Case Analysis of Misdiagnosis in Emergency Internal Medicine

Objective: This paper attempts to determine the clinical factors associated with the diagnosis of stroke in young adults. Method: We registered and examined young patients from the hospital stroke center. Demographic data, past medical history, 3 hours diagnosis time within the time frame, and the outcomes were assessed. We compared the patients with misdiagnosis and those who were correctly diagnosed in order to identify the factors associated with acute stroke. Results: From 2005−2011, 57 patients (16−50 years) were enrolled in the registry. 8 patients (14%; 4 men and 4 women, mean age 38 years) were misdiagnosed. Of these 8 patients, seven were initially discharged from the emergency department. Patients aged less than 35 years old (p = 0.05) and posterior circulation stroke patients (p = 0.006) were more likely to be misdiagnosed. Conclusion: First aid department needs to popularize the awareness of stroke among young adults. Misdiagnosis may cause the patient to lose the best chance of thrombolysis

Evaluation of Natural Gas Hydrate Fault System: A Case from a Sag in Deep-Water Slope Area of the Northern South China Sea

AbstractThe fault system is one of the structural carrier systems of gas hydrate accumulation, which plays a vital role in controlling the distribution of natural gas hydrate (NGH) accumulation. The previous studies mainly focus on summarizing the vertical migration mode of high flux fluid along the fault with obvious geophysical response characteristics on the seismic profile, such as “fault with gas chimney,” “fault with mud diapir,” and “fault with submarine collapse”, but lack of evaluation methods for the fault carrier system. We use the X sag in the deep-water continental margin slope area of the northern South China Sea as an example to study the fault systems closely related to NGH. This paper puts to use attribute technologies, such as coherence, curvature, and fusion, to analyze the characteristics and combination of the fault systems. We discussed migration patterns and evaluation methods of dominant fault carrier systems. This research proves that the strike-slip fault system in the platform area can directly connect the gas source bed with high-quality hydrocarbon generation to the gas hydrate stability zone (GHSZ). The activity of this fault system is more conducive to the accumulation of hydrocarbon in the GHSZ. This area has a good site for pore-filling gas hydrate prospecting and a preferential favorable fault carrier system. The composite fault system, consisting of a normal dip-slip fault system and a polygonal fault system, in the slope area can jointly communicate the biogenic gas-rich reservoir. Its activity and well-migration performance are the main reasons for the submarine gas leakage and collapse. It is a secondary favorable fault carrier system in the study area. There may be massive and vein natural gas hydrate formation in fractures in the leakage passage, and pore-filled gas hydrate may exist in the submarine nonleakage area. In this work, a three-factor evaluation method of the fault carrier system is proposed for the first time. This method is of great significance for the evaluation and exploration of NGH reservoirs in the continental margin slope area of the northern South China Sea

A Modified TOPSIS Method Based on D

Multicriteria decision-making (MCDM) is an important branch of operations research which composes multiple-criteria to make decision. TOPSIS is an effective method in handling MCDM problem, while there still exist some shortcomings about it. Upon facing the MCDM problem, various types of uncertainty are inevitable such as incompleteness, fuzziness, and imprecision result from the powerlessness of human beings subjective judgment. However, the TOPSIS method cannot adequately deal with these types of uncertainties. In this paper, a D-TOPSIS method is proposed for MCDM problem based on a new effective and feasible representation of uncertain information, called D numbers. The D-TOPSIS method is an extension of the classical TOPSIS method. Within the proposed method, D numbers theory denotes the decision matrix given by experts considering the interrelation of multicriteria. An application about human resources selection, which essentially is a multicriteria decision-making problem, is conducted to demonstrate the effectiveness of the proposed D-TOPSIS method

Efficient network-matrix architecture for general flow transport inspired by natural pinnate leaves

