Considering the fact that in the real world, a certain agent may have some sort of advantage to act before others, a novel hierarchical optimal synchronization problem for linear systems, composed of ...one major agent and multiple minor agents, is formulated and studied in this article from a Stackelberg-Nash game perspective. The major agent herein makes its decision prior to others, and then, all the minor agents determine their actions simultaneously. To seek the optimal controllers, the Hamilton-Jacobi-Bellman (HJB) equations in coupled forms are established, whose solutions are further proven to be stable and constitute the Stackelberg-Nash equilibrium. Due to the introduction of the asymmetric roles for agents, the established HJB equations are more strongly coupled and more difficult to solve than that given in most existing works. Therefore, we propose a new reinforcement learning (RL) algorithm, i.e., a two-level value iteration (VI) algorithm, which does not rely on complete system matrices. Furthermore, the proposed algorithm is shown to be convergent, and the converged values are exactly the optimal ones. To implement this VI algorithm, neural networks (NNs) are employed to approximate the value functions, and the gradient descent method is used to update the weights of NNs. Finally, an illustrative example is provided to verify the effectiveness of the proposed algorithm.
Background:
Regarding the thermal ablation treatment of refractory secondary hyperparathyroidism (SHPT), there is no consensus on the ablation range of the hyperplastic parathyroid gland. Therefore, ...this meta-analysis was conducted to evaluate the efficacy and complications between full and partial thermal ablation in patients with refractory SHPT.
Methods:
Databases including PubMed, EMbase, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang databases were searched from inception to July 1, 2023. Eligible studies comparing full thermal ablation and partial thermal ablation for SHPT were included. Data were analyzed using Review Manager Version 5.3.
Results:
Four studies were included in the meta-analysis. Three cohort studies and one randomized controlled trial involving 62 patients in the full thermal ablation group and 63 patients in the partial thermal ablation group were included. The serum parathyroid hormone (PTH), calcium, and phosphorus levels after full ablation were all lower than those after partial ablation (
P
< .05). There was no significant difference between the partial and full ablation groups concerning the incidence rate of severe hypocalcemia (
P
= .09). There was no significant difference between the partial and full ablation groups concerning symptom improvement, including bone joint pain, itching, and myasthenia (
P
< .05).
Conclusion:
Full ablation was superior to partial ablation in terms of reducing PTH, calcium and phosphorus levels. Full ablation might not significantly increase the incidence of severe hypocalcemia. Larger multicentre randomized controlled trials are necessary to confirm the conclusion.
•The paper focus on the gas–liquid two-phase transient process of reactor coolant pump under stuck shaft accident with different inlet gas volume fractions.•LBM-LES is used for refined numerical ...simulation, and compared with the standard k-ε model and LES.•LBM-LES has advantages in the expression of gas and vorticity, and the deviation is minimal from the experiments.
The stuck shaft accident (SSA) is a typical and severe accident of the reactor coolant pump (RCP). During this accident, significant friction and heat generation result in gas–liquid two-phase flow, which adversely affects the working performance and stability of the RCP. In order to explore the internal flow field and transient pressure fluctuation of the two-phase flow in the RCP under the SSA, this study adopts three methods of standard k-ε, Large Eddy Simulation (LES) and Lattice Boltzmann Method-Large Eddy Simulation (LBM-LES) for refined simulation and then are validated by experiments. It finds that the gas volume fraction (GVF) is relatively high in the inlet path of the guide vane during the initial stage, and then the gas disperses from the suction surface of the impeller blade to the pressure surface. When the GVF increases, the small gas masses accumulate into large masses and collapses in the RCP. At this time, the vorticity in the impeller path increases and then decreases at the outlet. The pressure fluctuation on the pressure surface at the impeller outlet increases with the increase of GVF. The impact of the GVF on the pressure surface is greater than that on the suction surface, particularly in the high-frequency band during the initial stages of the SSA. Among these three models, LBM-LES demonstrates the highest accuracy with a maximum deviation of only 8.84% when the inlet GVF is 10%. The research results improve the prevention and mitigation ability of related accidents, and provide theoretical basis and technical support for subsequent optimization and improvement.
