).The prediction accuracy of the model within the error range of±0.25 kPa was 92.63%.SHAP analysis was employed to improve the interpretability of the prediction model.The effects of various sintering operation parameters on flue pressure,the relation-ship between the numerical range of key operation parameters and flue pressure,the effect of operation parameter combinations on flue pressure,and the prediction process of the flue pressure prediction model on a single sample were analyzed.A flue pressure optimization module was also constructed and analyzed when the prediction satisfied the judgment conditions.The operating parameter combination was then pushed.The flue pressure was increased by 5.87%during the verification process,achieving a good optimization effect.展开更多
Recently published in Joule,Feng Liu and colleagues from Shanghai Jiaotong University reported a record-breaking 20.8%power conversion efficiency in organic solar cells(OSCs)with an interpenetrating fibril network act...Recently published in Joule,Feng Liu and colleagues from Shanghai Jiaotong University reported a record-breaking 20.8%power conversion efficiency in organic solar cells(OSCs)with an interpenetrating fibril network active layer morphology,featuring a bulk p-in structure and proper vertical segregation achieved through additive-assisted layer-by-layer deposition.This optimized hierarchical gradient fibrillar morphology and optical management synergistically facilitates exciton diffusion,reduces recombination losses,and enhances light capture capability.This approach not only offers a solution to achieving high-efficiency devices but also demonstrates the potential for commercial applications of OSCs.展开更多
Thin walls of an AZ91 magnesium alloy with fine equiaxed grains were fabricated via cold arc-based wire arc additive manufacturing(CA-WAAM),and the droplet transfer behaviours,microstructures,and mechanical properties...Thin walls of an AZ91 magnesium alloy with fine equiaxed grains were fabricated via cold arc-based wire arc additive manufacturing(CA-WAAM),and the droplet transfer behaviours,microstructures,and mechanical properties were investigated.The results showed that the cold arc process reduced splashing at the moment of liquid bridge breakage and effectively shortened the droplet transfer period.The microstructures of the deposited samples exhibited layered characteristics with alternating distributions of coarse and fine grains.During layer-by-layer deposition,the β-phase precipitated and grew preferentially along grain boundaries,while the fineη-Al_(8)Mn_(5)phase was dispersed in the α-Mg matrix.The mechanical properties of the CA-WAAM deposited sample showed isotropic characteristics.The ultimate tensile strength and elongation in the building direction(BD)were 282.7 MPa and 14.2%,respectively.The microhardness values of the deposited parts were relatively uniform,with an average value of HV 69.6.展开更多
Landslide dams,as frequent natural hazards,pose significant risks to human lives,property,and ecological environments.The grading characteristics and density of dam materials play a crucial role in determining the sta...Landslide dams,as frequent natural hazards,pose significant risks to human lives,property,and ecological environments.The grading characteristics and density of dam materials play a crucial role in determining the stability of landslide dams and the potential for dam breaches.To explore the failure mechanisms and evolutionary processes of landslide dams with varying soil properties,this study conducted a series of flume experiments,considering different grain compositions and material densities.The results demonstrated that grading characteristics significantly influence landslide dam stability,affecting failure patterns,breach processes,and final breach morphologies.Fine-graded materials exhibited a sequence of surface erosion,head-cut erosion,and subsequent surface erosion during the breach process,while well-graded materials typically experienced head-cut erosion followed by surface erosion.In coarse-graded dams,the high permeability of coarse particles allowed the dam to remain stable,as inflows matched outflows.The dam breach model experiments also showed that increasing material density effectively delayed the breach and reduced peak breach flow discharge.Furthermore,higher fine particle content led to a reduction in the residual dam height and the base slope of the final breach profile,although the relationship between peak breach discharge and the content of fine and coarse particles was nonlinear.To better understand breach morphology evolution under different soil characteristics and hydraulic conditions,three key points were identified—erosion point,control point,and scouring point.This study,by examining the evolution of failure patterns,breach processes,and breach flow discharges under various grading and density conditions,offers valuable insights into the mechanisms behind landslide dam failures.展开更多
Objective:To investigate the short-term and medium-term efficacy of one-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation in the treatment of Brucella spondylitis of the l...Objective:To investigate the short-term and medium-term efficacy of one-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation in the treatment of Brucella spondylitis of the lumbar spine.Method:156 cases of Brucella spondylitis of lumbar spine were selected and divided into experimental group(n=80)and combined group(n=76)according to different surgical methods.The experimental group was treated with one-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation.The combined group was treated with one-stage anterior debridement and intertransverse process bone grafting combined with posterior internal fixation.The operative indexes and clinical effects were compared between the two groups.Result:The operation time,intraoperative bleeding volume and time of landing after operation in the experimental group were less than those in the combined group,with statistical significance(P<0.05).VAS score,ODI index,Cobb angle and Frankel grade of nervous function in the two groups were significantly improved after 3 months and 36 months of treatment(P<0.05),but there was no significant difference between the two groups at the same time(P>0.05).There was no significant difference in the excellent and good rate between the two groups after 3 and 36 months of treatment(P>0.05).There was no recurrence of the lesion in both groups.The intertransverse process bone graft healed and the screw-rod system was well fixed.Conclusion:One-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation for treatment of Brucella spondylitis of lumbar spine are effective,with short operation time and less trauma,which are worthy of clinical promotion.展开更多
