We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed w...BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%–10%. The Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA) scoring system was established in 2008 specif ically for Asian populations. The aim of this study was to compare the modif ied Alvarado with the RIPASA scoring system in Kuwait population.METHODS: This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook(unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic(ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software.RESULTS: A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modif ied Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specif icity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specif icity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modif ied Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a signif icant difference(P<0.001) for both scoring systems.CONCLUSION: Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specif icity than the modif ied Alvarado scoring system in Asian populations. It consists of 14 clinical parameters that can be obtained from a good patient history, clinical examination and laboratory investigations. The RIPASA scoring system is more accurate and specific than the modif ied Alvarado scoring system for Kuwait population.展开更多
Objective:To identify the residue determinants of the serospecificity and sero-cross-reactivity of dengue virus(DENV)envelope protein domain 3(ED3),which contains two major putative epitopes of DENV.Methods:We constru...Objective:To identify the residue determinants of the serospecificity and sero-cross-reactivity of dengue virus(DENV)envelope protein domain 3(ED3),which contains two major putative epitopes of DENV.Methods:We constructed ED3 from DENV3(3ED3)and DENV4(4ED3),and six epitope-grafted variants,where we transferred epitope 1(L304I,K305D,V309M,and S310A)and/or epitope 2(D383N,K384S,K387T,and N389H)of 4ED3 onto 3ED3 and vice-versa.Swiss albino mice aged 3-4 weeks were immunized against wildtype and epitope-grafted ED3 variants and anti-ED3 IgG antibody responses were determined using ELISA.Results:Mouse immunization using 3ED3 and 4ED3 generated serotype-specific antisera,as expected.Similarly,most epitope-grafted ED3s produced antisera serospecific to the template ED3 with little or no cross-recognition of ED3 of the serotype from which the epitopes were taken.These indicated that a mere grafting of the epitope was not sufficient to transfer serospecificity,contrary to our expectations.However,one epitope-grafted ED3 mutant,where epitope 1 of 3ED3 was grafted onto 4ED3(4ED3^(epi1)),generated antisera that was serospecific to both 4ED3 and 3ED3.Conclusions:The 4ED3^(epi1)is a chimeric ED3 that produces antisera possessing serospecificity to both 3ED3 and 4ED3 onto a common 4ED3 scaffold.The 4ED3^(epi1),therefore,provides a unique tool for analyzing serospecificity and sero-cross-reactivity in dengue.We believe that chimeric ED3 may provide a template for future recombinant ED3 possessing serospecificity of multiple DENVs onto a single scaffold and may pave a way developing tri-and/or tetravalent anti-DENV antisera.展开更多
Seismic force reduction factor(SFRF) spectra of shear-type multi-degree-of-freedom(MDOF) structures are investigated. The modified Clough model, capable of considering the strength-degradation/hardening and stiffnessd...Seismic force reduction factor(SFRF) spectra of shear-type multi-degree-of-freedom(MDOF) structures are investigated. The modified Clough model, capable of considering the strength-degradation/hardening and stiffnessdegradation, is adopted. The SFRF mean spectra using 102 earthquake records on a typical site soil type(type C) are constructed with the period abscissa being divided into three period ranges to maintain the peak features at the two sitespecific characteristic periods. Based on a large number of results, it is found that the peak value of SFRF spectra may also exist for MDOF, induced by large high-mode contributions to elastic base shear, besides the mentioned two peak values. The variations of the stiffness ratio λk and the strength ratio λF of the top to bottom story are both considered. It is found that the SFRFs for λF ≤λk are smaller than those for λF > λk. A SFRF modification factor for MDOF systems is proposed with respect to SDOF. It is found that this factor is significantly affected by the story number and ductility. With a specific λF(= λk0.75), SFRF mean spectra are constructed and simple solutions are presented for MDOF systems. For frames satisfying the strong column/weak beam requirement, an approximate treatment in the MDOF shear-beam model is to assign a post-limit stiffness 15%-35% of the initial stiffness to the hysteretic curve. SFRF spectra for MDOF systems with 0.2 and 0.3 times the post-limit stiffness are remarkably larger than those without post-limit stiffness. Thus, the findings that frames with beam hinges have smaller ductility demand are explained through the large post-limit stiffness.展开更多
