Multifactorial correlation analysis is a new method used to predict the land subsidence caused by groundwater exploitation This article introduces and applies the method to establish the function of the surface settle...Multifactorial correlation analysis is a new method used to predict the land subsidence caused by groundwater exploitation This article introduces and applies the method to establish the function of the surface settlement rate （Vs） and the function of the time-dependent surface settlement （St） caused by groundwater exploitation, based on data acquired at three land subsidence monitoring stations in the Hanoi area of Vietnam. Comparison with actual monitoring data indicates that the prediction results are relatively close to the monitoring data. From this, we conclude that multifactorial correlation analysis is a reliable method and can be used to predict future land subsidence caused by groundwater exploitation in Hanoi.展开更多
The concept, fundamental theory, analytical steps and formulae of grey relational analysis (GRA)-a new statistical method or multifactorial analysis in the field of medicine were introduced. GRA of grouping sequence t...The concept, fundamental theory, analytical steps and formulae of grey relational analysis (GRA)-a new statistical method or multifactorial analysis in the field of medicine were introduced. GRA of grouping sequence that is applied to medical study was built by the authors. An example was given to demonstrate it. The superiority of GRA was recounted briefly.展开更多
Summary: Retrospective and prospective bio-behavioral cancer studies have revealed that psycho social stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a p...Summary: Retrospective and prospective bio-behavioral cancer studies have revealed that psycho social stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a pattern has emerged, which in analogy to the coronary prone pattern (type A) has been labelled type C, encompassing suppression of emotional responses, such as anger and hostility, rationality and antiemotionality, as well as high social conformity and a lack of self-assertiveness. There is growing evidence in both infrahuman and human research that specific coping styles (repressive coping) with stress may be associated with specific biologic responses, including neuroendocrine, immunologic and other bodily functions. The application of this model appears to be of importance for further research, as well as for the detection of high risk individuals, but also in regard to therapy, rehabilitation, early detection and possibly also prevention of malignant disease. This concept suggests also new directions and modifications of stress research, as stressors are to be viewed not necessarily as pathological, but in some instances as quite possibly salutary, depending on the nature of the stres-sor, the psychophysiologic state of the individual and his or her ability to cope with adverse life situations. Quite naturally, the development of this concept is still in its initial stages, there remain anumber of open questions, and it needs hardly to be pointed out in this connection that further and painstaking clinical and laboratory work is warranted in order to clarify the role of stressors, life and coping styles and its biological concomitants in neo-plastic disease.展开更多
Existing multifactorial particle swarm optimisation(MFPSO)algorithms only explore a relatively narrow area between the inter-task particles.Meanwhile,these algorithms use a fixed inter-task learning probability throug...Existing multifactorial particle swarm optimisation(MFPSO)algorithms only explore a relatively narrow area between the inter-task particles.Meanwhile,these algorithms use a fixed inter-task learning probability throughout the evolution process.However,the parameter is problem dependent and can be various at different stages of the evolution.In this work,the authors devise an inter-task learning-based information transferring mechanism to replace the corresponding part in MFPSO.This inter-task learning mechanism transfers the searching step by using a differential term and updates the personal best position by employing an inter-task crossover.By this mean,the particles can explore a broad search space when utilising the additional searching experiences of other tasks.In addition,to enhance the performance on problems with different complementarity,they design a self-adaption strategy to adjust the inter-task learning probability according to the performance feedback.They compared the proposed algorithm with the state-of-the-art algorithms on various benchmark problems.Experimental results demonstrate that the proposed algorithm can transfer inter-task knowledge efficiently and perform well on the problems with different complementarity.展开更多
