Ventilation is an important engineering measure to control the airborne infection risk of acute respiratory diseases,e.g.,Corona Virus Disease 2019(COVID-19).Occupancy-aided ventilation methods can effectively improve...Ventilation is an important engineering measure to control the airborne infection risk of acute respiratory diseases,e.g.,Corona Virus Disease 2019(COVID-19).Occupancy-aided ventilation methods can effectively improve the airborne infection risk control performance with a sacrifice of decreasing working productivity because of the reduced occupancy.This study evaluates the effectiveness of two occupancy-aided ventilation methods,i.e.,the continuously reduced occupancy method and the intermittently reduced occupancy method.The continuously reduced occupancy method is determined by the steady equation of the mass conservation law of the indoor contaminant,and the intermittently reduced occupancy method is determined by a genetic algorithm-based optimization.A two-scenarios-based evaluation framework is developed,i.e.,one with targeted airborne infection risk control performance(indicated by the mean rebreathed fraction)and the other with targeted working productivity(indicated by the accumulated occupancy).The results show that the improvement in the airborne infection risk control performance linearly and quadratically increases with the reduction in the working productivity for the continuously reduced occupancy method and the intermittently reduced occupancy method respectively.At a given targeted airborne infection risk control performance,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the working productivity by up to 92%.At a given targeted working productivity,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the airborne infection risk control performance by up to 38%.展开更多
Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensiona...Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters.Therefore,a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed.True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro.The effects of intermediate principal stress and amplitude on the strength characteristics,deformation characteristics,failure characteristics,and precursors of monzogabbro are analyzed,intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism.Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance.Based on the experimental result,the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed.A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established,and the model predicted results align well with the experimental results.The sensitivity of stress states and model parameters is further explored,and the intermittent disturbance behaviors at different f are predicted.This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.展开更多
A lab-scale intermittently aerated sequencing batch reactor（IASBR）was applied to treat anaerobically digested swine wastewater（ADSW）to explore the removal characteristics of veterinary antibiotics.The removal rate...A lab-scale intermittently aerated sequencing batch reactor（IASBR）was applied to treat anaerobically digested swine wastewater（ADSW）to explore the removal characteristics of veterinary antibiotics.The removal rates of 11 veterinary antibiotics in the reactor were investigated under different chemical organic demand（COD）volumetric loadings,solid retention times（SRT）and ratios of COD to total nitrogen（TN）or COD/TN.Both sludge sorption and biodegradation were found to be the major contributors to the removal of veterinary antibiotics.Mass balance analysis revealed that greater than 60%of antibiotics in the influent were biodegraded in the IASBR,whereas averagely 24%were adsorbed by sludge under the condition that sludge sorption gradually reached its equilibrium.Results showed that the removal of antibiotics was greatly influenced by chemical oxygen demand（COD）volumetric loadings,which could achieve up to 85.1%±1.4%at 0.17±0.041 kg COD/m-3/day,while dropped to 75.9%±1.3%and 49.3%±12.1%when COD volumetric loading increased to 0.65±0.032 and1.07±0.073 kg COD/m-3/day,respectively.Tetracyclines,the dominant antibiotics in ADSW,were removed by 87.9%in total at the lowest COD loading,of which 30.4%were contributed by sludge sorption and 57.5%by biodegradation,respectively.In contrast,sulfonamides were removed about 96.2%,almost by biodegradation.Long SRT seemed to have little obvious impact on antibiotics removal,while a shorter SRT of 30–40 day could reduce the accumulated amount of antibiotics and the balanced antibiotics sorption capacity of sludge.Influent COD/TN ratio was found not a key impact factor for veterinary antibiotics removal in this work.展开更多
Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to...Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86.Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer.Results In total,143 patients were enrolled(NH group,n=49;NA group,n=47;P group,n=47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001.Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.展开更多