This study aims to enhance the digital drilling process monitoring(DPM)or monitoring while drilling(MWD)technique,which is a widely recognized method in geological exploration for evaluating rock mass quality.First,ro...This study aims to enhance the digital drilling process monitoring(DPM)or monitoring while drilling(MWD)technique,which is a widely recognized method in geological exploration for evaluating rock mass quality.First,robust displacement and torque measurement facilities for rotary-core drilling are discussed.The conventional cable encoder for displacement measurement is replaced with a magnetostrictive displacement sensor,which is more reliable in harsh field drilling environments.This enables the measurement of the bit position with an accuracy of<1 mm.Most importantly,this new instrument is proven to be successful in improving the detection of structural discontinuities with thicknesses>1 mm.In addition,by measuring the electric current of the driving motor,the torque applied to the bit is conveniently and accurately converted.These innovations ensure high-quality data collection for DPM practices.Second,two indices derived from DPM are proposed to quantitatively describe rock mass quality.The specific energy index(SEI)and specific penetration index(SPI)are based on the principles of energy conservation and Mohr-Coulomb failure criterion,respectively.Extensive field tests conducted in a dam grouting area confirm a linear relationship between the thrust force and penetration per rotation,and between the torque and penetration per rotation.The correlation ratios of the related regressions are typically>0.9.These two indices allow for the quantitative interpretation of DPM data into rock mechanics characteristics,such as uniaxial compressive strength,rock quality designation(RQD),and rock mass permeability,eliminating the need for subjective judgment normally involved in the currently used rock mass quality rating approaches.展开更多
Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to...Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.展开更多
Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poo...Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poor.Survival is largely determined by the complexity and severity of cardiac abnormalities,the efficiency of abdominal wall closure and postoperative complications.A 24-year-old male patient with complete pentalogy of Cantrell was diagnosed.One-stage surgical repair of all abnormalities were completed.The patient recovered well and had been follow-up for 7 years.He has a good cosmetic outcome,with no signs of cardiac dysfunction.No complications were noted.展开更多
BACKGROUND Ochronotic arthropathy(OcA)is a rare disease,which is caused by the accumulation of homogentisic acid in the joint.Patients with OcA have obvious joint pain and the disease progresses rapidly,eventually res...BACKGROUND Ochronotic arthropathy(OcA)is a rare disease,which is caused by the accumulation of homogentisic acid in the joint.Patients with OcA have obvious joint pain and the disease progresses rapidly,eventually resulting in disability.Arthroplasty is an efficacious treatment in patients with OcA.However,when OcA patients have joint infection,is joint replacement an option?In the present report,we performed total knee arthroplasty in a patient with OcA and knee infection under the guidance of one-stage revision theory.CASE SUMMARY A 64-year-old male was referred to our hospital due to severe left knee pain with limited mobility for 2 years.On physical examination,the patient was found to have dark brown pigmentation of the sclera and auricle.Laboratory test results showed elevations in C-reactive protein level(65.79 mg/L)and erythrocyte sedimentation rate(90.00 mm/h).The patient underwent debridement of the left knee joint,during which the cartilage surface of the knee joint was found to be black-brown in color.Bacterial culture of synovial fluid revealed Achromobacter xylosoxidans.We then carried out arthroplasty under the guidance of the theory of one-stage revision.After surgery,the patient’s left knee joint pain disappeared and function recovered without joint infection.CONCLUSION OcA accompanied by joint infection is rare.One-stage revision arthroplasty may be a treatment option for this disease.展开更多
The sensory perception of food is a dynamic process,which is closely related to the release of flavor substances during oral processing.It’s not only affected by the food material,but also subjected to the individual...The sensory perception of food is a dynamic process,which is closely related to the release of flavor substances during oral processing.It’s not only affected by the food material,but also subjected to the individual oral environment.To explore the oral processing characteristics of soft-boiled chicken,the sensory properties,texture,particle size,viscosity,characteristic values of electronic nose and tongue of different chicken samples were investigated.The correlation analysis showed that the physical characteristics especially the cohesiveness,springiness,resilience of the sample determined oral processing behavior.The addition of chicken skin played a role in lubrication during oral processing.The particle size of the bolus was heightened at the early stage,and the fluidity was enhanced in the end,which reduced the chewing time to the swallowing point and raised the aromatic compounds signal of electronic nose.But the effect of chicken skin on chicken thigh with relatively high fat content,was opposite in electronic nose,which had a certain masking effect on the perception of umami and sweet taste.In conclusion,fat played a critical role in chicken oral processing and chicken thigh had obvious advantages in comprehensive evaluation of soft-boiled chicken,which was more popular among people.展开更多
