The burden of upper motor neuron involvement is correlated with the bilateral limb involvement interval in patients with amyotrophic lateral sclerosis:a retrospective observational study

Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.

Upper bound analytical solution for surrounding rock pressure of shallow unsymmetrical loading tunnels

By combining the results of laboratory model tests with relevant flow rules, the failure mode of shallow unsymmetrical loading tunnels and the corresponding velocity field were established. According to the principle of virtual power, the upper bound solution for surrounding rock pressure of shallow unsymmetrical loading tunnel was derived and verified by an example. The results indicate that the calculated results of the derived upper bound method for surrounding rock pressure of shallow unsymmetrical loading tunnels are relatively close to those of the existing "code method" and test results, which means that the proposed method is feasible. The current code method underestimates the unsymmetrical loading feature of surrounding rock pressure of shallow unsymmetrical loading tunnels, so it is unsafe; when the burial depth is less or greater than two times of the tunnel span and the unsymmetrical loading angle is less than 45°, the upper bound method or the average value of the results calculated by the upper bound method and code method respectively, is comparatively reasonable. When the burial depth is greater than two times of the tunnel span and the unsymmetrical loading angle is greater than 45°, the code method is more suitable.

A new failure mechanism for deep cavity and upper bound solution of supporting pressure

The investigation of supporting pressure is of great significance to the design of underground structures.Based on the kinematical approach of limit analysis,an improved failure mechanism is proposed,and the supporting pressure is investigated for deep buried cavity.Three failure mechanisms are first introduced according to the existing failure mechanisms of geotechnical structures of limit analysis.A comparison with respect to the optimal failure mechanisms and the upper bound solutions provided among these three mechanisms are then conducted in an attempt to obtain the improved failure mechanism.The results provided by the improved failure mechanism are in good agreement with those by the existing method,the numerical solution and field monitoring,which demonstrates that the proposed failure mechanism is effective for the upper bound analysis of supporting pressure.

Upper Bound Solutions for Uplift Ultimate Bearing Capacity of Suction Caisson Foundation

Suction caisson foundation derives most of their uplift resistance from passive suction developed during the pullout movement. It was observed that the passive suction generated in soil at the bottom of the caisson and the failure mode of suction caisson foundation subjecting pullout loading behaves as a reverse compression failure mechanism.The upper bound theorems have been proved to be a powerful method to find the critical failure mechanism and critical load associated with foundations, buried caissons and other geotechnical structures. However, limited attempts have been reported to estimate the uplift bearing capacity of the suction caisson foundation using the upper bound solution. In this paper, both reverse failure mechanisms from Prandtl and Hill were adopted as the failure mechanisms for the computation of the uplift bearing capacity of the suction caisson. New equations were proposed based on both failure mechanisms to estimate the pullout capacity of the suction caisson. The proposed equations were verified by the test results and experimental data from published literature. And the two solutions agree reasonably well with the other test results. It can be proved that both failure mechanisms are reasonably and more consistent with the actual force condition.

A Generalized Upper and Lower Solution Method for Singular Discrete Boundary Value Problems

This paper presents new existence results for singular discrete boundary value problems. In particular our nonlinearity may be singular in its dependent variable and is allowed to change sign.

Upper Bound Solution of Soil Slope Stability under Coupling Effect of Rainfall and Earthquake

Based on the limit analysis upper bound method,a new model of soil slope collapse has been proposed which consists of two rigid block zones and a plastic shear zone.Soil slope was induced failure by coupling effect of rainfall and earthquake,and these blocks were also incorporated horizontal earthquake force and vertical gravitate.The velocities and forces were analyzed in three blocks,and the expression of velocity discontinuities was obtained by the principle of incompressibility.The external force work for the blocks,the internal energy of the plastic shear zone and the velocity discontinuous were solved.The present stability ratios are compared to the prevenient research,which shows the superiority of the mechanism and rationality of the analysis.The critical height of the soil slope can provide theoretical basis for slope support and design.

Upper bound solution for supporting pressure acting on shallow tunnel based on modified tangential technique

Based on the nonlinear failure criterion and the upper bound theorem, the modified tangential technique method was proposed to derive the expression of supporting pressure acting on shallow tunnel. Instead of the same stress state, different normal stresses on element boundaries were used. In order to investigate the influence of different factors on supporting pressures, the failure mechanism was established. The solution of supporting pressure, with different parameters, was obtained by optimization theory. The corresponding failure mechanism and numerical results were presented. In comparison with the results using the single tangential technique method, it is found that the proposed method is effective, and the good agreement shows that the present solution of supporting pressure is reliable.

Vertex solution theorem for the upper and lower bounds on the dynamic response of structures with uncertain-but-bounded parameters

The aim of this paper is to evaluate the effects of uncertain-but-bounded parameters on the dynamic response of structures. By combining the interval mathematics and the finite element analysis, the mass matrix, damping matrix, stiffness matrix and the external loads are represented as interval matrices and vector. With the help of the optimization theory, we present the vertex solution theorem for determining both the exact upper bounds or maximum values and the exact lower bounds or minimum values of the dynamic response of structures, in which these parameters reach their extreme values on the boundary of the interval mass, damping, stiffness matrices and the interval extemal loads vector. Three examples are used to illustrate the computational aspects of the presented vertex solution theorem.