Silicon is considered to be one of the most promising anode materials for lithium-ion batteries(LIBs),but its application is limited by the large volume expansion during alloying and dealloying.The constructing of a h...Silicon is considered to be one of the most promising anode materials for lithium-ion batteries(LIBs),but its application is limited by the large volume expansion during alloying and dealloying.The constructing of a high-performance solid electrolyte interface(SEI) film on the surface of the anode material is considered to be one of the effective strategies to mitigate volume expansion of silicon-based anode.In this study,an intermittent discharge strategy which helps to improve the utilization efficiency of electrolyte additive of lithium difluorobisoxalate phosphate(LiDFBOP) is proposed to construct a highly conductive and dense SEI film.The results of electrochemical and physical characterization and theoretical calculations show that the intermittent discharge in the voltage range from open circuit voltage(OCV) to 1.8 V facilitates the diffusion of the soluble products,creates the conditions for the repeated direct contact between Si@C anode and LiDFBOP additive,increases the decomposition of LiDFBOP additive,and thus produces a uniform,dense and inorganics-rich(Li_(2)C_(2)O_(4),LiF and Li_(x)PO_yF_z) SEI film.Subsequently,this SEI film helps to ensure the even intercalation/de-intercalation of Li^(+) in the SEI film and the homogeneous diffusion of Li^(+) inside the Si particles,decreasing the internal stresses and anisotropic phase transitions,maintaining the integrity of Si particles,inhibiting the volume expansion and thu s improving the electrochemical performance of cells.This study not only improves the utilization efficiency of expensive additives through a simply and low-cost method,but also enriches the strategy to improve the electrochemical performance of Si@C anode through interfacial engineering.展开更多
AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive p...AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.展开更多
This study investigates the aerodynamic performance of the NACA 633-421 airfoil and the effectiveness and feasibility of intermittent disturbance flow control methods on laminar separation bubbles(LSBs).It is found th...This study investigates the aerodynamic performance of the NACA 633-421 airfoil and the effectiveness and feasibility of intermittent disturbance flow control methods on laminar separation bubbles(LSBs).It is found that the average velocity and influence range of the synthetic jet actuator increase with the increasing of driving frequency and driving amplitude.LSB occurs at Re=1.0×10^(5),and ruptures atα=6°.But with intermittent disturbance control,the stall angle of attack(AoA)increases while significantly reducing drag.Research shows that although certain disturbance cannot fully recover from LSB stall,decreasing driving amplitude partially restores wing aerodynamic performance,more effectively than increasing driving amplitude.展开更多
Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed ...Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed that two cycles of fasting treatment significantly inhibited breast tumor growth and lung tissue metastasis,as well as prolonged overall survival in mice bearing 4T1 and 4T07 breast cancer.During this process,both the immunosuppressive monocytic-(M-)and granulocytic-(G-)myeloid-derived suppressor cell(MDSC)decreased,accompanied by an increase in interleukin(IL)7R^(+)and granzyme B^(+)T cells in the tumor microenvironment.Interestingly,we observed that Ly6G^(low)G-MDSC sharply decreased after fasting treatment,and the cell surface markers and protein mass spectrometry data showed potential therapeutic targets.Mechanistic investigation revealed that glucose metabolism restriction suppressed the splenic granulocytemonocyte progenitor and the generation of colony-stimulating factors and IL-6,which both contributed to the accumulation of G-MDSC.On the other hand,glucose metabolism restriction can directly induce the apoptosis of Ly6G^(low)G-MDSC,but not Ly6G^(high)subsets.In summary,these results suggest that glucose metabolism restriction induced by fasting treatment attenuates the immune-suppressive milieu and enhances the activation of CD3^(+)T cells,providing potential solutions for enhancing immune-based cancer interventions.展开更多
An intermittently aerated sequencing batch reactor （IASBR） and a traditional sequencing batch reactor （SBR） were parallelly constructed to treat digested piggery wastewater, which was in high NH4＋ -N concentratio...An intermittently aerated sequencing batch reactor （IASBR） and a traditional sequencing batch reactor （SBR） were parallelly constructed to treat digested piggery wastewater, which was in high NH4＋ -N concentration but in a low COD/TN ratio. Their pollutant removal perfonnance was compared under COD/TN ratios of 1.6-3.4 d and hydraulic retention times of 5 3 d. The results showed that the IASBR removed TN, NH4＋-N and TOC more efficiently than the SBR. The average removal rates of TN, NH4＋-N and TOC were 83.1%, 96.5%, and 89.0%, respectively, in the IASBR, significantly higher than the corresponding values of 74.8%, 82.0%, and 86.2%. in the SBR. Mass balance of organic carbon revealed that the higher TN removal in the IASBR might be attributed to its efficient utilization of the organic carbon for denitrification, since that 48.7%- 52.2% of COD was used for denitrification in the IASBR, higher than the corresponding proportion of 43.1%-47.4% in the SBR. A prc-anoxic process in the IASBR would enhance the ammonium oxidation while restrict the nitrite oxidation. Anoxic duration of 40-80 min should be beneficial for achieving stable nitritation.展开更多
