Insulin-induced severe thyrotoxic periodic paralysis:A case report

BACKGROUND Thyrotoxic periodic paralysis(TPP)is an endocrine emergency caused by thyrotoxicosis,manifesting mainly as periodic myasthenia and hypokalemia,and posing a serious threat to the patient's health.Fatigue,strenuous exercise,alcohol abuse,high carbohydrate intake and insulin injections are common triggers of paralysis.This article reports a case of severe TPP induced by insulin injection,elucidates the characteristics and pathogenesis of the disease,analyses the risk factors for triggering TPP,and hopefully provides more clinical data for TPP patients.CASE SUMMARY A 38-year-old Asian man presented to the emergency department with a oneweek history of limb weakness and worsening half-day.His medical history included poorly controlled type 2 diabetes and he had been switched to Aspart50 a week earlier.He was alert and oriented with upper extremity strength grade 3 and lower extremity strength grade 1.Emergency department tests showed hypokalemia of 1.6 mmol/L.The paramedics administered 1.5 g of potassium intravenously,followed by 4.0 g orally.Weakness in the arms and legs improved.He was referred to endocrinology where he was diagnosed with Graves'disease,with suboptimal control and insulin injections possibly causing TPP.We stopped his insulin and he was discharged with a potassium level of 4.0 mmol/L.CONCLUSION Insulin is a trigger for TPP and should be avoided in patients with hyperthyroidism.Early recognition and treatment of TPP is crucial,especially in patients presenting with hypokalemic periodic paralysis.

Dynamical complexity of Anosov systems driven by a quasi-periodic force

Consider C^(2)Anosov systems on a compact manifold driven by a quasi-periodic force.We study their dynamical complexity on various levels from the perspectives of both path-wise dynamics and stochastic processes.Assuming that these systems are non-wandering(i.e.,every point in the phase space is nonwandering),we prove a set of results:(1)the existence of abundance of random periodic points;(2)a random Livsic theorem;(3)a random Mañé-Bousch-Conze-Guivarc'h lemma;(4)the existence of strong random horseshoes.Additionally,a concrete example constructed on a 2-dimensional torus is also given to uncover some interesting phenomena of the systems.

Ultrafast dynamics of femtosecond laser-induced high spatial frequency periodic structures on silicon surfaces

Femtosecond laser-induced periodic surface structures(LIPSS)have been extensively studied over the past few decades.In particular,the period and groove width of high-spatial-frequency LIPSS(HSFL)is much smaller than the diffraction limit,making it a useful method for efficient nanomanufacturing.However,compared with the low-spatial-frequency LIPSS(LSFL),the structure size of the HSFL is smaller,and it is more easily submerged.Therefore,the formation mechanism of HSFL is complex and has always been a research hotspot in this field.In this study,regular LSFL with a period of 760 nm was fabricated in advance on a silicon surface with two-beam interference using an 800 nm,50 fs femtosecond laser.The ultrafast dynamics of HSFL formation on the silicon surface of prefabricated LSFL under single femtosecond laser pulse irradiation were observed and analyzed for the first time using collinear pump-probe imaging method.In general,the evolution of the surface structure undergoes five sequential stages:the LSFL begins to split,becomes uniform HSFL,degenerates into an irregular LSFL,undergoes secondary splitting into a weakly uniform HSFL,and evolves into an irregular LSFL or is submerged.The results indicate that the local enhancement of the submerged nanocavity,or the nanoplasma,in the prefabricated LSFL ridge led to the splitting of the LSFL,and the thermodynamic effect drove the homogenization of the splitting LSFL,which evolved into HSFL.

ON THE STABILITY OF PERIODIC SOLUTIONS OF PIECEWISE SMOOTH PERIODIC DIFFERENTIAL EQUATIONS

In this paper,we address the stability of periodic solutions of piecewise smooth periodic differential equations.By studying the Poincarémap,we give a sufficient condition to judge the stability of a periodic solution.We also present examples of some applications.

Pseudo Almost Periodic Solutions of Nonlinear Hyperbolic Equations with Piecewise Constant Argument

In this paper, we investigate the pseudo almost periodicity of the unique bounded solution for a nonlinear hyperbolic equation with piecewise constant argument. The equation under consideration is a mathematical model for the dynamics of gas absorption,

Four-to Six-Year Periodic Variation of Arctic Sea-Ice Extent and Its Three Main Driving Factors

