BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case ...BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.展开更多
Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential S...Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.展开更多
BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriat...BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.展开更多
This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Fun...This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Functional Foods,it introduced the features of the BOPPPS teaching model and its implementation in course design.By incorporating research cases and presenting teaching examples,the steps and methods of BOPPPS-based teaching reform were explored while incorporating ideological and political elements into specialized instruction.This study provides insights and references for reforming other food-related courses and contributes to cultivating more food professionals with practical awareness and critical thinking.展开更多
BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of...BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of treating metastatic GINECs. There is a lack of effective treatment methods after chemotherapy failure.Therefore, Therefore, selecting appropriate posterior-line treatment programs toimprove the prognosis of patients is urgently needed.CASE SUMMARYA 64-year-old female was diagnosed with stage IV NEC of the rectum due toabdominal pain and rectal bleeding. After multiline chemotherapy, the conditionprogressed, and the patient was treated with a combination of camrelizumab and surufatinib. The efficacy evaluation revealed partial remission (PR) and stable conditions, with the expression ofthe tumor marker neuron-specific enolase (NSE) returning to normal. The adverse reactions were controllable, andthe overall condition was good, with weight gain achieved in the past four years. Another 51-year-old femaleexperienced recurrence and metastasis of a duodenal NEC after surgery. After multiline chemotherapy, shereceived sintilimab combined with surufatinib. The curative effect fluctuated between PR and stability. Duringtreatment, she recovered from immune-related diabetes and later died due to deterioration of her condition.During the treatment, the patient’s NSE level returned to normal.CONCLUSIONThe combination of antiangiogenic targeted drugs and immunotherapy provides a new therapeutic approach forthe treatment of metastatic GI-NECs.展开更多
Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).W...Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.展开更多
BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry com...BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.展开更多
This paper is to address structural optimization problems where multiple structure cases or multiple payload cases can be considered simultaneously.Both types of optimization problems involve multiple finite element m...This paper is to address structural optimization problems where multiple structure cases or multiple payload cases can be considered simultaneously.Both types of optimization problems involve multiple finite element models at each iteration step,which draws high demands in opti-mization methods.Considering the common characteristic for these two types of problems,which is that the design domain keeps the same no matter what the structure cases or payload cases are,both problems can be formulated into the unified expressions.A two-level multipoint approxima-tion(TMA)method is firstly improved with the use of analytical sensitivity analysis for structural mass,and then this improved method is utilized to tackle these two types of problems.Based on the commercial finite element software MSC.Patran/Nastran,an optimization system for multiple structure cases and multiple payload cases is developed.Numerical examples are conducted to verify its feasibility and efficiency,and the necessity for the simultaneous optimizations of multiple structure cases and multiple payload cases are illustrated as well.展开更多
Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,...Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,2]. The disease, 2019-novel coronavirus(2019-nCoV) infection, already existed outside China and the importation of disease is the cause of emerging 2019-nCoV infections in new settings.展开更多
Viral hepatitis is an important challenge to public health worldwide.As hepatitis B is well controlled due to vaccination,the disease burden caused by the spread of hepatitis C has become increasingly prominent.Hepati...Viral hepatitis is an important challenge to public health worldwide.As hepatitis B is well controlled due to vaccination,the disease burden caused by the spread of hepatitis C has become increasingly prominent.Hepatitis C is an infectious disease that is mainly blood-borne.The rate of chronicity ranges from 55% to 85% after people are infected with the hepatitis C virus （HCV）.展开更多
In this paper, a mathematical model for topology optimization oftruss structures with constraints of displacement and systemreliability under multiple loading cases is constructed. In order toavoid the difficulty of c...In this paper, a mathematical model for topology optimization oftruss structures with constraints of displacement and systemreliability under multiple loading cases is constructed. In order toavoid the difficulty of computing the structure's system reliability,a solving approach is presented in which the failure probability ofsystem is divided into the sum of a all bars' failures probability bymeans of reliability distribution. In addition, by drawing into thereliability safety factor and the fundamen- tal relationship instructural mechanics, all probability constraints of displacement andstress are equiv- alently displayed as conventional form and linearfunction of the design variables.展开更多
Objective We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases.Meth...Objective We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases.Methods We performed a descriptive study of notifiable infectious diseases among foreigners reported from 2004 to 2017 in China using data from the Chinese National Notifiable Infectious Disease Reporting System(NNIDRIS). Demographic, temporal-spatial distribution were described and analyzed.Results A total of 67,939 cases of 33 different infectious diseases were reported among foreigners.These diseases were seen in 31 provinces of China and originated from 146 countries of the world. The infectious diseases with the highest incidence number were human immunodeficiency virus(HIV) of18,713 cases, hepatitis B(6,461 cases), hand, foot, and mouth disease(6,327 cases). Yunnan province had the highest number of notifiable infectious diseases in foreigners. There were different trends of the major infectious diseases among foreign cases seen in China and varied among provinces.Conclusions This is the first description of the epidemiological characteristic of notifiable infectious diseases among foreigners in China from 2004 to 2017. These data can be used to better inform policymakers about national health priorities for future research and control strategies.展开更多
