Objectives:This study aimed to assess the impact of exercise rehabilitation during the vulnerable period on cardiac recovery(CR)outcomes in patients with acute decompensated heart failure(ADHF).Methods:Multiple databa...Objectives:This study aimed to assess the impact of exercise rehabilitation during the vulnerable period on cardiac recovery(CR)outcomes in patients with acute decompensated heart failure(ADHF).Methods:Multiple databases including PubMed,Web of Science,Embase,the Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical Database(VIP),Wanfang database,SinoMed,ClinicalTrials.gov,and American Heart Association(AHA)and European Society of Cardiology(ESC)were searched for RCTs on exercise rehabilitation in ADHF patients’vulnerable period from inception to April 2,2025.The risk of bias was assessed with Cochrane Risk of Bias 2.0,and data were analyzed in RevMan 5.3.Results:A total of seven RCTs involving 946 patients were included.The results demonstrated that exercise rehabilitation training during the vulnerable period in patients with ADHF significantly increased the 6-min walk test distance(6-MWTD)(SMD=0.37;95%CI:0.09,0.65;P=0.01),short physical performance battery(SPPB)score(MD=1.26;95%CI:0.82,1.70;P<0.001)and peak oxygen consumption(VO2peak)(SMD=1.43;95%CI:0.53,2.34;P=0.002),improved quality of life(QoL)(SMD=0.85;95%CI:0.07,1.64,P=0.03),reduced depression score(MD=-0.73;95%CI:1.27,-0.18;P=0.009),frailty(MD=-0.22;95%CI:-0.48,0.05;P=0.11),and decreased 6-month all-cause readmission(OR=0.67;95%CI:0.49,0.91;P=0.01).However,no statistically significantdifferences were observed between the two groups in left ventricular ejection fraction(LVEF)(MD=0.96;95%CI:-1.84,3.77;P=0.50),6-month heart failure(HF)-related readmission(OR=1.01;95%CI:0.66,1.53;P=0.98),and all-cause mortality(OR=0.63;95%CI:0.18,2.24;P=0.47).There were no adverse events reported.Conclusions:Exercise rehabilitation during the vulnerable phase improves exercise tolerance,QoL,and depressive symptoms while reducing 6-month all-cause readmissions in ADHF patients,with no reported adverse events.Although trends toward improved LVEF,HF-related readmissions,and all-cause mortality were observed.Large-scale,high-quality studies are warranted to explore individualized responses and long-term outcomes.展开更多
Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patien...Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patients are suitable recipients of allo-HCT, particularly the elderly patients and those with high comorbidity burdens.Furthermore, patients who develop relapse or graft failure after initial transplantation encounter additional challenges when evaluated for a second transplant.展开更多
Aiming at the problem that it is difficult to build model and identify the vulnerable equipment for aviation armament System-of-Systems(SoS)due to complex equipment interaction relationships and high confrontation,the...Aiming at the problem that it is difficult to build model and identify the vulnerable equipment for aviation armament System-of-Systems(SoS)due to complex equipment interaction relationships and high confrontation,the interdependent network theory is introduced to solve it.Firstly,a two-layer heterogeneous interdependent network model for aviation armament SoS is proposed,which reflects the information interaction,functional dependency and inter-network dependence effectively.Secondly,using the attack cost to describe the confrontation process and taking the comprehensive impact on kill chains as the entry point,the node importance index and the attack cost measurement method are constructed.Thirdly,the identification of vulnerable nodes is transformed into the optimization problem of node combinatorial selection,and the vulnerable node identification method based on tabu search is proposed.Based on vulnerable nodes,a robustness enhancement strategy for aviation armament SoS network is presented.Finally,the above methods are used to an aerial confrontation SoS,and the results verify the rationality and effectiveness of the proposed methods.展开更多
Social anxiety (SA) is a prevalent mental health issue among adolescents, and vulnerable narcissism (VN) can exacerbate thiscondition. This study aims to investigate the impact of vulnerable narcissism on social anxie...Social anxiety (SA) is a prevalent mental health issue among adolescents, and vulnerable narcissism (VN) can exacerbate thiscondition. This study aims to investigate the impact of vulnerable narcissism on social anxiety in adolescents, specificallyfocusing on the mediating effects of self-concept clarity (SCC) and self-esteem (SE) in the relationship between vulnerablenarcissism and social anxiety. Through cluster sampling, a questionnaire survey was conducted among 982 students from threesecondary schools in two provinces. The data was analyzed using structural equation modeling (SEM). The results revealedthat there was a significant negative correlation between vulnerable narcissism and both self-concept clarity and self-esteem,while there was a significant positive correlation between vulnerable narcissism and social anxiety. Additionally, self-conceptclarity showed a significant positive correlation with self-esteem but had a negative correlation with social anxiety. Both selfconceptclarity and self-esteem played an intermediary role in the chain linking vulnerable narcissism to social anxiety. Thisstudy confirms the mediating role of both self-concept clarity and self-esteem in explaining how vulnerable narcissisminfluences social anxiety, providing valuable insights into its underlying mechanism.展开更多
Train rails are associated with environmental and safety risks, often concentrating industry near their yards and rails. ArcGIS was applied to map the rail network, land uses, and industrial sites in Point Douglas and...Train rails are associated with environmental and safety risks, often concentrating industry near their yards and rails. ArcGIS was applied to map the rail network, land uses, and industrial sites in Point Douglas and St. Boniface in Winnipeg, Canada. We identified 123 land uses with vulnerable populations needing assistance in evacuation from hospitals, senior living facilities, schools and early childhood centres within a buffer of two km of the rails and conducted hotspot analysis. About two-fifths of the total population, 39% in Point Douglas and 40% in St. Boniface, are at risk from fire, spill or train derailment involving dangerous goods and requiring evacuations or isolation.展开更多
