Initial Reduction Research Articles

Hydrostatic reduction of intussusception: the impact of high enema pressure on success rates.

The aim of this study is to analyze the effect of increasing enema pressure on enema outcomes. We conducted a retrospective study to compare the effect of increasing enema pressure on enema outcomes. The primary outcome was the success rate of reduction, while secondary outcomes included intestinal perforation and recurrence rate. From May 2017 to April 2021, a total of 531 intussusceptions in 499 patients (Group A 247 patients, Group B 252 patients) were collected. The overall success reduction rate was 97.00%. The success reduction rate in Group A was 99.20% (245/247) and 94.8% (239/252) in Group B (P = 0.004). The overall recurrence rate within 48h after the initial enema reduction was 8.02%, and beyond 48h was 6.41%. The recurrence rates within 48h and beyond 48h were 9.39% and 6.53% in group A and 7.11% and 6.69% in group B, respectively (P = 0.526). No complications were associated with the enema reduction procedure. Our study has shown that using a hydrostatic pressure of 130mmHg for enema reduction is both effective and safe, with a higher success rate and no increased risk of complications. Therapeutic study, III.

The combination of a glucagon-like peptide-1 and amylin receptor agonists reduces alcohol consumption in both male and female rats.

Combining different pharmaceuticals may be beneficial when treating disorders with complex neurobiology, including alcohol use disorder (AUD). The gut-brain peptides amylin and GLP-1 may be of potential interest as they individually reduce alcohol intake in rodents. While the combination of amylin receptor (AMYR) and glucagon-like peptide-1 receptor (GLP-1R) agonists have been found to decrease feeding and body weight in obese male rats synergistically, their combined impact on alcohol intake is unknown. Therefore, the effect of the combination of an AMYR (salmon calcitonin (sCT)) and a GLP-1R (dulaglutide) agonist on alcohol intake in rats of both sexes was explored in two separate alcohol-drinking experiments. The first alcohol-drinking experiment evaluated the potential of adding sCT to an ongoing dulaglutide treatment, whereas the second alcohol-drinking experiment examined the effect when adding sCT and dulaglutide simultaneously. When adding sCT to an ongoing dulaglutide treatment, a reduction in alcohol intake was observed in both male and female rats. However, when combining sCT and dulaglutide simultaneously, an initial reduction in alcohol intake was observed in rats of both sexes, whereas tolerance towards treatment was observed. In both alcohol-drinking experiments, this treatment combination consistently decreased food consumption and body weight in males and females. While the treatment combination did not affect inflammatory mediators, the gene expression of AMYR or GLP-1R, it changed fat tissue morphology. Further investigation needs to be done on the combination of AMYR and GLP-1R agonists to assess their combined effects on alcohol intake.

Case report of a dog treated with radioactive iodine (I131) and stereotactic body radiation therapy (SBRT) for metastatic ectopic thyroid carcinoma

BackgroundThyroid carcinoma is a rare malignancy in middle-aged to older, medium to large breed dogs. Most are carcinomas or adenocarcinomas and are often detected incidentally via palpation or advanced imaging, such as computed tomography. Up to 48% of dogs present with metastatic disease, primarily in lymph nodes and lungs. Preferred treatment is thyroidectomy, but many dogs are poor candidates due to tumour immobility and metastasis. Stereotactic body radiation therapy and radioactive iodine (I131) are emerging treatments with promising outcomes in these cases. This report describes a dog with metastatic ectopic thyroid carcinoma treated with both SBRT and I131.Case presentationThis case describes a 10-year-old Jack Russell Terrier mix presenting with an ectopic thyroid carcinoma at the heart base and pericardial effusion. Initial treatment involved stereotactic body radiation therapy in three fractions totalling 21 Gy. Seven weeks later, with persistent tumour-related signs, a subcutaneous injection of 1600 MBq of I131 was administered. The dog clinically improved, while showing initial tumour reduction on cardiac ultrasound and thoracic radiographs. 37 months later, the dog presented again with recurrent pericardial effusion. Thoracic radiographs and ultrasound revealed metastatic nodules and increased size of the primary heart-based mass, indicating disease progression. A second dose of I131 (1600 MBq) was administered, but restrictive pericarditis and effusion necessitated a subtotal pericardectomy. Nine months after the second I131 treatment, the dog presented with similar signs and further disease progression evident on imaging including pleural effusion. Though treatment options, including a third I131 dose and a second SBRT course, were discussed, the owners chose to humanely euthanise the dog.ConclusionsThis case highlights an unusually prolonged survival in a dog with metastatic ectopic thyroid carcinoma, suggesting the potential for extended disease control with multimodal external beam radiation and I131 therapies.