Gas hydrate drilling expeditions in the Pearl River Mouth Basin,South China Sea,have identified concentrated gas hydrates with variable thickness.Moreover,free gas and the coexistence of gas hydrate and free gas have ...Gas hydrate drilling expeditions in the Pearl River Mouth Basin,South China Sea,have identified concentrated gas hydrates with variable thickness.Moreover,free gas and the coexistence of gas hydrate and free gas have been confirmed by logging,coring,and production tests in the foraminifera-rich silty sediments with complex bottom-simulating reflectors(BSRs).The broad-band processing is conducted on conventional three-dimensional(3D)seismic data to improve the image and detection accuracy of gas hydratebearing layers and delineate the saturation and thickness of gas hydrate-and free gas-bearing sediments.Several geophysical attributes extracted along the base of the gas hydrate stability zone are used to demonstrate the variable distribution and the controlling factors for the differential enrichment of gas hydrate.The inverted gas hydrate saturation at the production zone is over 40% with a thickness of 90 m,showing the interbedded distribution with different boundaries between gas hydrate-and free gas-bearing layers.However,the gas hydrate saturation value at the adjacent canyon is 70%,with 30-m-thick patches and linear features.The lithological and fault controls on gas hydrate and free gas distributions are demonstrated by tracing each gas hydrate-bearing layer.Moreover,the BSR depths based on broad-band reprocessed 3D seismic data not only exhibit variations due to small-scale topographic changes caused by seafloor sedimentation and erosion but also show the upward shift of BSR and the blocky distribution of the coexistence of gas hydrate and free gas in the Pearl River Mouth Basin.展开更多
The current methods used to industrially produce sinomenine hydrochloride involve several issues,including high solvent toxicity,long process flow,and low atomic utilization efficiency,and the greenness scores of the ...The current methods used to industrially produce sinomenine hydrochloride involve several issues,including high solvent toxicity,long process flow,and low atomic utilization efficiency,and the greenness scores of the processes are below 65 points.To solve these problems,a new process using anisole as the extractant was proposed.Anisole exhibits high selectivity for sinomenine and can be connected to the subsequent water-washing steps.After alkalization of the medicinal material,heating extraction,water washing,and acidification crystallization were carried out.The process was modeled and optimized.The design space was constructed.The recommended operating ranges for the critical process parameters were 3.0–4.0 h for alkalization time,60.0–80.0℃ for extraction temperature,2.0–3.0(volume ratio)for washing solution amount,and 2.0–2.4 mol·L^(-1) for hydrochloric acid concentration.The new process shows good robustness because different batches of medicinal materials did not greatly impact crystal purity or sinomenine transfer rate.The sinomenine transfer rate was about 20%higher than that of industrial processes.The greenness score increased to 90 points since the novel process proposed in this research solves the problems of long process flow,high solvent toxicity,and poor atomic economy,better aligning with the concept of green chemistry.展开更多
Recently,the increasing interest in wearable technology for personal healthcare and smart virtual/augmented reality applications has led to the development of facile fabrication methods.Lasers have long been used to d...Recently,the increasing interest in wearable technology for personal healthcare and smart virtual/augmented reality applications has led to the development of facile fabrication methods.Lasers have long been used to develop original solutions to such challenging technological problems due to their remote,sterile,rapid,and site-selective processing of materials.In this review,recent developments in relevant laser processes are summarized under two separate categories.First,transformative approaches,such as for laser-induced graphene,are introduced.In addition to design optimization and the alteration of a native substrate,the latest advances under a transformative approach now enable more complex material compositions and multilayer device configurations through the simultaneous transformation of heterogeneous precursors,or the sequential addition of functional layers coupled with other electronic elements.In addition,the more conventional laser techniques,such as ablation,sintering,and synthesis,can still be used to enhance the functionality of an entire system through the expansion of applicable materials and the adoption of new mechanisms.Later,various wearable device components developed through the corresponding laser processes are discussed,with an emphasis on chemical/physical sensors and energy devices.In addition,special attention is given to applications that use multiple laser sources or processes,which lay the foundation for the all-laser fabrication of wearable devices.展开更多
BACKGROUND Bilateral one-stage total knee arthroplasty(BTKA)is now in greater use as an alternative option for patients with bilateral end-stage knee arthropathy.However,postoperative pain and disablement during conva...BACKGROUND Bilateral one-stage total knee arthroplasty(BTKA)is now in greater use as an alternative option for patients with bilateral end-stage knee arthropathy.However,postoperative pain and disablement during convalescence from BTKA,and procedure-related complications have been concerning issues for patients and surgeons.Although some studies reported that BTKA in selected patients is as safe as the staged procedure,well-defined guidelines for patient screening,and perioperative care and monitoring to avoid procedure-related complications are still controversial.AIM To compare the perioperative outcomes including perioperative blood loss(PBL),cardiac biomarkers,pain intensity,functional recovery,and complications between unilateral total knee arthroplasty(UTKA)and BTKA performed with a similar perioperative protocol.METHODS We conducted a retrospective study on consecutive patients undergoing UTKA and BTKA that had been performed by a single surgeon with identical perioperative protocols.The exclusion criteria of this study included patients with an American Society of Anesthesiologists score>3,and known cardiopulmonary comorbidity or high-sensitivity Troponin-T(hs-TnT)>14 ng/L.Outcome measures included visual analogue scale(VAS)score