The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on th...The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on the potential impact of extreme heat exposure on human survival and habitability.The physiological condition of lower adaptability to high temperature environments and the assessment of individuals who may have higher tolerance time in high temperature environments based on spatial perspectives suggest the need for targeted spatial optimization strategies for commuters and disadvantaged populations.This is demonstrated through a case study.These optimization measures encompass a variety of aspects,including the integration of transportation systems,the expansion of grey space corridors,the improvement of green space layout,and the implantation of green infrastructure.The study aims to reduce the exposure time of thermally vulnerable individuals to high temperature environments through spatial optimization strategies,to enhance the resilience of urban green spaces to heat stress,and to reduce the probability of heat-wave occurrence.展开更多
Numerical simulation and experimental results were employed for the identification of the most vulnerable zones in three-pass cold-metal-transferring （CMT） welded joint. The residual stress distribution in the joint...Numerical simulation and experimental results were employed for the identification of the most vulnerable zones in three-pass cold-metal-transferring （CMT） welded joint. The residual stress distribution in the joint was predicted by finite element （FE） method, while the structural morphology of distinctive zones was obtained through metallographic experiments. The highest principal stress made the symmetric face of the joint most sensitive to tensile cracks under service conditions. Whereas, the boundaries between the weld seam and the base plates were sensitive to cracks because the equivalent von Mises stress was the highest when the first interpass cooling was finished. The third weld pass and the inter-pass remelted zones exhibited the modest mechanical performances as a result of the coarse grain and coarse grain boundary, respectively. The most vulnerable zones were regarded to be the crossed parts between the zones identified by numerical and experimental methods.展开更多
A new method is proposed for calculating the aircraft equivalent single vulnerable area using Monte-Carlo simulation technique. The method simulates the kill events of single vulnerable components and multiply vulnera...A new method is proposed for calculating the aircraft equivalent single vulnerable area using Monte-Carlo simulation technique. The method simulates the kill events of single vulnerable components and multiply vulnerable components or redundant components to ＇Model of Filling Boxes with Balls＇, in which the area of each box is equal to the component＇s vulnerable area. By randomly and uniformly sampling the threat hit locations, the expected number of hits required to kill an aircraft can be given and the aircraft equivalent singly vulnerable area can be attained. Examples demonstrate the correctness and feasibility of the proposed method. Analysis show that the developed method overcomes two shortcomings of currently used methods. （1） It can calculate the equivalent single vulnerable area of aircraft with several sets of multiply vulnerable components, and （2） When the components of each multiple set have different vulnerable areas, the method also applies.展开更多
Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of res...Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine.Necropsy studies have described histopathological changes associated with the development of acute coronary events.In this regard,thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature.Hence,many imaging techniques,such as coronary computed tomography,cardiac magnetic resonance or positron emission tomography,have tried to detect noninvasively these histomorphological characteristics with different approaches.In this article,we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.展开更多
The evolvement of a vulnerable ecological region is a dynamic process, which is affected by various factors. During the evolvement process, human activities have a decisive effect. The purpose of studying vulnerable e...The evolvement of a vulnerable ecological region is a dynamic process, which is affected by various factors. During the evolvement process, human activities have a decisive effect. The purpose of studying vulnerable ecological region is to control human economic activities and to develop a negative feedback modulation mechanism.This paper established a model of vulnerable ecological region's evolvement by considering four synthetic variables.These synthetic variables are ecological carrying capacity, ecological resilience, economic development intensity, and economic development velocity. Finally, Ongniud Banner and Aohan Banner in North China were taken as study cases to simulate the evolvement processes of vulnerable ecological regions under different conditions of economic development. The results show that human activities have an important influence on the evolvement trend of vulnerable ecological region.展开更多
