Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,...Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.展开更多
BACKGROUND Fever of unknown origin(FUO)remains a diagnostic challenge and was originally defined in 1961.Its classic criteria include fever≥38.3°C(≥101°F)on multiple occasions,fever lasting three weeks or ...BACKGROUND Fever of unknown origin(FUO)remains a diagnostic challenge and was originally defined in 1961.Its classic criteria include fever≥38.3°C(≥101°F)on multiple occasions,fever lasting three weeks or longer,and a diagnosis after one week of inpatient evaluation.However,these criteria may not fully encompass the varied clinical presentations seen in resource-limited settings such as India.The adaptation of FUO definitions to local healthcare contexts is crucial for enhancing diagnostic accuracy and optimizing patient outcomes.AIM To investigate the applicability of revised FUO criteria in a tertiary care setting in India.METHODS This longitudinal-exploratory study at All India Institute of Medical Sciences Rishikesh(January 2018–December 2022)analyzed 228 adult patients with fever≥99.1°F lasting over three days.Patients diagnosed within three days of admission were excluded.Data were collected retrospectively and prospectively using predefined FUO definitions based on durations of nondiagnosis(3-21 days,>21 days),temperature ranges(99.1°F-100.9°F,≥101°F),and hospitalization durations(3-7 days,>7 days).Descriptive statistics and comparative tests(Fisher's exact test,χ2 test)evaluated outcomes across definitions.RESULTS Among the proposed FUO definitions,Definition B(fever lasting 3-21 days,temperatures between 99.1°F-100.9°F,hospitalization>7 days)predominated(40.8%),while only 2.2%met the classical criteria.Notably,36.5%of Definition B patients remained undiagnosed after 7-10 days,despite 94%undergoing diagnostic workups within 21 days.Infection emerged as the leading etiology across definitions,without significant variation in outcomes or mortality during hospitalization(χ2=27.937,P=0.142).CONCLUSION Adapting FUO criteria to local contexts improves diagnostic accuracy and treatment.Definition B(40.8%prevalence)showed practical utility,with higher mortality in patients discharged on empirical'Anti-tuberculosis therapy'.展开更多
Background:The masseter vestibular evoked myogenic potential(mVEMP) is a novel test that has been explored in various brainstem lesions. However, it has not yet been studied in individuals with definite Meniere's ...Background:The masseter vestibular evoked myogenic potential(mVEMP) is a novel test that has been explored in various brainstem lesions. However, it has not yet been studied in individuals with definite Meniere's disease. Therefore, the current study aimed to investigate m VEMP responses in individuals with definite Meniere's disease and compare them with those of a reference group.Method:The present study investigated narrowband Claus Elberling chirp-evoked m VEMP responses in 22 ears diagnosed with definite Meniere's disease and 22 ears with hearing sensitivity ≤ 15 dB HL across three stimulation frequencies.Results:m VEMP responses in participants with definite Meniere's disease varied from normal to reduced or absent across three octave frequencies. These individuals exhibited significantly reduced P11-N21 peak-to-peak amplitudes compared to those in the reference group. Although a frequency tuning shift toward 1000 Hz was observed, the inter-frequency amplitude ratio of m VEMP was not found to be a sensitive parameter for detecting individuals with definite Meniere's disease. Additionally, no association was found between the degree of hearing loss or the duration of the disease and m VEMP responses. Conclusion: Participants with definite Meniere's disease exhibited reduced P11-N21 amplitude and a tuning shift toward 1000 Hz. These findings suggest the involvement of the vestibulo-trigeminal reflex pathway in this condition.展开更多
Accurate drought assessment demands thoughtful consideration of drought definition first of all.Drought is commonly defined as a prolonged period of below-average precipitation leading to water shortages that impact e...Accurate drought assessment demands thoughtful consideration of drought definition first of all.Drought is commonly defined as a prolonged period of below-average precipitation leading to water shortages that impact ecosystems,agriculture,and human societies.However,meteorologists,hydrologists,and agronomists often use different criteria to define drought,depending on their specific focus areas.For example,hydrologists define drought according to water deficits in some components of the hydrological cycle(such as precipitation,soil moisture,river flow,and groundwater)or its impacts on the level of services provided to public water supply,irrigation,or hydropower demands(Tate and Gustard,2000).Differences in drought definitions may result in great uncertainties in drought assessment(Satoh et al.,2021).We cannot expect the existence of any workable generalized objective definition of drought(Lloyd-Hughes,2014).展开更多
This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly l...This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly limited qualitative concepts.The meaning of mathematical definition of operators for cartographic generalization and the application prospect in computer_aided cartography (CAC) is stated.ract The Jurassic strata in Jingyan of Sichuan containing the Mamenchinsaurus fauna are dealt with and divided in this paper. The Mamenchisaurus fossils contained there are compared in morphological features and stratigraphically with other types of the genus on by one. The comprehensive analysis show that the Mamenchisaurus fauna of Jingyan appeared in the early Late Jurassic and is primitive in morphology. The results of the morphological identification and stratigraphical study agree with each other. Their evolutionary processes in different apoches of the Late Jurassic also made clear. Key words Jingyan, Sichuan, Mamenchisaurus Fauna, stratigraphy, evolution展开更多
In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many...In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many distinguishing features,the most notable of which are water presence,unique soil conditions,and biota that are adapted to or tolerant of saturated soils.Many wetland definitions have been developed by scientists,U.S.federal agencies,and the Ramsar Convention for both scientific and regulatory purposes.Wetlands are not easily defined but a well-conceived,science-based definition of wetlands is important for scientists and resource managers to understand the nature of wetlands and/or to use and protect wetlands.A scientific definition is the basis for wetland classification.Developing an effective wetland classification system requires a well-conceived,science-based definition and clearly explicit guidance on the appropriate use of various wetland indicators to verify the presence of wetlands on the ground.Based on a well-accepted wetland definition,both wetland classification and inventory further provide needed information and a working frame for wise use and management of wetlands.展开更多