of postoperative pain,morphine consumption,range of knee motion,straight leg raise(SLR),length of stay(LOS),and serum hemoglobin(Hb)and hs-TnT monitored during hospitalization.RESULTS Of 210 UTKA and 137 BTKA patients,those in the BTKA group were younger and more predominately female.The PBL of the UTKA vs BTKA group was 646.45±272.26 mL vs 1012.40±391.95 mL(P<0.01),and blood transfusion rates were 10.48%and 40.88%(P<0.01),respectively.Preoperative Hb and body mass index were predictive factors for blood transfusion in BTKA,whereas preoperative Hb was only a determinant in UTKA patients.The BTKA group had significantly higher VAS scores than the UTKA group at 48,72,and 96 h after surgery,and also had a significantly lower degree of SLR at 72 h.The BTKA group also had a significantly longer LOS than the UTKA group.Of the patients who had undergone the procedure,5.71%of the UTKA patients and 12.41%of the BTKA patients(P=0.04)had hs-TnT>14 ng/L during the first 72 h postoperatively.However,there was no difference in other outcome measures and complications.CONCLUSION Following similar perioperative management,the blood transfusion rate in BTKA is 4-fold that required in UTKA.Also,BTKA is associated with higher pain intensity at 48 h postoperatively and prolonged LOS when compared to the UTKA.Hence,BTKA patients may require more extensive perioperative management for blood loss and pain,even if having no higher risk of complications than UTKA.展开更多
The emergence of polymerized small molecule acceptors(PSMAs)has significantly improved the performance of all-polymer solar cells(all-PSCs).However,the pace of device engineering lacks behind that of materials develop...The emergence of polymerized small molecule acceptors(PSMAs)has significantly improved the performance of all-polymer solar cells(all-PSCs).However,the pace of device engineering lacks behind that of materials development,so that a majority of the PSMAs have not fulfilled their potentials.Furthermore,most high-performance all-PSCs rely on the use of chloroform as the processing solvent.For instance,the recent highperformance PSMA,named PJ1-γ,with high LUMO,and HOMO levels,could only achieve a PCE of 16.1%with a high-energy-level donor(JD40)using chloroform.Herein,we present a methodology combining sequential processing(SqP)with the addition of 0.5%wt PC_(71)BM as a solid additive(SA)to achieve an impressive efficiency of 18.0%for all-PSCs processed from toluene,an aromatic hydrocarbon solvent.Compared to the conventional blend-casting(BC)method whose best efficiency(16.7%)could only be achieved using chloroform,the SqP method significantly boosted the device efficiency using toluene as the processing solvent.In addition,the donor we employ is the classic PM6 that has deeper energy levels than JD40,which provides low energy loss for the device.We compare the results with another PSMA(PYF-T-o)with the same method.Finally,an improved photostability of the SqP devices with the incorporation of SA is demonstrated.展开更多
文摘Security and safety remain paramount concerns for both governments and individuals worldwide.In today’s context,the frequency of crimes and terrorist attacks is alarmingly increasing,becoming increasingly intolerable to society.Consequently,there is a pressing need for swift identification of potential threats to preemptively alert law enforcement and security forces,thereby preventing potential attacks or violent incidents.Recent advancements in big data analytics and deep learning have significantly enhanced the capabilities of computer vision in object detection,particularly in identifying firearms.This paper introduces a novel automatic firearm detection surveillance system,utilizing a one-stage detection approach named MARIE(Mechanism for Realtime Identification of Firearms).MARIE incorporates the Single Shot Multibox Detector(SSD)model,which has been specifically optimized to balance the speed-accuracy trade-off critical in firearm detection applications.The SSD model was further refined by integrating MobileNetV2 and InceptionV2 architectures for superior feature extraction capabilities.The experimental results demonstrate that this modified SSD configuration provides highly satisfactory performance,surpassing existing methods trained on the same dataset in terms of the critical speedaccuracy trade-off.Through these innovations,MARIE sets a new standard in surveillance technology,offering a robust solution to enhance public safety effectively.
基金The study was approved by the Ethics Committee(2019ZDSYLL094-P01).
文摘BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasis are unclear.AIM To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe AC.METHODS We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July 2023.The outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later,employing a propensity score(PS)frame-work.Our primary outcomes were intensive care unit(ICU)admission rates,ICU length of stay,and duration of antibiotic use.RESULTS In total,we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention:The urgent group(≤24 h,n=102)and the elective group(>24 h,n=152).Ninety-three pairs of patients with similar characteristics were selected by PS matching.The urgent ERCP group had more ICU admissions(34.4%vs 21.5%,P=0.05),shorter ICU stays(3 d vs 9 d,P<0.001),fewer antibiotic use(6 d vs 9 d,P<0.001),and shorter hospital stays(9 d vs 18.5 d,P<0.001).There were no significant differences observed in adverse events,in-hospital mortality,recurrent cholangitis occurrence,30-d readmission rate or 30-d mortality.CONCLUSION Urgent one-stage ERCP provides the advantages of a shorter ICU stay,a shorter duration of antibiotic use,and a shorter hospital stay.
基金funded by CONAHCYT grant(252808)to GFCONAHCYT’s“Estancias Posdoctorales por México”program(662350)to HTB。
文摘Recent reports suggest that aging is not solely a physiological process in living beings;instead, it should be considered a pathological process or disease(Amorim et al., 2022). Consequently, this process involves a wide range of factors, spanning from genetic to environmental factors, and even includes the gut microbiome(GM)(Mayer et al., 2022). All these processes coincide at some point in the inflammatory process, oxidative stress, and apoptosis, at different degrees in various organs and systems that constitute a living organism(Mayer et al., 2022;AguilarHernández et al., 2023).
