Anemia is a common extraintestinal manifestation of inflammatory bowel disease(IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia(IDA) secondary to...Anemia is a common extraintestinal manifestation of inflammatory bowel disease(IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia(IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used labora-tory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and con-venient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.展开更多
In a multi-lane area,the increasing randomness of lane changes contributes to traffic insecurity and local traffic flow instability.A study on safe lane shifting activity that focuses on threat assessment under real-t...In a multi-lane area,the increasing randomness of lane changes contributes to traffic insecurity and local traffic flow instability.A study on safe lane shifting activity that focuses on threat assessment under real-time knowledge is necessary to enhance smooth vehicle flow.This paper proposed amore comprehensive lane changing guidance rule to investigate the status of surrounding vehicles to accommodate future vehicle-on-road collaborative environments based on these parameters 1)lane change demand and 2)treat assessment function.The collaborative relationships between vehicles are analyzed using a cellular automata model based on their location,velocity,and acceleration.We analyze and examine the relationship between the number of lanes and traffic flow when the road capacity is heavily mined via intelligent lane changing.Our analysis can further provide theoretical guidance for the selection of road expansion mode.Our proposed STCA-L is compared based on the average speed,average flow,lane changing frequency,spatial and temporal pattern of STCA,STCA-I,and STCA-S,and STCA-M under different vehicle densities.The numerical simulation results show that our proposed STCA-L provides themost flexible lane changing guidance in the multi-lanes road.Moreover,the simulated results show that the exponential growth of physical space cannot provide the corresponding increase in the average flow of vehicles.展开更多
文摘Anemia is a common extraintestinal manifestation of inflammatory bowel disease(IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia(IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used labora-tory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and con-venient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.
基金supported in part by the National Natural Science Foundation of China(No.51905405)Basic Research Program of Natural Science of Shaanxi Province(No.2022JM-407)Guiding Program of Science and Technology of China Textile Industry Federation(No.2020106).
文摘In a multi-lane area,the increasing randomness of lane changes contributes to traffic insecurity and local traffic flow instability.A study on safe lane shifting activity that focuses on threat assessment under real-time knowledge is necessary to enhance smooth vehicle flow.This paper proposed amore comprehensive lane changing guidance rule to investigate the status of surrounding vehicles to accommodate future vehicle-on-road collaborative environments based on these parameters 1)lane change demand and 2)treat assessment function.The collaborative relationships between vehicles are analyzed using a cellular automata model based on their location,velocity,and acceleration.We analyze and examine the relationship between the number of lanes and traffic flow when the road capacity is heavily mined via intelligent lane changing.Our analysis can further provide theoretical guidance for the selection of road expansion mode.Our proposed STCA-L is compared based on the average speed,average flow,lane changing frequency,spatial and temporal pattern of STCA,STCA-I,and STCA-S,and STCA-M under different vehicle densities.The numerical simulation results show that our proposed STCA-L provides themost flexible lane changing guidance in the multi-lanes road.Moreover,the simulated results show that the exponential growth of physical space cannot provide the corresponding increase in the average flow of vehicles.