Current industrial methods for dissolution of cellulose in making regenerated cellulose products are relatively expensive,toxic and dangerous and have environmental problems coming with the hazard chemical wastes.To s...Current industrial methods for dissolution of cellulose in making regenerated cellulose products are relatively expensive,toxic and dangerous and have environmental problems coming with the hazard chemical wastes.To solve these problems,a novel ethylenediamine and potassium thiocyanate(ED/KSCN)solvent system was developed,that is economical,ecofriendly,and highly efficient.The ED/KSCN solvent system was proven to be a suitable solvent for fabricating cellulose(blended with other polymers)membranes.In this study,gluten was used to develop nonporous membranes with cellulose.The method of casting these membranes provided better ones than the former researchers’techniques.These composite membranes’physical and mechanical properties were studied by analysis of morphology,viscosity,crystallinity,thermal behaviors,tensile properties and water absorption of membranes.Results showed that membranes are nonporous,uniform,strong,flexible,ecofriendly and renewable.Mechanical and physical properties were influenced by the ratio of cellulose/gluten.By blending 40% gluten,the tensile strength of cellulose membrane dropped to 15.89 MPa from 35.11 MPa.However,its elongation at break increased from 35.3% to 57.02% accordingly.展开更多
The integration of the Internet of Things(IoT)and cloud computing is the most popular growing technology in the IT world.IoT integrated cloud com-puting technology can be used in smart cities,health care,smart homes,e...The integration of the Internet of Things(IoT)and cloud computing is the most popular growing technology in the IT world.IoT integrated cloud com-puting technology can be used in smart cities,health care,smart homes,environ-mental monitoring,etc.In recent days,IoT integrated cloud can be used in the health care system for remote patient care,emergency care,disease prediction,pharmacy management,etc.but,still,security of patient data and disease predic-tion accuracy is a major concern.Numerous machine learning approaches were used for effective early disease prediction.However,machine learning takes more time and less performance while classification.In this research work,the Attribute based Searchable Honey Encryption with Functional Neural Network(ABSHE-FNN)framework is proposed to analyze the disease and provide stronger security in IoT-cloud healthcare data.In this work,the Cardiovascular Disease and Pima Indians diabetes dataset are used for heart and diabetic disease classification.Initi-ally,means-mode normalization removes the noise and normalizes the IoT data,which helps to enhance the quality of data.Rectified Linear Unit(RLU)was applied to adjust the feature weight to reduce the training cost and error classifi-cation.This proposed ABSHE-FNN technique provides better security and achieves 92.79%disease classification accuracy compared to existing techniques.展开更多
The economic dispatch problem(EDP) of microgrids operating in both grid-connected and isolated modes within an energy internet framework is addressed in this paper. The multi-agent leader-following consensus algorithm...The economic dispatch problem(EDP) of microgrids operating in both grid-connected and isolated modes within an energy internet framework is addressed in this paper. The multi-agent leader-following consensus algorithm is employed to address the EDP of microgrids in grid-connected mode, while the push-pull algorithm with a fixed step size is introduced for the isolated mode. The proposed algorithm of isolated mode is proven to converge to the optimum when the interaction digraph of microgrids is strongly connected. A unified algorithmic framework is proposed to handle the two modes of operation of microgrids simultaneously, enabling our algorithm to achieve optimal power allocation and maintain the balance between power supply and demand in any mode and any mode switching. Due to the push-pull structure of the algorithm and the use of fixed step size,the proposed algorithm can better handle the case of unbalanced graphs, and the convergence speed is improved. It is documented that when the transmission topology is strongly connected and there is bi-directional communication between the energy router and its neighbors, the proposed algorithm in composite mode achieves economic dispatch even with arbitrary mode switching.Finally, we demonstrate the effectiveness and superiority of our algorithm through numerical simulations.展开更多
