As government agencies continue to tighten emissions regulations due to the continued increase in greenhouse gas production, automotive industries are seeking to produce increasingly efficient vehicle technology. Hybr...As government agencies continue to tighten emissions regulations due to the continued increase in greenhouse gas production, automotive industries are seeking to produce increasingly efficient vehicle technology. Hybrid electric vehicles (HEVs) have been introduced to mitigate problems while improving fuel economy. HEVs have led to the demand of creating more advanced controls software to consider multiple components for propulsive power in a vehicle. A large section in the software development process is the implementation of an optimal energy management strategy meant to improve the overall fuel efficiency of the vehicle. Optimal strategies can be implemented when driving conditions are known a prior. The Equivalent Consumption Minimization Strategy (ECMS) is an optimal control strategy that uses an equivalence factor to equate electrical to mechanical power when performing torque split determination between the internal combustion engine and electric motor for propulsive and regenerative torque. This equivalence factor is determined from offline vehicle simulations using a sensitivity analysis to provide optimal fuel economy results while maintaining predetermined high voltage battery state of charge (SOC) constraints. When the control hierarchy is modified or different driving styles are applied, the analysis must be redone to update the equivalence factor. The goal of this work is to implement a fuzzy logic controller that dynamically updates the equivalence factor to improve fuel economy, maintain a strict charge sustaining window of operation for the high voltage battery, and reduce computational time required during algorithm development. The adaptive algorithm is validated against global optimum fuel economy and charge sustaining results from a sensitivity analysis performed for multiple drive cycles. Results show a maximum fuel economy improvement of 9.82% when using a mild driving style and a 95% success rate when maintaining an ending SOC within 5% of the desired SOC regardless of starting SOC.展开更多
Pavement infrastructure is vital in providing services and links between various sectors of society. Therefore, thepreservation and maintenance of these roads are critical to attaining a pavement network in good condi...Pavement infrastructure is vital in providing services and links between various sectors of society. Therefore, thepreservation and maintenance of these roads are critical to attaining a pavement network in good conditionthroughout its service life. Various performance indicators like the international roughness index (IRI), pavementcondition index (PCI), and present serviceability rating (PSR) have been used by the state department of transportation (DOT) and highway agencies for evaluating pavement surface conditions and planning future maintenance strategies. Limited data availability, multiple distresses depending on region, lack of correlation of thesecondition indices to maintenance strategies, and data collection limitations pose a challenge for applying theseindices to local conditions. This paper compares condition indices of different states for rigid pavements. Further,using a specific condition index for local conditions is also highlighted. For this purpose, five states and theircorresponding condition indices were evaluated and compared to the Michigan DOT distress index (DI). Thesestates include Virginia, Minnesota, North Dakota, Louisiana, and Oregon. The corresponding distresses of eachcondition index were converted to make them compatible with the MDOT DI. This study used the MDOT'spavement management system (PMS) database to evaluate each condition index for 433 rigid pavement sections.Each distress index was plotted against MDOT DI and compared using a paired t-test. Results show that thecondition indices of Virginia and Minnesota are comparable to DI in terms of the Spearman correlation value. Thet-test results show that except for Virgina, condition indices from other states statistically differ from DI.Therefore, one can't use those directly for local conditions in Michigan. This paper presents the evaluation anddata requirements for each condition index and its impact on selecting a maintenance treatment.展开更多
Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing ...Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing cells lead to increased cell turnover which exceeds the kidneys’ ability to adequately filtrate by-products of cellular breakdown (i.e., phosphate, potassium, anduric acid), leading to end organ damage. It has been reported in the past that kidney failure is a sequelae of Tumor Lysis Syndrome (TLS), but there have been no reports that demonstrate acute kidney injury (AKI) preceding TLS. The case presented here demonstrates TLS in a patient with no formal cancer diagnosis, who had received no chemotherapy or radiation that was precipitated by an iatrogenic AKI with chlorthalidone and ibuprofen. This unusual pattern of AKI preceding STLS may provide insight into the pathophysiology of the condition and could possibly lead to greater understanding of this phenomenon.展开更多
Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,mili...Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work environment.Methods:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise regimen.Omics profiles post-vs.pre-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics modalities.Results:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of samples.The blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy demands.The urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid balance.In saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory infection.Conclusions:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.展开更多
BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and imp...BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared to non-frail.Larger studies are warranted to investigate and mitigate modifiable risk factors.展开更多
This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(...This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(XRD)-based DIP method effectively analyzed the mineral composition contents and spatial distributions of granite. During the particle flow code(PFC2D) model calibration phase, the numerical simulation exhibited that the uniaxial compressive strength(UCS) value, elastic modulus(E), and failure pattern of the granite specimen in the UCS test were comparable to the experiment. By establishing 351 sets of numerical models and exploring the impacts of mineral composition on the mechanical properties of granite, it indicated that there was no negative correlation between quartz and feldspar for UCS, tensile strength(σ_(t)), and E. In contrast, mica had a significant negative correlation for UCS, σ_(t), and E. The presence of quartz increased the brittleness of granite, whereas the presence of mica and feldspar increased its ductility in UCS and direct tensile strength(DTS) tests. Varying contents of major mineral compositions in granite showed minor influence on the number of cracks in both UCS and DTS tests.展开更多
Identifying the sex pheromone systems of local pest populations facilitates their management,especially for moth species that show significant geographic variation in sex pheromone communication.We investigated the ph...Identifying the sex pheromone systems of local pest populations facilitates their management,especially for moth species that show significant geographic variation in sex pheromone communication.We investigated the pheromone production and behavioral responses of the Asian corn borer(Ostrinia furnacalis Guenée;ACB)in Xinjiang,China.The ACB produces three compounds:(Z)-12-tetradecenyl acetate(Z12-14:Ac)and(E)-12-tetradecenyl acetate(E12-14:Ac)which are two sex pheromone compounds,and n-tetradecyl acetate(14:Ac)which has variable roles in mediating behavioral responses.The ratios of these three compounds produced in female gland are geographically distinct among different populations.Quantitative analysis of pheromone production showed that the proportions of Z12-14:Ac in the E/Z isomers(i.e.,Z and E12-14:Ac)and the proportions of 14:Ac in the ternary blend respectively averaged 60.46%(SD=5.26)and 25.00%(SD=7.37),with their probabilities normally or near-normally distributed.Trapping experiments in a cornfield indicated that deploying the E/Z isomers and the three compounds in rubber septa close to their gland ratios yielded the most captured males,while other ratios that deviated from the gland ratios showed reduced field captures.The ternary blend was significantly more attractive to males than the E/Z isomers in the field,indicating a functional role of 14:Ac as the third pheromone component used by the local population.Additionally,the dose-response test demonstrated that the application of the three compounds at dosages between 200 and 350μg attracted significantly more males compared to other dosages.Therefore,the characterization of this local ACB pheromone system provides additional information about its geographic variation and serves as a basis for optimizing the pheromone-mediated control of this pest in Xinjiang.展开更多
Today, the oil and gas industry, and in particular hydraulic fracturing operations, have come under increasing pressure from regulators and the public to reduce emissions. As the industry evolves, oil and gas producer...Today, the oil and gas industry, and in particular hydraulic fracturing operations, have come under increasing pressure from regulators and the public to reduce emissions. As the industry evolves, oil and gas producers are in the position of evaluating alternative technologies which will support their objectives of reducing their overall emissions profile and carbon footprint. As a response, the deployment of technology and solutions to reduce emissions related to hydraulic fracturing applications has recently accelerated, creating various options to address these industry challenges. BJ Energy Solutions and West Virginia University have been working on the application and emissions characterization of various hydraulic fracturing technologies. A study was conducted to evaluate the efficiency and resultant emissions from various technologies, including natural gas reciprocating engines, diesel-natural gas dual-fuel engines, large (>24 MW) gas turbines, and direct drive turbines. The study involved the development of an emissions model with the purpose of estimating total emissions of carbon dioxide (CO<sub>2</sub>), nitrous oxide (N2O) and exhaust methane (CH<sub>4</sub>) slip, all Greenhouse Gases (GHGs), and converted to tons of CO<sub>2</sub> equivalent emissions per day of operation. The model inputs are the required Hydraulic Horsepower (HHP) based on pumping rate and pressure for various shale play scenarios. The model calculates emissions from the TITAN, which is a direct-drive turbine model fielded by BJ, using data collected following U.S. Environmental Protection Agency (EPA) testing protocols. The model also calculates and compares other hydraulic fracturing technologies utilizing published Original Equipment Manufacturer (OEM) data. Relevant EPA-regulated criteria emissions of oxides of nitrogen (NO<sub>x</sub>), Carbon Monoxide (CO) and Particulate Matter (PM) are also reported. Modeling results demonstrated that in most cases, the TITAN gas turbine system has lower total GHG emissions than conventional diesel and other next-generation technologies, and also has lower criteria emissions. The benefits of the TITAN gas turbine system compared to the other technologies stems from significantly lower methane slip, and the high-power transfer efficiency resulting from directly connecting a turbine to a reciprocating pump, despite the comparatively lower thermal efficiency.展开更多