A multivariate analysis of 617 female patients with primary breast cancer treated by radical mastectomy between 1974 and 1981 was done. All patients were followed for more than five years. Survival was 76.6% and 64.7%...A multivariate analysis of 617 female patients with primary breast cancer treated by radical mastectomy between 1974 and 1981 was done. All patients were followed for more than five years. Survival was 76.6% and 64.7% at 5 and 10 years, respectively. Eleven clinical and pathological factors were available for study. The data were analysed by Cox's proportional hazards regression model. A final set of five independent significant prognostic factors was obtained. In order of importance they were, clinical stage, age at diagnosis, axillary lymph node status, histologic type and size of the primary tumor. To test the time-varying effect of these factors using Cox's model, all except age reduced their prognostic impact significantly after five years, however, age was a powerful prognostic factor for long-term survival. A prognostic index based on the regression coefficients was constructed. This index can give a better prediction for patients' survival and can be taken as reference when formulating treatment protocols for breast cancer.展开更多
BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains unce...BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains uncertain.AIM To evaluate the association between glycated hemoglobin(HbA1c)target achievement and long-term cardiovascular outcomes in patients receiving standard of care(SoC)or multifactorial intensive therapy(MT).METHODS This post-hoc analysis of the nephropathy in diabetes type 2 cluster-randomized trial included 323 patients with T2D,albuminuria,and retinopathy(SoC:n=139;MT:n=184),who underwent a 4-year intervention phase.Outcomes were major adverse cardiovascular events(MACE)and all-cause mortality.Associations with HbA1c target achievement(≤7%vs>7%)were assessed using Kaplan-Meier curves and shared frailty Cox regression models.RESULTS During a median follow-up of 12.1 years,190 MACEs and 139 deaths occurred.Achievement of the HbA1c target was not associated with reduced mortality in either group.However,a significant reduction in MACEs was observed only among SoC patients achieving HbA1c≤7%(P=0.031),whereas no benefit was seen in the MT group(P=0.645).In multivariable Cox regression models adjusted for cluster effect,in the MT group age[hazard ratio(HR)=1.07,P<0.001]and female sex(HR=0.38,P<0.001)were independent predictors of MACE,while in the SoC group only age(HR=1.04,P=0.009).For all-cause mortality,age(HR=1.11,P<0.001)and blood pressure control(HR=0.55,P=0.041)were significant predictors in the MT group,whereas age(HR=1.06,P=0.002)was independently associated with increased mortality in the SoC group.CONCLUSION In high-risk patients with T2D receiving standard care,achieving an HbA1c≤7%was associated with fewer cardiovascular events only under standard care,but not with reduced mortality.This association was not observed in patients managed with a multifactorial strategy.These findings suggest that the prognostic value of glycemic control depends on the broader treatment context and highlight the central role of comprehensive risk factor management in microvascularcomplicated T2D.展开更多
Background A five-year follow-up study of intensive multifactorial intervention was undertaken to assess the changes of circulating serum amyloid A （SAA） levels and the incidence of atherosclerosis （AS） in patient...Background A five-year follow-up study of intensive multifactorial intervention was undertaken to assess the changes of circulating serum amyloid A （SAA） levels and the incidence of atherosclerosis （AS） in patients with short-duration type 2 diabetes mellitus （T2DM） without macroangiopathy, and whether intensive multifactorial intervention could prevent or at least postpone the occurence of macroangiopathy. Methods Among 150 patients with short-duration T2DM, 75 were assigned to receive conventional outpatient treatment （conventional group） and the others underwent intensive multifactorial integrated therapy targeting hyperglycemia, hypertension, dyslipidemia and received aspirin simultaneously （intensive group）. Results Plasma SAA levels were higher in diabetic patients than those in healthy control subjects, and decreased obviously after intensive multifactorial intervention. The levels of SAA were positively correlated with body mass index （BMI）, waist hip ratio （WHR）, triglyceride （TG）, high sensitive C-reactive protein （hs-CRP） and common carotid intima-media thickness （CC-IMT）. The standard-reaching rates of glycemia, blood pressure and lipidemia were significantly higher in intensive group than those of conventional group. The incidence of macroangiopathy decreased by 58.96% in intensive group compared with conventional group. Conclusions Intensive multifactorial intervention may significantly reduce the SAA levels and prevent the occurrence of AS in short-duration patients with T2DM. SAA might be one of the risk factors of T2DM combined with AS.展开更多