An imbalance in adenosine-mediated signaling,particularly the increased A_(2A)R-mediated signaling,plays a role in the pathogenesis of Parkinson's disease.Existing therapeutic approaches fail to alter disease prog...An imbalance in adenosine-mediated signaling,particularly the increased A_(2A)R-mediated signaling,plays a role in the pathogenesis of Parkinson's disease.Existing therapeutic approaches fail to alter disease progression,demonstrating the need for novel approaches in PD.Repetitive transcranial magnetic stimulation is a non-invasive approach that has been shown to improve motor and non-motor symptoms of Parkinson's disease.However,the underlying mechanisms of the beneficial effects of repetitive transcranial magnetic stimulation remain unknown.The purpose of this study is to investigate the extent to which the beneficial effects of prolonged intermittent theta burst stimulation in the 6-hydroxydopamine model of experimental parkinsonism are based on modulation of adenosine-mediated signaling.Animals with unilateral 6-hydroxydopamine lesions underwent intermittent theta burst stimulation for 3 weeks and were tested for motor skills using the Rotarod test.Immunoblot,quantitative reverse transcription polymerase chain reaction,immunohistochemistry,and biochemical analysis of components of adenosine-mediated signaling were performed on the synaptosomal fraction of the lesioned caudate putamen.Prolonged intermittent theta burst stimulation improved motor symptoms in 6-hydroxydopamine-lesioned animals.A 6-hydroxydopamine lesion resulted in progressive loss of dopaminergic neurons in the caudate putamen.Treatment with intermittent theta burst stimulation began 7 days after the lesion,coinciding with the onset of motor symptoms.After treatment with prolonged intermittent theta burst stimulation,complete motor recovery was observed.This improvement was accompanied by downregulation of the e N/CD73-A_(2A)R pathway and a return to physiological levels of A_(1)R-adenosine deaminase 1 after 3 weeks of intermittent theta burst stimulation.Our results demonstrated that 6-hydroxydopamine-induced degeneration reduced the expression of A_(1)R and elevated the expression of A_(2A)R.Intermittent theta burst stimulation reversed these effects by restoring the abundances of A_(1)R and A_(2A)R to control levels.The shift in ARs expression likely restored the balance between dopamine-adenosine signaling,ultimately leading to the recovery of motor control.展开更多
This paper investigates the adaptive fuzzy finite-time output-feedback fault-tolerant control (FTC) problemfor a class of nonlinear underactuated wheeled mobile robots (UWMRs) system with intermittent actuatorfaults. ...This paper investigates the adaptive fuzzy finite-time output-feedback fault-tolerant control (FTC) problemfor a class of nonlinear underactuated wheeled mobile robots (UWMRs) system with intermittent actuatorfaults. The UWMR system includes unknown nonlinear dynamics and immeasurable states. Fuzzy logic systems(FLSs) are utilized to work out immeasurable functions. Furthermore, with the support of the backsteppingcontrol technique and adaptive fuzzy state observer, a fuzzy adaptive finite-time output-feedback FTC scheme isdeveloped under the intermittent actuator faults. It is testifying the scheme can ensure the controlled nonlinearUWMRs is stable and the estimation errors are convergent. Finally, the comparison results and simulationvalidate the effectiveness of the proposed fuzzy adaptive finite-time FTC approach.展开更多
BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymph...BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymphangiomas can give rise to complications such as abdominal pain,bleeding,volvulus,and intussusception.Here,we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.CASE SUMMARY A 66-year-old man presented with intermittent melena,fatigue and refractory anemia nine months prior.Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding.Conservative management,including transfusion,hemostasis,gastric acid secretion inhibition and symptomatic treatment,was performed,but the lesions tended to recur shortly after surgery.Ultimately,the patient underwent capsule endoscopy,which revealed a more than 10 cm lesion accompanied by active bleeding.After singleballoon enteroscopy and biopsy,a diagnosis of jejunal cavernous lymphangioma was confirmed,and the patient underwent surgical resection.No complications or recurrences were observed postoperatively.CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding.Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis.Surgical resection is an effective management method.展开更多
Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The dur...Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.展开更多
Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bl...Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.展开更多
Background: Chronic fatigue syndrome (CFS) shows as its main symptoms debilitating fatigue that is not relieved by physiological rest, depression, inflammation, learning disability and memory impairment. But, intermit...Background: Chronic fatigue syndrome (CFS) shows as its main symptoms debilitating fatigue that is not relieved by physiological rest, depression, inflammation, learning disability and memory impairment. But, intermittent hypoxia, consisting of alternating exposure to hypoxia and normoxia, plays a very important role in improving CFS. However, the essential components for improving learning and memory in CFS patients as well as their mechanism are largely unknown. Objectives: This study aims to analyze the effects of 12% and 15% hypoxia on the expression of alpha tumor necrosis factor (TNF-α) and nuclear factor kappa B (NF-κB) in CFS induced-mouse model for clarifying the effects on the learning and memory function. Methods: A total of 48 type IC mice were used. The CFS mouse model was established using restrained stress and repeated forced swimming. Treatment of CFS was done by exposing CFS mice to intermittent hypoxia at 12% and 15%. The effects of intermittent hypoxia on learning and memory as well as its mechanism of action on inflammation were tested respectively with the Morris test, the SDS page, the immunohistochemistry technique and the Nissl staining. Results: We found that 12% and 15% intermittent hypoxia exposure improved learning capacity and memory of CFS induced-mice. SDS page showed that CFS caused higher TNF-α expression. By exposing CFS mice to 12% and 15% intermittent hypoxia, TNF-α expression decreased significantly, with a much better effect at 15%. Both TNF-α and NF-κB increased in CFS state and decreased after treatment with intermittent hypoxia. Conclusion: Intermittent hypoxia improves learning capacity and memory. It acted by decreasing NF-κB come to down-regulating TNF-α and ameliorates learning capacity and memory impairment in CFS mice.展开更多
Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years fol...Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.展开更多
Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with m...Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.展开更多
The explosive technological improvement of photovoltaic systems as well as the necessity of populations to come to less expensive energy sources, that have led to an implosion at the level of solar panel manufacturers...The explosive technological improvement of photovoltaic systems as well as the necessity of populations to come to less expensive energy sources, that have led to an implosion at the level of solar panel manufacturers. This causes a large flow of these equipments to developing countries where the need is high, without any quality control. That conducted an experimental investigation on the performance characteristics of a 250 wp monocrystalline silicon photovoltaic module in other to check the verification and quality control. Most of these PV panels which often have missing informations are manufactured and tested in places that are inadequate for our environmental and meteorological conditions. Also, their influences on the stability of internal parameters were evaluated in order to optimize their performance. The results obtained at maximum illumination (1000 w/m<sup>2</sup>) confirmed those produced by the manufacturer. The analysis of these characteristics showed that the illumination and the temperature (meteorological factors) influenced at most the stability of the internal characteristics of the module in the sense that the maximum power increased very rapidly beyond 750 w/m<sup>2</sup> but a degradation of performance was accentuated for a temperature of the solar cells exceeding 50°C. The degradation coefficients were evaluated at -0.0864 V/°C for the voltage and at -1.6248 w/°C for the power. The 10° inclination angle of the solar panel proved to be ideal for optimizing overall efficiency in practical situations.展开更多
A traditional sequencing batch reactor （SBR） and two intermittently aerated sequencing batch reactors （IASBRs） were parallelly operated for treating digested piggery wastewater. Their microbial communities were an...A traditional sequencing batch reactor （SBR） and two intermittently aerated sequencing batch reactors （IASBRs） were parallelly operated for treating digested piggery wastewater. Their microbial communities were analyzed, and the nitrogen removal performance was compared during the long term run. IASBRs demonstrated higher removal rates of total nitrogen （TN） and ammonium nitrogen （NH4＋ -N） than the SBR, and also demonstrated higher resistance against TN shock load. It was found that the more switch times between aerobic/anoxic in an IASBR, the higher the removal rates of TN and NH4＋ N. All the reactors were predominated by Thauera, Nitrosomonas and Nitrobacter, which were considered to be species of denitrifiers, ammonium oxidizing bacteria （AOB） and nitrite oxidizing bacteria （NOB）, respectively. However, the abundance and diversity was of great difference. Compared with SBR, IASBRs achieved higher abundance of denitrification related bacteria. IASBR 1# with four aerobic/anoxic switch times was detected with 25.63% of Thauera, higher than that in IASBR 2# with two aerobic/anoxic switch times （l 1.57% of Thauera）, and much higher than that in the SBR （only 6.19% of Thauera）. IASBR 2# had the highest percentage of AOB, while 1ASBR 1# had the lowest percentage. The denitrifiers abundance was significantly positive correlated with the TN removal rate. However, the NH4＋ N removal rate showed no significant correlation with the AOB abundance, but might relate to the AOB activity which was influenced by the average free ammonium （FA） concentration. Nitrobacter was the only NOB genus detectable in all reactors, and were less than 0.03%.展开更多
A mapping function between the Reynolds-averaged Navier-Stokes mean flow variables and transition intermittency factor is constructed by fully connected artificial neural network(ANN),which replaces the governing equa...A mapping function between the Reynolds-averaged Navier-Stokes mean flow variables and transition intermittency factor is constructed by fully connected artificial neural network(ANN),which replaces the governing equation of the intermittency factor in transition-predictive Spalart-Allmaras(SA)-γmodel.By taking SA-γmodel as the benchmark,the present ANN model is trained at two airfoils with various angles of attack,Mach numbers and Reynolds numbers,and tested with unseen airfoils in different flow states.The a posteriori tests manifest that the mean pressure coefficient,skin friction coefficient,size of laminar separation bubble,mean streamwise velocity,Reynolds shear stress and lift/drag/moment coefficient from the present two-way coupling ANN model almost coincide with those from the benchmark SA-γmodel.Furthermore,the ANN model proves to exhibit a higher calculation efficiency and better convergence quality than traditional SA-γmodel.展开更多
基金supported by the Fundamental Research Funds for the Central Universities(No.xzy012022078)the Top Young Talent Programme of Xi’an Jiaotong University(No.011900/71211201030703).