Efficiently enhancing stability for a low concentration HCHO degradation using hexagonal prism MnCe-MOFs catalysts

The efficient and stable removal of indoor formaldehyde (HCHO) a low concentration, as required by the national standard (≤ 0.08 mg/m3), remains a significant challenge. In this study, we investigated a novel hexagonal prism structure of MnCe-MOFs catalysts, synthesized via the hydrothermal method using DMF (N, N-Dimethylformamide), for the complete degradation of HCHO at ambient temperature. Monometallic and bimetallic MOFs materials, as well as the effects of calcination temperature and the stability of these high-performance catalysts in degrading HCHO were investigated and characterized using EDS, XPS, H2-TPR, IR and ESR. Results demonstrated that HCHO degradation using MnCe-MOFs achieved 97.2% efficiency within 48 hours, maintaining above 96% efficiency after three experimental cycles, exhibiting the highest activity and stability. The high performance was attributed to the columnar structure with abundant pores and a high specific surface area, lower initial reduction temperature, and an abundant presence of surface hydroxyl groups. Moreover, the spherical nanoparticles of MnCe-MOFs were uniformly distributed, and the highly dispersed CeOx provided plentiful active sites, contributing to the catalysts’ high activity and stability.

Changes in clinical presentation, management, and survival outcomes in patients affected by colorectal cancer following COVID-19 pandemic.

As an extended analysis of the COVID-DELAY study, we aimed to assess the impact of the COVID-19 pandemic on diagnosis, staging, and survival outcomes among patients with colorectal cancer (CRC) diagnosis performed from 2019 to 2022. All consecutive newly diagnosed CRC patients referred to 11 Italian Oncology Departments between March and December 2019, 2020, 2021, and 2022 were enrolled. Access rate, demographics, diagnostic-therapeutic temporal intervals, and first-line progression-free survival (PFS) and OS among metastatic patients were assessed. Compared to 2019 (n = 690), an initial global reduction in new CRC cases in 2020 (n = 564, -18.3%) was observed, followed by a progressive increase in new CRC diagnoses in 2021 (n = 748, + 8.4%) and 2022 (n = 756, + 9.6%); a higher rate of TNM stage IV tumors was diagnosed in 2020 (35.4%) and 2021 (31.0%) compared to 2019 (29.6%), with normalization in 2022 (26.4%) (P < .001). Not clinically relevant differences between histological diagnosis and first oncological examination, cytohistological diagnosis and systemic treatment start, first oncological appointment and systemic treatment start, treatment start and first radiological assessment between 2020 and 2021-2022 years were found. After propensity score matching according to the year of diagnosis, median OS was significantly worse in 2020, 2021, and 2022 compared to 2019 (27.6 vs 24.8 vs not reached vs 38.9 months, respectively) (P < .001). Concordantly, the median PFS was significantly worse with each passing year: 13.0 vs 11.1 vs 9.2 vs 7.2 months in 2019, 2020, 2021, and 2022, respectively (P = .00027). A progressive normalization in the rate of new CRC diagnosis as well as TNM stages at diagnosis, in 2021 and 2022 compared to 2020 and 2019, was found. The increase in new CRC cases might have affected some diagnostic-therapeutic time intervals in 2021-2022 years compared to 2020. Significantly, compared to the pre-pandemic phase, pandemic years were independently associated with worse PFS and OS outcomes in patients affected by metastatic disease.

Spatial mapping of activity changes across sensory areas following visual deprivation in adults.