Aerodynamic roughness length is an important physical parameter in atmospheric numerical models and microme- teorological calculations, the accuracy of which can affect numerical model performance and the level of mic...Aerodynamic roughness length is an important physical parameter in atmospheric numerical models and microme- teorological calculations, the accuracy of which can affect numerical model performance and the level of micrometeorological computations. Many factors influence the aerodynamic roughness length, but formulas for its parameterization often only con- sider the action of a single factor. This limits their adaptive capacity and often introduces considerable errors in the estimation of land surface momentum flux (friction velocity). In this study, based on research into the parameterization relations between aerodynamic roughness length and influencing factors such as windrow conditions, thermodynamic characteristics of the sur- face layer, natural rhythm of vegetation growth, ecological effects of interannual fluctuations of precipitation, and vegetation type, an aerodynamic roughness length parameterization scheme was established. This considers almost all the factors that af- fect aerodynamic roughness length on flat land surfaces with short vegetation. Furthermore, using many years' data recorded at the Semi-Arid Climate and Environment Observatory of Lanzhou University, a comparative analysis of the application of the proposed parameterization scheme and other experimental schemes was performed. It was found that the error in the friction velocity estimated by the proposed parameterization scheme was considerably less than that estimated using a constant aero- dynamic roughness length and by the other parameterization schemes. Compared with the friction velocity estimated using a constant aerodynamic roughness length, the correlation coefficient with the observed friction velocity increased from 0.752 to 0.937, and the standard deviation and deviation decreased by about 20% and 80%, respectively. Its mean value differed from the observed value by only 0.004 m s-l and the relative error was only about 1.6%, which indicates a significant decrease in the estimation error of surface-layer momentum flux. The test results show that the multifactorial universal parameterization scheme of aerodynamic roughness length for flat land surfaces with short vegetation can offer a more scientific parameteriza- tion scheme for numerical atmospheric models.展开更多
Background and objective: Coronary angioplasty is one of the techniques introduced in 1976 by Andreas Grüntzig in Zurich. It is a revolutionary procedure that allows coronary circulation to be restored by inserti...Background and objective: Coronary angioplasty is one of the techniques introduced in 1976 by Andreas Grüntzig in Zurich. It is a revolutionary procedure that allows coronary circulation to be restored by inserting a stent. This new technique has considerably evolved over time, but sometimes has limitations, such as the development of neo-pathologies like stent thrombosis. The aim of our case report is to highlight one of the limitations of coronary angioplasty, although rare, and to encourage greater clinical and electrical monitoring after each procedure. Case report: We report the case of a patient who presented with early stent thrombosis barely an hour after placement of a pharmacoactive stent. Chest pain reported by the patient after the procedure and electrical changes prompted an urgent repeat procedure. Aetiologies of stent thrombosis are multifactorial, including patient-, procedure- and stent-dependent factors. Conclusion: Although rare, there is a risk of stent thrombosis after coronary angioplasty. Careful monitoring and rigorous follow-up of patients after coronary angioplasty are therefore required, as the prognosis for stent thrombosis is fairly poor.展开更多
The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis(CP).In this context,pain represents the most common and debilitating symptom,and it deeply affects patient’s quality of...The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis(CP).In this context,pain represents the most common and debilitating symptom,and it deeply affects patient’s quality of life.Multiple rating scales(unidimensional,bidimensional and multidimensional)have been proposed to quantify CP pain.However,it represents the result of complex mechanisms,involving genetic,neuropathic and neurogenic factors.Considering all these aspects,the treatment should be discussed in a multidisciplinary setting and it should be approached in a stepwise manner.First,a lifestyle change is recommended and nonsteroidal anti-inflammatory drugs represent the gold standard among medical treatments for CP patients.The second step,after medical approach,is endoscopic therapy,especially for complicated CP.In case of failure,tailored surgery represents the third step and decompressive or resection procedures can be chosen.In conclusion,CP pain’s management is challenging considering all these complex aspects and the lack of international protocols.展开更多
Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in para...Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in parallel with the increasing global pandemic of type 2 diabetes. Based on landmark clinical trials, DKD has become preventable by controlling conventional factors, including hyperglycemia and hypertension, with multifactorial therapy; however, the remaining risk of DKD progression is still high. In this review, we show the importance of targeting remission/regression of microalbuminuria in type 2 diabetic patients, which may protect against the progression of DKD and cardiovascular events. To achieve remission/regression of microalbuminuria, several steps are important, including the early detection of microalbuminuria with continuousscreening, targeting HbA1c < 7.0% for glucose control, the use of renin angiotensin system inhibitors to control blood pressure, the use of statins or fibrates to control dyslipidemia, and multifactorial treatment. Reducing microalbuminuria is therefore an important therapeutic goal, and the absence of microalbuminuria could be a pivotal biomarker of therapeutic success in diabetic patients. Other therapies, including vitamin D receptor activation, uric acid-lowering drugs, and incretin-related drugs, may also be promising for the prevention of DKD progression.展开更多
