High performance components, e.g., fasteners, nowadays are usually made out of cold forged and heat treated steels like steel 1.5525 (20MnB4). To overcome the problems of heat treatment, e.g., low surface quality, new...High performance components, e.g., fasteners, nowadays are usually made out of cold forged and heat treated steels like steel 1.5525 (20MnB4). To overcome the problems of heat treatment, e.g., low surface quality, new workpiece materials for cold forging should be found to achieve the needlessness of heat treatment after cold forging. One possible material is given by high nitrogen steels like steel 1.3815 (X8CrMnN19-19). Due to the high strain hardening of these materials the process and tool design for an industrial batch process are challenging and should be conducted by FE-simulation. The numerical results show that, high strength tool materials, like PM-steels or cemented carbides, in most cases, are inevitable. Additionally to the selection of suitable tool materials, the tool layout should be developed further to achieve a high loadability of the tools. The FE-models, used for process and tool design, are validated with respect to the materials' flow and occurring forming force to assure a proper design process. Also the comparison of strength of components made out of steel 1.5525 in quenched and tempered conditions and steel 1.3815 in strain hardened condition is done. The results show that the component made of steel 1.3815 has a significantly higher strength than the component made of steel 1.5525. This shows that by the use of high nitrogen steels a high performance component can be manufactured by cold forging.展开更多
Idiopathic normal pressure hydrocephalus(iNPH)is caused by impaired cerebrospinal fluid absorption in the elderly;it is a surgically treatable form of dementia.Gait disturbance,dementia,and urinary incontinence are th...Idiopathic normal pressure hydrocephalus(iNPH)is caused by impaired cerebrospinal fluid absorption in the elderly;it is a surgically treatable form of dementia.Gait disturbance,dementia,and urinary incontinence are the triad of signs for iNPH.In addition to these clinical findings,imaging studies show characteristic ventricular enlargement.High Evans Index and‘disproportionately enlarged subarachnoid hydrocephalus’are other well-known imaging findings of iNPH.If the tap test shows improved symptoms,shunt surgery is performed.The disease was first described by Hakim and Adams in 1965,followed by the publication of the first,second,and third editions of the guidelines in 2004,2012,and 2020,respectively.Recent studies signal the glymphatic system and classical cerebrospinal fluid(CSF)absorption from the dural lymphatics as aetiological mechanisms of CSF retention.Research is also underway on imaging test and biomarker developments for more precise diagnosis,shunting technique options with fewer sequelae and complications,and the influence of genetics.Particularly,the newly introduced‘suspected iNPH’in the third edition of the guidelines may be useful for earlier diagnosis.However,less well-studied areas remain,such as pharmacotherapy in non-operative indications and neurological findings other than the triadic signs.This review briefly presents previous research on these and future issues.展开更多
Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma...Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma,its therapeutic efficacy in difficultto-treat asthma is limited.Recently,a precision medicine approach based on the identification and intervention of treatable traits of chronic airway disease has been proposed and appears to be of greater benefit to asthmatics.We reported a 71-year-old male with uncontrolled asthma and multiple exacerbations over the past year.He complained of persistent dyspnea despite high-dose of inhaled corticosteroids plus other controllers.Does this patient have some potential treatable traits contributing to difficult-to-treat asthma?Through a multidimensional assessment of three domains including pulmonary,extrapulmonary,and behavioral/risk factors,15 treatable traits were identified in the patient,mainly including airflow limitation,eosinophilic airway inflammation,small airway dysfunction,exacerbation prone,dilated cardiomyopathy,diabetes mellitus,inhaler device polypharmacy,smoking,and the absence of an asthma action plan.After targeted treatment for these treatable traits,the patient experienced significant improvement in dyspnea and he could maintain good asthma control with low-dose inhaled corticosteroids and long-acting β_(2)-agonist.This study shows that,in response to the limitation of a stepwise approach to therapy,treatable traits is a new strategy where patients are individually assessed for a specified set of treatable problems,and an individualized treatment program is developed and implemented based on this multidimensional assessment,especially for difficult-to-treat asthma.展开更多
我今年55岁,夜里经常失眠。依靠安眠药助眠毕竟不是长久之计。最近我在网上读到一篇短文,是讲改善老人睡眠的。读后很为美国人搞科研的精神和方法所动。他们把参加试验的人分为三组,一组服药,一组服药加行为治疗,一组服用的是安慰剂。...我今年55岁,夜里经常失眠。依靠安眠药助眠毕竟不是长久之计。最近我在网上读到一篇短文,是讲改善老人睡眠的。读后很为美国人搞科研的精神和方法所动。他们把参加试验的人分为三组,一组服药,一组服药加行为治疗,一组服用的是安慰剂。试验结束后再作对比。鄙人孤陋寡闻,尚未见国内搞过如此试验。本文提出了一些很好的改变行为,促进睡眠的建议。我对其中的两条感兴趣,也照办了。一条是Get up at the same time each morning, regardless of the amount of sleep during the previous night.这一条果然灵验。我以前的做法是“堤内损失堤外补”,夜里损失早晨补。这样做的效果其实很差。另一条是把Use the bedroom for sleep and sex only—no reading, TV watching or worrying about sleep,我将电视机从我的卧室“请”了出去,卧室就是卧室,不作他用(值得庆幸的是我最近刚迁人三室一厅的新居)。没有想到,此举真灵!读一篇短文,能学到一两点有用的知识足矣!我将此文用email发给贵刊,并附上我的译文,希望能够刊出,让更多的人能够从中受益。不知译文是否可用。展开更多
文摘High performance components, e.g., fasteners, nowadays are usually made out of cold forged and heat treated steels like steel 1.5525 (20MnB4). To overcome the problems of heat treatment, e.g., low surface quality, new workpiece materials for cold forging should be found to achieve the needlessness of heat treatment after cold forging. One possible material is given by high nitrogen steels like steel 1.3815 (X8CrMnN19-19). Due to the high strain hardening of these materials the process and tool design for an industrial batch process are challenging and should be conducted by FE-simulation. The numerical results show that, high strength tool materials, like PM-steels or cemented carbides, in most cases, are inevitable. Additionally to the selection of suitable tool materials, the tool layout should be developed further to achieve a high loadability of the tools. The FE-models, used for process and tool design, are validated with respect to the materials' flow and occurring forming force to assure a proper design process. Also the comparison of strength of components made out of steel 1.5525 in quenched and tempered conditions and steel 1.3815 in strain hardened condition is done. The results show that the component made of steel 1.3815 has a significantly higher strength than the component made of steel 1.5525. This shows that by the use of high nitrogen steels a high performance component can be manufactured by cold forging.