Besides the rapid retreating trend of Arctic sea-ice extent(SIE),this study found the most outstanding low-frequency variation of SIE to be a 4-6-year periodic variation.Using a clustering analysis algorithm,the SIE in most ice-covered regions was clustered into two special regions:Region-1 around the Barents Sea and Region-2 around the Canadian Basin,which were located on either side of the Arctic Transpolar Drift.Clear 4-6-year periodic variation in these two regions was identified using a novel method called“running linear fitting algorithm”.The rate of temporal variation of the Arctic SIE was related to three driving factors:the regional air temperature,the sea-ice areal flux across the Arctic Transpolar Drift,and the divergence of sea-ice drift.The 4-6-year periodic variation was found to have always been present since 1979,but the SIE responded to different factors under heavy and light ice conditions divided by the year 2005.The joint contribution of the three factors to SIE variation exceeded 83%and 59%in the two regions,respectively,remarkably reflecting their dynamic mechanism.It is proven that the process of El Niño-Southern Oscillation(ENSO)is closely associated with the three factors,being the fundamental source of the 4-6-year periodic variations of Arctic SIE.

Periodic signal extraction of GNSS height time series based on adaptive singular spectrum analysis

Singular spectrum analysis is widely used in geodetic time series analysis.However,when extracting time-varying periodic signals from a large number of Global Navigation Satellite System(GNSS)time series,the selection of appropriate embedding window size and principal components makes this method cumbersome and inefficient.To improve the efficiency and accuracy of singular spectrum analysis,this paper proposes an adaptive singular spectrum analysis method by combining spectrum analysis with a new trace matrix.The running time and correlation analysis indicate that the proposed method can adaptively set the embedding window size to extract the time-varying periodic signals from GNSS time series,and the extraction efficiency of a single time series is six times that of singular spectrum analysis.The method is also accurate and more suitable for time-varying periodic signal analysis of global GNSS sites.

Elastic wave insulation and propagation control based on the programmable curved-beam periodic structure

Curved-beams can be used to design modular multistable metamaterials(MMMs)with reprogrammable material properties,i.e.,programmable curved-beam periodic structure(PCBPS),which is promising for controlling the elastic wave propagation.The PCBPS is theoretically equivalent to a spring-oscillator system to investigate the mechanism of bandgap,analyze the wave propagation mechanisms,and further form its geometrical and physical criteria for tuning the elastic wave propagation.With the equivalent model,we calculate the analytical solutions of the dispersion relations to demonstrate its adjustability,and investigate the wave propagation characteristics through the PCBPS.To validate the equivalent system,the finite element method(FEM)is employed.It is revealed that the bandgaps of the PCBPS can be turned on-and-off and shifted by varying its physical and geometrical characteristics.The findings are highly promising for advancing the practical application of periodic structures in wave insulation and propagation control.

Optimal design for rubber concrete layered periodic foundations based on the analytical approximations of band gaps and mapping relations

The seismic performance of rubber concrete-layered periodic foundations are significantly influenced by their design,in which the band gaps play a paramount role.Aiming at providing better designs for these foundations,this study first proposes and validates the analytical formulas to approximate the bounds of the first few band gaps.In addition,the mapping relations linking the frequencies of different band gaps are presented.Furthermore,an optimal design method for these foundations is developed,which is validated through an engineering example.It is demonstrated that ensuring the superstructure’s resonance zones are completely covered by the corresponding periodic foundation’s band gaps can achieve satisfactory vibration attenuation effects,which is a good strategy for the design of rubber concrete layered periodic foundations.

3D Printing of Periodic Porous Metamaterials for Tunable Electromagnetic Shielding Across Broad Frequencies

The new-generation electronic components require a balance between electromagnetic interference shielding efficiency and open structure factors such as ventilation and heat dissipation.In addition,realizing the tunable shielding of porous shields over a wide range of wavelengths is even more challenging.In this study,the well-prepared thermoplastic polyurethane/carbon nanotubes composites were used to fabricate the novel periodic porous flexible metamaterials using fused deposition modeling 3D printing.Particularly,the investigation focuses on optimization of pore geometry,size,dislocation configuration and material thickness,thus establishing a clear correlation between structural parameters and shielding property.Both experimental and simulation results have validated the superior shielding performance of hexagon derived honeycomb structure over other designs,and proposed the failure shielding size(D_(f)≈λ/8-λ/5)and critical inclined angle(θf≈43°-48°),which could be used as new benchmarks for tunable electromagnetic shielding.In addition,the proper regulation of the material thickness could remarkably enhance the maximum shielding capability(85-95 dB)and absorption coefficient A(over 0.83).The final innovative design of the porous shielding box also exhibits good shielding effectiveness across a broad frequency range(over 2.4 GHz),opening up novel pathways for individualized and diversified shielding solutions.