In this study, a group of indices were defined regarding intensity （P）, area （S） and central position （λc, Фc） of the Aleutian low （AL） in the Northern Hemisphere in winter, using seasonal and monthly mean h...In this study, a group of indices were defined regarding intensity （P）, area （S） and central position （λc, Фc） of the Aleutian low （AL） in the Northern Hemisphere in winter, using seasonal and monthly mean height field at 1000-hPa. These indices were calculated over 60 winter seasons from 1948/1949 to 2007/2008 using reanalysis data. Climatic and anomalous characteristics of the AL were analyzed based on these indices and relationships between the AL, and general circulations were explored using correlations between indicesP, λc, and Pacific SST, as well as Northern Hemisphere temperature and precipitation. The main results are these： （1） AL is the strongest in January, when the center shifts to the south and west of its climatological position, and it is the weakest in December when the center shifts to the north and east. （2） AL intensity （P） is negatively correlated with its longitude （λc）： a deeper low occurs toward the east and a shallower low occurs toward the west. On a decadal scale, the AL has been persistently strong and has shifted eastward since the 1970s, but reversal signs have been observed in recent years. （3） The AL is stronger and is located toward the east during strong E1 Nifio winters and vice versa during strong La Nifia years; this tendency is particularly evident after 1975. The AL is also strongly correlated with SST in the North Pacific. It intensifies and moves eastward with negative SST anomalies, and it weakens and moves westward with positive SST anomalies. （4） Maps of significance correlation between AL intensity and Northern Hemisphere temperature and rainfall resemble the PNA teleconnection pattern in mid-latitudes in the North Pacific and across North America. The AL and the Mongolian High are two permanent atmospheric pressure systems adjacent to each other during boreal winter over the middle and high latitudes in the Northern Hemisphere, but their relationships with the E1 Nifio/La Nifia events and with temperature and precipitation in the Northern Hemisphere are significantly different.展开更多
Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, how...Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, however, with the extensive use of nanomaterials in batteries, fast redox kinetics comparable to pseudocapacitive have been achieved in many kinds of battery materials due to the much shortened ion diffusion lengths and highly exposed surface/interface as a result of nanosize effect. Consequently, the terms"pseudocapacitive materials" and "battery materials" are becoming more and more confusing. In this review, different opinions on the definition of pseudocapacitive materials and the evolution of the definitions as well as the resulting confusion will be firstly reviewed. Then, to accurately distinguish pseudocapacitive and battery materials, method with the consideration of both the electrochemical signatures(CVs and GCD) and quantitative kinetics analysis as a supplement is proposed. Finally, we end this review by discussing the possible device configurations of asymmetric supercapacitors and hybrid supercapacitors. The present review will help understanding the differences between pseudocapacitive materials and battery materials, and thus avoiding the definition confusion.展开更多
Based on GC-MS data of saturate and aromatic hydrocarbon fractions in crude oils from Well TD 2 and the Yingmaili and Tazhong area in the Tarim Basin, the end-member oil derived from Cambrian-Lower Ordovician source r...Based on GC-MS data of saturate and aromatic hydrocarbon fractions in crude oils from Well TD 2 and the Yingmaili and Tazhong area in the Tarim Basin, the end-member oil derived from Cambrian-Lower Ordovician source rocks was determined. The analytical results show that the crude oil from Well TD2 is rich in 3-6 ring polycyclic aromatic hydrocarbons without alkyl group, suggesting that this oil was altered by an abnormally thermal event. It contains a complete series of normal alkanes and 25-norhopanes,展开更多
Along with industrial development, adverse impacts on the natural environment become more serious, and the states of ecosystem health and ecological security have also deteriorated. As the basic needs for human surviv...Along with industrial development, adverse impacts on the natural environment become more serious, and the states of ecosystem health and ecological security have also deteriorated. As the basic needs for human survival, ecosystem health and ecological security possess very important meanings. Therefore, ecosystem health and ecological security have become research hot topics in recent decades. This paper reviewed the developments of definitions and applications of ecosystem health and ecological security, and found that the research on ecosystem health had achieved a lot. However, the research on ecological security was still relatively undeveloped. Moreover, there are also some confusion between the concepts of ecosystem health and ecological security. We consider that ecosystem health indicates the status of the ecosystem in normal conditions, whereas, ecological security indicates the capabilities of an ecosystem to react to external accidents or extremely adverse effects. An ecosystem which is healthy does not mean that it is secure. However, the ecological security requires an ecosystem to possess the capacity for integrity against any risk, and ecosystem health is the precondition to ecological security.展开更多
The synthetic defining style, a predominant way used to define verbs in many dictionaries, is the main factor that makes dictionary definitions vague and incomplete. The present paper argues that instead of the synthe...The synthetic defining style, a predominant way used to define verbs in many dictionaries, is the main factor that makes dictionary definitions vague and incomplete. The present paper argues that instead of the synthetic defining mode, an analytical meaning-explaining way should be used in dictionaries designed for SLA learners. The analytical meanings of verbs are viewed as mini-narratives and form event schemata comprised of three sub-schemata, namely, participant schema, action schema and scenario schema. The three sub-schemata should be clearly fore-grounded in verbs＇ definitions in learners＇ dictionaries.展开更多
This paper classifies the definitions of rhetoric into four groups based on the defining methods in Li’s English Rhetoric and Essay Writing so that one can have a deeper understanding of the term "rhetoric".