基金supported by the General Program of the National Natural Science Foundation of China(No.52274326)the China Baowu Low Carbon Metallurgy Innovation Foundation(No.BWLCF202109)the Seventh Batch of Ten Thousand Talents Plan of China(No.ZX20220553).
文摘Sinter is the core raw material for blast furnaces.Flue pressure,which is an important state parameter,affects sinter quality.In this paper,flue pressure prediction and optimization were studied based on the shapley additive explanation(SHAP)to predict the flue pressure and take targeted adjustment measures.First,the sintering process data were collected and processed.A flue pressure prediction model was then constructed after comparing different feature selection methods and model algorithms using SHAP+extremely random-ized trees(ET).The prediction accuracy of the model within the error range of±0.25 kPa was 92.63%.SHAP analysis was employed to improve the interpretability of the prediction model.The effects of various sintering operation parameters on flue pressure,the relation-ship between the numerical range of key operation parameters and flue pressure,the effect of operation parameter combinations on flue pressure,and the prediction process of the flue pressure prediction model on a single sample were analyzed.A flue pressure optimization module was also constructed and analyzed when the prediction satisfied the judgment conditions.The operating parameter combination was then pushed.The flue pressure was increased by 5.87%during the verification process,achieving a good optimization effect.
基金Technology Development Program of Jilin Province(YDZJ202201ZYTS640)the National Key Research and Development Program of China(2022YFB4200400)funded by MOST+4 种基金the National Natural Science Foundation of China(52172048 and 52103221)Shandong Provincial Natural Science Foundation(ZR2021QB024 and ZR2021ZD06)Guangdong Basic and Applied Basic Research Foundation(2023A1515012323,2023A1515010943,and 2024A1515010023)the Qingdao New Energy Shandong Laboratory open Project(QNESL OP 202309)the Fundamental Research Funds of Shandong University.
文摘Recently published in Joule,Feng Liu and colleagues from Shanghai Jiaotong University reported a record-breaking 20.8%power conversion efficiency in organic solar cells(OSCs)with an interpenetrating fibril network active layer morphology,featuring a bulk p-in structure and proper vertical segregation achieved through additive-assisted layer-by-layer deposition.This optimized hierarchical gradient fibrillar morphology and optical management synergistically facilitates exciton diffusion,reduces recombination losses,and enhances light capture capability.This approach not only offers a solution to achieving high-efficiency devices but also demonstrates the potential for commercial applications of OSCs.
基金supported by the National Natural Science Foundation of China(No.51805265)the Fundamental Research Funds for the Central Universities,China(No.30922010921).
文摘Thin walls of an AZ91 magnesium alloy with fine equiaxed grains were fabricated via cold arc-based wire arc additive manufacturing(CA-WAAM),and the droplet transfer behaviours,microstructures,and mechanical properties were investigated.The results showed that the cold arc process reduced splashing at the moment of liquid bridge breakage and effectively shortened the droplet transfer period.The microstructures of the deposited samples exhibited layered characteristics with alternating distributions of coarse and fine grains.During layer-by-layer deposition,the β-phase precipitated and grew preferentially along grain boundaries,while the fineη-Al_(8)Mn_(5)phase was dispersed in the α-Mg matrix.The mechanical properties of the CA-WAAM deposited sample showed isotropic characteristics.The ultimate tensile strength and elongation in the building direction(BD)were 282.7 MPa and 14.2%,respectively.The microhardness values of the deposited parts were relatively uniform,with an average value of HV 69.6.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.U22A20602,U2040221,and 42207228)the Sichuan Science and Technology Program(2022NSFSC1060)the Fundamental Research Funds for Central Public Research Institutes(Grant No.Y324006)。
文摘Landslide dams,as frequent natural hazards,pose significant risks to human lives,property,and ecological environments.The grading characteristics and density of dam materials play a crucial role in determining the stability of landslide dams and the potential for dam breaches.To explore the failure mechanisms and evolutionary processes of landslide dams with varying soil properties,this study conducted a series of flume experiments,considering different grain compositions and material densities.The results demonstrated that grading characteristics significantly influence landslide dam stability,affecting failure patterns,breach processes,and final breach morphologies.Fine-graded materials exhibited a sequence of surface erosion,head-cut erosion,and subsequent surface erosion during the breach process,while well-graded materials typically experienced head-cut erosion followed by surface erosion.In coarse-graded dams,the high permeability of coarse particles allowed the dam to remain stable,as inflows matched outflows.The dam breach model experiments also showed that increasing material density effectively delayed the breach and reduced peak breach flow discharge.Furthermore,higher fine particle content led to a reduction in the residual dam height and the base slope of the final breach profile,although the relationship between peak breach discharge and the content of fine and coarse particles was nonlinear.To better understand breach morphology evolution under different soil characteristics and hydraulic conditions,three key points were identified—erosion point,control point,and scouring point.This study,by examining the evolution of failure patterns,breach processes,and breach flow discharges under various grading and density conditions,offers valuable insights into the mechanisms behind landslide dam failures.