文摘Ventilation is an important engineering measure to control the airborne infection risk of acute respiratory diseases,e.g.,Corona Virus Disease 2019(COVID-19).Occupancy-aided ventilation methods can effectively improve the airborne infection risk control performance with a sacrifice of decreasing working productivity because of the reduced occupancy.This study evaluates the effectiveness of two occupancy-aided ventilation methods,i.e.,the continuously reduced occupancy method and the intermittently reduced occupancy method.The continuously reduced occupancy method is determined by the steady equation of the mass conservation law of the indoor contaminant,and the intermittently reduced occupancy method is determined by a genetic algorithm-based optimization.A two-scenarios-based evaluation framework is developed,i.e.,one with targeted airborne infection risk control performance(indicated by the mean rebreathed fraction)and the other with targeted working productivity(indicated by the accumulated occupancy).The results show that the improvement in the airborne infection risk control performance linearly and quadratically increases with the reduction in the working productivity for the continuously reduced occupancy method and the intermittently reduced occupancy method respectively.At a given targeted airborne infection risk control performance,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the working productivity by up to 92%.At a given targeted working productivity,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the airborne infection risk control performance by up to 38%.
基金the financial support from the National Natural Science Foundation of China(No.52109119)the Guangxi Natural Science Foundation(No.2021GXNSFBA075030)+2 种基金the Guangxi Science and Technology Project(No.Guike AD20325002)the Chinese Postdoctoral Science Fund Project(No.2022 M723408)the Open Research Fund of State Key Laboratory of Simulation and Regulation of Water Cycle in River Basin(China Institute of Water Resources and Hydropower Research)(No.IWHR-SKL-202202).
文摘Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters.Therefore,a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed.True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro.The effects of intermediate principal stress and amplitude on the strength characteristics,deformation characteristics,failure characteristics,and precursors of monzogabbro are analyzed,intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism.Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance.Based on the experimental result,the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed.A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established,and the model predicted results align well with the experimental results.The sensitivity of stress states and model parameters is further explored,and the intermittent disturbance behaviors at different f are predicted.This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.
文摘A lab-scale intermittently aerated sequencing batch reactor（IASBR）was applied to treat anaerobically digested swine wastewater（ADSW）to explore the removal characteristics of veterinary antibiotics.The removal rates of 11 veterinary antibiotics in the reactor were investigated under different chemical organic demand（COD）volumetric loadings,solid retention times（SRT）and ratios of COD to total nitrogen（TN）or COD/TN.Both sludge sorption and biodegradation were found to be the major contributors to the removal of veterinary antibiotics.Mass balance analysis revealed that greater than 60%of antibiotics in the influent were biodegraded in the IASBR,whereas averagely 24%were adsorbed by sludge under the condition that sludge sorption gradually reached its equilibrium.Results showed that the removal of antibiotics was greatly influenced by chemical oxygen demand（COD）volumetric loadings,which could achieve up to 85.1%±1.4%at 0.17±0.041 kg COD/m-3/day,while dropped to 75.9%±1.3%and 49.3%±12.1%when COD volumetric loading increased to 0.65±0.032 and1.07±0.073 kg COD/m-3/day,respectively.Tetracyclines,the dominant antibiotics in ADSW,were removed by 87.9%in total at the lowest COD loading,of which 30.4%were contributed by sludge sorption and 57.5%by biodegradation,respectively.In contrast,sulfonamides were removed about 96.2%,almost by biodegradation.Long SRT seemed to have little obvious impact on antibiotics removal,while a shorter SRT of 30–40 day could reduce the accumulated amount of antibiotics and the balanced antibiotics sorption capacity of sludge.Influent COD/TN ratio was found not a key impact factor for veterinary antibiotics removal in this work.
基金supported by the National Key Research and Development Program[2022YFC2603500,2022YFC2603505]Capital Clinical Diagnostic Techniques and Translational Application Projects(Z211100002921059)+2 种基金Capital’s Funds for Health Improvement and Research[2022-1-2172]Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support[XMLX 202127]National Science and Technology Major Project of China[2017ZX10203202-003]。
文摘Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86.Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer.Results In total,143 patients were enrolled(NH group,n=49;NA group,n=47;P group,n=47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001.Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.