The Internet is believed to bring more technological dividends to vulnerable farmers during the green agriculture transformation.However,this is different from the theory of skill-biased technological change,which emp...The Internet is believed to bring more technological dividends to vulnerable farmers during the green agriculture transformation.However,this is different from the theory of skill-biased technological change,which emphasizes that individuals with higher levels of human capital and more technological endowments benefit more.This study investigates the effects of Internet use on farmers'adoption of integrated pest management(IPM),theoretically and empirically,based on a dataset containing 1015 farmers in China's Shandong Province.By exploring the perspective of rational inattention,the reasons for the heterogeneity of the effects across farmers with different endowments,i.e.,education and land size,are analyzed.The potential endogeneity issues are addressed using the endogenous switching probit model.The results reveal that:(1)although Internet use significantly positively affects farmers'adoption of IPM,vulnerable farmers do not benefit more from it.Considerable selection bias leads to an overestimation of technological dividends for vulnerable farmers;(2)different sources of technology information lead to the difference in the degree of farmers'rational inattention toward Internet information,which plays a crucial role in the heterogeneous effect of Internet use;and(3)excessive dependence on strong-tie social network information sources entraps vulnerable farmers in information cocoons,hindering their ability to reap the benefits of Internet use fully.Therefore,it is essential to promote services geared towards elderly-oriented Internet agricultural technology information and encourage farmers with strong Internet utilization skills to share technology information with other farmers actively.展开更多
It can be seen from the calculation that the vulnerable area along China's coast in which the elevation is less than 5 m, is 143 900 km2, accounting for about 11. 3% of the total area of the 11 coastal provinces, ...It can be seen from the calculation that the vulnerable area along China's coast in which the elevation is less than 5 m, is 143 900 km2, accounting for about 11. 3% of the total area of the 11 coastal provinces, municipalities and autonomous regions. These areas are threatened to varying extent by sea level rise. According to prediction, the relative sea level rise (including global sea level rise caused by climate change and local relative as level rise caused by vertical crust movement and ground subsidence) along China's coast will be 4～16 cm by the year 2030 with the optimum estimated value of 6～14cm. It will be 9～26 cm by the year 2050 with the optimum estimated value of 12-23 cm. And it will be 31-74 cm by the year 2100 with the optimum estimated value of 47～65 cm. The calcuation result shows that the percentage of the cost for up-grading (heightening and consolidating) sea dykes/walls in adaptation strategy in the losses of submerged areas varies from area to area: 6. 9% in the Zhujiang (Pearl) River Deta, 1. 3% ～24. 6% in the Changjiang (Yangtze) River Delta, and 0. 9%～2. 0% in the Huanghe River Delta.展开更多
The effect of hazard was determined by the dangerous degree of hazard factor—environment and the vulnerable degree of sustaining body. The research into the latter is of importance for the hazard theory and the forma...The effect of hazard was determined by the dangerous degree of hazard factor—environment and the vulnerable degree of sustaining body. The research into the latter is of importance for the hazard theory and the formation of laws on the mitigation of natural hazards. The way to evaluate the vulnerable degree is the foundation of and the key to the research. In this paper, the extenics model is established to do this job.展开更多
Objective To explore the relationship between coronary vulnerable plaque instability and serum C-reactive protein(CRP) , B-type natriuretic peptide(BNP) levels in 85 patients with coronary heart disease. Methods Eight...Objective To explore the relationship between coronary vulnerable plaque instability and serum C-reactive protein(CRP) , B-type natriuretic peptide(BNP) levels in 85 patients with coronary heart disease. Methods Eighty-five patients( aged 63±16,M= 52 ) were divided into two groups.The control group was 28 patients with stable angina pectoris (SAP). The study group was 57 patients with acute coronary syndrome (ACS) .which were further divided into 21 patients with non ST elevated myocardial infarction (NSTEMI) and 36 patients with unstable angina pectoris (UAP). Plasma BNP and CRP were measured as well as coronary angiography made for all 85 patients. Plaques of coronary culprit arteries were classified as I -III three types according to Ambrose classification. Results (1). BNP and CRP levels of NSTEMI and UAP groups were significant higher than in SAP group. (2).The levels of BNP and CRP correlated with Ambrose classification, especially positively with Ambrose II type ,but no relation with coronary narosis. (3). The levels of BNP was much higher in patients of left anterior descending or multiple coronary artery diseases .(4). The Plaques of coronary culprit arteries in high risk of NSTEMI and UAP patients were mostly Ambrose II or III type. Conclusions The prevalence of higher levels of plasma BNP and CRP in patients with ACS ,when compared with those of SAP, was associated with the instability of coronary vulnerable plaques (ie, Ambrose II type). The level of BNP was much higher in patients of left anterior descending or multiple complicated coronary diseases. So, BNP and CRP are not only markers of vulnerable plaques, but also indicators of ACS prognosis.展开更多
Using rural survey data for the year 2009,we provide evidence of work choices of rural laborers in ecologically vulnerable areas in North China,and model these choices as a function of characteristics of individuals,h...Using rural survey data for the year 2009,we provide evidence of work choices of rural laborers in ecologically vulnerable areas in North China,and model these choices as a function of characteristics of individuals,households,and land endowments.The findings reveal large differences between males and females,and between non-farm employment and part-time farming engagement Land scarcity is still an important driving factor in non-farming participation of rural laborers in the study area;and in the current case of land productivity and the total amount of land,there are still surplus rural labor forces in the study area.Diversification of livelihood reduces the pressure on land,thus facilitating ecosystem conservation.So,the paper concludes with the argument that establishing coordination mechanisms among non-farm employment of rural laborers,agricultural production,and restoration of ecosystems are essential for mitigating the conflicts of ecological security,agricultural production,and rural development in mis area.展开更多
BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilit...BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters.METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses(PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubM ed, Scopus, Science Direct, Ovid, ProQ uest, Wiley, Google Scholar were searched.RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for f inal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-f ive studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic.CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.展开更多
With the development of intelligent vehicles and autonomous driving technology,the safety of vulnerable road user(VRU)in traffic has been more guaranteed,and many research achievements have been made in the key area o...With the development of intelligent vehicles and autonomous driving technology,the safety of vulnerable road user(VRU)in traffic has been more guaranteed,and many research achievements have been made in the key area of collision avoidance decision-making methods.In this paper,the knowledge mapping method is used to mine the available literature in depth,and it is found that the research focus has shifted from the traditional accident cause analysis to emerging deep learning and virtual reality technology.This paper summarizes research on the three core dimensions of environmental perception,behavior cognition and collision avoidance decision-making in intelligent vehicle systems.In terms of perception,accurate identification of pedestrians and cyclists in complex environments is a major demand for VRU perception;in terms of behavior cognition,the coupling of VRU intention identification and motion trajectory prediction and other multiple factors needs further research;in terms of decision-making,the intention identification and trajectory prediction of collision objects are not included in the risk assessment model,and there is a lack of exploration specifically for cyclists'collision risk.On this basis,this paper provides guidance for the improvement of traffic safety of contemporary VRU under the conditions of intelligent and connected transportation.展开更多
The interests of vulnerable groups can’t be guaranteed due to their weaker capacity and the limited interests demand channels during the water pollution conflicts. The interest protection for the vulnerable people in...The interests of vulnerable groups can’t be guaranteed due to their weaker capacity and the limited interests demand channels during the water pollution conflicts. The interest protection for the vulnerable people in the water pollution conflicts has attracted attentions of the international scholars. The paper tries to construct the market mechanism which can make the vulnerable people to involve in the emission trading. The vulnerable people can buy American put option in the emission trading market. When the price of the emission runs below the contract price, the vulnerable people can get the benefit through executing the option. When the price of the emission runs above the contract price, the vulnerable people can give up the right. The binomial tree option pricing model can help the vulnerable people to make a decision through the analysis of the worth of the American put option.展开更多
Ecology-oriented poverty alleviation is not only a livelihood project that affects the vast majority of rural people but also a major project to win the fight against poverty. It is also an indispensable income compon...Ecology-oriented poverty alleviation is not only a livelihood project that affects the vast majority of rural people but also a major project to win the fight against poverty. It is also an indispensable income component for the relocation of poor farmers. Dongchuan District,located at the intersection of Jinsha River and Xiaojiang River,is one of the key counties for poverty alleviation and development in China with a wide range of poverty and extreme poverty. The incidence of poverty reached 24. 36%. The ecology is fragile,and earthquake outbreaks frequently. Dongchuan District is a national key monitoring and defense area for earthquakes. A large number of goafs,subsidence areas and geological hazard areas have been formed in the mining area. The number of dangerous houses is large,and ' it has no way of supporting its own inhabitants' is the key point,difficulty and focus of the county’s poverty alleviation. Relocation is a must-have measure to move away from poverty. It is also complex system engineering,which is policy-oriented and difficult. Since 2017,Dongchuan District has regarded relocation has the top priority for poverty alleviation. It has strictly implemented national,provincial and municipal policies,focused on the overall goal of ' moving,securing and getting rich',and strongly promoted the relocation work for poverty alleviation. Obvious social,economic and ecological benefits have been achieved. Successful relocation,combined with ecology-oriented poverty alleviation and other targeted poverty alleviation measures,Dongchuan District’s fight against poverty has achieved a decisive victory. At the end of December 2018,the incidence of poverty in the region fell to 1. 09%,and 129 poor villages( including 86 extremely poor villages) had been successfully lifted out of poverty. This paper analyzes and condenses the specific practices,main achievements,benefits,successful experiences and implications of the region’s relocation combined with ecology-oriented poverty alleviation model,so as to provide necessary reference for the innovation of relocation in poverty-stricken counties of Yunnan Province and similar provinces( cities,districts).展开更多