This paper classifies the definitions of rhetoric into four groups based on the defining methods in Li’s English Rhetoric and Essay Writing so that one can have a deeper understanding of the term "rhetoric"?
The science that underpins our knowledge and understanding of Isotope-Based Hydrograph separation (IHS) has gained grounds, over the last few decades, in the identification of streamflow sources. However, challenges s...The science that underpins our knowledge and understanding of Isotope-Based Hydrograph separation (IHS) has gained grounds, over the last few decades, in the identification of streamflow sources. However, challenges still exist in identifying appropriate tracers and the right combination of end-members for the IHS process. In a two-component IHS analysis, the application of the dual isotopes tracers, δ18O and (or) δ2H, is regarded as the simplest method. We undertook an IHS study within a nested system of eight Prairie watersheds located in South central Manitoba, Canada. The work evaluated about 17,000 results emanating from the application of a combination of two potential tracers (δ18O and δ2H) and eight each of potential “old” and “new” water end-members in a two-component IHS process. The outcome showed occurrences of many mathematically possible but hydrologically unacceptable IHS results. The observation was particularly predominant within relatively larger perennial sub-catchments of the watershed. It is also shown that inter-site sub-catchment isotopic end-member transferability is possible within watersheds of similar physio-hydrographic characteristics. We suggest that a careful evaluation of the physio-hydrographic characteristics of catchments be considered in IHS studies in addition to the recommended guidelines in the selection of tracers and end-members.展开更多
Objectives: We aimed to 1) investigate the prevalence of MS in apparently healthy, non-hypertensive non-diabetic individuals living in Jeddah using the IDF and the NCEP-ATP III criteria to test for agreement in classi...Objectives: We aimed to 1) investigate the prevalence of MS in apparently healthy, non-hypertensive non-diabetic individuals living in Jeddah using the IDF and the NCEP-ATP III criteria to test for agreement in classification, and to determine the characteristics of subjects identified by either definition, and 2) examine the significance of family medical history and life style habits. Methods: 557 apparently healthy individuals aged 18 - 50 y were randomly approached in Jeddah health centres. 412 agreed to participate, while 55 were excluded because they were found to be frankly hypertensive and/or diabetic. Finally, 357 apparently healthy subjects with no hypertension or diabetes were fully studied. Anthropometric and demographic information were collected. Insulin, glucose, and lipid profile were obtained in fasting blood samples. Individuals were identified using the two definitions of metabolic syndrome, and their characteristics were compared statistically to the rest of the population. Results: Of the 233 subjects fulfilling the inclusion criteria, 44 and 39 (18.9% and 16.7%) were identified as having MS by the IDF or ATPIII definitions, respectively. The most common characteristic was central obesity using the IDF definition, and low HDL-cholesterol using the NCEP-ATP III definition. As expected from our exclusion criteria, the least common feature was high blood pressure in both cases. There was no significant difference between subgroups with and without MS with regard to smoking, exercise, and family history of disease. Regression analysis indicated the strongest predictors of MS were: blood glucose, LDL-C/HDL-C ratio and plasma insulin using the NCEP-ATPIII definition, and blood glucose, Waist /Hip ratio and plasma atherogenic index (PAI) using the IDF definition. Conclusions: In the absence of local cut-off thresholds for waist circumference, subjects might escape diagnosis using the IDF definition. The use of waist/Hip ratio, LDL-C: HDL-C, PAI and circulating insulin help with the diagnosis.展开更多
Partial formalization, which involves the development of deductive connections among statements, can be used to examine assumptions, definitions and related methodologies that are used in science. This approach has be...Partial formalization, which involves the development of deductive connections among statements, can be used to examine assumptions, definitions and related methodologies that are used in science. This approach has been applied to the study of nucleic acids recovered from natural microbial assemblages (NMA) by the use of bulk extraction. Six pools of bulk-extractable nucleic acids (BENA) are suggested to be present in a NMA: (pool 1) inactive microbes (abiotic-limited);(pool 2) inactive microbes (abiotic permissive, biotic-limited);(pool 3) dormant microbes (abiotic permissive, biotic-limited, but can become biotic permissive);(pool 4) in situ active microbes (the microbial community);(pool 5) viruses (virocells/virions/cryptic viral genomes);and (pool 6) extracellular nucleic acids including extracellular DNA (eDNA). Definitions for cells, the microbial community (in situ active cells), the rare biosphere, dormant cells (the microbial seed bank), viruses (virocells/virions/cryptic viral genomic), and diversity are presented, together with methodology suggested to allow their study. The word diversity will require at least 4 definitions, each involving a different methodology. These suggested definitions and methodologies should make it possible to make further advances in bulk extraction-based molecular microbial ecology.