Investigation of flow field characteristics and performance of carbon-hydrogen/oxygen-rich air rotating detonation engine

Numerical simulations were conducted to investigate the flow field characteristics and performance of a carbon-hydrogen/oxygen-rich air rotating detonation engine (RDE). Three distinct flow field structures were observed in the gas-solid two-phase RDE. The results show that reducing the hydrogen equivalence ratio and particle diameter both contribute to the transition from gas-phase single-front detonation to gas-solid two-phase double-front detonation and further to gas-solid two-phase single-front detonation. The effects of solid fuel particle diameter and hydrogen equivalence ratio on the flow field characteristics and performance are revealed. The results show that reducing the particle diameter enhances the speed of the two-phase detonation wave, improves the pressure gain in the combustion chamber, and increases the specific impulse. Decreasing the hydrogen equivalence ratio reduces the detonation wave speed, enhances the stability of the detonation flow field, increases the pressure gain in the detonation wave and combustion chamber and boosts thrust. Furthermore, the selection of operational conditions to ensure stable operation and optimal performance of the RDE is discussed. In order to take into account the requirements of stability, pressure gain performance and propulsion performance, two-phase single-front detonation should be realized in gas-solid two-phase RDE, and smaller hydrogen equivalent ratio and appropriate particle diameter should be selected. According to the conclusion of this study, the particle diameter should be 0.5-1 {\mu}m. Under such conditions, the detonation flow field demonstrates good stability, allowing the RDE to achieve higher pressure gain and specific impulse while maintaining stable operation

Bloodstream infection, peritonitis, and pneumonia caused by Pasteurella multocida in a patient with liver cirrhosis despite no animal contact: case report and literature review

Pasteurella multocida is an opportunistic pathogen. Previously reported infections associated with P. multocida have often been linked to contact with cats, dogs, and other animals. Cases of systemic multiple-site infections following P. multocida infection are rare. This case study presents a 49-year-old middle-aged man with post-hepatitis B cirrhosis and no history of animal contact. The patient was admitted with symptoms of fever accompanied by diarrhea, abdominal distension, and cough. Blood tests showed elevated levels of CRP, PCT, and IL-6, and blood culture revealed the growth of P. multocida. CT scans revealed a large amount of abdominal effusion, a small amount of pleural effusion, and pulmonary infection foci. The patient’s condition improved after successive administration of ceftriaxone and levofloxacin to fight the infection, and abdominal puncture and drainage. Multiple-site infections caused by P. multocida are rarely encountered in patients with liver cirrhosis but without animal contact, which could be regarded as serious conditions warranting careful attention in terms of clinical diagnosis and treatment

A novel immune checkpoint score system for prognostic evaluation in pancreatic adenocarcinoma

Abstract Background Pancreatic adenocarcinoma (PAAD) remains a lethal malignancy making the detection of novel prognostic biomarkers urgent. Limited studies have investigated the predictive capability of immune checkpoints in PAAD. Method Gene expression data and correlative clinical information of PAAD cohort were obtained from public databases, including TCGA, ICGC, GTEX and GEO databases. Risk factors were screened and used to establish a risk score model through LASSO and Cox regression analyses. The prognostic ability of the risk score model was demonstrated. The association between risk score with immune cells infiltration, immune checkpoint genes expression, immunogenic cell death, somatic mutations and signaling pathways enrichment were analysed. scRNA-seq data were collected to confirmed the immune checkpoints expression in PAAD samples. The prognosis prediction ability of OX40/TNFRSF4 was identified. The mRNA and protein expression of OX40 in our clinical specimens were examined by RT-PCR and IHC method and its prognosis ability was verified. Results First of all, the difference of immune microenvironment between pancreatic cancer and adjacent tissues was shown. A risk score system based on three immune checkpoints (OX40, TNFSF14 and KIR3DL1) was established. The risk score model was an independent prognostic factor and performed well regarding overall survival (OS) predictions among PAAD patients. A nomogram was established to facilitate the risk model application in clinical prognosis. Immune cells including naive B cells, CD8+ T cells and Tregs were negatively correlated with the risk score. The risk score was associated with expression of immune checkpoint genes, immunogenic cell death related genes and somatic mutations. Glycolysis processes, IL-2-STAT5, IL-6-STAT3, and mTORC1 signaling pathways were enriched in the high-risk score group. Furthermore, scRNA-seq data confirmed that TNFRSF4, TNFSF14 and KIR3DL1 were expressed on immune cells in PAAD samples. We then identified OX40 as an independent prognosis-related gene, and a higher OX40 expression was associated with increased survival rate and immune environment change. In 84 PAAD clinical specimens collected from our center, we confirmed that higher OX40 mRNA expression levels were related to a good prognosis. The protein expression of OX40 on tumor-infiltrating immune cells (TIICs), endothelial cells and tumor cells was verified in PAAD tissues by immunohistochemistry (IHC) method. Conclusions Overall, our findings strongly suggested that the three-immune checkpoints score system might be useful in the prognosis and design of personalized treatments for PAAD patients. Finally, we identified OX40 as an independent potential biomarker for PAAD prognosis prediction

Development of a ZTD Vertical Profile Model Considering the Spatiotemporal Variation of Height Scale Factor with Different Reanalysis Products in China