Public service deregulation is favoured for motivating providers to offer consumers better price-quality services. Consequently, consumers are enabled to make informed choices and choose for the best service provider....Public service deregulation is favoured for motivating providers to offer consumers better price-quality services. Consequently, consumers are enabled to make informed choices and choose for the best service provider. However, recent publications reveal that consumers are not capable of exercising optimal choice behaviour. Despite these concerns, evidence is lacking on the extent to which potentially vulnerable consumers make use of the core element of deregulation—switching health plans. This article is meant to study whether potentially vulnerable consumers do indeed switch less health plans in the deregulated Dutch health insurance market than regular consumers. In order to answer this question, we extract questionnaire data from the LISS panel, covering the years 2009-2012. A total of 16,779 health insurance consumers were included in the sample. The average response rate was 78%. Logistic regression results show that consumers being chronically ill, 60 and older, and without Internet access, do indeed switch less often. Intriguingly, non-working consumers and those living equal to or below the poverty line, turn out to switch more often than regular consumers. As a result, we conclude that the vulnerable consumer in the Dutch health insurance market is described by the following characteristics: chronically ill, 60 and older, and without Internet access. This specific group tends to get locked-in and suffers disproportion- ately from suboptimal choice behaviour.展开更多
基金funded by the Young Clinical Research Special Fund Project of Peking University First Hospital(No.2024YC05)。
文摘Objectives:This study aimed to assess the impact of exercise rehabilitation during the vulnerable period on cardiac recovery(CR)outcomes in patients with acute decompensated heart failure(ADHF).Methods:Multiple databases including PubMed,Web of Science,Embase,the Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical Database(VIP),Wanfang database,SinoMed,ClinicalTrials.gov,and American Heart Association(AHA)and European Society of Cardiology(ESC)were searched for RCTs on exercise rehabilitation in ADHF patients’vulnerable period from inception to April 2,2025.The risk of bias was assessed with Cochrane Risk of Bias 2.0,and data were analyzed in RevMan 5.3.Results:A total of seven RCTs involving 946 patients were included.The results demonstrated that exercise rehabilitation training during the vulnerable period in patients with ADHF significantly increased the 6-min walk test distance(6-MWTD)(SMD=0.37;95%CI:0.09,0.65;P=0.01),short physical performance battery(SPPB)score(MD=1.26;95%CI:0.82,1.70;P<0.001)and peak oxygen consumption(VO2peak)(SMD=1.43;95%CI:0.53,2.34;P=0.002),improved quality of life(QoL)(SMD=0.85;95%CI:0.07,1.64,P=0.03),reduced depression score(MD=-0.73;95%CI:1.27,-0.18;P=0.009),frailty(MD=-0.22;95%CI:-0.48,0.05;P=0.11),and decreased 6-month all-cause readmission(OR=0.67;95%CI:0.49,0.91;P=0.01).However,no statistically significantdifferences were observed between the two groups in left ventricular ejection fraction(LVEF)(MD=0.96;95%CI:-1.84,3.77;P=0.50),6-month heart failure(HF)-related readmission(OR=1.01;95%CI:0.66,1.53;P=0.98),and all-cause mortality(OR=0.63;95%CI:0.18,2.24;P=0.47).There were no adverse events reported.Conclusions:Exercise rehabilitation during the vulnerable phase improves exercise tolerance,QoL,and depressive symptoms while reducing 6-month all-cause readmissions in ADHF patients,with no reported adverse events.Although trends toward improved LVEF,HF-related readmissions,and all-cause mortality were observed.Large-scale,high-quality studies are warranted to explore individualized responses and long-term outcomes.
基金supported by National Natural Science Foundation of China (No. 82370215).
文摘Allogeneic hematopoietic cell transplantation(allo-HCT) remains a cornerstone therapy for severe hematologic malignancies, offering a potential cure when conventional therapies are ineffective. However, not all patients are suitable recipients of allo-HCT, particularly the elderly patients and those with high comorbidity burdens.Furthermore, patients who develop relapse or graft failure after initial transplantation encounter additional challenges when evaluated for a second transplant.
基金supported by the Fundamental Research Funds for the Central Universities,China.
文摘Aiming at the problem that it is difficult to build model and identify the vulnerable equipment for aviation armament System-of-Systems(SoS)due to complex equipment interaction relationships and high confrontation,the interdependent network theory is introduced to solve it.Firstly,a two-layer heterogeneous interdependent network model for aviation armament SoS is proposed,which reflects the information interaction,functional dependency and inter-network dependence effectively.Secondly,using the attack cost to describe the confrontation process and taking the comprehensive impact on kill chains as the entry point,the node importance index and the attack cost measurement method are constructed.Thirdly,the identification of vulnerable nodes is transformed into the optimization problem of node combinatorial selection,and the vulnerable node identification method based on tabu search is proposed.Based on vulnerable nodes,a robustness enhancement strategy for aviation armament SoS network is presented.Finally,the above methods are used to an aerial confrontation SoS,and the results verify the rationality and effectiveness of the proposed methods.
基金the National Natural Science Foundation of China(31960181,32360213 and 82260364).
文摘Social anxiety (SA) is a prevalent mental health issue among adolescents, and vulnerable narcissism (VN) can exacerbate thiscondition. This study aims to investigate the impact of vulnerable narcissism on social anxiety in adolescents, specificallyfocusing on the mediating effects of self-concept clarity (SCC) and self-esteem (SE) in the relationship between vulnerablenarcissism and social anxiety. Through cluster sampling, a questionnaire survey was conducted among 982 students from threesecondary schools in two provinces. The data was analyzed using structural equation modeling (SEM). The results revealedthat there was a significant negative correlation between vulnerable narcissism and both self-concept clarity and self-esteem,while there was a significant positive correlation between vulnerable narcissism and social anxiety. Additionally, self-conceptclarity showed a significant positive correlation with self-esteem but had a negative correlation with social anxiety. Both selfconceptclarity and self-esteem played an intermediary role in the chain linking vulnerable narcissism to social anxiety. Thisstudy confirms the mediating role of both self-concept clarity and self-esteem in explaining how vulnerable narcissisminfluences social anxiety, providing valuable insights into its underlying mechanism.