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the compa...BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the comparative efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC remain unclear.AIM To compare the efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC.METHODS We retrospectively analyzed the hospitalized data of a total of 472 consecutive patients with cT1N0M0 EC treated at Sun Yat-sen University Cancer center between 2017-2019 and followed up until October 30th,2022.We analyzed demographic,medical recorded,histopathologic characteristics,imaging and endoscopic,and follow-up data.The Kaplan-Meier method and Cox proportional hazards modeling were used to analyze the difference of survival outcome by treatments.Inverse probability of treatment weighting(IPTW)was used to minimize potential confounding factors.RESULTS We retrospectively analyzed patients who underwent ESD(n=99)or surgery(n=220)or d-CRT(n=16)at the Sun Yat-sen University Cancer Center from 2017 to 2019.The median follow-up time for the ESD group,the surgery group,and the d-CRT group was 42.0 mo(95%CI:35.0-60.2),45.0 mo(95%CI:34.0-61.75)and 32.5 mo(95%CI:28.3-40.0),respectively.After adjusting for background factors using IPTW,the highest 3-year overall survival(OS)rate and 3-year recurrence-free survival(RFS)rate were observed in the ESD group(3-year OS:99.7% and 94.7% and 79.1%;and 3-year RFS:98.3%,87.4% and 79.1%,in the ESD,surgical,and d-CRT groups,respectively).There was no difference of severe complications occurring between the three groups(P≥0.05).Multivariate analysis showed that treatment method,histology and depth of infiltration were independently associated with OS and RFS.CONCLUSION For cT1N0M0 EC,ESD had better long-term survival and lower hospitalization costs than those who underwent d-CRT and surgery,with a similar rate of severe complications occurring.展开更多
Reproduction and development are complex couple-dependent processes. Risk assessment for these health outcomes requires the use of biomarkers to link exposures to disease. Biological markers of susceptability, externa...Reproduction and development are complex couple-dependent processes. Risk assessment for these health outcomes requires the use of biomarkers to link exposures to disease. Biological markers of susceptability, external dose, internal dose, biologically effective dose, early or late biological responses, altered reproductive or developmental function, and reproductive or developmental disease are introduced. Using these biomarkers it is possible to define a biologically based risk assessment methodology for reproductive and developmental toxicity. Risk assessment for reproductive toxicity requires definition of male and female fecundity, couple-specific factors, spontaneous abortion, rate, and other factors. Using using sperm count as a biomarker for male fecundity, an example of a reproductive risk assessment using biomarkers is performed.展开更多
To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study...To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study involved 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two Malaysian tertiary hospitals. Socio-demographic data were assessed using a pre-tested interviewer-administered structured questionnaire. Anthropometric measurements were carried out according to standard protocols. Clinical and laboratory characteristics were examined. Kappa (k) statistics were used for the agreement between the four MetS definitions. The overall prevalence rates of MetS (95% CI) were 95.8% (93.6-98.1), 96.1% (94.0-98.3), 84.8% (80.8-88.9) and 97.7% (96.1-99.4) according to the WHO, NCEP ATP III, IDF and the Harmonized definitions, respectively. The Kappa statistics demonstrated a slight to substantial agreement between the definitions (k = 0.179-0.875, p k = 0.875, p hest specificity (100%) in identifying MetS. In conclusion, the new Harmonized criteria established the highest prevalence of MetS among the four definitions applied. There was a very good concordance between the WHO and NCEP ATP III criteria. The extremely high prevalence of MetS observed in type 2 diabetic patients indicates an impending pandemic of CVD risk in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM.展开更多
Background The relationship between contrast-induced acute kidney injury(CI-AKI)and long-term mortality of anemia patients still remain controversial.Previous researches indicated that inconsistent definition may cont...Background The relationship between contrast-induced acute kidney injury(CI-AKI)and long-term mortality of anemia patients still remain controversial.Previous researches indicated that inconsistent definition may contributed to this problem.Methods This study conducted a retrospective cohort study enrolling 5,406 patients with anemia undergoing coronary angiography or percutaneous coronary intervention between January 2007 and December 2018 in Guangdong Provincial People’s Hospital.The CI-AKI was evaluated according to two definitions:1.CI-AKIA:With a serum creatinine(SCr)elevation of 25%or 0.5 mg/d L from baseline in the first 72 hours after procedure;2:CI-AKIB:With a SCr elevation of 50%or 0.3 mg/d L from baseline in the first 72 hours after procedure.The endpoint was all-cause mortality.Univariable and multivariable Cox regression model were used to explore association between long-term all-cause mortality and CI-AKI.Population attributable risks(PARs)based on two different CI-AKI definitions for mortality were calculated.Results CI-AKIAwas associated with 1.36 fold risk of long-term death(HR:1.36,95%CI:1.18-1.57),while CI-AKIBwas associated with 1.32 fold risk of long-term death(HR:1.32,95%CI:1.13-1.54).Between two definitions,the prevalence of CI-AKI was higher for CI-AKIA(16.7%),compared with CI-AKIB(12.6%).For the PARs,PAR based on CI-AKIA(PAR:5.65,95%CI:2.91-8.67),was higher than that based on CI-AKIB(PAR:3.87,95%CI:1.61-6.36).Conclusions Patients complicated with CI-AKI had a higher risk of mortality than those without CI-AKI in all definitions.The prevalence and PAR of CI-AKI were higher when it was defined as CI-AKIA.CI-AKIAwas considered as a better definition to identify anemia patients with higher risk of CI-AKI and higher risk of CI-AKI-associated mortality.展开更多
文摘Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.