文摘Idiopathic normal pressure hydrocephalus(iNPH)is caused by impaired cerebrospinal fluid absorption in the elderly;it is a surgically treatable form of dementia.Gait disturbance,dementia,and urinary incontinence are the triad of signs for iNPH.In addition to these clinical findings,imaging studies show characteristic ventricular enlargement.High Evans Index and‘disproportionately enlarged subarachnoid hydrocephalus’are other well-known imaging findings of iNPH.If the tap test shows improved symptoms,shunt surgery is performed.The disease was first described by Hakim and Adams in 1965,followed by the publication of the first,second,and third editions of the guidelines in 2004,2012,and 2020,respectively.Recent studies signal the glymphatic system and classical cerebrospinal fluid(CSF)absorption from the dural lymphatics as aetiological mechanisms of CSF retention.Research is also underway on imaging test and biomarker developments for more precise diagnosis,shunting technique options with fewer sequelae and complications,and the influence of genetics.Particularly,the newly introduced‘suspected iNPH’in the third edition of the guidelines may be useful for earlier diagnosis.However,less well-studied areas remain,such as pharmacotherapy in non-operative indications and neurological findings other than the triadic signs.This review briefly presents previous research on these and future issues.
基金supported by the National Natural Science Foundation of China(Grants No.81920108002 and 81870027)the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University(Grant No.2018hXFH016)+1 种基金the Science and Technology Bureau of Chengdu,China(Grant No.2021-GH03-00007-HZ)the Sichuan Provincial Science and Technology Agency,Sichuan,China(Grant No.2022YFS0263).
文摘Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma control.However,due to the generalized heterogeneity and complexity of asthma,its therapeutic efficacy in difficultto-treat asthma is limited.Recently,a precision medicine approach based on the identification and intervention of treatable traits of chronic airway disease has been proposed and appears to be of greater benefit to asthmatics.We reported a 71-year-old male with uncontrolled asthma and multiple exacerbations over the past year.He complained of persistent dyspnea despite high-dose of inhaled corticosteroids plus other controllers.Does this patient have some potential treatable traits contributing to difficult-to-treat asthma?Through a multidimensional assessment of three domains including pulmonary,extrapulmonary,and behavioral/risk factors,15 treatable traits were identified in the patient,mainly including airflow limitation,eosinophilic airway inflammation,small airway dysfunction,exacerbation prone,dilated cardiomyopathy,diabetes mellitus,inhaler device polypharmacy,smoking,and the absence of an asthma action plan.After targeted treatment for these treatable traits,the patient experienced significant improvement in dyspnea and he could maintain good asthma control with low-dose inhaled corticosteroids and long-acting β_(2)-agonist.This study shows that,in response to the limitation of a stepwise approach to therapy,treatable traits is a new strategy where patients are individually assessed for a specified set of treatable problems,and an individualized treatment program is developed and implemented based on this multidimensional assessment,especially for difficult-to-treat asthma.
文摘我今年55岁,夜里经常失眠。依靠安眠药助眠毕竟不是长久之计。最近我在网上读到一篇短文,是讲改善老人睡眠的。读后很为美国人搞科研的精神和方法所动。他们把参加试验的人分为三组,一组服药,一组服药加行为治疗,一组服用的是安慰剂。试验结束后再作对比。鄙人孤陋寡闻,尚未见国内搞过如此试验。本文提出了一些很好的改变行为,促进睡眠的建议。我对其中的两条感兴趣,也照办了。一条是Get up at the same time each morning, regardless of the amount of sleep during the previous night.这一条果然灵验。我以前的做法是“堤内损失堤外补”,夜里损失早晨补。这样做的效果其实很差。另一条是把Use the bedroom for sleep and sex only—no reading, TV watching or worrying about sleep,我将电视机从我的卧室“请”了出去,卧室就是卧室,不作他用(值得庆幸的是我最近刚迁人三室一厅的新居)。没有想到,此举真灵!读一篇短文,能学到一两点有用的知识足矣!我将此文用email发给贵刊,并附上我的译文,希望能够刊出,让更多的人能够从中受益。不知译文是否可用。