High-resolution seismic tomography of the upper crust in the source region of the April 20,2013 Lushan earthquake and its seismotectonic implications

Both P- and S-wave arrivals were collected for imaging upper crustal structures in the source region of the April 20, 2013 Lushan earthquake. High-resolution, three- dimensional P and S velocity models were constructed by travel-time tomography. Moreover, more than 3700 after- shocks of the Lushan earthquake were relocated via a grid search method. The P- and S-wave velocity images of the upper crust show largely similar characters, with high and low velocity anomalies, which mark the presence of sig- nificant lateral and vertical heterogeneity at the source region of the Lushan earthquake. The characteristics of the velocity anomalies also reflect the associated surface geo- logical tectonics in this region. The distributions of high velocity anomalies of both P- and S-waves to 18 km depth are consistent with the distributions of relocated after- shocks, suggesting that most of the ruptures were localized inside the high velocity region. In contrast, low P and S velocities were found in the surrounding regions without aftershocks, especially in the region to the northeast of the Lushan earthquake. For the relocated aftershocks of the Lushan earthquake from this study, we found that mostaftershocks were concentrated in a zone of about 40 km long and 20 km wide, and were located in the hanging wall of Dayi-Mingshan fault. The focal depths of aftershocks increase from the southeast to the northwest region in the direction perpendicular to the fault strike, suggesting that the fault ruptured at an approximate dip angle of 45°. The main depths of the aftershocks in the northwest of the main shock are significantly shallower than expected, revealing the different seismogenic conditions in the source region.

Near-Infrared Spectroscopy Combined with Absorbance Upper Optimization Partial Least Squares Applied to Rapid Analysis of Polysaccharide for Proprietary Chinese Medicine Oral Solution

Near-infrared (NIR) spectroscopy was applied to reagent-free quantitative analysis of polysaccharide of a brand product of proprietary Chinese medicine (PCM) oral solution samples. A novel method, called absorbance upper optimization partial least squares (AUO-PLS), was proposed and successfully applied to the wavelength selection. Based on varied partitioning of the calibration and prediction sample sets, the parameter optimization was performed to achieve stability. On the basis of the AUO-PLS method, the selected upper bound of appropriate absorbance was 1.53 and the corresponding wavebands combination was 400 - 1880 & 2088 - 2346 nm. With the use of random validation samples excluded from the modeling process, the root-mean-square error and correlation coefficient of prediction for polysaccharide were 27.09 mg·L-1 and 0.888, respectively. The results indicate that the NIR prediction values are close to those of the measured values. NIR spectroscopy combined with AUO-PLS method provided a promising tool for quantification of the polysaccharide for PCM oral solution and this technique is rapid and simple when compared with conventional methods.

Upper bound solutions of stability factor of shallow tunnels in saturated soil based on strength reduction technique

Based on the upper bound theorem of limit analysis,the factor of safety for shallow tunnel in saturated soil is calculated in conjunction with the strength reduction technique.To analyze the influence of the pore pressure on the factor of safety for shallow tunnel,the power of pore pressure is regarded as a power of external force in the energy calculation.Using the rigid multiple-block failure mechanism,the objective function for the factor of safety is constructed and the optimal solutions are derived by employing the sequential quadratic programming.According to the results of optimization calculation,the factor of safety of shallow tunnel for different pore pressure coefficients and variational groundwater tables are obtained.The parameter analysis shows that the pore pressure coefficient and the location of the groundwater table have significant influence on the factor of safety for shallow tunnel.

Upper bound solution for active thrust of nonhomogeneous cohesive soil considering effects of intermediate principal stress

Considering the variation of cohesion along the depth,the upper bound solution of active earth pressure for a rough inclined wall with sloped backfill is formulated based on a log-spiral failure mechanism.For a more accurate prediction,the influence of intermediate principal stress is taken into consideration using the unified strength theory.Converting the search for the active pressure to an optimization problem,the most critical failure surface can be located by a natural selection-based gravitational search algorithm(GSA).The proposed method is validated compared with existing methods for noncohesive and cohesive cases and proved to be more accordance with the limit equilibrium solution.The influences of the variation of soil cohesion and intermediate principal stress on active earth pressure coefficient are then fully studied.It can be concluded that both the variations of soil cohesion and intermediate principal stress have a significant influence on the active earth pressure coefficient.

Upper Bound Solution of the Resisting Moment Bearing Capacity of A Composite Bucket Shallow Foundation of An Offshore Wind Turbine in Sand

Bearing the large moment that is generated by the wind load that acts on the upper structure of offshore wind turbines is an important feature of their foundations that is different from other offshore structures.A composite bucket shallow foundation(CBSF)has been proposed by Tianjin University to address the soft geological conditions in the offshore regions of China for wind turbines.The CBSF is a new type of foundation and is effective against large moments.The soil deformation test of a CBSF and the numerical simulation study under the same working conditions are carried out to determine the failure mechanism of a CBSF under moment loading.The resisting soil compression rateηm is defined as a new empirical parameter that indicates the ability of the soil inside the bucket to resist moment loading.The upper limit of the resisting moment bearing capacity of the bucket foundation is derived through the upper bound theorem of classical plasticity theory based on the failure mechanism.The calculation method is validated by tests of bucket models with different height-diameter ratios in sand under moment loading.