文摘BACKGROUND Fever of unknown origin(FUO)remains a diagnostic challenge and was originally defined in 1961.Its classic criteria include fever≥38.3°C(≥101°F)on multiple occasions,fever lasting three weeks or longer,and a diagnosis after one week of inpatient evaluation.However,these criteria may not fully encompass the varied clinical presentations seen in resource-limited settings such as India.The adaptation of FUO definitions to local healthcare contexts is crucial for enhancing diagnostic accuracy and optimizing patient outcomes.AIM To investigate the applicability of revised FUO criteria in a tertiary care setting in India.METHODS This longitudinal-exploratory study at All India Institute of Medical Sciences Rishikesh(January 2018–December 2022)analyzed 228 adult patients with fever≥99.1°F lasting over three days.Patients diagnosed within three days of admission were excluded.Data were collected retrospectively and prospectively using predefined FUO definitions based on durations of nondiagnosis(3-21 days,>21 days),temperature ranges(99.1°F-100.9°F,≥101°F),and hospitalization durations(3-7 days,>7 days).Descriptive statistics and comparative tests(Fisher's exact test,χ2 test)evaluated outcomes across definitions.RESULTS Among the proposed FUO definitions,Definition B(fever lasting 3-21 days,temperatures between 99.1°F-100.9°F,hospitalization>7 days)predominated(40.8%),while only 2.2%met the classical criteria.Notably,36.5%of Definition B patients remained undiagnosed after 7-10 days,despite 94%undergoing diagnostic workups within 21 days.Infection emerged as the leading etiology across definitions,without significant variation in outcomes or mortality during hospitalization(χ2=27.937,P=0.142).CONCLUSION Adapting FUO criteria to local contexts improves diagnostic accuracy and treatment.Definition B(40.8%prevalence)showed practical utility,with higher mortality in patients discharged on empirical'Anti-tuberculosis therapy'.
文摘Background:The masseter vestibular evoked myogenic potential(mVEMP) is a novel test that has been explored in various brainstem lesions. However, it has not yet been studied in individuals with definite Meniere's disease. Therefore, the current study aimed to investigate m VEMP responses in individuals with definite Meniere's disease and compare them with those of a reference group.Method:The present study investigated narrowband Claus Elberling chirp-evoked m VEMP responses in 22 ears diagnosed with definite Meniere's disease and 22 ears with hearing sensitivity ≤ 15 dB HL across three stimulation frequencies.Results:m VEMP responses in participants with definite Meniere's disease varied from normal to reduced or absent across three octave frequencies. These individuals exhibited significantly reduced P11-N21 peak-to-peak amplitudes compared to those in the reference group. Although a frequency tuning shift toward 1000 Hz was observed, the inter-frequency amplitude ratio of m VEMP was not found to be a sensitive parameter for detecting individuals with definite Meniere's disease. Additionally, no association was found between the degree of hearing loss or the duration of the disease and m VEMP responses. Conclusion: Participants with definite Meniere's disease exhibited reduced P11-N21 amplitude and a tuning shift toward 1000 Hz. These findings suggest the involvement of the vestibulo-trigeminal reflex pathway in this condition.
基金supported by the National Natural Science Foundation of China(Grant No.42471027).
文摘Accurate drought assessment demands thoughtful consideration of drought definition first of all.Drought is commonly defined as a prolonged period of below-average precipitation leading to water shortages that impact ecosystems,agriculture,and human societies.However,meteorologists,hydrologists,and agronomists often use different criteria to define drought,depending on their specific focus areas.For example,hydrologists define drought according to water deficits in some components of the hydrological cycle(such as precipitation,soil moisture,river flow,and groundwater)or its impacts on the level of services provided to public water supply,irrigation,or hydropower demands(Tate and Gustard,2000).Differences in drought definitions may result in great uncertainties in drought assessment(Satoh et al.,2021).We cannot expect the existence of any workable generalized objective definition of drought(Lloyd-Hughes,2014).
文摘This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly limited qualitative concepts.The meaning of mathematical definition of operators for cartographic generalization and the application prospect in computer_aided cartography (CAC) is stated.ract The Jurassic strata in Jingyan of Sichuan containing the Mamenchinsaurus fauna are dealt with and divided in this paper. The Mamenchisaurus fossils contained there are compared in morphological features and stratigraphically with other types of the genus on by one. The comprehensive analysis show that the Mamenchisaurus fauna of Jingyan appeared in the early Late Jurassic and is primitive in morphology. The results of the morphological identification and stratigraphical study agree with each other. Their evolutionary processes in different apoches of the Late Jurassic also made clear. Key words Jingyan, Sichuan, Mamenchisaurus Fauna, stratigraphy, evolution
基金funded by the National Nat-ural Science Foundation of China(No.40830535andNo.40871089)
文摘In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many distinguishing features,the most notable of which are water presence,unique soil conditions,and biota that are adapted to or tolerant of saturated soils.Many wetland definitions have been developed by scientists,U.S.federal agencies,and the Ramsar Convention for both scientific and regulatory purposes.Wetlands are not easily defined but a well-conceived,science-based definition of wetlands is important for scientists and resource managers to understand the nature of wetlands and/or to use and protect wetlands.A scientific definition is the basis for wetland classification.Developing an effective wetland classification system requires a well-conceived,science-based definition and clearly explicit guidance on the appropriate use of various wetland indicators to verify the presence of wetlands on the ground.Based on a well-accepted wetland definition,both wetland classification and inventory further provide needed information and a working frame for wise use and management of wetlands.