Networks embedded in three dimensional matrices are beneficial to deliver physical flows to the matrices. Leaf architectures, pervasive natural network-matrix architectures, endow leaves with high transpiration rates and low water pressure drops, providing inspiration for efficient network-matrix architectures. In this study, the network-matrix model for general flow transport inspired by natural pinnate leaves is investigated analytically. The results indicate that the optimal network structure inspired by natural pinnate leaves can greatly reduce the maximum potential drop and the total potential drop caused by the flow through the network while maximizing the total flow rate through the matrix. These results can be used to design efficient networks in network-matrix architectures for a variety of practical applications, such as tissue engineering, cell culture, photovoltaic devices and heat transfer

Full waveform inversion based on dynamic data matching of convolutional wavefields

Cycle skipping problem caused by the absent of low frequencies and inaccurate initial model makes full waveform inversion (FWI) deviate from the true model. A novel method is proposed to mitigate cycle skipping phenomenon by dynamic data matching which improves the matching of synthetic and observed events to regulate the updating of initial model in a correct direction. 1-dimentional (1-D) Gaussian convolutional kernels with different lengths are used to extract features of each time sample in each trace which represents the integrated properties of wavefield at different time ranges centered on each time sample. According to the minimum Euclidean distance of the features, the optimally matched pairs of time samples in the observed and synthetic trace can be found. A constraint evaluates the reliability of dynamic matching by attenuating the amplitude of synthetic data according to the values of traveltime differences between each pairs of optimally matched time samples is proposed to improve the accuracy of data matching. In addition, Gaussian kernels have the capability to extract features of time samples contaminated by strong noises accurately to improve the robustness of the propose method further. The selection scheme of optimal parameters is discussed and concluded to ensure the convergence of the proposed method. Numerical tests on Marmousi model verify the feasibility of the propose method. The proposed method provides a new approach to tackle the convergence problem of FWI when using the field seismic data

Blocking type I interferon signaling enhances T cell recovery and reduces HIV-1 reservoirs

Despite the efficient suppression of HIV-1 replication that can be achieved with combined antiretroviral therapy (cART), low levels of type I interferon (IFN-I) signaling persist in some individuals. This sustained signaling may impede immune recovery and foster viral persistence. Here we report studies using a monoclonal antibody to block IFN-α/β receptor (IFNAR) signaling in humanized mice (hu-mice) that were persistently infected with HIV-1. We discovered that effective cART restored the number of human immune cells in HIV-1–infected hu-mice but did not rescue their immune hyperactivation and dysfunction. IFNAR blockade fully reversed HIV-1–induced immune hyperactivation and rescued anti–HIV-1 immune responses in T cells from HIV-1–infected hu-mice. Finally, we found that IFNAR blockade in the presence of cART reduced the size of HIV-1 reservoirs in lymphoid tissues and delayed HIV-1 rebound after cART cessation in the HIV-1–infected hu-mice. We conclude that low levels of IFN-I signaling contribute to HIV-1–associated immune dysfunction and foster HIV-1 persistence in cART-treated hosts. Our results suggest that blocking IFNAR may provide a potential strategy to enhance immune recovery and reduce HIV-1 reservoirs in individuals with sustained elevations in IFN-I signaling during suppressive cART

Ailanthone targets p23 to overcome MDV3100 resistance in castration-resistant prostate cancer

Androgen receptor (AR) antagonist MDV3100 is the first therapeutic approach in treating castration-resistant prostate cancer (CRPC), but tumours frequently become drug resistant via multiple mechanisms including AR amplification and mutation. Here we identify the small molecule Ailanthone (AIL) as a potent inhibitor of both full-length AR (AR-FL) and constitutively active truncated AR splice variants (AR-Vs). AIL binds to the co-chaperone protein p23 and prevents AR's interaction with HSP90, thus resulting in the disruption of the AR-chaperone complex followed by ubiquitin/proteasome-mediated degradation of AR as well as other p23 clients including AKT and Cdk4, and downregulates AR and its target genes in PCa cell lines and orthotopic animal tumours. In addition, AIL blocks tumour growth and metastasis of CRPC. Finally, AIL possesses favourable drug-like properties such as good bioavailability, high solubility, lack of CYP inhibition and low hepatotoxicity. In general, AIL is a potential candidate for the treatment of CRPC