Building Energy Management Systems(BEMS)are computer-based systems that aid in managing,controlling,and monitoring the building technical services and energy consumption by equipment used in the building.The effective...Building Energy Management Systems(BEMS)are computer-based systems that aid in managing,controlling,and monitoring the building technical services and energy consumption by equipment used in the building.The effectiveness of BEMS is dependent upon numerous factors,among which the operational characteristics of the building and the BEMS control parameters also play an essential role.This research develops a user-driven simulation tool where users can input the building parameters and BEMS controls to determine the effectiveness of their BEMS.The simulation tool gives the user the flexibility to understand the potential energy savings by employing specific BEMS control and help in making intelligent decisions.The simulation is developed using Visual Basic Application(VBA)in Microsoft Excel,based on discrete-event Monte Carlo Simulation(MCS).The simulation works by initially calculating the energy required for space cooling and heating based on current building parameters input by the user in the model.Further,during the second simulation,the user selects all the BEMS controls and improved building envelope to determine the energy required for space cooling and heating during that case.The model compares the energy consumption from the first simulation and the second simulation.Then the simulation model will provide the rating of the effectiveness of BEMS on a continuous scale of 1 to 5(1 being poor effectiveness and 5 being excellent effectiveness of BEMS).This work is intended to facilitate building owner/energy managers to analyze the building energy performance concerning the efficacy of their energy management system.展开更多
Industrial applications that require steam for their end-use generally utilize steam boilers that are typically oversized,citing operations flexibility.Similarly,gas turbine-based power plants corroborate a gas turbin...Industrial applications that require steam for their end-use generally utilize steam boilers that are typically oversized,citing operations flexibility.Similarly,gas turbine-based power plants corroborate a gas turbine system that may eventually relieve the usable exhaust into the atmosphere.This study explores the economic and technical feasibility of a topping cycle combined heat and power(CHP)system.It does so by leveraging a partially loaded boiler or gas turbine by increasing its unused load to generate steam and heat for subsequent usage.To this end,a decision support tool(COGENTEC)was developed,which emulates a given facility’s boiler or gas-turbine system,and its operational parameters with the application of steam turbines.The tool provides necessary insights into the most appropriate parameters that enable a CHP system to be technically and economically advantageous.Based on input variables such as boiler-rated capacity,steam pressure,steam temperature,and existing boiler load,among others,COGENTEC designs a topping cycle CHP system to inform a user whether this system is feasible in their facility or not.If applicable,the tool assists the user to realize the point of break-even(fuel cost incurred and cost savings)at the desired steam flow rate.It also conducts sensitivity analyses between energy usage,cost savings,and payback on the investment of the operating parameters to understand the relationship between relevant variables.By utilizing parameters from a pulp and paper manufacturing facility,the research determines that the fuel cost,electricity cost,and steam flow rate are the most important parameters for the feasibility of the system with a desirable payback on the investment.展开更多
BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated fro...BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large populations.AIM To assess the risk of PC in CD patients.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform.We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this study.Among them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control cohort.The mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,respectively.During the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.CONCLUSION Patients with CD are at increased risk of PC.Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.展开更多
基金supported by the National Institutes of Health[Grant Number:3R15NR018547]Praboromrajachanok Institute for Health Workforce Development,Ministry of Public Health,Thailand[Grant number 2/2561]。