Sepsis management has significantly improved over the past decades,with intensivists playing a pivotal role in its identification and treatment.[1,2]However,resource constraints in large tertiary hospitals in China li...Sepsis management has significantly improved over the past decades,with intensivists playing a pivotal role in its identification and treatment.[1,2]However,resource constraints in large tertiary hospitals in China limit patient admissions,leading to overcrowding in the emergency departments(EDs)with critically ill patients.[3]This highlights the urgent need for enhanced risk stratification and optimized sepsis management in emergency settings.展开更多
By doping with Mg atoms,the bandgap of Mg-doped NiO thin films can be adjusted larger.By using NiO and MgO as sputtering targets,Mg-doped NiO thin films were deposited using radio-frequency magnetron co-sputtering met...By doping with Mg atoms,the bandgap of Mg-doped NiO thin films can be adjusted larger.By using NiO and MgO as sputtering targets,Mg-doped NiO thin films were deposited using radio-frequency magnetron co-sputtering method in pure argon and pure oxygen gas,respectively.The crystal structure,morphological characteristics,composition and optical properties of the obtained films were compared by X-ray diffraction(XRD),scanning electron microscope(SEM),energy dispersive spectrometer(EDS)and ultraviolet(UV)-visible spectrophotometer.The properties of the thin films deposited in different sputtering gases are quite different.For the films deposited in pure argon gas,it is a polycrystalline thin film with(200)preferred orientation,while the film deposited in pure oxygen has no preferred orientation.The grain size,molar ratio of Mg to Ni atoms and optical bandgap are larger for the films deposited in pure argon gas than those deposited in oxygen gas.展开更多
By using a certain hybrid-type convolution operator,we first introduce a new subclass of normalized analytic functions in the open unit disk.For members of this analytic function class,we then derive several propertie...By using a certain hybrid-type convolution operator,we first introduce a new subclass of normalized analytic functions in the open unit disk.For members of this analytic function class,we then derive several properties and characteristics including(for example)the modified Hadamard products,Holder's inequalities and convolution properties as well as some closure properties under a general family of integral transforms.展开更多
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
文摘BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%–10%. The Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA) scoring system was established in 2008 specif ically for Asian populations. The aim of this study was to compare the modif ied Alvarado with the RIPASA scoring system in Kuwait population.METHODS: This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook(unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic(ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software.RESULTS: A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modif ied Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specif icity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specif icity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modif ied Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a signif icant difference(P<0.001) for both scoring systems.CONCLUSION: Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specif icity than the modif ied Alvarado scoring system in Asian populations. It consists of 14 clinical parameters that can be obtained from a good patient history, clinical examination and laboratory investigations. The RIPASA scoring system is more accurate and specific than the modif ied Alvarado scoring system for Kuwait population.
基金This research was supported by a GARE project grant(MOE,Bangladesh,grant no.LS201615)a Chittagong University Revenue Budget Grant(6160/2018)to MMI.