基金Department of Education of Gansu Province: Industrial Support Plan Project (2022CYZC-23)National Natural Science Foundation of China (22269012)Gansu Key Research and Development Program (23YFGA0053)。
文摘Silicon is considered to be one of the most promising anode materials for lithium-ion batteries(LIBs),but its application is limited by the large volume expansion during alloying and dealloying.The constructing of a high-performance solid electrolyte interface(SEI) film on the surface of the anode material is considered to be one of the effective strategies to mitigate volume expansion of silicon-based anode.In this study,an intermittent discharge strategy which helps to improve the utilization efficiency of electrolyte additive of lithium difluorobisoxalate phosphate(LiDFBOP) is proposed to construct a highly conductive and dense SEI film.The results of electrochemical and physical characterization and theoretical calculations show that the intermittent discharge in the voltage range from open circuit voltage(OCV) to 1.8 V facilitates the diffusion of the soluble products,creates the conditions for the repeated direct contact between Si@C anode and LiDFBOP additive,increases the decomposition of LiDFBOP additive,and thus produces a uniform,dense and inorganics-rich(Li_(2)C_(2)O_(4),LiF and Li_(x)PO_yF_z) SEI film.Subsequently,this SEI film helps to ensure the even intercalation/de-intercalation of Li^(+) in the SEI film and the homogeneous diffusion of Li^(+) inside the Si particles,decreasing the internal stresses and anisotropic phase transitions,maintaining the integrity of Si particles,inhibiting the volume expansion and thu s improving the electrochemical performance of cells.This study not only improves the utilization efficiency of expensive additives through a simply and low-cost method,but also enriches the strategy to improve the electrochemical performance of Si@C anode through interfacial engineering.
基金the Nature and Science of Science Technology Department of Fujian Province(No.2020J01233).
文摘AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.
文摘This study investigates the aerodynamic performance of the NACA 633-421 airfoil and the effectiveness and feasibility of intermittent disturbance flow control methods on laminar separation bubbles(LSBs).It is found that the average velocity and influence range of the synthetic jet actuator increase with the increasing of driving frequency and driving amplitude.LSB occurs at Re=1.0×10^(5),and ruptures atα=6°.But with intermittent disturbance control,the stall angle of attack(AoA)increases while significantly reducing drag.Research shows that although certain disturbance cannot fully recover from LSB stall,decreasing driving amplitude partially restores wing aerodynamic performance,more effectively than increasing driving amplitude.
基金supported by the Postdoctoral Research Funds of Hebei Medical University(30705010016-3759)Natural Science Foundation of China(32272328)+4 种基金Natural Science Foundation of Hebei Province(B2022321001)National Key Research Project of Hebei Province(20375502D)Postdoctoral Research Project of Hebei Province(B2022003031)Science and Technology Research Program of Hebei Provincial Colleges(QN2023229)Hebei Provincial Key Laboratory of Nutrition and Health(2023YDYY-KF05)。
文摘Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed that two cycles of fasting treatment significantly inhibited breast tumor growth and lung tissue metastasis,as well as prolonged overall survival in mice bearing 4T1 and 4T07 breast cancer.During this process,both the immunosuppressive monocytic-(M-)and granulocytic-(G-)myeloid-derived suppressor cell(MDSC)decreased,accompanied by an increase in interleukin(IL)7R^(+)and granzyme B^(+)T cells in the tumor microenvironment.Interestingly,we observed that Ly6G^(low)G-MDSC sharply decreased after fasting treatment,and the cell surface markers and protein mass spectrometry data showed potential therapeutic targets.Mechanistic investigation revealed that glucose metabolism restriction suppressed the splenic granulocytemonocyte progenitor and the generation of colony-stimulating factors and IL-6,which both contributed to the accumulation of G-MDSC.On the other hand,glucose metabolism restriction can directly induce the apoptosis of Ly6G^(low)G-MDSC,but not Ly6G^(high)subsets.In summary,these results suggest that glucose metabolism restriction induced by fasting treatment attenuates the immune-suppressive milieu and enhances the activation of CD3^(+)T cells,providing potential solutions for enhancing immune-based cancer interventions.
文摘An intermittently aerated sequencing batch reactor （IASBR） and a traditional sequencing batch reactor （SBR） were parallelly constructed to treat digested piggery wastewater, which was in high NH4＋ -N concentration but in a low COD/TN ratio. Their pollutant removal perfonnance was compared under COD/TN ratios of 1.6-3.4 d and hydraulic retention times of 5 3 d. The results showed that the IASBR removed TN, NH4＋-N and TOC more efficiently than the SBR. The average removal rates of TN, NH4＋-N and TOC were 83.1%, 96.5%, and 89.0%, respectively, in the IASBR, significantly higher than the corresponding values of 74.8%, 82.0%, and 86.2%. in the SBR. Mass balance of organic carbon revealed that the higher TN removal in the IASBR might be attributed to its efficient utilization of the organic carbon for denitrification, since that 48.7%- 52.2% of COD was used for denitrification in the IASBR, higher than the corresponding proportion of 43.1%-47.4% in the SBR. A prc-anoxic process in the IASBR would enhance the ammonium oxidation while restrict the nitrite oxidation. Anoxic duration of 40-80 min should be beneficial for achieving stable nitritation.