基金2018 Hebei health technology research and achievement transformation key project(No.zh2018014)2018 Hebei Medical applicable technology tracking project(No.gl2018074)+1 种基金2017 Zhangjiakou city level plan(No.17120010d)2018 Hebei North University School level scientific research project(No.yb2018010)
文摘Objective:To investigate the short-term and medium-term efficacy of one-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation in the treatment of Brucella spondylitis of the lumbar spine.Method:156 cases of Brucella spondylitis of lumbar spine were selected and divided into experimental group(n=80)and combined group(n=76)according to different surgical methods.The experimental group was treated with one-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation.The combined group was treated with one-stage anterior debridement and intertransverse process bone grafting combined with posterior internal fixation.The operative indexes and clinical effects were compared between the two groups.Result:The operation time,intraoperative bleeding volume and time of landing after operation in the experimental group were less than those in the combined group,with statistical significance(P<0.05).VAS score,ODI index,Cobb angle and Frankel grade of nervous function in the two groups were significantly improved after 3 months and 36 months of treatment(P<0.05),but there was no significant difference between the two groups at the same time(P>0.05).There was no significant difference in the excellent and good rate between the two groups after 3 and 36 months of treatment(P>0.05).There was no recurrence of the lesion in both groups.The intertransverse process bone graft healed and the screw-rod system was well fixed.Conclusion:One-stage posterior debridement,intertransverse process bone grafting and screw-rod system fixation for treatment of Brucella spondylitis of lumbar spine are effective,with short operation time and less trauma,which are worthy of clinical promotion.
基金financially supported by the National Natural Science Foundation of China(Grant No.52079150)Science and Technology Major Project of the Xizang Autonomous Region of China(XZ202201ZD0003G)Water Conservancy Technology Demonstration Project(SF-202404).
文摘This study aims to enhance the digital drilling process monitoring(DPM)or monitoring while drilling(MWD)technique,which is a widely recognized method in geological exploration for evaluating rock mass quality.First,robust displacement and torque measurement facilities for rotary-core drilling are discussed.The conventional cable encoder for displacement measurement is replaced with a magnetostrictive displacement sensor,which is more reliable in harsh field drilling environments.This enables the measurement of the bit position with an accuracy of<1 mm.Most importantly,this new instrument is proven to be successful in improving the detection of structural discontinuities with thicknesses>1 mm.In addition,by measuring the electric current of the driving motor,the torque applied to the bit is conveniently and accurately converted.These innovations ensure high-quality data collection for DPM practices.Second,two indices derived from DPM are proposed to quantitatively describe rock mass quality.The specific energy index(SEI)and specific penetration index(SPI)are based on the principles of energy conservation and Mohr-Coulomb failure criterion,respectively.Extensive field tests conducted in a dam grouting area confirm a linear relationship between the thrust force and penetration per rotation,and between the torque and penetration per rotation.The correlation ratios of the related regressions are typically>0.9.These two indices allow for the quantitative interpretation of DPM data into rock mechanics characteristics,such as uniaxial compressive strength,rock quality designation(RQD),and rock mass permeability,eliminating the need for subjective judgment normally involved in the currently used rock mass quality rating approaches.
文摘Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.
基金Supported by grants from the National Natural Science Foundation of China(81873502 and 31330029)the Fundamental Research Funds for the Central Universities(2017KFYXJJ250)Scientific Research Fund of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology(02.03.2017-307).
文摘Pentalogy of Cantrell is a rare congenital abnormality.Even with high-quality medical care and staged corrective surgeries in professional hospitals,the mortality rate is still very high and long-term prognosis is poor.Survival is largely determined by the complexity and severity of cardiac abnormalities,the efficiency of abdominal wall closure and postoperative complications.A 24-year-old male patient with complete pentalogy of Cantrell was diagnosed.One-stage surgical repair of all abnormalities were completed.The patient recovered well and had been follow-up for 7 years.He has a good cosmetic outcome,with no signs of cardiac dysfunction.No complications were noted.
基金Supported by Talent Training Project of Guangdong Provincial Bureau of Traditional Chinese Medicine,No.0103030908Guangdong Provincial Hospital of Traditional Chinese Medicine and the School of Biomedicine,Chinese University of Hong Kong School of Medicine,Basic Clinical Collaborative Innovation Project,No.YN2018HK04。
文摘BACKGROUND Ochronotic arthropathy(OcA)is a rare disease,which is caused by the accumulation of homogentisic acid in the joint.Patients with OcA have obvious joint pain and the disease progresses rapidly,eventually resulting in disability.Arthroplasty is an efficacious treatment in patients with OcA.However,when OcA patients have joint infection,is joint replacement an option?In the present report,we performed total knee arthroplasty in a patient with OcA and knee infection under the guidance of one-stage revision theory.CASE SUMMARY A 64-year-old male was referred to our hospital due to severe left knee pain with limited mobility for 2 years.On physical examination,the patient was found to have dark brown pigmentation of the sclera and auricle.Laboratory test results showed elevations in C-reactive protein level(65.79 mg/L)and erythrocyte sedimentation rate(90.00 mm/h).The patient underwent debridement of the left knee joint,during which the cartilage surface of the knee joint was found to be black-brown in color.Bacterial culture of synovial fluid revealed Achromobacter xylosoxidans.We then carried out arthroplasty under the guidance of the theory of one-stage revision.After surgery,the patient’s left knee joint pain disappeared and function recovered without joint infection.CONCLUSION OcA accompanied by joint infection is rare.One-stage revision arthroplasty may be a treatment option for this disease.