Loss of a sensory modality triggers global adaptation across brain areas, allowing the remaining senses to guide behavior more effectively. There are specific synaptic and circuit plasticity observed across many sensory areas, which suggests potential widespread changes in activity. Here we used a cFosTRAP2 mouse line to drive tdTomato (tdT) expression in active cells to spatially map the extent of activity changes in various sensory areas in adult mice of both sexes following two modes of visual deprivation. We found that in the primary visual cortex (V1) both dark exposure (DE) and enucleation (EN) caused an initial loss of active cells followed by a partial rebound, which occurred relatively more in the superficial layers. A similar pattern was observed in the secondary visual cortex, especially in the lateral areas (V2L). The spared primary sensory cortices adapted distinctly. In the primary somatosensory barrel cortex (S1BF) there was a change in the density of active cells dependent on the duration and the mode of visual deprivation. In the primary auditory cortex (A1), there was a relative reduction in the density of active cells in the superficial layers without a significant change in the overall density. There were minimal changes in the active cell density in the secondary cortices of the spared senses and the multisensory retrosplenial cortex (RSP). Our results are consistent with cross-modal recruitment of the deprived visual cortex and compensatory plasticity in the spared primary sensory cortices that can support enhanced processing and refinement of the spared senses.Significance Statement The neural basis for improved processing of the spared senses after losing vision is largely dependent on plasticity mechanisms driven by neural activity. Using a transgenic mouse model to label active neurons in a temporally controlled manner, this study reveals the spatial pattern of widespread activity changes across brain areas following visual deprivation in adult mice. The findings suggest that the deprived visual cortex undergoes an initial reduction in activity followed by a rebound suggestive of cross-modal recruitment. Activity changes in the spared primary sensory cortices conform to compensatory plasticity, which could support improved processing of the spared senses. The results highlight the presence of large-scale plasticity in the adult brain to compensate for loss of vision.

Characterization of Sodium Thermal Insulation Reaction Product and its Effect on Fatigue Crack Growth in 316 LN Austenitic Steel

Though sodium is the most preferred coolant for fast breeder reactors due to excellent heat transfer capabilities, its high chemical reactivity poses a concern during accidental leaks. Despite defense in depth in various levels for protecting the sodium leaks in the heat transport circuits, small undetected leaks may lead to localized degradation of structural material due to deposition of reaction products in the leak zone. Experiments have been conducted by exposing SS-316 LN specimens to sodium–glass wool interaction zone at 300 °C in air to study the influence of reaction products on chemical composition and crack growth properties. Post-exposure X-ray diffraction analysis of the samples revealed presence of silicates and aluminates of sodium in the outer layers, and complex ternary and quaternary oxides of sodium, iron, chromium and nickel in the inner layers. Scanning electron microscopy analysis revealed deposition of oxides on the exposed surface. Elemental analysis of the samples carried out by energy-dispersive spectroscopy indicated leaching of major alloying elements like chromium, nickel and iron to a depth of about ~ 25 µm from the exposed surface. Room-temperature fatigue crack growth studies on the exposed specimen shown considerable reduction in crack initiation (threshold) fracture toughness range ΔKth.

Southerly winds and rapid sea ice reductions along the Sea of Okhotsk coast of Hokkaido

The Sea of Okhotsk, between northern Japan and Siberia, is the southernmost sea region of the Northern Hemisphere with seasonal sea ice cover. During early spring, occasional rapid reduction in sea ice cover observed in the southern Sea of Okhotsk can lead to anomalously early disappearance of sea ice along the Hokkaido coast (northern Japan). This study investigated the atmospheric and oceanic processes leading to rapid reduction in sea ice in the southern Sea of Okhotsk during early spring. We detected six events of subseasonal continued reduction in sea ice cover in March between 1993 and 2019. Strong southerly winds with marked thermal advection and moisture transport over northern Japan were observed in five of the six events. The passage of extratropical cyclones brought warm moist air from the south, which led to drifting and melting of sea ice by changing the surface wind speed and surface heat budget in the southern Sea of Okhotsk. The perturbation in sensible heat flux attributable to warm air advection contributed substantially to sea ice reduction, whereas longwave radiation played a secondary role. In addition to the atmospheric processes, an enhanced Soya Current also transports heat from the Sea of Japan, possibly contributing to the sea ice melt. The initial sea ice reduction leads to further sea ice loss through ice–albedo feedback, resulting in prolonged sea ice reductions for 1–2 weeks.