A novel triple periodic minimal surface-like plate lattice and its data-driven optimization method for superior mechanical properties

Lattice structures can be designed to achieve unique mechanical properties and have attracted increasing attention for applications in high-end industrial equipment,along with the advances in additive manufacturing(AM)technologies.In this work,a novel design of plate lattice structures described by a parametric model is proposed to enrich the design space of plate lattice structures with high connectivity suitable for AM processes.The parametric model takes the basic unit of the triple periodic minimal surface(TPMS)lattice as a skeleton and adopts a set of generation parameters to determine the plate lattice structure with different topologies,which takes the advantages of both plate lattices for superior specific mechanical properties and TPMS lattices for high connectivity,and therefore is referred to as a TPMS-like plate lattice(TLPL).Furthermore,a data-driven shape optimization method is proposed to optimize the TLPL structure for maximum mechanical properties with or without the isotropic constraints.In this method,the genetic algorithm for the optimization is utilized for global search capability,and an artificial neural network(ANN)model for individual fitness estimation is integrated for high efficiency.A set of optimized TLPLs at different relative densities are experimentally validated by the selective laser melting(SLM)fabricated samples.It is confirmed that the optimized TLPLs could achieve elastic isotropy and have superior stiffness over other isotropic lattice structures.

PERIODIC SYSTEMS WITH TIME DEPENDENT MAXIMAL MONOTONE OPERATORS

We consider a first order periodic system in R^(N),involving a time dependent maximal monotone operator which need not have a full domain and a multivalued perturbation.We prove the existence theorems for both the convex and nonconvex problems.We also show the existence of extremal periodic solutions and provide a strong relaxation theorem.Finally,we provide an application to nonlinear periodic control systems.

Tuning Second Chern Number in a Four-Dimensional Topological Insulator by High-Frequency Time-Periodic Driving

Floquet engineering has attracted considerable attention as a promising approach for tuning topological phase transitions.We investigate the effects of high-frequency time-periodic driving in a four-dimensional(4D)topological insulator,focusing on topological phase transitions at the off-resonant quasienergy gap.The 4D topological insulator hosts gapless three-dimensional boundary states,characterized by the second Chern number C_(2).We demonstrate that the second Chern number of 4D topological insulators can be modulated by tuning the amplitude of time-periodic driving.This includes transitions from a topological phase with C_(2)=±3 to another topological phase with C_(2)=±1,or to a topological phase with an even second Chern number C_(2)=±2,which is absent in the 4D static system.Finally,the approximation theory in the high-frequency limit further confirms the numerical conclusions.

Frequency-dependent viscoelasticity effects on the wave attenuation performance of multi-layered periodic foundations

In this paper,layered periodic foundations(LPFs)are numerically examined for their responses to longitudinal and transverse modes in the time and frequency domains.Three different unit-cells,i.e.,2-layer,4-layer,and 6-layer unit-cells,comprising concrete/rubber,concrete/rubber/steel/rubber,and concrete/rubber/steel/rubber/lead/rubber materials,respectively,are taken into account.Also,the viscoelasticity behavior of the rubber is modeled with two factors,i.e.,a frequency-independent(FI)loss factor and a linear frequency-dependent(FD)loss factor.Following the extraction of the complex dispersion curves and the identification of the band gaps(BGs),the simulations of wave transmission in the time and frequency domains are performed using the COMSOL software.Subsequent parametric studies evaluate the effects of the rubber viscoelasticity models on the dispersion curves and the wave transmission for the longitudinal and transverse modes.The results show that considering the rubber viscoelasticity enhances the wave attenuation performance.Moreover,the transverse-mode damping is more sensitive to the viscoelasticity model than its longitudinal counterpart.The 6-layer unit-cell LPF exhibits the lowest BG,ranging from 4.8 Hz to 6.5 Hz.

Solitons and Their Biperiodic Pulsation in Ultrafast Fiber Lasers Based on CB/GO

The carbon black(CB)is introduced to manufacture CB/graphene oxide(GO)composite material to mitigate limitations of GO as a saturable absorber with the excellent performance in ultrafast fiber lasers.At a central wavelength of 1555.5 nm,the stable mode-locked pulse with width of 656 fs,repetition rate of 20.16 MHz,and high signal-to-noise ratio of 82.07 dB is experimentally obtained.Additionally,experimental observations for pulsation phenomena of vector biperiodic solitons combining period-1 and period-17,period-2 and period-32,period-3 and period-36 are verified via simulations.

Frictional contact analysis of a rigid solid with periodic surface sliding on the thermoelectric material

Understanding and characterizing rough contact and wavy surfaces are essential for developing effective strategies to mitigate wear,optimize lubrication,and enhance the overall performance and durability of mechanical systems.The sliding friction contact problem between a thermoelectric(TE)half-plane and a rigid solid with a periodic wavy surface is the focus of this investigation.To simplify the problem,we utilize mixed boundary conditions,leading to a set of singular integral equations(SIEs)with the Hilbert kernels.The analytical solutions for the energy flux and electric current density are obtained by the variable transform method in the context of the electric and temperature field.The contact problem for the elastic field is transformed into the second-kind SIE and solved by the Jacobi polynomials.Notably,the smoothness of the wavy contact surface ensures that there are no singularities in the surface contact stress,and ensures that it remains free at the contact edge.Based on the plane strain theory of elasticity,the analysis primarily examines the correlation between the applied load and the effective contact area.The distribution of the normal stress on the surface with or without TE loads is discussed in detail for various friction coefficients.Furthermore,the obtained results indicate that the in-plane stress decreases behind the trailing edge,while it increases ahead of the trailing edge when subjected to TE loads.