基金supported by a grant from Ministry of Science,Technological Development and Innovation,Serbia,No.451-03-68/2022-14/200178(to NN)University of Defence,No.MFVMA/02/22-24(to MN)。
文摘An imbalance in adenosine-mediated signaling,particularly the increased A_(2A)R-mediated signaling,plays a role in the pathogenesis of Parkinson's disease.Existing therapeutic approaches fail to alter disease progression,demonstrating the need for novel approaches in PD.Repetitive transcranial magnetic stimulation is a non-invasive approach that has been shown to improve motor and non-motor symptoms of Parkinson's disease.However,the underlying mechanisms of the beneficial effects of repetitive transcranial magnetic stimulation remain unknown.The purpose of this study is to investigate the extent to which the beneficial effects of prolonged intermittent theta burst stimulation in the 6-hydroxydopamine model of experimental parkinsonism are based on modulation of adenosine-mediated signaling.Animals with unilateral 6-hydroxydopamine lesions underwent intermittent theta burst stimulation for 3 weeks and were tested for motor skills using the Rotarod test.Immunoblot,quantitative reverse transcription polymerase chain reaction,immunohistochemistry,and biochemical analysis of components of adenosine-mediated signaling were performed on the synaptosomal fraction of the lesioned caudate putamen.Prolonged intermittent theta burst stimulation improved motor symptoms in 6-hydroxydopamine-lesioned animals.A 6-hydroxydopamine lesion resulted in progressive loss of dopaminergic neurons in the caudate putamen.Treatment with intermittent theta burst stimulation began 7 days after the lesion,coinciding with the onset of motor symptoms.After treatment with prolonged intermittent theta burst stimulation,complete motor recovery was observed.This improvement was accompanied by downregulation of the e N/CD73-A_(2A)R pathway and a return to physiological levels of A_(1)R-adenosine deaminase 1 after 3 weeks of intermittent theta burst stimulation.Our results demonstrated that 6-hydroxydopamine-induced degeneration reduced the expression of A_(1)R and elevated the expression of A_(2A)R.Intermittent theta burst stimulation reversed these effects by restoring the abundances of A_(1)R and A_(2A)R to control levels.The shift in ARs expression likely restored the balance between dopamine-adenosine signaling,ultimately leading to the recovery of motor control.
基金the National Natural Science Foundation of China under Grant U22A2043.
文摘This paper investigates the adaptive fuzzy finite-time output-feedback fault-tolerant control (FTC) problemfor a class of nonlinear underactuated wheeled mobile robots (UWMRs) system with intermittent actuatorfaults. The UWMR system includes unknown nonlinear dynamics and immeasurable states. Fuzzy logic systems(FLSs) are utilized to work out immeasurable functions. Furthermore, with the support of the backsteppingcontrol technique and adaptive fuzzy state observer, a fuzzy adaptive finite-time output-feedback FTC scheme isdeveloped under the intermittent actuator faults. It is testifying the scheme can ensure the controlled nonlinearUWMRs is stable and the estimation errors are convergent. Finally, the comparison results and simulationvalidate the effectiveness of the proposed fuzzy adaptive finite-time FTC approach.
文摘BACKGROUND Lymphangiomas in the gastrointestinal tract are extremely rare in adults.As a benign lesion,small intestine lymphangiomas often remain asymptomatic and pose challenges for definitive diagnosis.However,lymphangiomas can give rise to complications such as abdominal pain,bleeding,volvulus,and intussusception.Here,we report a case of jejunal cavernous lymphangioma that presented with intermittent melena and refractory anemia in a male adult.CASE SUMMARY A 66-year-old man presented with intermittent melena,fatigue and refractory anemia nine months prior.Esophagogastroduodenoscopy and colonoscopy were performed many times and revealed no apparent bleeding.Conservative management,including transfusion,hemostasis,gastric acid secretion inhibition and symptomatic treatment,was performed,but the lesions tended to recur shortly after surgery.Ultimately,the patient underwent capsule endoscopy,which revealed a more than 10 cm lesion accompanied by active bleeding.After singleballoon enteroscopy and biopsy,a diagnosis of jejunal cavernous lymphangioma was confirmed,and the patient underwent surgical resection.No complications or recurrences were observed postoperatively.CONCLUSION Jejunal cavernous lymphangioma should be considered a cause of obscure gastrointestinal bleeding.Capsule endoscopy and single-balloon enteroscopy can facilitate diagnosis.Surgical resection is an effective management method.
文摘Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.
文摘Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.