文摘Train rails are associated with environmental and safety risks, often concentrating industry near their yards and rails. ArcGIS was applied to map the rail network, land uses, and industrial sites in Point Douglas and St. Boniface in Winnipeg, Canada. We identified 123 land uses with vulnerable populations needing assistance in evacuation from hospitals, senior living facilities, schools and early childhood centres within a buffer of two km of the rails and conducted hotspot analysis. About two-fifths of the total population, 39% in Point Douglas and 40% in St. Boniface, are at risk from fire, spill or train derailment involving dangerous goods and requiring evacuations or isolation.
基金by General Project of Natural Science Foundation of Beijing City(8202017)Beijing Urban Governance Research Base of North China University of Technology(2024CSZL07).
文摘The objective of this study is to investigate the factors that contribute to brittleness and to identify strategies for mitigating these factors in populations with varying degrees of thermal vulnerability,based on the potential impact of extreme heat exposure on human survival and habitability.The physiological condition of lower adaptability to high temperature environments and the assessment of individuals who may have higher tolerance time in high temperature environments based on spatial perspectives suggest the need for targeted spatial optimization strategies for commuters and disadvantaged populations.This is demonstrated through a case study.These optimization measures encompass a variety of aspects,including the integration of transportation systems,the expansion of grey space corridors,the improvement of green space layout,and the implantation of green infrastructure.The study aims to reduce the exposure time of thermally vulnerable individuals to high temperature environments through spatial optimization strategies,to enhance the resilience of urban green spaces to heat stress,and to reduce the probability of heat-wave occurrence.
基金Project(9140C850205120C8501)supported by the Major Program of State Key Laboratory of Remanufacturing,China
文摘Numerical simulation and experimental results were employed for the identification of the most vulnerable zones in three-pass cold-metal-transferring （CMT） welded joint. The residual stress distribution in the joint was predicted by finite element （FE） method, while the structural morphology of distinctive zones was obtained through metallographic experiments. The highest principal stress made the symmetric face of the joint most sensitive to tensile cracks under service conditions. Whereas, the boundaries between the weld seam and the base plates were sensitive to cracks because the equivalent von Mises stress was the highest when the first interpass cooling was finished. The third weld pass and the inter-pass remelted zones exhibited the modest mechanical performances as a result of the coarse grain and coarse grain boundary, respectively. The most vulnerable zones were regarded to be the crossed parts between the zones identified by numerical and experimental methods.
基金National Natural Science Foundation of China (10372082) Aeronautical Science Foundation of China(02B53008) and Doctorate Foun-dation of Northwestern Polytechnical University(CX200301)
文摘A new method is proposed for calculating the aircraft equivalent single vulnerable area using Monte-Carlo simulation technique. The method simulates the kill events of single vulnerable components and multiply vulnerable components or redundant components to ＇Model of Filling Boxes with Balls＇, in which the area of each box is equal to the component＇s vulnerable area. By randomly and uniformly sampling the threat hit locations, the expected number of hits required to kill an aircraft can be given and the aircraft equivalent singly vulnerable area can be attained. Examples demonstrate the correctness and feasibility of the proposed method. Analysis show that the developed method overcomes two shortcomings of currently used methods. （1） It can calculate the equivalent single vulnerable area of aircraft with several sets of multiply vulnerable components, and （2） When the components of each multiple set have different vulnerable areas, the method also applies.
文摘Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine.Necropsy studies have described histopathological changes associated with the development of acute coronary events.In this regard,thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature.Hence,many imaging techniques,such as coronary computed tomography,cardiac magnetic resonance or positron emission tomography,have tried to detect noninvasively these histomorphological characteristics with different approaches.In this article,we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.
基金Under the auspices of the National Natural Science Foundation of China (No. 40301052)the 10th Five-year National Key Technology R&D Program of Ministry of Science and Technology (No. 2001BA606A-01)
文摘The evolvement of a vulnerable ecological region is a dynamic process, which is affected by various factors. During the evolvement process, human activities have a decisive effect. The purpose of studying vulnerable ecological region is to control human economic activities and to develop a negative feedback modulation mechanism.This paper established a model of vulnerable ecological region's evolvement by considering four synthetic variables.These synthetic variables are ecological carrying capacity, ecological resilience, economic development intensity, and economic development velocity. Finally, Ongniud Banner and Aohan Banner in North China were taken as study cases to simulate the evolvement processes of vulnerable ecological regions under different conditions of economic development. The results show that human activities have an important influence on the evolvement trend of vulnerable ecological region.