Tropospheric delay is one of the key factors that may affect high-precision satellite navigation and positioning and water vapor retrieval performance. Its variation in the vertical direction is much greater than that in the horizontal direction. Therefore, the vertical profile model of zenith total delay (ZTD) is important for the spatial interpolation of high-precision ZTD products and the development of ZTD models. However, in China, low spatial and temporal resolutions remain persistent in ZTD vertical profile models and limit their application. In this study, ZTD vertical profile grid models (CZTD-H model: CZTD-HM and CZTD-HE models) were developed by considering the time-varying height scale factor for China and employing ZTD layered profile information with high temporal-spatial resolution calculated using MERRA-2 data and ERA5 data based on the integration method during 2012–2016. The CZTD-H model accuracy was verified using the global navigation satellite system (GNSS) data acquired from the Crustal Movement Observation Network of China (CMONOC) and radiosonde data as reference and was compared with the canonical GPT3 model accuracy. The applicability of CZTD-HM and CZTD-HE models was discussed. The results showed that: (1) CZTD-HM and CZTD-HE models exhibited excellent performance for ZTD layered vertical interpolation in northwestern and southeastern China, respectively. Among ZTD layered profiles from 84 radiosonde stations, the RMSE of ZTD data interpolated using CZTD-HM and CZTD-HE models improved by 12.9/16.23% and 13.8/17.16% compared with GPT3-1 and GPT3-5 models, respectively. (2) The CZTD-H model maintained high performance for the spatial interpolation of GGOS grid ZTD data. Validation with ZTD data from 249 GNSS stations showed that the RMSEs of both CZTD-HM and CZTD-HE models improved by 2.8 mm (19.7%) and 2.6 mm (18.6%) compared with those of the GPT3-1 and GPT3-5 models, respectively. The CZTD-HE model showed excellent performance in summer among all the models. Only the location and day of the year were required for the application of the CZTD-H model, which showed excellent ZTD vertical correction performance in China. With the different performances of the CZTD-HE and CZTD-HM models in China, the ERA5 model can be recommended for practical applications. Therefore, these results can provide a reference for the data source selection of ZTD vertical profile model construction on the basis of high-precision reanalysis data, GNSS real-time high-precision positioning, and GNSS meteorology in China

Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China

Since few studies evaluated the impact of the global budget payment system (GBPS) over time, and by expenditure type, this paper aims to evaluate the impact of the GBPS on expenditure of inpatients, and explores how hospitals curb the expenditure in patients with cardiovascular diseases (CVDs) in Shanghai. We built a time series model with the monthly expenditure of CVDs from 2009 to 2012. We evaluated the instant impact and trends impact of the GBPS and analyzed results based on medical expenditure types (e.g., drug, examination, cure, unclassified items), discharge number, and expenditure per capita. We found GBPS instantly dropped the medical expenditure by Chinese Yuan (CNY) 55.71 million (p < 0.001), and decreased the monthly increasing trend by CNY 4.23 million (p = 0.011). The discharge number had 10.4% instant reduction and 225.55 monthly decrease (p = 0.021) while the expenditure per capita experienced fewer changes. Moreover, the expenditure of drug and cure had an instant reduction of CNY 28.31 million and 16.28 million (p < 0.001). In conclusion, we considered the GBPS is an effective solution to control the expenditure of CVDs by decreasing the discharge number, and a focus on the drug and cure expenditures lead to greater spend reduction than other types of expenditures

Molecular characterization and antimicrobial susceptibility of Streptococcus pneumoniae isolated from children hospitalized with respiratory infections in Suzhou, China.

BACKGROUND: Dissemination of antibiotic resistant clones is recognized as an important factor in the emergence and prevalence of resistance in pneumococcus. This study was undertaken to survey the antimicrobial susceptibility and serotypes distribution of pneumococci and to explore the circulating clones in hospitalized children in Suzhou, China. METHODS: The pneumococci were isolated from the nasopharyngeal aspirates of children less than 5 years of age admitted to Soochow-University-Affiliated-Children's-Hospital with respiratory infections. The capsular serotypes were identified by multiplex polymerase chain reaction (PCR). Antimicrobial susceptibility was tested by E-test. The presence of ermB, mefA/E genes were detected by PCR and the genotypes were explored by Multilocus sequence typing (MLST). RESULTS: From July 2012 to July 2013, a total of 175 pneumococcal isolates were collected and all strains were resistant to erythromycin and clindamycin, about 39.4% strains were non-susceptible to penicillin G. Overall, 174 (99.4%) isolates were resistant to ≥ 3 types of antibiotics. Serotypes 19F (28.1%), 6B (19.7%), 19A (18.0%), and 23F (17.4%) were the most common serotypes in all identified strains. The serotypes coverage of PCV7 and PCV13 were 71.9% and 89.9%, respectively. Four international antibiotic-resistant clones, including Taiwan19F-14 (n = 79), Spain23F-1(n = 25), Taiwan23F-15(n = 7) and Spain6B-2(n = 7), were identified. The Taiwan19F-14 clones have a higher non-susceptibility rate in β-lactams than other clones and non-clone isolates (p<0.001). In addition, 98.7% Taiwan19F-14 clones were positive of both ermB and mefA/E genes, compare to 33.3% in other clones and non-clone strains. CONCLUSIONS: The spread of international antibiotic-resistant clones, especially Taiwan19F-14 clones, played a predominant role in the dissemination of antimicrobial resistant isolates in Suzhou, China. Considering the high prevalence of PCV7 serotypes and serotype 19A, the introduction of PCV13 may be a promising preventive strategy to control the increasing trend of clonal spread in China