文摘Objective:To identify the residue determinants of the serospecificity and sero-cross-reactivity of dengue virus(DENV)envelope protein domain 3(ED3),which contains two major putative epitopes of DENV.Methods:We constructed ED3 from DENV3(3ED3)and DENV4(4ED3),and six epitope-grafted variants,where we transferred epitope 1(L304I,K305D,V309M,and S310A)and/or epitope 2(D383N,K384S,K387T,and N389H)of 4ED3 onto 3ED3 and vice-versa.Swiss albino mice aged 3-4 weeks were immunized against wildtype and epitope-grafted ED3 variants and anti-ED3 IgG antibody responses were determined using ELISA.Results:Mouse immunization using 3ED3 and 4ED3 generated serotype-specific antisera,as expected.Similarly,most epitope-grafted ED3s produced antisera serospecific to the template ED3 with little or no cross-recognition of ED3 of the serotype from which the epitopes were taken.These indicated that a mere grafting of the epitope was not sufficient to transfer serospecificity,contrary to our expectations.However,one epitope-grafted ED3 mutant,where epitope 1 of 3ED3 was grafted onto 4ED3(4ED3^(epi1)),generated antisera that was serospecific to both 4ED3 and 3ED3.Conclusions:The 4ED3^(epi1)is a chimeric ED3 that produces antisera possessing serospecificity to both 3ED3 and 4ED3 onto a common 4ED3 scaffold.The 4ED3^(epi1),therefore,provides a unique tool for analyzing serospecificity and sero-cross-reactivity in dengue.We believe that chimeric ED3 may provide a template for future recombinant ED3 possessing serospecificity of multiple DENVs onto a single scaffold and may pave a way developing tri-and/or tetravalent anti-DENV antisera.
基金Supported by:National Key Research and Development Program of China under Grant No.2016YFC0701201
文摘Seismic force reduction factor(SFRF) spectra of shear-type multi-degree-of-freedom(MDOF) structures are investigated. The modified Clough model, capable of considering the strength-degradation/hardening and stiffnessdegradation, is adopted. The SFRF mean spectra using 102 earthquake records on a typical site soil type(type C) are constructed with the period abscissa being divided into three period ranges to maintain the peak features at the two sitespecific characteristic periods. Based on a large number of results, it is found that the peak value of SFRF spectra may also exist for MDOF, induced by large high-mode contributions to elastic base shear, besides the mentioned two peak values. The variations of the stiffness ratio λk and the strength ratio λF of the top to bottom story are both considered. It is found that the SFRFs for λF ≤λk are smaller than those for λF > λk. A SFRF modification factor for MDOF systems is proposed with respect to SDOF. It is found that this factor is significantly affected by the story number and ductility. With a specific λF(= λk0.75), SFRF mean spectra are constructed and simple solutions are presented for MDOF systems. For frames satisfying the strong column/weak beam requirement, an approximate treatment in the MDOF shear-beam model is to assign a post-limit stiffness 15%-35% of the initial stiffness to the hysteretic curve. SFRF spectra for MDOF systems with 0.2 and 0.3 times the post-limit stiffness are remarkably larger than those without post-limit stiffness. Thus, the findings that frames with beam hinges have smaller ductility demand are explained through the large post-limit stiffness.
基金Supported by National Natural Science Foundation of China 60404022,60704009)National Outstanding Youth Foundation 60525303)Natural Science Foundation of Hebei Province(F2005000390,F2006000270)
文摘Current industrial methods for dissolution of cellulose in making regenerated cellulose products are relatively expensive,toxic and dangerous and have environmental problems coming with the hazard chemical wastes.To solve these problems,a novel ethylenediamine and potassium thiocyanate(ED/KSCN)solvent system was developed,that is economical,ecofriendly,and highly efficient.The ED/KSCN solvent system was proven to be a suitable solvent for fabricating cellulose(blended with other polymers)membranes.In this study,gluten was used to develop nonporous membranes with cellulose.The method of casting these membranes provided better ones than the former researchers’techniques.These composite membranes’physical and mechanical properties were studied by analysis of morphology,viscosity,crystallinity,thermal behaviors,tensile properties and water absorption of membranes.Results showed that membranes are nonporous,uniform,strong,flexible,ecofriendly and renewable.Mechanical and physical properties were influenced by the ratio of cellulose/gluten.By blending 40% gluten,the tensile strength of cellulose membrane dropped to 15.89 MPa from 35.11 MPa.However,its elongation at break increased from 35.3% to 57.02% accordingly.