基金the National Social Science Fund of China(20CGL027)。
文摘The Internet is believed to bring more technological dividends to vulnerable farmers during the green agriculture transformation.However,this is different from the theory of skill-biased technological change,which emphasizes that individuals with higher levels of human capital and more technological endowments benefit more.This study investigates the effects of Internet use on farmers'adoption of integrated pest management(IPM),theoretically and empirically,based on a dataset containing 1015 farmers in China's Shandong Province.By exploring the perspective of rational inattention,the reasons for the heterogeneity of the effects across farmers with different endowments,i.e.,education and land size,are analyzed.The potential endogeneity issues are addressed using the endogenous switching probit model.The results reveal that:(1)although Internet use significantly positively affects farmers'adoption of IPM,vulnerable farmers do not benefit more from it.Considerable selection bias leads to an overestimation of technological dividends for vulnerable farmers;(2)different sources of technology information lead to the difference in the degree of farmers'rational inattention toward Internet information,which plays a crucial role in the heterogeneous effect of Internet use;and(3)excessive dependence on strong-tie social network information sources entraps vulnerable farmers in information cocoons,hindering their ability to reap the benefits of Internet use fully.Therefore,it is essential to promote services geared towards elderly-oriented Internet agricultural technology information and encourage farmers with strong Internet utilization skills to share technology information with other farmers actively.
文摘It can be seen from the calculation that the vulnerable area along China's coast in which the elevation is less than 5 m, is 143 900 km2, accounting for about 11. 3% of the total area of the 11 coastal provinces, municipalities and autonomous regions. These areas are threatened to varying extent by sea level rise. According to prediction, the relative sea level rise (including global sea level rise caused by climate change and local relative as level rise caused by vertical crust movement and ground subsidence) along China's coast will be 4～16 cm by the year 2030 with the optimum estimated value of 6～14cm. It will be 9～26 cm by the year 2050 with the optimum estimated value of 12-23 cm. And it will be 31-74 cm by the year 2100 with the optimum estimated value of 47～65 cm. The calcuation result shows that the percentage of the cost for up-grading (heightening and consolidating) sea dykes/walls in adaptation strategy in the losses of submerged areas varies from area to area: 6. 9% in the Zhujiang (Pearl) River Deta, 1. 3% ～24. 6% in the Changjiang (Yangtze) River Delta, and 0. 9%～2. 0% in the Huanghe River Delta.
文摘The effect of hazard was determined by the dangerous degree of hazard factor—environment and the vulnerable degree of sustaining body. The research into the latter is of importance for the hazard theory and the formation of laws on the mitigation of natural hazards. The way to evaluate the vulnerable degree is the foundation of and the key to the research. In this paper, the extenics model is established to do this job.
文摘Objective To explore the relationship between coronary vulnerable plaque instability and serum C-reactive protein(CRP) , B-type natriuretic peptide(BNP) levels in 85 patients with coronary heart disease. Methods Eighty-five patients( aged 63±16,M= 52 ) were divided into two groups.The control group was 28 patients with stable angina pectoris (SAP). The study group was 57 patients with acute coronary syndrome (ACS) .which were further divided into 21 patients with non ST elevated myocardial infarction (NSTEMI) and 36 patients with unstable angina pectoris (UAP). Plasma BNP and CRP were measured as well as coronary angiography made for all 85 patients. Plaques of coronary culprit arteries were classified as I -III three types according to Ambrose classification. Results (1). BNP and CRP levels of NSTEMI and UAP groups were significant higher than in SAP group. (2).The levels of BNP and CRP correlated with Ambrose classification, especially positively with Ambrose II type ,but no relation with coronary narosis. (3). The levels of BNP was much higher in patients of left anterior descending or multiple coronary artery diseases .(4). The Plaques of coronary culprit arteries in high risk of NSTEMI and UAP patients were mostly Ambrose II or III type. Conclusions The prevalence of higher levels of plasma BNP and CRP in patients with ACS ,when compared with those of SAP, was associated with the instability of coronary vulnerable plaques (ie, Ambrose II type). The level of BNP was much higher in patients of left anterior descending or multiple complicated coronary diseases. So, BNP and CRP are not only markers of vulnerable plaques, but also indicators of ACS prognosis.
基金support from the National Natural Science Foundation of China[grant number 40971062]
文摘Using rural survey data for the year 2009,we provide evidence of work choices of rural laborers in ecologically vulnerable areas in North China,and model these choices as a function of characteristics of individuals,households,and land endowments.The findings reveal large differences between males and females,and between non-farm employment and part-time farming engagement Land scarcity is still an important driving factor in non-farming participation of rural laborers in the study area;and in the current case of land productivity and the total amount of land,there are still surplus rural labor forces in the study area.Diversification of livelihood reduces the pressure on land,thus facilitating ecosystem conservation.So,the paper concludes with the argument that establishing coordination mechanisms among non-farm employment of rural laborers,agricultural production,and restoration of ecosystems are essential for mitigating the conflicts of ecological security,agricultural production,and rural development in mis area.