基金supported by National Key Technology Research and Development Program (Grant No. 2007BAC29B02)the National Basic Research Program of China’s 973 Program (Grant Nos.2010CB950502 and 2010CB428904)the project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD)
文摘In this study, a group of indices were defined regarding intensity （P）, area （S） and central position （λc, Фc） of the Aleutian low （AL） in the Northern Hemisphere in winter, using seasonal and monthly mean height field at 1000-hPa. These indices were calculated over 60 winter seasons from 1948/1949 to 2007/2008 using reanalysis data. Climatic and anomalous characteristics of the AL were analyzed based on these indices and relationships between the AL, and general circulations were explored using correlations between indicesP, λc, and Pacific SST, as well as Northern Hemisphere temperature and precipitation. The main results are these： （1） AL is the strongest in January, when the center shifts to the south and west of its climatological position, and it is the weakest in December when the center shifts to the north and east. （2） AL intensity （P） is negatively correlated with its longitude （λc）： a deeper low occurs toward the east and a shallower low occurs toward the west. On a decadal scale, the AL has been persistently strong and has shifted eastward since the 1970s, but reversal signs have been observed in recent years. （3） The AL is stronger and is located toward the east during strong E1 Nifio winters and vice versa during strong La Nifia years; this tendency is particularly evident after 1975. The AL is also strongly correlated with SST in the North Pacific. It intensifies and moves eastward with negative SST anomalies, and it weakens and moves westward with positive SST anomalies. （4） Maps of significance correlation between AL intensity and Northern Hemisphere temperature and rainfall resemble the PNA teleconnection pattern in mid-latitudes in the North Pacific and across North America. The AL and the Mongolian High are two permanent atmospheric pressure systems adjacent to each other during boreal winter over the middle and high latitudes in the Northern Hemisphere, but their relationships with the E1 Nifio/La Nifia events and with temperature and precipitation in the Northern Hemisphere are significantly different.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.51672205,51872104 and 21673169)the National Key R&D Program of China(Grant No.2016YFA0202602)+1 种基金the Research Start-Up Fund from Wuhan University of Technologythe Fundamental Research Funds for the Central Universities(WUT:2016IVA083,2017IB005,185220011)
文摘Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, however, with the extensive use of nanomaterials in batteries, fast redox kinetics comparable to pseudocapacitive have been achieved in many kinds of battery materials due to the much shortened ion diffusion lengths and highly exposed surface/interface as a result of nanosize effect. Consequently, the terms"pseudocapacitive materials" and "battery materials" are becoming more and more confusing. In this review, different opinions on the definition of pseudocapacitive materials and the evolution of the definitions as well as the resulting confusion will be firstly reviewed. Then, to accurately distinguish pseudocapacitive and battery materials, method with the consideration of both the electrochemical signatures(CVs and GCD) and quantitative kinetics analysis as a supplement is proposed. Finally, we end this review by discussing the possible device configurations of asymmetric supercapacitors and hybrid supercapacitors. The present review will help understanding the differences between pseudocapacitive materials and battery materials, and thus avoiding the definition confusion.
基金Supported by the National Natural Science Foundation of China(41772119,41272169)
文摘Based on GC-MS data of saturate and aromatic hydrocarbon fractions in crude oils from Well TD 2 and the Yingmaili and Tazhong area in the Tarim Basin, the end-member oil derived from Cambrian-Lower Ordovician source rocks was determined. The analytical results show that the crude oil from Well TD2 is rich in 3-6 ring polycyclic aromatic hydrocarbons without alkyl group, suggesting that this oil was altered by an abnormally thermal event. It contains a complete series of normal alkanes and 25-norhopanes,
文摘Along with industrial development, adverse impacts on the natural environment become more serious, and the states of ecosystem health and ecological security have also deteriorated. As the basic needs for human survival, ecosystem health and ecological security possess very important meanings. Therefore, ecosystem health and ecological security have become research hot topics in recent decades. This paper reviewed the developments of definitions and applications of ecosystem health and ecological security, and found that the research on ecosystem health had achieved a lot. However, the research on ecological security was still relatively undeveloped. Moreover, there are also some confusion between the concepts of ecosystem health and ecological security. We consider that ecosystem health indicates the status of the ecosystem in normal conditions, whereas, ecological security indicates the capabilities of an ecosystem to react to external accidents or extremely adverse effects. An ecosystem which is healthy does not mean that it is secure. However, the ecological security requires an ecosystem to possess the capacity for integrity against any risk, and ecosystem health is the precondition to ecological security.