Interference-induced suppression of particle emission from a Bose-Einstein condensate in lattice with time-periodic modulations

Emission of matter-wave jets from a parametrically driven condensate has attracted significant experimental and theoretical attention due to the appealing visual effects and potential metrological applications.In this work,we investigate the collective particle emission from a Bose-Einstein condensate confined in a one-dimensional lattice with periodically modulated interparticle interactions.We give the regimes for discrete modes,and find that the emission can be distinctly suppressed.The configuration induces a broad band,but few particles are ejected due to the interference of the matter waves.We further qualitatively model the emission process and demonstrate the short-time behaviors.This engineering provides a way to manipulate the propagation of particles and the corresponding dynamics of condensates in lattices,and may find application in the dynamical excitation control of other nonequilibrium problems with time-periodic driving.

Self-propelled Leidenfrost droplets on femtosecond-laser-induced surface with periodic hydrophobicity gradient

The controllable transfer of droplets on the surface of objects has a wide application prospect in the fields of microfluidic devices,fog collection and so on.The Leidenfrost effect can be utilized to significantly reduce motion resistance.However,the use of 3D structures limits the widespread application of self-propulsion based on Leidenfrost droplets in microelectromechanical system.To manipulate Leidenfrost droplets,it is necessary to create 2D or quasi-2D geometries.In this study,femtosecond laser is applied to fabricate a surface with periodic hydrophobicity gradient(SPHG),enabling directional self-propulsion of Leidenfrost droplets.Flow field analysis within the Leidenfrost droplets reveals that the vapor layer between the droplets and the hot surface can be modulated by the SPHG,resulting in directional propulsion of the inner gas.The viscous force between the gas and liquid then drives the droplet to move.

Conditional Generative Adversarial Network Enabled Localized Stress Recovery of Periodic Composites

Structural damage in heterogeneousmaterials typically originates frommicrostructures where stress concentration occurs.Therefore,evaluating the magnitude and location of localized stress distributions within microstructures under external loading is crucial.Repeating unit cells(RUCs)are commonly used to represent microstructural details and homogenize the effective response of composites.This work develops a machine learning-based micromechanics tool to accurately predict the stress distributions of extracted RUCs.The locally exact homogenization theory efficiently generates the microstructural stresses of RUCs with a wide range of parameters,including volume fraction,fiber/matrix property ratio,fiber shapes,and loading direction.Subsequently,the conditional generative adversarial network(cGAN)is employed and constructed as a surrogate model to establish the statistical correlation between these parameters and the corresponding localized stresses.The stresses predicted by cGAN are validated against the remaining true data not used for training,showing good agreement.This work demonstrates that the cGAN-based micromechanics tool effectively captures the local responses of composite RUCs.It can be used for predicting potential crack initiations starting from microstructures and evaluating the effective behavior of periodic composites.

Impact of Alcian blue and periodic acid Schiff expression on the prognosis of gastric signet ring cell carcinoma

BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and neutral mucus,respectively.However,the clinical importance of the special combined AB and PAS stain is unclear.AIM To investigate AB expression,PAS expression and the AB-to-PAS(A/P)ratio in gastric SRCC patients and to assess patient prognosis.METHODS Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS,and signet ring cell positivity was assessed quantitatively.Immuno-histochemical staining for Ki67,protein 53(P53)and human epidermal growth factor receptor 2(HER2)was performed simultaneously.The cancer-specific survival(CSS)rate was estimated via Kaplan-Meier analysis.Cox proportional hazards models were used for univariate and multivariate survival analyses.RESULTS Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup(P<0.001).The 3-year CSS rate in the A/P≤0.5 group was significantly greater than that in the A/P>0.5 group(P=0.042).Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter,lymph node metastasis,vessel carcinoma embolus,tumor stage,the A/P ratio and the expression of Ki67,P53 and the PAS.Cox multivariate regression analysis confirmed that low PAS expression[hazard ratio(HR)=3.809,95%confidence interval(CI):1.563-9.283,P=0.003]and large tumor diameter(HR=2.761,95%CI:1.086-7.020,P=0.033)were independent risk factors for poor prognosis.CONCLUSION A/P>0.5 is potentially a risk factor for prognosis,and low PAS expression is an independent risk factor in the prognosis of gastric SRCC.PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.