基金supported by China Agriculture Research System of MOF and MARA(CARS-41)Wens Fifth Five R&D Major Project(WENS-2020-1-ZDZX-007)。
文摘The sensory perception of food is a dynamic process,which is closely related to the release of flavor substances during oral processing.It’s not only affected by the food material,but also subjected to the individual oral environment.To explore the oral processing characteristics of soft-boiled chicken,the sensory properties,texture,particle size,viscosity,characteristic values of electronic nose and tongue of different chicken samples were investigated.The correlation analysis showed that the physical characteristics especially the cohesiveness,springiness,resilience of the sample determined oral processing behavior.The addition of chicken skin played a role in lubrication during oral processing.The particle size of the bolus was heightened at the early stage,and the fluidity was enhanced in the end,which reduced the chewing time to the swallowing point and raised the aromatic compounds signal of electronic nose.But the effect of chicken skin on chicken thigh with relatively high fat content,was opposite in electronic nose,which had a certain masking effect on the perception of umami and sweet taste.In conclusion,fat played a critical role in chicken oral processing and chicken thigh had obvious advantages in comprehensive evaluation of soft-boiled chicken,which was more popular among people.
基金supported by the State Key Laboratory of Natural Gas Hydrate(No.2022-KFJJ-SHW)the National Natural Science Foundation of China(No.42376058)+2 种基金the International Science&Technology Cooperation Program of China(No.2023YFE0119900)the Hainan Province Key Research and Development Project(No.ZDYF2024GXJS002)the Research Start-Up Funds of Zhufeng Scholars Program.
文摘Gas hydrate drilling expeditions in the Pearl River Mouth Basin,South China Sea,have identified concentrated gas hydrates with variable thickness.Moreover,free gas and the coexistence of gas hydrate and free gas have been confirmed by logging,coring,and production tests in the foraminifera-rich silty sediments with complex bottom-simulating reflectors(BSRs).The broad-band processing is conducted on conventional three-dimensional(3D)seismic data to improve the image and detection accuracy of gas hydratebearing layers and delineate the saturation and thickness of gas hydrate-and free gas-bearing sediments.Several geophysical attributes extracted along the base of the gas hydrate stability zone are used to demonstrate the variable distribution and the controlling factors for the differential enrichment of gas hydrate.The inverted gas hydrate saturation at the production zone is over 40% with a thickness of 90 m,showing the interbedded distribution with different boundaries between gas hydrate-and free gas-bearing layers.However,the gas hydrate saturation value at the adjacent canyon is 70%,with 30-m-thick patches and linear features.The lithological and fault controls on gas hydrate and free gas distributions are demonstrated by tracing each gas hydrate-bearing layer.Moreover,the BSR depths based on broad-band reprocessed 3D seismic data not only exhibit variations due to small-scale topographic changes caused by seafloor sedimentation and erosion but also show the upward shift of BSR and the blocky distribution of the coexistence of gas hydrate and free gas in the Pearl River Mouth Basin.
基金supported by the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202002)the Fundamental Research Funds for the Central Universities(226-2022-00226).
文摘The current methods used to industrially produce sinomenine hydrochloride involve several issues,including high solvent toxicity,long process flow,and low atomic utilization efficiency,and the greenness scores of the processes are below 65 points.To solve these problems,a new process using anisole as the extractant was proposed.Anisole exhibits high selectivity for sinomenine and can be connected to the subsequent water-washing steps.After alkalization of the medicinal material,heating extraction,water washing,and acidification crystallization were carried out.The process was modeled and optimized.The design space was constructed.The recommended operating ranges for the critical process parameters were 3.0–4.0 h for alkalization time,60.0–80.0℃ for extraction temperature,2.0–3.0(volume ratio)for washing solution amount,and 2.0–2.4 mol·L^(-1) for hydrochloric acid concentration.The new process shows good robustness because different batches of medicinal materials did not greatly impact crystal purity or sinomenine transfer rate.The sinomenine transfer rate was about 20%higher than that of industrial processes.The greenness score increased to 90 points since the novel process proposed in this research solves the problems of long process flow,high solvent toxicity,and poor atomic economy,better aligning with the concept of green chemistry.
基金supported by the Basic Research Program through the National Research Foundation of Korea(NRF)(Nos.2022R1C1C1006593,2022R1A4A3031263,and RS-2023-00271166)the National Science Foundation(Nos.2054098 and 2213693)+1 种基金the National Natural Science Foundation of China(No.52105593)Zhejiang Provincial Natural Science Foundation of China(No.LDQ24E050001).EH acknowledges a fellowship from the Hyundai Motor Chung Mong-Koo Foundation.
文摘Recently,the increasing interest in wearable technology for personal healthcare and smart virtual/augmented reality applications has led to the development of facile fabrication methods.Lasers have long been used to develop original solutions to such challenging technological problems due to their remote,sterile,rapid,and site-selective processing of materials.In this review,recent developments in relevant laser processes are summarized under two separate categories.First,transformative approaches,such as for laser-induced graphene,are introduced.In addition to design optimization and the alteration of a native substrate,the latest advances under a transformative approach now enable more complex material compositions and multilayer device configurations through the simultaneous transformation of heterogeneous precursors,or the sequential addition of functional layers coupled with other electronic elements.In addition,the more conventional laser techniques,such as ablation,sintering,and synthesis,can still be used to enhance the functionality of an entire system through the expansion of applicable materials and the adoption of new mechanisms.Later,various wearable device components developed through the corresponding laser processes are discussed,with an emphasis on chemical/physical sensors and energy devices.In addition,special attention is given to applications that use multiple laser sources or processes,which lay the foundation for the all-laser fabrication of wearable devices.