文摘Background: Chronic fatigue syndrome (CFS) shows as its main symptoms debilitating fatigue that is not relieved by physiological rest, depression, inflammation, learning disability and memory impairment. But, intermittent hypoxia, consisting of alternating exposure to hypoxia and normoxia, plays a very important role in improving CFS. However, the essential components for improving learning and memory in CFS patients as well as their mechanism are largely unknown. Objectives: This study aims to analyze the effects of 12% and 15% hypoxia on the expression of alpha tumor necrosis factor (TNF-α) and nuclear factor kappa B (NF-κB) in CFS induced-mouse model for clarifying the effects on the learning and memory function. Methods: A total of 48 type IC mice were used. The CFS mouse model was established using restrained stress and repeated forced swimming. Treatment of CFS was done by exposing CFS mice to intermittent hypoxia at 12% and 15%. The effects of intermittent hypoxia on learning and memory as well as its mechanism of action on inflammation were tested respectively with the Morris test, the SDS page, the immunohistochemistry technique and the Nissl staining. Results: We found that 12% and 15% intermittent hypoxia exposure improved learning capacity and memory of CFS induced-mice. SDS page showed that CFS caused higher TNF-α expression. By exposing CFS mice to 12% and 15% intermittent hypoxia, TNF-α expression decreased significantly, with a much better effect at 15%. Both TNF-α and NF-κB increased in CFS state and decreased after treatment with intermittent hypoxia. Conclusion: Intermittent hypoxia improves learning capacity and memory. It acted by decreasing NF-κB come to down-regulating TNF-α and ameliorates learning capacity and memory impairment in CFS mice.
文摘Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.
文摘Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.
文摘The explosive technological improvement of photovoltaic systems as well as the necessity of populations to come to less expensive energy sources, that have led to an implosion at the level of solar panel manufacturers. This causes a large flow of these equipments to developing countries where the need is high, without any quality control. That conducted an experimental investigation on the performance characteristics of a 250 wp monocrystalline silicon photovoltaic module in other to check the verification and quality control. Most of these PV panels which often have missing informations are manufactured and tested in places that are inadequate for our environmental and meteorological conditions. Also, their influences on the stability of internal parameters were evaluated in order to optimize their performance. The results obtained at maximum illumination (1000 w/m<sup>2</sup>) confirmed those produced by the manufacturer. The analysis of these characteristics showed that the illumination and the temperature (meteorological factors) influenced at most the stability of the internal characteristics of the module in the sense that the maximum power increased very rapidly beyond 750 w/m<sup>2</sup> but a degradation of performance was accentuated for a temperature of the solar cells exceeding 50°C. The degradation coefficients were evaluated at -0.0864 V/°C for the voltage and at -1.6248 w/°C for the power. The 10° inclination angle of the solar panel proved to be ideal for optimizing overall efficiency in practical situations.
文摘A traditional sequencing batch reactor （SBR） and two intermittently aerated sequencing batch reactors （IASBRs） were parallelly operated for treating digested piggery wastewater. Their microbial communities were analyzed, and the nitrogen removal performance was compared during the long term run. IASBRs demonstrated higher removal rates of total nitrogen （TN） and ammonium nitrogen （NH4＋ -N） than the SBR, and also demonstrated higher resistance against TN shock load. It was found that the more switch times between aerobic/anoxic in an IASBR, the higher the removal rates of TN and NH4＋ N. All the reactors were predominated by Thauera, Nitrosomonas and Nitrobacter, which were considered to be species of denitrifiers, ammonium oxidizing bacteria （AOB） and nitrite oxidizing bacteria （NOB）, respectively. However, the abundance and diversity was of great difference. Compared with SBR, IASBRs achieved higher abundance of denitrification related bacteria. IASBR 1# with four aerobic/anoxic switch times was detected with 25.63% of Thauera, higher than that in IASBR 2# with two aerobic/anoxic switch times （l 1.57% of Thauera）, and much higher than that in the SBR （only 6.19% of Thauera）. IASBR 2# had the highest percentage of AOB, while 1ASBR 1# had the lowest percentage. The denitrifiers abundance was significantly positive correlated with the TN removal rate. However, the NH4＋ N removal rate showed no significant correlation with the AOB abundance, but might relate to the AOB activity which was influenced by the average free ammonium （FA） concentration. Nitrobacter was the only NOB genus detectable in all reactors, and were less than 0.03%.
基金the financial supports provided by the National Natural Science Foundation of China(Nos.91852112 and 11988102)。
文摘A mapping function between the Reynolds-averaged Navier-Stokes mean flow variables and transition intermittency factor is constructed by fully connected artificial neural network(ANN),which replaces the governing equation of the intermittency factor in transition-predictive Spalart-Allmaras(SA)-γmodel.By taking SA-γmodel as the benchmark,the present ANN model is trained at two airfoils with various angles of attack,Mach numbers and Reynolds numbers,and tested with unseen airfoils in different flow states.The a posteriori tests manifest that the mean pressure coefficient,skin friction coefficient,size of laminar separation bubble,mean streamwise velocity,Reynolds shear stress and lift/drag/moment coefficient from the present two-way coupling ANN model almost coincide with those from the benchmark SA-γmodel.Furthermore,the ANN model proves to exhibit a higher calculation efficiency and better convergence quality than traditional SA-γmodel.