文摘As government agencies continue to tighten emissions regulations due to the continued increase in greenhouse gas production, automotive industries are seeking to produce increasingly efficient vehicle technology. Hybrid electric vehicles (HEVs) have been introduced to mitigate problems while improving fuel economy. HEVs have led to the demand of creating more advanced controls software to consider multiple components for propulsive power in a vehicle. A large section in the software development process is the implementation of an optimal energy management strategy meant to improve the overall fuel efficiency of the vehicle. Optimal strategies can be implemented when driving conditions are known a prior. The Equivalent Consumption Minimization Strategy (ECMS) is an optimal control strategy that uses an equivalence factor to equate electrical to mechanical power when performing torque split determination between the internal combustion engine and electric motor for propulsive and regenerative torque. This equivalence factor is determined from offline vehicle simulations using a sensitivity analysis to provide optimal fuel economy results while maintaining predetermined high voltage battery state of charge (SOC) constraints. When the control hierarchy is modified or different driving styles are applied, the analysis must be redone to update the equivalence factor. The goal of this work is to implement a fuzzy logic controller that dynamically updates the equivalence factor to improve fuel economy, maintain a strict charge sustaining window of operation for the high voltage battery, and reduce computational time required during algorithm development. The adaptive algorithm is validated against global optimum fuel economy and charge sustaining results from a sensitivity analysis performed for multiple drive cycles. Results show a maximum fuel economy improvement of 9.82% when using a mild driving style and a 95% success rate when maintaining an ending SOC within 5% of the desired SOC regardless of starting SOC.
文摘Pavement infrastructure is vital in providing services and links between various sectors of society. Therefore, thepreservation and maintenance of these roads are critical to attaining a pavement network in good conditionthroughout its service life. Various performance indicators like the international roughness index (IRI), pavementcondition index (PCI), and present serviceability rating (PSR) have been used by the state department of transportation (DOT) and highway agencies for evaluating pavement surface conditions and planning future maintenance strategies. Limited data availability, multiple distresses depending on region, lack of correlation of thesecondition indices to maintenance strategies, and data collection limitations pose a challenge for applying theseindices to local conditions. This paper compares condition indices of different states for rigid pavements. Further,using a specific condition index for local conditions is also highlighted. For this purpose, five states and theircorresponding condition indices were evaluated and compared to the Michigan DOT distress index (DI). Thesestates include Virginia, Minnesota, North Dakota, Louisiana, and Oregon. The corresponding distresses of eachcondition index were converted to make them compatible with the MDOT DI. This study used the MDOT'spavement management system (PMS) database to evaluate each condition index for 433 rigid pavement sections.Each distress index was plotted against MDOT DI and compared using a paired t-test. Results show that thecondition indices of Virginia and Minnesota are comparable to DI in terms of the Spearman correlation value. Thet-test results show that except for Virgina, condition indices from other states statistically differ from DI.Therefore, one can't use those directly for local conditions in Michigan. This paper presents the evaluation anddata requirements for each condition index and its impact on selecting a maintenance treatment.
文摘Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing cells lead to increased cell turnover which exceeds the kidneys’ ability to adequately filtrate by-products of cellular breakdown (i.e., phosphate, potassium, anduric acid), leading to end organ damage. It has been reported in the past that kidney failure is a sequelae of Tumor Lysis Syndrome (TLS), but there have been no reports that demonstrate acute kidney injury (AKI) preceding TLS. The case presented here demonstrates TLS in a patient with no formal cancer diagnosis, who had received no chemotherapy or radiation that was precipitated by an iatrogenic AKI with chlorthalidone and ibuprofen. This unusual pattern of AKI preceding STLS may provide insight into the pathophysiology of the condition and could possibly lead to greater understanding of this phenomenon.
基金supported by the BRAVE Agile Investment from the PNNL
文摘Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work environment.Methods:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise regimen.Omics profiles post-vs.pre-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics modalities.Results:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of samples.The blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy demands.The urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid balance.In saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory infection.Conclusions:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.
文摘BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared to non-frail.Larger studies are warranted to investigate and mitigate modifiable risk factors.
基金This research was supported by the Department of Mining Engineering at the University of Utah.In addition,the lead author wishes to acknowledge the financial support received from the Talent Introduction Project,part of the Elite Program of Shandong University of Science and Technology(No.0104060540171).