文摘The integration of the Internet of Things(IoT)and cloud computing is the most popular growing technology in the IT world.IoT integrated cloud com-puting technology can be used in smart cities,health care,smart homes,environ-mental monitoring,etc.In recent days,IoT integrated cloud can be used in the health care system for remote patient care,emergency care,disease prediction,pharmacy management,etc.but,still,security of patient data and disease predic-tion accuracy is a major concern.Numerous machine learning approaches were used for effective early disease prediction.However,machine learning takes more time and less performance while classification.In this research work,the Attribute based Searchable Honey Encryption with Functional Neural Network(ABSHE-FNN)framework is proposed to analyze the disease and provide stronger security in IoT-cloud healthcare data.In this work,the Cardiovascular Disease and Pima Indians diabetes dataset are used for heart and diabetic disease classification.Initi-ally,means-mode normalization removes the noise and normalizes the IoT data,which helps to enhance the quality of data.Rectified Linear Unit(RLU)was applied to adjust the feature weight to reduce the training cost and error classifi-cation.This proposed ABSHE-FNN technique provides better security and achieves 92.79%disease classification accuracy compared to existing techniques.
基金supported by the National Natural Science Foundation of China(62103203)
文摘The economic dispatch problem(EDP) of microgrids operating in both grid-connected and isolated modes within an energy internet framework is addressed in this paper. The multi-agent leader-following consensus algorithm is employed to address the EDP of microgrids in grid-connected mode, while the push-pull algorithm with a fixed step size is introduced for the isolated mode. The proposed algorithm of isolated mode is proven to converge to the optimum when the interaction digraph of microgrids is strongly connected. A unified algorithmic framework is proposed to handle the two modes of operation of microgrids simultaneously, enabling our algorithm to achieve optimal power allocation and maintain the balance between power supply and demand in any mode and any mode switching. Due to the push-pull structure of the algorithm and the use of fixed step size,the proposed algorithm can better handle the case of unbalanced graphs, and the convergence speed is improved. It is documented that when the transmission topology is strongly connected and there is bi-directional communication between the energy router and its neighbors, the proposed algorithm in composite mode achieves economic dispatch even with arbitrary mode switching.Finally, we demonstrate the effectiveness and superiority of our algorithm through numerical simulations.
基金supported by grants from the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-062,to BD).
文摘Sepsis management has significantly improved over the past decades,with intensivists playing a pivotal role in its identification and treatment.[1,2]However,resource constraints in large tertiary hospitals in China limit patient admissions,leading to overcrowding in the emergency departments(EDs)with critically ill patients.[3]This highlights the urgent need for enhanced risk stratification and optimized sepsis management in emergency settings.
基金supported by the Jilin Provincial Scientific and Technological Development Program(No.20220101036JC)。
文摘By doping with Mg atoms,the bandgap of Mg-doped NiO thin films can be adjusted larger.By using NiO and MgO as sputtering targets,Mg-doped NiO thin films were deposited using radio-frequency magnetron co-sputtering method in pure argon and pure oxygen gas,respectively.The crystal structure,morphological characteristics,composition and optical properties of the obtained films were compared by X-ray diffraction(XRD),scanning electron microscope(SEM),energy dispersive spectrometer(EDS)and ultraviolet(UV)-visible spectrophotometer.The properties of the thin films deposited in different sputtering gases are quite different.For the films deposited in pure argon gas,it is a polycrystalline thin film with(200)preferred orientation,while the film deposited in pure oxygen has no preferred orientation.The grain size,molar ratio of Mg to Ni atoms and optical bandgap are larger for the films deposited in pure argon gas than those deposited in oxygen gas.
文摘By using a certain hybrid-type convolution operator,we first introduce a new subclass of normalized analytic functions in the open unit disk.For members of this analytic function class,we then derive several properties and characteristics including(for example)the modified Hadamard products,Holder's inequalities and convolution properties as well as some closure properties under a general family of integral transforms.