文摘The synthetic defining style, a predominant way used to define verbs in many dictionaries, is the main factor that makes dictionary definitions vague and incomplete. The present paper argues that instead of the synthetic defining mode, an analytical meaning-explaining way should be used in dictionaries designed for SLA learners. The analytical meanings of verbs are viewed as mini-narratives and form event schemata comprised of three sub-schemata, namely, participant schema, action schema and scenario schema. The three sub-schemata should be clearly fore-grounded in verbs＇ definitions in learners＇ dictionaries.
文摘This paper classifies the definitions of rhetoric into four groups based on the defining methods in Li’s English Rhetoric and Essay Writing so that one can have a deeper understanding of the term "rhetoric".
文摘This paper classifies the definitions of rhetoric into four groups based on the defining methods in Li’s English Rhetoric and Essay Writing so that one can have a deeper understanding of the term "rhetoric"?
文摘The science that underpins our knowledge and understanding of Isotope-Based Hydrograph separation (IHS) has gained grounds, over the last few decades, in the identification of streamflow sources. However, challenges still exist in identifying appropriate tracers and the right combination of end-members for the IHS process. In a two-component IHS analysis, the application of the dual isotopes tracers, δ18O and (or) δ2H, is regarded as the simplest method. We undertook an IHS study within a nested system of eight Prairie watersheds located in South central Manitoba, Canada. The work evaluated about 17,000 results emanating from the application of a combination of two potential tracers (δ18O and δ2H) and eight each of potential “old” and “new” water end-members in a two-component IHS process. The outcome showed occurrences of many mathematically possible but hydrologically unacceptable IHS results. The observation was particularly predominant within relatively larger perennial sub-catchments of the watershed. It is also shown that inter-site sub-catchment isotopic end-member transferability is possible within watersheds of similar physio-hydrographic characteristics. We suggest that a careful evaluation of the physio-hydrographic characteristics of catchments be considered in IHS studies in addition to the recommended guidelines in the selection of tracers and end-members.
文摘Objectives: We aimed to 1) investigate the prevalence of MS in apparently healthy, non-hypertensive non-diabetic individuals living in Jeddah using the IDF and the NCEP-ATP III criteria to test for agreement in classification, and to determine the characteristics of subjects identified by either definition, and 2) examine the significance of family medical history and life style habits. Methods: 557 apparently healthy individuals aged 18 - 50 y were randomly approached in Jeddah health centres. 412 agreed to participate, while 55 were excluded because they were found to be frankly hypertensive and/or diabetic. Finally, 357 apparently healthy subjects with no hypertension or diabetes were fully studied. Anthropometric and demographic information were collected. Insulin, glucose, and lipid profile were obtained in fasting blood samples. Individuals were identified using the two definitions of metabolic syndrome, and their characteristics were compared statistically to the rest of the population. Results: Of the 233 subjects fulfilling the inclusion criteria, 44 and 39 (18.9% and 16.7%) were identified as having MS by the IDF or ATPIII definitions, respectively. The most common characteristic was central obesity using the IDF definition, and low HDL-cholesterol using the NCEP-ATP III definition. As expected from our exclusion criteria, the least common feature was high blood pressure in both cases. There was no significant difference between subgroups with and without MS with regard to smoking, exercise, and family history of disease. Regression analysis indicated the strongest predictors of MS were: blood glucose, LDL-C/HDL-C ratio and plasma insulin using the NCEP-ATPIII definition, and blood glucose, Waist /Hip ratio and plasma atherogenic index (PAI) using the IDF definition. Conclusions: In the absence of local cut-off thresholds for waist circumference, subjects might escape diagnosis using the IDF definition. The use of waist/Hip ratio, LDL-C: HDL-C, PAI and circulating insulin help with the diagnosis.
文摘Partial formalization, which involves the development of deductive connections among statements, can be used to examine assumptions, definitions and related methodologies that are used in science. This approach has been applied to the study of nucleic acids recovered from natural microbial assemblages (NMA) by the use of bulk extraction. Six pools of bulk-extractable nucleic acids (BENA) are suggested to be present in a NMA: (pool 1) inactive microbes (abiotic-limited);(pool 2) inactive microbes (abiotic permissive, biotic-limited);(pool 3) dormant microbes (abiotic permissive, biotic-limited, but can become biotic permissive);(pool 4) in situ active microbes (the microbial community);(pool 5) viruses (virocells/virions/cryptic viral genomes);and (pool 6) extracellular nucleic acids including extracellular DNA (eDNA). Definitions for cells, the microbial community (in situ active cells), the rare biosphere, dormant cells (the microbial seed bank), viruses (virocells/virions/cryptic viral genomic), and diversity are presented, together with methodology suggested to allow their study. The word diversity will require at least 4 definitions, each involving a different methodology. These suggested definitions and methodologies should make it possible to make further advances in bulk extraction-based molecular microbial ecology.