文摘BACKGROUND Bilateral one-stage total knee arthroplasty(BTKA)is now in greater use as an alternative option for patients with bilateral end-stage knee arthropathy.However,postoperative pain and disablement during convalescence from BTKA,and procedure-related complications have been concerning issues for patients and surgeons.Although some studies reported that BTKA in selected patients is as safe as the staged procedure,well-defined guidelines for patient screening,and perioperative care and monitoring to avoid procedure-related complications are still controversial.AIM To compare the perioperative outcomes including perioperative blood loss(PBL),cardiac biomarkers,pain intensity,functional recovery,and complications between unilateral total knee arthroplasty(UTKA)and BTKA performed with a similar perioperative protocol.METHODS We conducted a retrospective study on consecutive patients undergoing UTKA and BTKA that had been performed by a single surgeon with identical perioperative protocols.The exclusion criteria of this study included patients with an American Society of Anesthesiologists score>3,and known cardiopulmonary comorbidity or high-sensitivity Troponin-T(hs-TnT)>14 ng/L.Outcome measures included visual analogue scale(VAS)score of postoperative pain,morphine consumption,range of knee motion,straight leg raise(SLR),length of stay(LOS),and serum hemoglobin(Hb)and hs-TnT monitored during hospitalization.RESULTS Of 210 UTKA and 137 BTKA patients,those in the BTKA group were younger and more predominately female.The PBL of the UTKA vs BTKA group was 646.45±272.26 mL vs 1012.40±391.95 mL(P<0.01),and blood transfusion rates were 10.48%and 40.88%(P<0.01),respectively.Preoperative Hb and body mass index were predictive factors for blood transfusion in BTKA,whereas preoperative Hb was only a determinant in UTKA patients.The BTKA group had significantly higher VAS scores than the UTKA group at 48,72,and 96 h after surgery,and also had a significantly lower degree of SLR at 72 h.The BTKA group also had a significantly longer LOS than the UTKA group.Of the patients who had undergone the procedure,5.71%of the UTKA patients and 12.41%of the BTKA patients(P=0.04)had hs-TnT>14 ng/L during the first 72 h postoperatively.However,there was no difference in other outcome measures and complications.CONCLUSION Following similar perioperative management,the blood transfusion rate in BTKA is 4-fold that required in UTKA.Also,BTKA is associated with higher pain intensity at 48 h postoperatively and prolonged LOS when compared to the UTKA.Hence,BTKA patients may require more extensive perioperative management for blood loss and pain,even if having no higher risk of complications than UTKA.
基金supported by the Guangdong Basic and Applied Basic Research Foundation(2022A1515010875)Guangdong Basic and Applied Basic Research Foundation(2021A1515110017)+10 种基金Natural Science Foundation of Top Talent of SZTU(grant no.20200205)Project of Education Commission of Guangdong Province of China(2021KQNCX080)Research on the electrochemical reaction mechanism of the anode of mediumlow temperature direct ammonia SOFCs(20231063020006)the project of al solid-state high energy density energy storage system(20221063010031)the project of Shenzhen Overseas Talent upon Industrialization of 1kw stack for direct ammonia SOFCs(20221061010002)Guangdong Basic and Applied Basic Research Foundation(No.2019A1515011673)Education Department of Guangdong Province(No.2021KCXTD045)National Natural Science Foundation of China(No.12274303)the support from the Fundamental Research Funds for the Central Universities(2232023A-01)NSFC No.52103202beamline BL16B1 at Shanghai Synchrotron Radiation Facility(SSRF)for the synchrotron experiment
文摘The emergence of polymerized small molecule acceptors(PSMAs)has significantly improved the performance of all-polymer solar cells(all-PSCs).However,the pace of device engineering lacks behind that of materials development,so that a majority of the PSMAs have not fulfilled their potentials.Furthermore,most high-performance all-PSCs rely on the use of chloroform as the processing solvent.For instance,the recent highperformance PSMA,named PJ1-γ,with high LUMO,and HOMO levels,could only achieve a PCE of 16.1%with a high-energy-level donor(JD40)using chloroform.Herein,we present a methodology combining sequential processing(SqP)with the addition of 0.5%wt PC_(71)BM as a solid additive(SA)to achieve an impressive efficiency of 18.0%for all-PSCs processed from toluene,an aromatic hydrocarbon solvent.Compared to the conventional blend-casting(BC)method whose best efficiency(16.7%)could only be achieved using chloroform,the SqP method significantly boosted the device efficiency using toluene as the processing solvent.In addition,the donor we employ is the classic PM6 that has deeper energy levels than JD40,which provides low energy loss for the device.We compare the results with another PSMA(PYF-T-o)with the same method.Finally,an improved photostability of the SqP devices with the incorporation of SA is demonstrated.