With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19,the sensitivity of RT-qPCR detection ...With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19,the sensitivity of RT-qPCR detection of SARS-CoV-2 RNA in wastewater that correspond to the communities was computed by using Probit analysis.This study determined the number of new COVID-19 cases per 100,000 population required to detect SARS-CoV-2RNA in wastewater at defined probabilities and provided an evidence-based framework of wastewater-based epidemiology surveillance (WBE).Input data were positive and negative test results of SARS-CoV-2 RNA in wastewater samples and the corresponding new COVID-19 case rates per 100,000 population served by each WWTP.The analyses determined that RT-qPCR-based SARS-CoV-2 RNA detection threshold at 50%,80%and 99%probability required a median of 8 (range:4-19),18 (9-43),and 38 (17-97) of new COVID-19 cases/100,000,respectively.Namely,the positive detection rate at 50%,80%and 99%probability were 0.01%,0.02%,and 0.04%averagely for new cases in the population.This study improves understanding of the performance of WBE SARS-CoV-2 RNA detection using the large datasets and prolonged study period.Estimated COVID-19 burden at a community level that would result in a positive detection of SARS-CoV-2 in wastewater is critical to support WBE application as a supplementary warning/monitoring system for COVID-19 prevention and control.展开更多
Dear Editor,Priapism is an uncommon pathological erection that mainly occurs in adult males between the ages of 20 years and 50 years.1 It is defined as an involuntary erection that persists more than 4 h without any ...Dear Editor,Priapism is an uncommon pathological erection that mainly occurs in adult males between the ages of 20 years and 50 years.1 It is defined as an involuntary erection that persists more than 4 h without any sexual stimulation.2 This article reports two patients with high-flow priapism,which is relatively rare.We propose some new ultrasound features to diagnose this disease.After embolization,we assessed the embolization location and monitored whether there was recanalization in the embolization treatment site following therapy through ultrasonography.These have not been mentioned in the previous literature.展开更多
A new method for topology optimization of truss-like structures with stress constraints under multiple-load cases(MLCs)is presented.A spatial truss-like material model with three families of orthotropic members is ado...A new method for topology optimization of truss-like structures with stress constraints under multiple-load cases(MLCs)is presented.A spatial truss-like material model with three families of orthotropic members is adopted,in which the three families of members along three orthotropic directions are embedded continuously in a weak matrix.The densities and directions of the three families of members at the nodes are taken as the design variables.An optimality criterion is suggested based on the concept of directional stiffness.First,under each single-load case(SLC),the truss-like structure is optimized as per the fully stressed criterion.Accordingly,the directional stiffness of the optimal structure under an SLC at every node is obtained.Next,the directional stiffness of the truss-like structure under MLCs is determined by ensuring that the directional stiffness is as similar as possible to the maximum directional stiffness of the optimal structure under every SLC along all directions.Finally,the directions and densities of the members in the optimal truss-like structures under MLCs are obtained by solving the eigenvalue problems of the coefficient matrix of the directional stiffness at every node.Two examples are presented to demonstrate the effectiveness and efficiency of the method.展开更多
The World Health Organization(WHO)launched the‘End TB Strategy’,which aims to reduce the mortality and incidence rate of tuberculosis(TB)by 95% and 90% by 2035,respectively,compared with the levels in 2015.To achiev...The World Health Organization(WHO)launched the‘End TB Strategy’,which aims to reduce the mortality and incidence rate of tuberculosis(TB)by 95% and 90% by 2035,respectively,compared with the levels in 2015.To achieve these targets and milestones,the strategy set three pillars and 10 indicators,one of which is systematic screening of contacts and high-risk groups[1].展开更多
BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple comp...BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.展开更多
Test complexity and test adequacy are frequently raised by software developers and testing agents.However,there is little research works at this aspect on specification-based testing at the use case description level....Test complexity and test adequacy are frequently raised by software developers and testing agents.However,there is little research works at this aspect on specification-based testing at the use case description level.Thus,this research proposes an automatic test cases generator approach to reduce the test complexity and to enhance the percentage of test coverage.First,to support the infrastructure for performing automatic,this proposed approach refines the use cases using use case describing template and save it in the text file.Then,the saved file is input to the Algorithm of Control Flow Diagram(ACFD)to convert use case details to a control flow diagram.After that,the Proposed Tool of Generating Test Paths(PTGTP)is used to generate test cases from the control flow diagram.Finally,the genetic algorithm associated with transition coverage is adapted to optimize and evaluate the adequacy of such test cases.A money withdrawal use case in the ATM system is used as an ongoing case study.Preliminary results show that the generated test cases achieve high coverage with an optimal test case.This automatic test case generation approach is effective and efficient.Therefore,it could promote to use other test case coverage criteria.展开更多
文摘BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.