基金Supported by the Guangdong Esophageal Cancer Institute Science and Technology Program,No.M202013Guangdong Medical Research Foundation,No.A2021369.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the comparative efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC remain unclear.AIM To compare the efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC.METHODS We retrospectively analyzed the hospitalized data of a total of 472 consecutive patients with cT1N0M0 EC treated at Sun Yat-sen University Cancer center between 2017-2019 and followed up until October 30th,2022.We analyzed demographic,medical recorded,histopathologic characteristics,imaging and endoscopic,and follow-up data.The Kaplan-Meier method and Cox proportional hazards modeling were used to analyze the difference of survival outcome by treatments.Inverse probability of treatment weighting(IPTW)was used to minimize potential confounding factors.RESULTS We retrospectively analyzed patients who underwent ESD(n=99)or surgery(n=220)or d-CRT(n=16)at the Sun Yat-sen University Cancer Center from 2017 to 2019.The median follow-up time for the ESD group,the surgery group,and the d-CRT group was 42.0 mo(95%CI:35.0-60.2),45.0 mo(95%CI:34.0-61.75)and 32.5 mo(95%CI:28.3-40.0),respectively.After adjusting for background factors using IPTW,the highest 3-year overall survival(OS)rate and 3-year recurrence-free survival(RFS)rate were observed in the ESD group(3-year OS:99.7% and 94.7% and 79.1%;and 3-year RFS:98.3%,87.4% and 79.1%,in the ESD,surgical,and d-CRT groups,respectively).There was no difference of severe complications occurring between the three groups(P≥0.05).Multivariate analysis showed that treatment method,histology and depth of infiltration were independently associated with OS and RFS.CONCLUSION For cT1N0M0 EC,ESD had better long-term survival and lower hospitalization costs than those who underwent d-CRT and surgery,with a similar rate of severe complications occurring.
文摘Reproduction and development are complex couple-dependent processes. Risk assessment for these health outcomes requires the use of biomarkers to link exposures to disease. Biological markers of susceptability, external dose, internal dose, biologically effective dose, early or late biological responses, altered reproductive or developmental function, and reproductive or developmental disease are introduced. Using these biomarkers it is possible to define a biologically based risk assessment methodology for reproductive and developmental toxicity. Risk assessment for reproductive toxicity requires definition of male and female fecundity, couple-specific factors, spontaneous abortion, rate, and other factors. Using using sperm count as a biomarker for male fecundity, an example of a reproductive risk assessment using biomarkers is performed.
文摘To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study involved 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two Malaysian tertiary hospitals. Socio-demographic data were assessed using a pre-tested interviewer-administered structured questionnaire. Anthropometric measurements were carried out according to standard protocols. Clinical and laboratory characteristics were examined. Kappa (k) statistics were used for the agreement between the four MetS definitions. The overall prevalence rates of MetS (95% CI) were 95.8% (93.6-98.1), 96.1% (94.0-98.3), 84.8% (80.8-88.9) and 97.7% (96.1-99.4) according to the WHO, NCEP ATP III, IDF and the Harmonized definitions, respectively. The Kappa statistics demonstrated a slight to substantial agreement between the definitions (k = 0.179-0.875, p k = 0.875, p hest specificity (100%) in identifying MetS. In conclusion, the new Harmonized criteria established the highest prevalence of MetS among the four definitions applied. There was a very good concordance between the WHO and NCEP ATP III criteria. The extremely high prevalence of MetS observed in type 2 diabetic patients indicates an impending pandemic of CVD risk in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM.
基金supported by Beijing Lisheng Cardiovascular Health Foundation Pilot Fund(No.LHJJ20141751)The National Science Foundation of China(No.81970311 and No.82070360)+1 种基金Study on the Function and Mechanism of the Potential Target for Early Warning of Cardio-renal Syndrome after Acute Myocardial Infarction Based on Translational Medicine(No.DFJH201919)Clinical Medicine Research Fund of Guangdong Province(No.2019ZX01)。
文摘Background The relationship between contrast-induced acute kidney injury(CI-AKI)and long-term mortality of anemia patients still remain controversial.Previous researches indicated that inconsistent definition may contributed to this problem.Methods This study conducted a retrospective cohort study enrolling 5,406 patients with anemia undergoing coronary angiography or percutaneous coronary intervention between January 2007 and December 2018 in Guangdong Provincial People’s Hospital.The CI-AKI was evaluated according to two definitions:1.CI-AKIA:With a serum creatinine(SCr)elevation of 25%or 0.5 mg/d L from baseline in the first 72 hours after procedure;2:CI-AKIB:With a SCr elevation of 50%or 0.3 mg/d L from baseline in the first 72 hours after procedure.The endpoint was all-cause mortality.Univariable and multivariable Cox regression model were used to explore association between long-term all-cause mortality and CI-AKI.Population attributable risks(PARs)based on two different CI-AKI definitions for mortality were calculated.Results CI-AKIAwas associated with 1.36 fold risk of long-term death(HR:1.36,95%CI:1.18-1.57),while CI-AKIBwas associated with 1.32 fold risk of long-term death(HR:1.32,95%CI:1.13-1.54).Between two definitions,the prevalence of CI-AKI was higher for CI-AKIA(16.7%),compared with CI-AKIB(12.6%).For the PARs,PAR based on CI-AKIA(PAR:5.65,95%CI:2.91-8.67),was higher than that based on CI-AKIB(PAR:3.87,95%CI:1.61-6.36).Conclusions Patients complicated with CI-AKI had a higher risk of mortality than those without CI-AKI in all definitions.The prevalence and PAR of CI-AKI were higher when it was defined as CI-AKIA.CI-AKIAwas considered as a better definition to identify anemia patients with higher risk of CI-AKI and higher risk of CI-AKI-associated mortality.