文摘This study investigated the correlations between mechanical properties and mineralogy of granite using the digital image processing(DIP) and discrete element method(DEM). The results showed that the X-ray diffraction(XRD)-based DIP method effectively analyzed the mineral composition contents and spatial distributions of granite. During the particle flow code(PFC2D) model calibration phase, the numerical simulation exhibited that the uniaxial compressive strength(UCS) value, elastic modulus(E), and failure pattern of the granite specimen in the UCS test were comparable to the experiment. By establishing 351 sets of numerical models and exploring the impacts of mineral composition on the mechanical properties of granite, it indicated that there was no negative correlation between quartz and feldspar for UCS, tensile strength(σ_(t)), and E. In contrast, mica had a significant negative correlation for UCS, σ_(t), and E. The presence of quartz increased the brittleness of granite, whereas the presence of mica and feldspar increased its ductility in UCS and direct tensile strength(DTS) tests. Varying contents of major mineral compositions in granite showed minor influence on the number of cracks in both UCS and DTS tests.
基金supported by grants from the Key R&D Program of the Xinjiang Autonomous Region,China(2021b02002-2)the National Natural Science Foundation of China(31960538)。
文摘Identifying the sex pheromone systems of local pest populations facilitates their management,especially for moth species that show significant geographic variation in sex pheromone communication.We investigated the pheromone production and behavioral responses of the Asian corn borer(Ostrinia furnacalis Guenée;ACB)in Xinjiang,China.The ACB produces three compounds:(Z)-12-tetradecenyl acetate(Z12-14:Ac)and(E)-12-tetradecenyl acetate(E12-14:Ac)which are two sex pheromone compounds,and n-tetradecyl acetate(14:Ac)which has variable roles in mediating behavioral responses.The ratios of these three compounds produced in female gland are geographically distinct among different populations.Quantitative analysis of pheromone production showed that the proportions of Z12-14:Ac in the E/Z isomers(i.e.,Z and E12-14:Ac)and the proportions of 14:Ac in the ternary blend respectively averaged 60.46%(SD=5.26)and 25.00%(SD=7.37),with their probabilities normally or near-normally distributed.Trapping experiments in a cornfield indicated that deploying the E/Z isomers and the three compounds in rubber septa close to their gland ratios yielded the most captured males,while other ratios that deviated from the gland ratios showed reduced field captures.The ternary blend was significantly more attractive to males than the E/Z isomers in the field,indicating a functional role of 14:Ac as the third pheromone component used by the local population.Additionally,the dose-response test demonstrated that the application of the three compounds at dosages between 200 and 350μg attracted significantly more males compared to other dosages.Therefore,the characterization of this local ACB pheromone system provides additional information about its geographic variation and serves as a basis for optimizing the pheromone-mediated control of this pest in Xinjiang.
文摘Today, the oil and gas industry, and in particular hydraulic fracturing operations, have come under increasing pressure from regulators and the public to reduce emissions. As the industry evolves, oil and gas producers are in the position of evaluating alternative technologies which will support their objectives of reducing their overall emissions profile and carbon footprint. As a response, the deployment of technology and solutions to reduce emissions related to hydraulic fracturing applications has recently accelerated, creating various options to address these industry challenges. BJ Energy Solutions and West Virginia University have been working on the application and emissions characterization of various hydraulic fracturing technologies. A study was conducted to evaluate the efficiency and resultant emissions from various technologies, including natural gas reciprocating engines, diesel-natural gas dual-fuel engines, large (>24 MW) gas turbines, and direct drive turbines. The study involved the development of an emissions model with the purpose of estimating total emissions of carbon dioxide (CO<sub>2</sub>), nitrous oxide (N2O) and exhaust methane (CH<sub>4</sub>) slip, all Greenhouse Gases (GHGs), and converted to tons of CO<sub>2</sub> equivalent emissions per day of operation. The model inputs are the required Hydraulic Horsepower (HHP) based on pumping rate and pressure for various shale play scenarios. The model calculates emissions from the TITAN, which is a direct-drive turbine model fielded by BJ, using data collected following U.S. Environmental Protection Agency (EPA) testing protocols. The model also calculates and compares other hydraulic fracturing technologies utilizing published Original Equipment Manufacturer (OEM) data. Relevant EPA-regulated criteria emissions of oxides of nitrogen (NO<sub>x</sub>), Carbon Monoxide (CO) and Particulate Matter (PM) are also reported. Modeling results demonstrated that in most cases, the TITAN gas turbine system has lower total GHG emissions than conventional diesel and other next-generation technologies, and also has lower criteria emissions. The benefits of the TITAN gas turbine system compared to the other technologies stems from significantly lower methane slip, and the high-power transfer efficiency resulting from directly connecting a turbine to a reciprocating pump, despite the comparatively lower thermal efficiency.
