AIM: To assess the appropriateness of referrals and to determine the diagnostic yield of colonoscopy according to the 2000 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE).METHODS: A total of 7...AIM: To assess the appropriateness of referrals and to determine the diagnostic yield of colonoscopy according to the 2000 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE).METHODS: A total of 736 consecutive patients (415males, 321 females; mean age 43.6±16.6 years)undergoing colonoscopy during October 2001-March2002 Were prospectively enrolled in the study. The 2000ASGE guidelines were used to assess the appropriateness of the indications for the procedure. Diagnostic yield was defined as the ratio between significant findings detected on colonoscopy and the total number of procedures performed for that indication.RESULTS: The large majority (64%) of patients had colonoscopy for an indication that was considered'generally indicated'; it was 'generally not indicated' for20%, and it was 'not listed' for 16% in the guidelines.The diagnostic yield of colonoscopy was highest for the 'generally indicated' (38%) followed by 'not listed'(13%) and 'generally not indicated' (5%) categories.In the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of indication that was 'generally indicated' (odds ratio=12.3) and referrals by gastroenterologist (odds ratio = 1.9).CONCLUSION: There is a high likelihood of inappropriate referrals for colonoscopy in an open-access endoscopy system. The diagnostic yield of the procedure is dependent on the appropriateness of indication and referring physician's specialty. Certain indications 'not listed' in the guidelines have an intermediate diagnostic yield and further studies are required to evaluate whether they should be included in future revisions of the ASGE guidelines.展开更多
Massive energy is consumed to cool buildings for comfortable life in hot climates due to indoor airconditioning,which necessitates the passive daytime radiative cooling of buildings.Given the high ambient temperature,...Massive energy is consumed to cool buildings for comfortable life in hot climates due to indoor airconditioning,which necessitates the passive daytime radiative cooling of buildings.Given the high ambient temperature,it is essential to increase the thermal resistance of building walls through paints and enhance their durability to dust and aerosol contamination.In this work,a multifunctional composite paint,mainly consisting of inorganic pigments and mesoporous silica aerogel(SA),is proposed for passive radiative cooling,low thermal conductivity,and surface self-cleaning.In comparison with ordinary paint,the SA microparticles-infused composite paint can enhance the reflectance(rVIS-NIR)to the solar irradiance by up to 15%in the visible and near-infrared ranges(0.3-2.5 mm).It also maintains the radiative cooling property with about 0.96 emissivity(εLWIR)in the atmospheric transparency windows(8-13 mm)for thermal radiation to dissipate into the cold outer space.Even after long-term outdoor exposure to harsh environmental conditions,SA-infused white paint can still maintain its spectral and wetting properties,achieving daytime cooling with 7.4℃lower than the ambient temperature.Moreover,the SA infusion enables the paint to reduce the thermal conductivity by 50%and provide much better thermal insulation,while SA renders the paint surface hydrophobic and self-cleaning.展开更多
文摘AIM: To assess the appropriateness of referrals and to determine the diagnostic yield of colonoscopy according to the 2000 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE).METHODS: A total of 736 consecutive patients (415males, 321 females; mean age 43.6±16.6 years)undergoing colonoscopy during October 2001-March2002 Were prospectively enrolled in the study. The 2000ASGE guidelines were used to assess the appropriateness of the indications for the procedure. Diagnostic yield was defined as the ratio between significant findings detected on colonoscopy and the total number of procedures performed for that indication.RESULTS: The large majority (64%) of patients had colonoscopy for an indication that was considered'generally indicated'; it was 'generally not indicated' for20%, and it was 'not listed' for 16% in the guidelines.The diagnostic yield of colonoscopy was highest for the 'generally indicated' (38%) followed by 'not listed'(13%) and 'generally not indicated' (5%) categories.In the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of indication that was 'generally indicated' (odds ratio=12.3) and referrals by gastroenterologist (odds ratio = 1.9).CONCLUSION: There is a high likelihood of inappropriate referrals for colonoscopy in an open-access endoscopy system. The diagnostic yield of the procedure is dependent on the appropriateness of indication and referring physician's specialty. Certain indications 'not listed' in the guidelines have an intermediate diagnostic yield and further studies are required to evaluate whether they should be included in future revisions of the ASGE guidelines.
文摘Massive energy is consumed to cool buildings for comfortable life in hot climates due to indoor airconditioning,which necessitates the passive daytime radiative cooling of buildings.Given the high ambient temperature,it is essential to increase the thermal resistance of building walls through paints and enhance their durability to dust and aerosol contamination.In this work,a multifunctional composite paint,mainly consisting of inorganic pigments and mesoporous silica aerogel(SA),is proposed for passive radiative cooling,low thermal conductivity,and surface self-cleaning.In comparison with ordinary paint,the SA microparticles-infused composite paint can enhance the reflectance(rVIS-NIR)to the solar irradiance by up to 15%in the visible and near-infrared ranges(0.3-2.5 mm).It also maintains the radiative cooling property with about 0.96 emissivity(εLWIR)in the atmospheric transparency windows(8-13 mm)for thermal radiation to dissipate into the cold outer space.Even after long-term outdoor exposure to harsh environmental conditions,SA-infused white paint can still maintain its spectral and wetting properties,achieving daytime cooling with 7.4℃lower than the ambient temperature.Moreover,the SA infusion enables the paint to reduce the thermal conductivity by 50%and provide much better thermal insulation,while SA renders the paint surface hydrophobic and self-cleaning.