With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a maj...With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.展开更多
Plants in their natural environment are constantly subjected to various abiotic and biotic stressors and,therefore,have developed several defense mechanisms to maintain fitness.Stress responses are intricate and requi...Plants in their natural environment are constantly subjected to various abiotic and biotic stressors and,therefore,have developed several defense mechanisms to maintain fitness.Stress responses are intricate and require various physiological,biochemical,and cellular changes in plants.The reaction mechanisms in plants subjected to drought,salinity,or heat stress alone have been explained in numerous studies.However,the field conditions are significantly different from the controlled laboratory conditions.In the field,crops or plants are simultaneously exposed to two or more abiotic and/or biotic stress conditions,such as a combination of salinity and heat,drought and cold,or any of the abiotic stresses combined with pathogen infection.Studies have shown that plants’reactions to combinations of more than two stress factors are distinct and cannot be explicitly deduced from their responses to different stresses when applied separately.Therefore,additional research is needed to understand the complete mechanism of plant responses to stress by analyzing data between single stress and multiple stress responses.This review aims to provide an overview of current research on plant responses to a combination of various stress conditions and their influence on the metabolic,transcriptional,and physiological characteristics of plants.展开更多
BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relat...BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.AIM To verify the relationship between a body shape index(ABSI)and the functional prognosis of the knee after ACLR in athletes with ACL injuries.METHODS We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020,with a follow-up period of more than 24 mo.First,all populations were divided into a High-ABSI group(ABSI>0.835,n=38)and a Low-ABSI group(ABSI<0.835,n=38)based on the arithmetic median(0.835)of ABSI values.The primary exposure factor was ABSI,and the outcome indicators were knee function scores as well as postoperative complications.The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.RESULTS The preoperative knee function scores of the two groups were similar.The surgery and postoperative rehabilitation exercises,range of motion(ROM)compliance rate,Lysholm score,and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased,whereas the quadriceps atrophy index gradually decreased.The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up(P<0.05).In multifactorial logistic regression,ABSI was a risk factor of low knee joint function score after surgery,specifically low ROM scores(odds ratio[OR]=1.31,95%confidence interval[CI][1.10-1.44];P<0.001),low quadriceps atrophy index(OR=1.11,95%CI[0.97-1.29];P<0.05),low Lysholm scores(OR=2.34,95%CI[1.78-2.94];P<0.001),low symptoms(OR=1.14,95%CI[1.02-1.34];P<0.05),low activity of daily living(OR=1.34,95%CI[1.18-1.65];P<0.05),low sports(OR=2.47,95%CI[1.78-2.84];P<0.001),and low quality of life(OR=3.34,95%CI[2.88-3.94];P<0.001).ABSI was also a risk factor for deep vein thrombosis of the lower limb(OR=2.14,95%CI[1.88-2.36],P<0.05]and ACL recurrent rupture(OR=1.24,95%CI[0.98-1.44],P<0.05)after ACLR.CONCLUSION ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR,and the risk of poor knee function after ACLR,deep vein thrombosis of lower limb,and ACL recurrent rupture gradually increases with the rise of ABSI.展开更多
<strong>Introduction:</strong> The goal of this study was to utilize physical characteristics instead of placing subjects in arbitrary diagnostic categories to test for associations with genetic variants. ...<strong>Introduction:</strong> The goal of this study was to utilize physical characteristics instead of placing subjects in arbitrary diagnostic categories to test for associations with genetic variants. <strong>Methods:</strong> Forty-four single nucleotide polymorphisms were tested for association with specific cephalometric measurements in thirty-nine University of Pittsburgh Dental Registry and DNA Repository orthodontic subjects. Cephalometric measurements included an evaluation of FMA, a Wits appraisal, and a Steiner’s ANB analysis. Genetic markers were genotyped using polymerase chain reaction and Taqman chemistry. Chi-square and Fischer’s exact tests (α = 0.05) were used in investigation of overrepresentation of marker alleles. Samples were divided into groups based upon having an FMA, Wits, or ANB measurement above or below the mean of the cohort studied. Secondary analysis was done for sex and ethnicity to determine their effect on FMA, Wits, or ANB. <strong>Results: </strong>An association between FMA measurements was discovered in the following genes: ACTN3, CASP4, ESR1, FGF13, KRT7, and PITX2. An association between Wits measurements was discovered in the following genes: ACTN2, BTBD11, CASP4, FGF3, and FGF10. No associations were found with ANB.<strong> Conclusions: </strong>Genetic markers in several genes at different loci may contribute to craniofacial deformities in humans. This approach of using physical measurements may be an advantage to placing patients in arbitrary diagnostic categories.展开更多