基金The first three authors who conducted this research were partly funded by the Industrial Assessment Center Project,supported by grants from the US Department of Energy and by the West Virginia Development Office.
文摘Building Energy Management Systems(BEMS)are computer-based systems that aid in managing,controlling,and monitoring the building technical services and energy consumption by equipment used in the building.The effectiveness of BEMS is dependent upon numerous factors,among which the operational characteristics of the building and the BEMS control parameters also play an essential role.This research develops a user-driven simulation tool where users can input the building parameters and BEMS controls to determine the effectiveness of their BEMS.The simulation tool gives the user the flexibility to understand the potential energy savings by employing specific BEMS control and help in making intelligent decisions.The simulation is developed using Visual Basic Application(VBA)in Microsoft Excel,based on discrete-event Monte Carlo Simulation(MCS).The simulation works by initially calculating the energy required for space cooling and heating based on current building parameters input by the user in the model.Further,during the second simulation,the user selects all the BEMS controls and improved building envelope to determine the energy required for space cooling and heating during that case.The model compares the energy consumption from the first simulation and the second simulation.Then the simulation model will provide the rating of the effectiveness of BEMS on a continuous scale of 1 to 5(1 being poor effectiveness and 5 being excellent effectiveness of BEMS).This work is intended to facilitate building owner/energy managers to analyze the building energy performance concerning the efficacy of their energy management system.
基金funded in part by the IndustrialAssessmentCenter Project,supported by grants fromthe US Department of Energy and by theWest Virginia Development Office.
文摘Industrial applications that require steam for their end-use generally utilize steam boilers that are typically oversized,citing operations flexibility.Similarly,gas turbine-based power plants corroborate a gas turbine system that may eventually relieve the usable exhaust into the atmosphere.This study explores the economic and technical feasibility of a topping cycle combined heat and power(CHP)system.It does so by leveraging a partially loaded boiler or gas turbine by increasing its unused load to generate steam and heat for subsequent usage.To this end,a decision support tool(COGENTEC)was developed,which emulates a given facility’s boiler or gas-turbine system,and its operational parameters with the application of steam turbines.The tool provides necessary insights into the most appropriate parameters that enable a CHP system to be technically and economically advantageous.Based on input variables such as boiler-rated capacity,steam pressure,steam temperature,and existing boiler load,among others,COGENTEC designs a topping cycle CHP system to inform a user whether this system is feasible in their facility or not.If applicable,the tool assists the user to realize the point of break-even(fuel cost incurred and cost savings)at the desired steam flow rate.It also conducts sensitivity analyses between energy usage,cost savings,and payback on the investment of the operating parameters to understand the relationship between relevant variables.By utilizing parameters from a pulp and paper manufacturing facility,the research determines that the fuel cost,electricity cost,and steam flow rate are the most important parameters for the feasibility of the system with a desirable payback on the investment.
文摘BACKGROUND Celiac disease(CD)has been associated with gastrointestinal malignancies.However,the magnitude of the risk of pancreatic cancer(PC)associated with CD is much less clear,and risks have not been estimated from large populations.AIM To assess the risk of PC in CD patients.METHODS We conducted a population-based,multicenter,propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform.We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD(non-CD,controls).Each patient in the main group(CD)was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio(HR)and 95%confidence interval(CI).RESULTS A total of 389980 patients were included in this study.Among them,155877 patients had a diagnosis of CD,and the remaining 234103 individuals without CD were considered a control cohort.The mean duration of follow-up for patients in the CD and control cohorts was 5.8±1.8 and 5.9±1.1 years,respectively.During the follow-up,309 patients with CD developed PC,whereas 240 patients developed PC in the control group(HR=1.29;95%CI:1.09-1.53).In the secondary analyses in the first year after diagnosis of CD,patients with CD were at a significant increase in risk for PC;151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group(HR=1.56;95%CI:1.20-2.01)and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.CONCLUSION Patients with CD are at increased risk of PC.Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.