CTNI-17. A PHASE 2 STUDY OF SAFETY AND EFFICACY OF CONCURRENT ACT001 AND RADIATION TREATMENT FOLLOWED BY ACT001 MAINTENANCE THERAPY IN NEWLY DIAGNOSED PEDIATRIC PATIENTS WITH DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG)

Abstract BACKGROUND ACT001, an oral parthenolide derivative targeting NF-κB and STAT3 pathways, has shown activity in preclinical DIPG model and dose-finding study in patients with diffuse midline glioma. We further evaluated safety and activity of ACT001 in newly diagnosed DIPG patients and presented the interim data from exploratory stage of this phase 2 study. METHODS Eligible patients ≥ 5 and ≤ 15 years old were treated with concurrent ACT001 and standard radiation followed by ACT001 single agent treatment in this single arm, open label, multicenter phase 2 study. Tumor lesions were evaluated at baseline, 4 weeks and then every 8 weeks after the end of radiation therapy per RAPNO criteria with ORR as primary endpoint. Interim data analysis was performed when data from approximately 20 efficacy evaluable patients became available during the exploratory stage of this study. RESULTS Among 30 patients enrolled since Sept, 2023, 27 took at least one dose of ACT001 by April 30th, 2024, the data cutoff date (with exception for May 15th as the MRI cutoff date). While 3 patients were quickly taken off study due to a disease progression or consent withdrawal, 17 out of 27 patients finished at least one post-radiation MRI exam whereas MRI results are pending for 7 other patients by this interim analysis. Median age was 8 years old and male to female patient ratio is 17:10. The median LPS score is 70.0. Among 17 efficacy evaluable subjects, 8 patients exhibited partial response (6 confirmed) including one with a deep tumor reduction (-91.7%) noted three months after end of radiation. Among 9 other evaluable patients, 5 and 4 exhibited ongoing stable disease and progressive disease respectively. Subject 05001 was considered PD despite confirmed objective response for the target lesion upon development of new lesions. Two patients withdrew consent after finishing first post-radiation MRI scans despite initial tumor burden reduction which were both close to PR criteria. Patients tolerated concurrent ACT001 and radiation well. In total, 289 TEAE and 184 TRAE events were reported in 23 and 22 patients respectively. There were two ACT001-related grade 3 or 4 adverse events including one grade 4 hemorrhagic tumor necrosis (a SUSAR event and the only ACT001 related SAE) likely due to a therapeutic effect of ACT001 and one clinically insignificant grade 3 decreased lymphocyte count. Most common TRAE were manageable grade 1 or 2 events such as weight loss (15/184), vomiting (71/184), decreased lymphocyte count (13/184) and abdominal bloating (7/184). No study discontinuation occurred due to ACT001 or radiation related TRAEs. Conclusion. Concurrent ACT001 and radiation treatment was well tolerated. Preliminary evidence of anti-tumor activity was shown in about 50% efficacy evaluable DIPG patients. It is worthwhile to explore ACT001 and temozolomide combination in future study based on safety and efficacy signal from DIPG and recurrent GBM studies. The confirmatory stage of this study is in planning to further evaluate the anti-tumor efficacy signal of this NF-κB and STAT3 dual inhibitor.

Safety and reliability of ultrasound-assisted reduction in the conservative management of completely displaced paediatric distal radius fractures.