For reasons not completely clear, natural killer (NK) cells from tumor patients displayed multiple exhaustion features and could not be completely restored even when the inhibitory signals from the ...intratumoral environment had ceased to exist. Here, we found that the circulating NK cells from bladder cancer patients presented significantly reduced cytotoxicity than the circulating NK cells from healthy volunteers. This impairment in cytotoxicity resulted in part from an overrepresentation of Tim-3+ NK cells in bladder cancer patients. Interestingly, patients with higher frequency of Tim-3+ NK cells tended to present higher frequency of Gal-9+ cells in tumor. Exogenous Gal-9 significantly reduced the cytotoxicity of Tim-3+, but not Tim-3-, NK cells. Patients with better prognosis presented lower levels of Tim-3+ NK cells and Gal-9+ tumor cells. We then attempted to improve the cytotoxicity of NK cells using a combination of exogenous cytokines. IL-2 + IL-15 and IL-2 + IL-21 significantly enhanced, but could not completely restore, the cytotoxicity of NK cells in bladder cancer patients. Notably, when the cytokine concentration increased from intermediate levels to high levels, the cytotoxicity of NK cells from healthy volunteers significantly increased with a strong upward trend, whereas the cytotoxicity of NK cells from bladder cancer patients plateaued at intermediate levels. Further examination revealed that high cytokine concentration significantly increased the Tim-3 expression in NK cells from bladder cancer patients. Blocking Tim-3 not only improved the cytotoxicity of NK cells from bladder cancer patients, but also eliminated the plateauing effect when the NK cells were stimulated with high concentrations of cytokines. Together, these data suggested that proinflammatory cytokines could moderately improve NK cell cytotoxicity in bladder cancer patients. However, the effect was limited due to a concurrent upregulation of Tim-3.
•NK cells from bladder cancer patients presented significant Tim-3 upregulation.•NK cells from bladder cancer patients presented significantly reduced cytotoxicity.•Cytokine-mediated stimulatory effects were less potent in bladder cancer patients.•Treatment with cytokines increased the expression of Tim-3 by NK cells.•Tim-3 blockade allowed the NK cells to present higher cytotoxicity in patients.
Recently, electric vehicles (EVs) have received more and more attention, but the problem of the insufficient range is still the main reason that hinders electric vehicles to travel long distances. ...Under the premise of the battery capacity without technological innovation, the path planning method can ensure the safety and efficiency of electric vehicles in long-distance travel. This paper studies the actual freeway network to optimize the vehicle driving path and give the charging strategy based on the shortest travel time of a single vehicle. In this paper, a path and charging strategy planning model is proposed. In this model, the shortest travel time of a single vehicle is taken as the objective function, and the state of charging equipment in the actual road network and the safe electric quantity are considered as constraints. And the genetic algorithm is used to solve the model. Through case analysis, the rationality and optimization efficiency of the model proposed in this paper are verified. Finally, the sensitivity analysis of the three parameters of traffic volume, temperature, and travel speed is carried out with the Shanghai-Nanjing freeway network. The experimental results can get the nodes with the highest service pressure in the network, which can provide a theoretical basis for charging nodes’ expansion in the freeway network in the future.
The typical semi conductivity and few active sites of hydrogen evolution of 2H MoSesub.2 severely restrict its electrocatalytic hydrogen evolution performance. At the same time, the 1T MoSesub.2 has ...metal conductivity and plentiful hydrogen evolution sites, making it feasible to optimize the electrocatalytic hydrogen evolution behavior of MoSesub.2 using phase engineering. In this study, we, through a simple one-step hydrothermal method, composed 1T/2H MoSesub.2, and then used newly emerging transition metal carbides with several atomic-layer thicknesses Tisub.3Csub.2Tsub.x to improve the conductivity of a MoSesub.2-based electrocatalyst. Finally, MoSesub.2@Tisub.3Csub.2Tsub.x was successfully synthesized, according to the control of the additional amount of Tisub.3Csub.2Tsub.x, to form a proper MoSesub.2/ Tisub.3Csub.2Tsub.x heterostructure with a better electrochemical HER performance. As obtained MoSesub.2@4 mg-Tisub.3Csub.2Tsub.x achieved a low overpotential, a small Tafel slope and this work offers additional insight into broadened MoSesub.2 and MXenes-based catalyst’s electrochemical application.
Tripterygium hypoglaucum
(Lévl.) Hutch (THH) is believed to play an important role in health care and disease treatment according to traditional Chinese medicine. Moreover, it is also the ...representative of medicine with both significant efficacy and potential toxicity. This characteristic causes THH hard for embracing and fearing. In order to verify its prospect for clinic, a wide variety of studies were carried out in the most recent years. However, there has not been any review about THH yet. Therefore, this review summarized its characteristic of components, pharmacological effect, pharmacokinetics and toxicity to comprehensively shed light on the potential clinical application. More than 120 secondary metabolites including terpenoids, alkaloids, glycosides, sugars, organic acids, oleanolic acid, polysaccharides and other components were found in THH based on phytochemical research. All these components might be the pharmacological bases for immunosuppression, anti-inflammatory and anti-tumour effect. In addition, recent studies found that THH and its bioactive compounds also demonstrated remarkable effect on obesity, insulin resistance, fertility and infection of virus. The main mechanism seemed to be closely related to regulation the balance of immune, inflammation, apoptosis and so on in various disease. Furthermore, the study of pharmacokinetics revealed quick elimination of the main component triptolide. The feature of celastrol was also investigated by several models. Finally, the side effect of THH was thought to be the key for its limitation in clinical application. A series of reports indicated that multiple organs or systems including liver, kidney and genital system were involved in the toxicity. Its potential serious problem in liver was paid specific attention in recent years. In summary, considering the significant effect and potential toxicity of THH as well as its components, the combined medication to inhibit the toxicity, maintain effect might be a promising method for clinical conversion. Modern advanced technology such as structure optimization might be another way to reach the efficacy and safety. Thus, THH is still a crucial plant which remains for further investigation.