文摘Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.
文摘BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.
文摘This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Functional Foods,it introduced the features of the BOPPPS teaching model and its implementation in course design.By incorporating research cases and presenting teaching examples,the steps and methods of BOPPPS-based teaching reform were explored while incorporating ideological and political elements into specialized instruction.This study provides insights and references for reforming other food-related courses and contributes to cultivating more food professionals with practical awareness and critical thinking.
文摘BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of treating metastatic GINECs. There is a lack of effective treatment methods after chemotherapy failure.Therefore, Therefore, selecting appropriate posterior-line treatment programs toimprove the prognosis of patients is urgently needed.CASE SUMMARYA 64-year-old female was diagnosed with stage IV NEC of the rectum due toabdominal pain and rectal bleeding. After multiline chemotherapy, the conditionprogressed, and the patient was treated with a combination of camrelizumab and surufatinib. The efficacy evaluation revealed partial remission (PR) and stable conditions, with the expression ofthe tumor marker neuron-specific enolase (NSE) returning to normal. The adverse reactions were controllable, andthe overall condition was good, with weight gain achieved in the past four years. Another 51-year-old femaleexperienced recurrence and metastasis of a duodenal NEC after surgery. After multiline chemotherapy, shereceived sintilimab combined with surufatinib. The curative effect fluctuated between PR and stability. Duringtreatment, she recovered from immune-related diabetes and later died due to deterioration of her condition.During the treatment, the patient’s NSE level returned to normal.CONCLUSIONThe combination of antiangiogenic targeted drugs and immunotherapy provides a new therapeutic approach forthe treatment of metastatic GI-NECs.
基金Supported by Shaanxi Provincial Science and Technology Development Plan Project(No.2024SFYBXM-327).
文摘Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.
文摘BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.
基金supported by the Innovation Foundation of Beihang University for Ph.D.Graduates
文摘This paper is to address structural optimization problems where multiple structure cases or multiple payload cases can be considered simultaneously.Both types of optimization problems involve multiple finite element models at each iteration step,which draws high demands in opti-mization methods.Considering the common characteristic for these two types of problems,which is that the design domain keeps the same no matter what the structure cases or payload cases are,both problems can be formulated into the unified expressions.A two-level multipoint approxima-tion(TMA)method is firstly improved with the use of analytical sensitivity analysis for structural mass,and then this improved method is utilized to tackle these two types of problems.Based on the commercial finite element software MSC.Patran/Nastran,an optimization system for multiple structure cases and multiple payload cases is developed.Numerical examples are conducted to verify its feasibility and efficiency,and the necessity for the simultaneous optimizations of multiple structure cases and multiple payload cases are illustrated as well.
文摘Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,2]. The disease, 2019-novel coronavirus(2019-nCoV) infection, already existed outside China and the importation of disease is the cause of emerging 2019-nCoV infections in new settings.
文摘Viral hepatitis is an important challenge to public health worldwide.As hepatitis B is well controlled due to vaccination,the disease burden caused by the spread of hepatitis C has become increasingly prominent.Hepatitis C is an infectious disease that is mainly blood-borne.The rate of chronicity ranges from 55% to 85% after people are infected with the hepatitis C virus （HCV）.
基金the National Natural Science Foundation of China
文摘In this paper, a mathematical model for topology optimization oftruss structures with constraints of displacement and systemreliability under multiple loading cases is constructed. In order toavoid the difficulty of computing the structure's system reliability,a solving approach is presented in which the failure probability ofsystem is divided into the sum of a all bars' failures probability bymeans of reliability distribution. In addition, by drawing into thereliability safety factor and the fundamen- tal relationship instructural mechanics, all probability constraints of displacement andstress are equiv- alently displayed as conventional form and linearfunction of the design variables.
基金sponsored by National Science and Technology Major Project No. 2016ZX10004222-001。
文摘Objective We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases.Methods We performed a descriptive study of notifiable infectious diseases among foreigners reported from 2004 to 2017 in China using data from the Chinese National Notifiable Infectious Disease Reporting System(NNIDRIS). Demographic, temporal-spatial distribution were described and analyzed.Results A total of 67,939 cases of 33 different infectious diseases were reported among foreigners.These diseases were seen in 31 provinces of China and originated from 146 countries of the world. The infectious diseases with the highest incidence number were human immunodeficiency virus(HIV) of18,713 cases, hepatitis B(6,461 cases), hand, foot, and mouth disease(6,327 cases). Yunnan province had the highest number of notifiable infectious diseases in foreigners. There were different trends of the major infectious diseases among foreign cases seen in China and varied among provinces.Conclusions This is the first description of the epidemiological characteristic of notifiable infectious diseases among foreigners in China from 2004 to 2017. These data can be used to better inform policymakers about national health priorities for future research and control strategies.