To assess the efficacy of ultrasound-assisted reduction in the conservative management of completely displaced pediatric distal radius fractures. The efficacy of ultrasound-assisted reduction versus conventional reduction was compared in a single-centre, retrospective, cross-sectional study involving 51 consecutive paediatric patients with completely displaced distal radius fractures, following manual reduction, from May 2021 to May 2023. The study group received ultrasound-assisted reduction (n = 24), while the control group underwent conventional blind manual reduction (n = 27). Comparative analysis included general clinical data, initial reduction success rates, frequency of exposure to radiation during reduction, post-reduction alignment rates, post-reduction angulation, re-displacement rates, conservative treatment failure rates, pain scores, and wrist joint scores at the last follow-up. All enrolled cases underwent manual reduction and conservative management. In the study group, all 24 patients underwent successful initial reduction procedures, with only one exposure to radiation during the entire process. Notably, no patient experienced re-displacement while in plaster, and the conservative treatment proved effective. The reduction and positioning rates were impressive, with success rates of 86.63 ± 3.65% in the coronal plane and 94.79 ± 3.06% in the sagittal plane. Furthermore, the post-reduction angulation was only 3.58 ± 0.65 degrees in the coronal plane and 8.70 ± 1.45 degrees in the sagittal plane. By contrast, within the control group comprising 27 patients, only 15 achieved successful initial reductions. Unfortunately, 12 patients required multiple exposure to radiation throughout the procedure. Furthermore, nine patients underwent re-displacement while in plaster and seven did not achieve successful conservative treatment. The alignment rates of the control group were similar to those of the study group (84.67 ± 4.35% in the coronal plane and 82.56 ± 5.45% in the sagittal plane). Similarly, the post-reduction angulation remained consistent, measuring 3.93 ± 0.87 degrees in the coronal plane and 12.03 ± 1.32 degrees in the sagittal plane. There were no statistically significant differences in pain scores during the process of fracture reduction and in wrist joint function scores at the final follow-up (P > 0.05). Ultrasound-assisted reduction in the conservative management of completely displaced paediatric distal radius fractures can enhance the initial reduction success rate, decrease the risk of subsequent redisplacement, minimize patient exposure to radiation, and yield favorable clinical outcomes. It is a safe and reliable approach.

California voters approve rollback of 2014 criminal justice measure

Concerns about the effects of crimes on local communities have convinced California voters to approve a rollback of a criminal justice initiative they had backed in 2014, in a vote that is expected to have a significant impact on mental health funding streams. With just over half of votes counted, Proposition 36 last week appeared headed for an overwhelming victory, standing at just over 70% support. The measure will reclassify as felonies some nonviolent offenses that had been reduced to misdemeanors when the state's voters approved Proposition 47 in 2014. Savings from the 2014 initiative's reduction in incarceration were directed to investment in mental health and related services (see “California ballot item could reduce major mental health funding source,” MHW, Oct. 14, 2024; https://doi.org/10.1002/mhw.34205). California Gov. Gavin Newsom had spoken out strongly against the new initiative, but voters appeared swayed by the effects of thefts, drug crimes and related acts on local communities' quality of life. Under the earlier act's funding formula, 65% of the state's savings from reduced incarceration were directed to mental health, substance use and diversion programs.

Urinary Lipoarabinomannan (LAM) in HIV sero-negative miliary tuberculosis patients.

BackgroundTuberculosis (TB) is the leading cause of death from infectious diseases worldwide next to COVID. Miliary presentation is a form of TB that can cause 100% mortality without treatment. Due to lack of a gold standard test, a systematic approach of high index of clinical suspicion and efforts at demonstrating Mycobacterium tuberculosis is imperative to early treatment initiation and mortality reduction. This study is designed to find the diagnostic value of urinary LAM using cage nanotechnology a new class of sandwich ELISA technique in HIV sero-negative miliary PTB patients. ResultsThis is a case-control study done in a tertiary care hospital. Fifty HIV sero-negative patients with clinical presentation of miliary TB and fifty asymptomatic individuals as controls were enrolled. Mean urinary LAM value among the miliary TB patients was 1.82±0.45 mg/L and control group was 0.48±0.18 mg/L. Miliary TB patients had urinary LAM sensitivity and specificity of 98% and 96%. ConclusionThe patients with urinary LAM values between 0.48 to 1.88 mg/L are most likely to have miliary TB. Patients with urinary LAM value of >1.88 mg/L will be likely to have microbiologically confirmed miliary TB and urinary LAM values less than 0.48 mg/L are less likely to have microbiologically confirmed miliary TB