文摘BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters.METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses(PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubM ed, Scopus, Science Direct, Ovid, ProQ uest, Wiley, Google Scholar were searched.RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for f inal review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-f ive studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic.CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.
基金funded by the National Natural Science Foundation of China,grant numbers 52072214 and 52242213.
文摘With the development of intelligent vehicles and autonomous driving technology,the safety of vulnerable road user(VRU)in traffic has been more guaranteed,and many research achievements have been made in the key area of collision avoidance decision-making methods.In this paper,the knowledge mapping method is used to mine the available literature in depth,and it is found that the research focus has shifted from the traditional accident cause analysis to emerging deep learning and virtual reality technology.This paper summarizes research on the three core dimensions of environmental perception,behavior cognition and collision avoidance decision-making in intelligent vehicle systems.In terms of perception,accurate identification of pedestrians and cyclists in complex environments is a major demand for VRU perception;in terms of behavior cognition,the coupling of VRU intention identification and motion trajectory prediction and other multiple factors needs further research;in terms of decision-making,the intention identification and trajectory prediction of collision objects are not included in the risk assessment model,and there is a lack of exploration specifically for cyclists'collision risk.On this basis,this paper provides guidance for the improvement of traffic safety of contemporary VRU under the conditions of intelligent and connected transportation.
文摘The interests of vulnerable groups can’t be guaranteed due to their weaker capacity and the limited interests demand channels during the water pollution conflicts. The interest protection for the vulnerable people in the water pollution conflicts has attracted attentions of the international scholars. The paper tries to construct the market mechanism which can make the vulnerable people to involve in the emission trading. The vulnerable people can buy American put option in the emission trading market. When the price of the emission runs below the contract price, the vulnerable people can get the benefit through executing the option. When the price of the emission runs above the contract price, the vulnerable people can give up the right. The binomial tree option pricing model can help the vulnerable people to make a decision through the analysis of the worth of the American put option.
基金Supported by Commissioned Project of Office of Rural Work Leading Group of Kunming Municipal Committee of the Communist Party of China"Study on the Poverty Alleviation Model of Kunming City in the Context of World Poverty Reduction"
文摘Ecology-oriented poverty alleviation is not only a livelihood project that affects the vast majority of rural people but also a major project to win the fight against poverty. It is also an indispensable income component for the relocation of poor farmers. Dongchuan District,located at the intersection of Jinsha River and Xiaojiang River,is one of the key counties for poverty alleviation and development in China with a wide range of poverty and extreme poverty. The incidence of poverty reached 24. 36%. The ecology is fragile,and earthquake outbreaks frequently. Dongchuan District is a national key monitoring and defense area for earthquakes. A large number of goafs,subsidence areas and geological hazard areas have been formed in the mining area. The number of dangerous houses is large,and ' it has no way of supporting its own inhabitants' is the key point,difficulty and focus of the county’s poverty alleviation. Relocation is a must-have measure to move away from poverty. It is also complex system engineering,which is policy-oriented and difficult. Since 2017,Dongchuan District has regarded relocation has the top priority for poverty alleviation. It has strictly implemented national,provincial and municipal policies,focused on the overall goal of ' moving,securing and getting rich',and strongly promoted the relocation work for poverty alleviation. Obvious social,economic and ecological benefits have been achieved. Successful relocation,combined with ecology-oriented poverty alleviation and other targeted poverty alleviation measures,Dongchuan District’s fight against poverty has achieved a decisive victory. At the end of December 2018,the incidence of poverty in the region fell to 1. 09%,and 129 poor villages( including 86 extremely poor villages) had been successfully lifted out of poverty. This paper analyzes and condenses the specific practices,main achievements,benefits,successful experiences and implications of the region’s relocation combined with ecology-oriented poverty alleviation model,so as to provide necessary reference for the innovation of relocation in poverty-stricken counties of Yunnan Province and similar provinces( cities,districts).
文摘Public service deregulation is favoured for motivating providers to offer consumers better price-quality services. Consequently, consumers are enabled to make informed choices and choose for the best service provider. However, recent publications reveal that consumers are not capable of exercising optimal choice behaviour. Despite these concerns, evidence is lacking on the extent to which potentially vulnerable consumers make use of the core element of deregulation—switching health plans. This article is meant to study whether potentially vulnerable consumers do indeed switch less health plans in the deregulated Dutch health insurance market than regular consumers. In order to answer this question, we extract questionnaire data from the LISS panel, covering the years 2009-2012. A total of 16,779 health insurance consumers were included in the sample. The average response rate was 78%. Logistic regression results show that consumers being chronically ill, 60 and older, and without Internet access, do indeed switch less often. Intriguingly, non-working consumers and those living equal to or below the poverty line, turn out to switch more often than regular consumers. As a result, we conclude that the vulnerable consumer in the Dutch health insurance market is described by the following characteristics: chronically ill, 60 and older, and without Internet access. This specific group tends to get locked-in and suffers disproportion- ately from suboptimal choice behaviour.