Approaches to the study of the genetic basis of common complex diseases and their clinical applications are con-sidered. Monogenic Mendelian inheritance in such conditions is infrequent but its elucidation may help to...Approaches to the study of the genetic basis of common complex diseases and their clinical applications are con-sidered. Monogenic Mendelian inheritance in such conditions is infrequent but its elucidation may help to detect pathogenic mechanisms in the more common variety of complex diseases. Involvement by multiple genes in complex diseases usually occurs but the isolation and identification of specific genes so far has been exceptional. The role of common polymorphisms as indicators of disease risk in various studies is discussed.展开更多
N_2O emission from soil is affected by many factors. In this study, N_2O flux, soil temperature, water content, NO_3^- and NH_4^+ concentrations were simultaneously measured in winter wheat field. N_2O flux, NO_3^- an...N_2O emission from soil is affected by many factors. In this study, N_2O flux, soil temperature, water content, NO_3^- and NH_4^+ concentrations were simultaneously measured in winter wheat field. N_2O flux, NO_3^- and NH_4^+ concentrations were all lognormally distributed, while water content was normally distributed. The relationship between N_2O flux and soil factors was also studied. N_2O flux was most highly correlated with soil temperature. Regression model was developed to explain the variability of N_2O emission from agricultural soil using multifactorial analysis.展开更多
Chronic disease management requires achievement of critical individualised targets to mitigate again long-term morbidity and premature mortality associated with diabetes mellitus.The responsibility for this lies with ...Chronic disease management requires achievement of critical individualised targets to mitigate again long-term morbidity and premature mortality associated with diabetes mellitus.The responsibility for this lies with both the patient and health care professionals.Care plans have been introduced in many healthcare settings to provide a patient-centred approach that is both evidence-based to deliver positive clinical outcomes and allow individualised care.The Alphabet strategy(AS) for diabetes is based around such a care plan and has been evidenced to deliver high clinical standards in both well-resourced and underresourced settings.Additional patient educational resources include special care plans for those people with diabetes undertaking fasting during Ramadan,Preconception Care, Prevention and Remission of Diabetes.The Strategy and Care Plan has facilitated evidence-based,cost-efficient multifactorial intervention with an improvement in the National Diabetes Audit targets for blood pressure,cholesterol levels and glycated haemoglobin.Many of these attainments were of the standard seen in intensively treated cohorts of key randomized controlled trials in diabetes care such as the Steno-2 and United Kingdom Prospective Diabetes Study.This is despite working in a relatively under-resourced service within the United Kingdom National Health Service.The AS for diabetes care is a useful tool to consider for planning care, education of people with diabetes and healthcare professional.During the time of the coronavirus disease 2019 pandemic the risk factors for the increased mortality observed have to be addressed aggressively.The AS has the potential to help with this aspiration.展开更多
This case-report underlines the difficulties of a correct diagnosis in a complex vitamin malnutrition that is seldom suspected in patients living in developed Countries with a good social and economic situation. A 79-...This case-report underlines the difficulties of a correct diagnosis in a complex vitamin malnutrition that is seldom suspected in patients living in developed Countries with a good social and economic situation. A 79-year-old woman was admitted to hospital with progressive fatigue, dyspnea till orthopnea, pallor and lumbar pain. On physical examination the patient was awake, conscious and pale with severe dyspnea and the laboratory findings revealed severe anemia normochromic and normocytic;chest radiography shows cardiomegaly. An abdomen echography showed hepatomegaly and an increased gallbladder volume with multiple gallstones and “biliary mud”. The patients received infusion of 4 Units of blood and started terapy for secondary congestive heart failure. The third day the temperature increased till 39°C and the urine of the patient shown clear hematuria;considering the hypothesis of hemolytic anemia was started methylprednisolone EV. Blood analysis was made in order to clarify anemia etiology: low blood levels of Vit B12, hypersideremia and very low Unsatured Iron Binding Capacity. A further investigation revealed that her diet had exclusively consisted of potatoes and fresh cheese since years. We started therapy with VitB12 and Folate and the patient was discharge fourteen days after admission. We feel that the importance of this clinical case lies in the diagnostic investigation for the cause of anemia, often more difficult than generally perceived.展开更多