Post-Operative Recovery and Preparation for Ambulation after Foot and Ankle Surgery

This is a review article that focuses on patient self-recovery, pain modulation without pain medication, edema control and preparation for ambulation after a foot or ankle surgery both elective and traumatic surgical procedures. The available evidence and literature review were limited due to the few studies that are devoted to this area of focus. This review article takes a comprehensive and prescriptive perspective into strategies of the aftermath of the physiological and psychological effects on the body, specifically the lower extremity after foot or ankle surgery. Some of these strategies include initial edema control, nutrition, scar massage and reduction of non-mobile skin from the surgical incision within the surgery. A review of the theory of prehabilitation and examples of therapeutic exercises are explained within the article which target important proximal gait muscles needed for ambulation which can be conditioned with the foot and ankle in a CAM boot or a cast.

Effects of short-term exposures to lower air temperature and cold spells on myocardial infarction hospital admissions: a nationwide study in Sweden

Abstract Background Exposures to lower air temperature and cold spells have been associated with an increased risk of various diseases. However, the short-term effect of lower air temperature and cold spells on myocardial infarction (MI) remains incompletely understood. Purpose We aimed to evaluate the short-term effects of lower air temperature and cold spells on MI hospital admissions within the nationwide SWEDEHEART registry. Methods This population-based nationwide study included 120,380 MI cases admitted to hospitals in Sweden during the cold season (October to March) from 2005 to 2019. Daily mean air temperature was estimated at 1 km2 spatial resolution across Sweden using a three-stage machine learning approach and percentiles of daily temperatures experienced by individuals in the same municipality were employed as individual exposure indicators to account for potential geographic adaptation. Cold spells were defined as periods of at least two consecutive days with a daily mean temperature below the 10th percentile of the temperature distribution for each municipality. A time-stratified case-crossover design incorporating a conditional logistic regression model with distributed lag non-linear model using lag 0-1 and lag 2-6 days was employed to evaluate the short-term effects of lower air temperature and cold spells on total MI, non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). Results We found significant increases in risk for total MI, NSTEMI, and STEMI in association with a decrease of one percentile in temperature at a lag of 2-6 days, indicated by ORs (95% CI) of 1.099 (1.057-1.142), 1.110 (1.06-1.164), and 1.076 (1.004-1.153), respectively. Additionally, we found that cold spells were significantly associated with increased risks for total MI, NSTEMI, and STEMI at a lag of 2-6 days, with ORs (95% CI) of 1.077 (1.037-1.12), 1.069 (1.02-1.119), and 1.095 (1.023-1.172), respectively. Moreover, independent effects of lower air temperature and cold spells on MI occurrence were found after adjusting for each other. Conversely, we observed that lower air temperature and cold spells were associated with decreased risks for MI at a lag of 0-1 days. Conclusions This nationwide case-crossover study demonstrated a novel biphasic pattern in MI risk following exposure to lower air temperatures and cold spells, characterized by an initial transient reduction in risk at lags 0-1 day, followed by a significant increase in risk at lags 2-6 days. As climate change continues to induce complex shifts in regional weather patterns, enhancing protections to reduce future cold-related cardiac hospitalizations is crucial.

Serial changes of 99mTc- pyrophosphate uptake in patients with hereditary transthyretin amyloid cardiomyopathy treated with tafamidis