Upper and Lower Solutions for Impulsive Differential Equations with Application to ODE

In this paper, we establish the existence of upper and lower solutions for a periodic boundary value problems (PBVP for short) of impulsive differential equations. which guarantees the existence of at least one solution for the problem. As an application, these results are applied to PBVP of ODE and some examples are given to illustrate our results.

Upper and Lower Semicontinuity of Solution Sets for Parametric Generalized Vector Quasi-equilibrium Problems

In this paper, two kinds of parametric generalized vector quasi-equilibrium problems are introduced and the relations between them are studied. The upper and lower semicontinuity of their solution sets to parameters are investigated.

THE INTEGRAL AS A FUNCTION OF THE UPPER LIMIT AND AN ANALYTICAL SOLUTION TO PLANE STRAIN DRAWING AND EXTRUSION

A kinematically admissible velocity field which is different from Avitzur's is established in Cartesian Coordinates. An upper-bound analytical solution to strip drawing andextrusion is obtained by using the integral as a function of the upper limit in this paper.

Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Ground State Solutions for a Kind of Schrödinger-Poisson System with Upper Critical Exponential Convolution Term

This paper mainly discusses the following equation: where the potential function V : R3 → R, α ∈ (0,3), λ > 0 is a parameter and Iα is the Riesz potential. We study a class of Schrödinger-Poisson system with convolution term for upper critical exponent. By using some new tricks and Nehair-Pohožave manifold which is presented to overcome the difficulties due to the presence of upper critical exponential convolution term, we prove that the above problem admits a ground state solution.

Upper esophageal sphincter abnormalities on high-resolution esophageal manometry and treatment response of type Ⅱ achalasia

BACKGROUND Little is known about the clinical significance of upper esophageal sphincter(UES)motility disorders and their association with the treatment response of typeⅡachalasia.None of the three versions of the Chicago Classification of Esophageal Motility Disorders has defined UES abnormality metrics or their function.UES abnormalities exist in some patients and indicate a clinically significant problem in patients with achalasia.AIM To demonstrate the manometric differentiation on high-resolution esophageal manometry between subjects with abnormal UES and normal UES,and the association between UES type and the treatment response of typeⅡachalasia.METHODS In total,498 consecutive patients referred for high-resolution esophageal manometry were analyzed retrospectively.The patients were divided into two groups,those with normal and abnormal UES function.UES parameters were analyzed after determining lower esophageal sphincter(LES)function.Patients with typeⅡachalasia underwent pneumatic dilation for treatment.Using mixed model analyses,correlations between abnormal UES and treatment response were calculated among subjects with typeⅡachalasia.RESULTS Of the 498 consecutive patients,246(49.40%)were found to have UES abnormalities.Impaired relaxation alone was the most common UES abnormality(52.85%,n=130).The incidence rate of typeⅡachalasia was significantly higher in subjects with abnormal UES than those with normal UES(9.77%vs 2.58%,P=0.01).After pneumatic dilation,LES resting pressure,LES integrated relaxation pressure,and UES residual pressure were significantly decreased(41.91±9.20 vs 26.18±13.08,38.94±10.28 vs 16.71±5.65,and 11.18±7.93 vs 5.35±4.77,respectively,P<0.05).According to the Eckardt score,subjects with typeⅡachalasia and abnormal UES presented a significantly poorer treatment response than those with normal UES(83.33%vs 0.00%,P<0.05).CONCLUSION Impaired relaxation alone is the most common UES abnormality.The incidence of typeⅡachalasia is associated with abnormal UES.TypeⅡachalasia with abnormal UES has a poorer treatment response,which is a potentially prognostic indicator of treatment for this disease.

Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding:Meta-analysis

BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new endoscopic hemostasis technique,which is being used in ANVUGIB and is more effective.AIM To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding,clinical success rate,procedure time,hospital stay,and adverse events in the treatment of ANVUGIB,to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.METHODS The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed,Web of Science,EMBASE,Cochrane,Google,and CNKI databases.Changes in recurrent bleeding(7 or 30 days),clinical results(clinical success rate,conversion rate to surgery,mortality),therapy time(procedure time,hospital stay),and adverse events in the OTSC intervention group were summarized and analyzed,and the MD or OR of 95%CI is calculated by Review Manager 5.3.RESULTS This meta-analysis involved 11 studies with 1266 patients.Total risk of bias was moderate-to-high.For patients in the OTSC group,7-and 30-days recurrent bleeding rates,as well as procedure time,hospital stay,and intensive care unit stay,were greatly inhibited.OTSC could significantly improve the clinical success rate of ANVUGIB.OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.CONCLUSION OTSC may provide more rapid and sustained hemostasis,and thus,promote recovery and reduce mortality in patients with ANVUGIB.In addition,the safety of OTSC is assured.