Chemical compositions during different growing periods, preference and in vitro digestibility at the post-fruiting period of five psammophyte shrubs, which include Caragana intermedia, Caragana korshinskii, Hedysarum ...Chemical compositions during different growing periods, preference and in vitro digestibility at the post-fruiting period of five psammophyte shrubs, which include Caragana intermedia, Caragana korshinskii, Hedysarum scoparium, Hedysarum laeve, Salix psammophylla were determined. The nutritive values were synthetically evaluated in terms of chemical composition, preference and in vitro digestibility through fuzzy multifactorial model. The crude protein (CP) concentrations of the five shrubs had the tendency to decrease with growing stage, the peak values of C. intermedia, C. korshinskii and S. psammophylla appeared at blooming period and those of H. scoparium and H. laeve appeared at vegetative period. The neutral-detergent fiber (NDF), acid-detergent fiber (ADF) and lignin concentrations of C. intermedia, C. korshinskii and S. psammophylla were all decreased before post-fruiting period and then increased significantly;while the variation tendency of those of H. scoparium and H. leave were alike, and the lowest NDF, ADF and lignin concentrations were at vegetative period or post-fruiting period. The five shrubs can be used as feedstuffs, the synthetical nutritive value at the post-fruiting period were high in order of C. intermedia, H. scoparium, H. laeve, C. korshinskii and S. psammophylla. Considering the characteristics of growth and nutritive value, the optimum time to use these shrubs as feedstuffs is the post-fruiting period in autumn. Among the five shrubs, C. intermedia is the best as feed-stuff for raising the production of livestock.展开更多
基金supported by Vietnam National Funds of Education and Training
文摘Multifactorial correlation analysis is a new method used to predict the land subsidence caused by groundwater exploitation This article introduces and applies the method to establish the function of the surface settlement rate （Vs） and the function of the time-dependent surface settlement （St） caused by groundwater exploitation, based on data acquired at three land subsidence monitoring stations in the Hanoi area of Vietnam. Comparison with actual monitoring data indicates that the prediction results are relatively close to the monitoring data. From this, we conclude that multifactorial correlation analysis is a reliable method and can be used to predict future land subsidence caused by groundwater exploitation in Hanoi.
文摘The concept, fundamental theory, analytical steps and formulae of grey relational analysis (GRA)-a new statistical method or multifactorial analysis in the field of medicine were introduced. GRA of grouping sequence that is applied to medical study was built by the authors. An example was given to demonstrate it. The superiority of GRA was recounted briefly.
文摘Summary: Retrospective and prospective bio-behavioral cancer studies have revealed that psycho social stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a pattern has emerged, which in analogy to the coronary prone pattern (type A) has been labelled type C, encompassing suppression of emotional responses, such as anger and hostility, rationality and antiemotionality, as well as high social conformity and a lack of self-assertiveness. There is growing evidence in both infrahuman and human research that specific coping styles (repressive coping) with stress may be associated with specific biologic responses, including neuroendocrine, immunologic and other bodily functions. The application of this model appears to be of importance for further research, as well as for the detection of high risk individuals, but also in regard to therapy, rehabilitation, early detection and possibly also prevention of malignant disease. This concept suggests also new directions and modifications of stress research, as stressors are to be viewed not necessarily as pathological, but in some instances as quite possibly salutary, depending on the nature of the stres-sor, the psychophysiologic state of the individual and his or her ability to cope with adverse life situations. Quite naturally, the development of this concept is still in its initial stages, there remain anumber of open questions, and it needs hardly to be pointed out in this connection that further and painstaking clinical and laboratory work is warranted in order to clarify the role of stressors, life and coping styles and its biological concomitants in neo-plastic disease.