Abstract Objective Transthyretin amyloid cardiomyopathy (ATTR-CM) arises from the deposition of amyloid in the heart, resulting in adverse outcomes. Tafamidis has demonstrated potential in slowing disease progression. Our research group, alongside others, has documented cases where decrease in cardiac tracer uptake were observed through bone scintigraphy after tafamidis treatment.[1-8] This study aims to assess the efficacy of Technetium-99m (99mTc)-pyrophosphate (PYP) scintigraphy in longitudinally monitoring tafamidis treatment for hereditary ATTR-CM over an extended follow-up period. Methods We retrospectively analyzed a prospective cohort of hereditary ATTR-CM patients treated with tafamidis (61 mg/day) retrospectively. A control group comprised hereditary ATTR-CM patients who hadn't received eplontersen, inotersen, tafamidis, or patisiran. 99mTc-PYP SPECT/CT scans were conducted at baseline and 1-3 years post-treatment, measuring visual score, planar heart to contralateral lung (H/CL) ratio, and volumetric heart to lung (H/L) ratio. Results Twenty hATTR-CM patients received tafamidis, with the other ten in the control group. After a 2-year follow-up, the tafamidis group experienced a significant decrease in volumetric heart to lung (H/L) ratio (3.817 to 3.011, p &amp;lt; 0.001), while the control group showed no significant change (3.775 to 3.621, p = 0.121)(Figure 1B). Significant decreases in volumetric H/L ratio were noted in the first year of tafamidis treatment (-21.71%), with minimal changes in the subsequent two years (-0.77% in the second year and -2.41% in the third year)(Figure 2B). Conclusion A significant initial reduction in 99mTc-PYP uptake was observed in hereditary ATTR-CM patients during the first year of tafamidis treatment. However, this effect was not sustained in the subsequent two years. Further investigation is warranted to comprehend the long-term efficacy of tafamidis in these patients.Changes in 99mTc-PYP uptake at 2 yearsChanges between 1st, 2nd and 3rd year

The impact of AI on enterprise energy management: from the perspective of carbon emissions

Given the significant impact of artificial intelligence (AI) technology on corporate energy management and the lack of research in this area, this paper employs text mining techniques to objectively assess the relative level of AI adoption among Chinese listed companies. Using econometric modelling methods, we verify these hypotheses and investigate both the direct and indirect effects of AI on corporate carbon emission intensity. our research finds that the carbon emission intensity of Chinese enterprises significantly decreased in the early stage, then stabilized, and has notably decreased again in recent years. The average level of AI among listed Chinese enterprises shows an overall upward trend, but the growth rate has slowed down. The level of AI in private enterprises is significantly higher than that in other types of enterprises, while the level of AI in state-owned enterprises is relatively lower. The level of AI in enterprises has a significant negative impact on carbon emission intensity, presenting an “S”-shaped relationship, characterized by initial emission reduction, mid-term rebound, and subsequent emission reduction. AI technology reduces the level of carbon emissions in enterprises by enhancing their green development standards and promoting technological innovation. There are significant differences in the impact of AI levels on carbon emission intensity across different types and regions of enterprises. The empirical conclusions remain robust after addressing endogeneity issues or variable substitution. This study provides important insights for corporate energy transitions and sustainable development, as well as for the formulation of government energy policies.

Target‐drift seismic‐force‐based design of one‐story reinforced concrete precast buildings considering the requirements of the second generation of the Eurocode 8 standard

AbstractResults are presented concerning the force‐based design of a wide range of reinforced concrete, single‐story precast buildings, considering the requirements of the new Eurocode 8 standard. The relevant criterion defining the cross‐sectional dimensions of the columns was the 2% drift limitation. Buildings were designed considering a behavior factor of 3 and a 50% reduction in stiffness corresponding to the gross cross‐section. The design evaluation, using a nonlinear pushover analysis, revealed that all the buildings could expect approximately twice the drift considered in the design with significant second‐order effects, particularly in very tall columns. The main reasons for large discrepancies between the elastic and nonlinear analyses were the arbitrarily selected behavior factor and the arbitrarily selected reduction in stiffness corresponding to the gross cross‐section (the stiffness considered in the design was approximately double what the nonlinear analysis revealed). The analysis revealed that these two quantities are closely correlated. Once the dimensions of the columns had been selected, the force and initial stiffness reduction could not be chosen arbitrarily. Correlations were determined between the column dimensions, theoretical stiffness reduction, seismic force reduction (behavior factor) and second‐order effects. From these correlations, a new target‐drift force‐based design methodology was proposed. All considered buildings were redesigned using the proposed method. The results of the new design and the nonlinear‐pushover‐based analysis correlated well.