基金supported by research grants from the Canadian Institutes of Health Research [grant number VR5-172701, 2020]Alberta Innovates and Alberta Health [grant number RES0051047, 2020]。
文摘With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19,the sensitivity of RT-qPCR detection of SARS-CoV-2 RNA in wastewater that correspond to the communities was computed by using Probit analysis.This study determined the number of new COVID-19 cases per 100,000 population required to detect SARS-CoV-2RNA in wastewater at defined probabilities and provided an evidence-based framework of wastewater-based epidemiology surveillance (WBE).Input data were positive and negative test results of SARS-CoV-2 RNA in wastewater samples and the corresponding new COVID-19 case rates per 100,000 population served by each WWTP.The analyses determined that RT-qPCR-based SARS-CoV-2 RNA detection threshold at 50%,80%and 99%probability required a median of 8 (range:4-19),18 (9-43),and 38 (17-97) of new COVID-19 cases/100,000,respectively.Namely,the positive detection rate at 50%,80%and 99%probability were 0.01%,0.02%,and 0.04%averagely for new cases in the population.This study improves understanding of the performance of WBE SARS-CoV-2 RNA detection using the large datasets and prolonged study period.Estimated COVID-19 burden at a community level that would result in a positive detection of SARS-CoV-2 in wastewater is critical to support WBE application as a supplementary warning/monitoring system for COVID-19 prevention and control.
文摘Dear Editor,Priapism is an uncommon pathological erection that mainly occurs in adult males between the ages of 20 years and 50 years.1 It is defined as an involuntary erection that persists more than 4 h without any sexual stimulation.2 This article reports two patients with high-flow priapism,which is relatively rare.We propose some new ultrasound features to diagnose this disease.After embolization,we assessed the embolization location and monitored whether there was recanalization in the embolization treatment site following therapy through ultrasonography.These have not been mentioned in the previous literature.
基金The research reported in this paper was financially supported by the Natural Science Foundation of China(No.11572131)the Subsidized Project for Postgraduates’Innovative Fund in Scientific Research of Huaqiao University(No.17011086002).
文摘A new method for topology optimization of truss-like structures with stress constraints under multiple-load cases(MLCs)is presented.A spatial truss-like material model with three families of orthotropic members is adopted,in which the three families of members along three orthotropic directions are embedded continuously in a weak matrix.The densities and directions of the three families of members at the nodes are taken as the design variables.An optimality criterion is suggested based on the concept of directional stiffness.First,under each single-load case(SLC),the truss-like structure is optimized as per the fully stressed criterion.Accordingly,the directional stiffness of the optimal structure under an SLC at every node is obtained.Next,the directional stiffness of the truss-like structure under MLCs is determined by ensuring that the directional stiffness is as similar as possible to the maximum directional stiffness of the optimal structure under every SLC along all directions.Finally,the directions and densities of the members in the optimal truss-like structures under MLCs are obtained by solving the eigenvalue problems of the coefficient matrix of the directional stiffness at every node.Two examples are presented to demonstrate the effectiveness and efficiency of the method.
基金sponsored by Beijing Natural Science Foundation[7174323]the Young Scholar Scientific Research Foundation of China CDC[2018A104]。
文摘The World Health Organization(WHO)launched the‘End TB Strategy’,which aims to reduce the mortality and incidence rate of tuberculosis(TB)by 95% and 90% by 2035,respectively,compared with the levels in 2015.To achieve these targets and milestones,the strategy set three pillars and 10 indicators,one of which is systematic screening of contacts and high-risk groups[1].
基金Supported by Medical Science and Technology Research Foundation of Guangdong Province,No.A2018461.
文摘BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.
文摘Test complexity and test adequacy are frequently raised by software developers and testing agents.However,there is little research works at this aspect on specification-based testing at the use case description level.Thus,this research proposes an automatic test cases generator approach to reduce the test complexity and to enhance the percentage of test coverage.First,to support the infrastructure for performing automatic,this proposed approach refines the use cases using use case describing template and save it in the text file.Then,the saved file is input to the Algorithm of Control Flow Diagram(ACFD)to convert use case details to a control flow diagram.After that,the Proposed Tool of Generating Test Paths(PTGTP)is used to generate test cases from the control flow diagram.Finally,the genetic algorithm associated with transition coverage is adapted to optimize and evaluate the adequacy of such test cases.A money withdrawal use case in the ATM system is used as an ongoing case study.Preliminary results show that the generated test cases achieve high coverage with an optimal test case.This automatic test case generation approach is effective and efficient.Therefore,it could promote to use other test case coverage criteria.