Obesity, particularly abdominal obesity, is seen as a risk factor for diabetic complications. The weight-adjusted-waist index (WWI) is a recently developed index for measuring adiposity. Our goal was ...to uncover the potential correlation between the WWI index and diabetic kidney disease (DKD) risk.
This cross-sectional study included adults with type 2 diabetes mellitus (T2DM) who participated in the NHANES database (2007-2018). The WWI index was calculated as waist circumference (WC, cm) divided by the square root of weight (kg). DKD was diagnosed based on impaired estimated glomerular filtration rate (eGFR<60 mL/min/1.73m
), albuminuria (urinary albumin to urinary creatinine ratio>30 mg/g), or both in T2DM patients. The independent relationship between WWI index and DKD risk was evaluated.
A total of 5,028 participants with T2DM were included, with an average WWI index of 11.61 ± 0.02. As the quartile range of the WWI index increased, the prevalence of DKD gradually increased (26.76% vs. 32.63% vs. 39.06% vs. 42.96%,
<0.001). After adjusting for various confounding factors, the WWI index was independently associated with DKD risk (OR=1.32, 95%CI:1.12-1.56,
<0.001). The area under the ROC curve (AUC) of the WWI index was higher than that of body mass index (BMI, kg/m
) and WC. Subgroup analysis suggested that the relationship between the WWI index and DKD risk was of greater concern in patients over 60 years old and those with cardiovascular disease.
Our findings suggest that higher WWI levels are linked to DKD in T2DM patients. The WWI index could be a cost-effective and simple way to detect DKD, but further prospective studies are needed to confirm this.
Background: The role of non-nitrogen-containing bisphosphonates (non-N-BPs) and nitrogen-containing bisphosphonates (N-BPs) in the treatment of atherosclerosis (AS) and vascular calcification (VC) is ...uncertain. This meta-analysis was conducted to evaluate the efficacy of non-N-BPs and N-BPs in the treatment of AS and VC. Methods: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched from their inception to July 5th, 2023. Eligible studies comparing bisphosphonates (BPs) versus no BPs in the treatment of AS and VC were included. The data were analyzed using Review Manager Version 5.3. Results: Seventeen studies were included in this meta-analysis. Twelve were randomized control trials (RCTs), and 5 were nonrandomized studies. Overall, 813 patients were included in the BPs group, and 821 patients were included in the no BPs group. Compared with no BP treatment, non-N-BP or N-BP treatment did not affect serum calcium ( P > .05), phosphorus ( P > .05) or parathyroid hormone (PTH) levels ( P > .05). Regarding the effect on serum lipids, non-N-BPs decreased the serum total cholesterol (TC) level ( P < .05) and increased the serum triglyceride (TG) level ( P < .01) but did not affect the serum low-density lipoprotein cholesterol (LDL-C) level ( P > .05). N-BPs did not affect serum TC ( P > .05), TG ( P > .05) or LDL-C levels ( P > .05). Regarding the effect on AS, non-N-BPs did not have a beneficial effect ( P > .05). N-BPs had a beneficial effect on AS, including reducing the intima-media thickness (IMT) ( P < .05) and plaque area ( P < .01). For the effect on VC, non-N-BPs had a beneficial effect ( P < .01), but N-BPs did not have a beneficial effect ( P > .05). Conclusion: Non-N-BPs and N-BPs did not affect serum calcium, phosphorus or PTH levels. Non-N-BPs decreased serum TC levels and increased serum TG levels. N-BPs did not affect serum lipid levels. Non-N-BPs had a beneficial effect on VC, and N-BPs had a beneficial effect on AS.
Infrared small target detection (IRSTD) involves determining the coordinate position of the target in complex infrared images. However, challenges arise due to the absence of internal texture ...structure, edge dispersion, weak energy characteristics of the target, and a significant amount of background clutter resembling the target's morphology, impeding precise target location. To address these challenges, we propose an IRSTD network, named frequency domain decoupling bidirectional interactive attention network (FDDBA-NET), designed from the perspective of frequency domain decoupling (FDD). To suppress backgrounds that are similar in shape and structure to the target, exploiting the spectral differences between the target and background in the frequency domain, we adopt two learnable masks to extract the target-specific spectrum and the target-background-consistent spectrum detrimental to detection. The specific spectrum aids in target detection. A target-level contrast loss is designed to maximize the disparity between these two spectra, ensuring optimal detection results. In addition, to preserve target details in high-level semantic information, we introduce a bidirectional interactive attention module that leverages mutual modulation of deep global and shallow local features, facilitating deep and shallow feature fusion. To validate our approach, we conduct experiments comparing our proposed network with state-of-the-art conventional methods and deep learning methods on public datasets. The results demonstrate the superior performance of our method.
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