Fracture mechanism and constitutive model considering post-peak plastic deformation of marble under thermal–mechanical action

Temperature plays an important impact on rock mechanical properties. In this paper, the mechanical properties, fracture mechanism and constitutive model of marble under 20–120 °C and 15 MPa are studied. The results show marble deformation can be divided into four stages: compaction, linear elasticity, crack propagation and post-peak failure. Stress–strain curve is not obviously affected by temperature. Macroscopic fracture characteristics change from shear failure to tensile mixed failure with temperature increasing. With the increase of temperature, the strength of marble tends to decrease, indicating that temperature increase has a weakening effect on marble, and there are temperature-sensitive areas of 20–60 °C and temperature sub-sensitive areas of 60–120 °C. The elastic modulus of marble decreases and Poisson’s ratio increases with increasing temperature. The energy evolution law of marble under different temperature is basically the same, which shows that before crack initiation, the energy dissipation is less, and after the damage and yielding occurs, the energy dissipation increases quickly. The energy dissipation in the failure process is mainly used for crack initiation-connection-penetration, as well as plastic deformation caused by friction and slip of cracks, and the plastic deformation and energy dissipation have good linear characteristics. The statistical damage constitutive model based on three-parameter Weibull distribution function can effectively reflect the characteristics of post-peak plastic deformation and strain softening. The weakening effect of marble at 20–120 °C is related to its internal moisture excitation. With the increase of temperature, water is stimulated to absorb and attach to the original relatively dry interface, which plays a role in lubrication. The relative motion friction resistance between solid particles or crack surfaces decreases, which leads to crack initiation and friction energy consumption reduction, changes the specific surface energy of rocks and weakens the strength of marble. The results provide a theoretical basis for predicting and evaluating the long-term stability and safety of surrounding rock of underground deep engineering in complex environment with high ground temperature and high geo-stress.

Modified cure cycles for increased fatigue performance of fiber metal laminates

Modified (MOD) cure cycles that deviate from the manufacturer’s recommended cure profile can reduce the inherent thermally induced residual stresses (TRS) in fiber metal laminates (FML). Literature shows that MOD cycles do not adversely affect the material properties but enhance the quasi-static material strength. However, the literature does not comprehensively discuss the impact of MOD cycles on material performance during cyclic fatigue loading. This paper, therefore, investigates how MOD cycles influence the fatigue characteristics of different FML layups made of carbon fiber-reinforced polymer (CFRP) and steel. The experimental results confirm that the quasi-static material strength and the modulus of the FML are increased when using MOD cure cycles. The evaluation of fatigue tests with digital image correlation, thermography, and electrical resistance measurements of notched specimens shows that a reduction of TRS delays damage initiation in the metal facesheets and decreases the crack growth rate until facesheet failure. The results further show that layup-dependent parameters, the maximum stress in the metal sheets, and metal sheet thickness significantly govern the evolution of fatigue damage. In summary, modified cure cycles are an efficient tool to enhance the quasi-static and fatigue performance of CFRP-steel hybrid laminates.

Parameter estimation from single patient, single time-point sequencing data of recurrent tumors.

In this study, we develop consistent estimators for key parameters that govern the dynamics of tumor cell populations when subjected to pharmacological treatments. While these treatments often lead to an initial reduction in the abundance of drug-sensitive cells, a population of drug-resistant cells frequently emerges over time, resulting in cancer recurrence. Samples from recurrent tumors present as an invaluable data source that can offer crucial insights into the ability of cancer cells to adapt and withstand treatment interventions. To effectively utilize the data obtained from recurrent tumors, we derive several large number limit theorems, specifically focusing on the metrics that quantify the clonal diversity of cancer cell populations at the time of cancer recurrence. These theorems then serve as the foundation for constructing our estimators. A distinguishing feature of our approach is that our estimators only require a single time-point sequencing data from a single tumor, thereby enhancing the practicality of our approach and enabling the understanding of cancer recurrence at the individual level.