文摘Existing multifactorial particle swarm optimisation(MFPSO)algorithms only explore a relatively narrow area between the inter-task particles.Meanwhile,these algorithms use a fixed inter-task learning probability throughout the evolution process.However,the parameter is problem dependent and can be various at different stages of the evolution.In this work,the authors devise an inter-task learning-based information transferring mechanism to replace the corresponding part in MFPSO.This inter-task learning mechanism transfers the searching step by using a differential term and updates the personal best position by employing an inter-task crossover.By this mean,the particles can explore a broad search space when utilising the additional searching experiences of other tasks.In addition,to enhance the performance on problems with different complementarity,they design a self-adaption strategy to adjust the inter-task learning probability according to the performance feedback.They compared the proposed algorithm with the state-of-the-art algorithms on various benchmark problems.Experimental results demonstrate that the proposed algorithm can transfer inter-task knowledge efficiently and perform well on the problems with different complementarity.
文摘A multivariate analysis of 617 female patients with primary breast cancer treated by radical mastectomy between 1974 and 1981 was done. All patients were followed for more than five years. Survival was 76.6% and 64.7% at 5 and 10 years, respectively. Eleven clinical and pathological factors were available for study. The data were analysed by Cox's proportional hazards regression model. A final set of five independent significant prognostic factors was obtained. In order of importance they were, clinical stage, age at diagnosis, axillary lymph node status, histologic type and size of the primary tumor. To test the time-varying effect of these factors using Cox's model, all except age reduced their prognostic impact significantly after five years, however, age was a powerful prognostic factor for long-term survival. A prognostic index based on the regression coefficients was constructed. This index can give a better prediction for patients' survival and can be taken as reference when formulating treatment protocols for breast cancer.
基金Supported by the Ministero dell’Universitàe della Ricerca(Italian Ministry of University and Research),No.2007PSYLRX.
文摘BACKGROUND Achieving optimal glycemic control is a cornerstone of cardiovascular risk reduction in type 2 diabetes(T2D).However,the extent to which multifactorial interventions influence this relationship remains uncertain.AIM To evaluate the association between glycated hemoglobin(HbA1c)target achievement and long-term cardiovascular outcomes in patients receiving standard of care(SoC)or multifactorial intensive therapy(MT).METHODS This post-hoc analysis of the nephropathy in diabetes type 2 cluster-randomized trial included 323 patients with T2D,albuminuria,and retinopathy(SoC:n=139;MT:n=184),who underwent a 4-year intervention phase.Outcomes were major adverse cardiovascular events(MACE)and all-cause mortality.Associations with HbA1c target achievement(≤7%vs>7%)were assessed using Kaplan-Meier curves and shared frailty Cox regression models.RESULTS During a median follow-up of 12.1 years,190 MACEs and 139 deaths occurred.Achievement of the HbA1c target was not associated with reduced mortality in either group.However,a significant reduction in MACEs was observed only among SoC patients achieving HbA1c≤7%(P=0.031),whereas no benefit was seen in the MT group(P=0.645).In multivariable Cox regression models adjusted for cluster effect,in the MT group age[hazard ratio(HR)=1.07,P<0.001]and female sex(HR=0.38,P<0.001)were independent predictors of MACE,while in the SoC group only age(HR=1.04,P=0.009).For all-cause mortality,age(HR=1.11,P<0.001)and blood pressure control(HR=0.55,P=0.041)were significant predictors in the MT group,whereas age(HR=1.06,P=0.002)was independently associated with increased mortality in the SoC group.CONCLUSION In high-risk patients with T2D receiving standard care,achieving an HbA1c≤7%was associated with fewer cardiovascular events only under standard care,but not with reduced mortality.This association was not observed in patients managed with a multifactorial strategy.These findings suggest that the prognostic value of glycemic control depends on the broader treatment context and highlight the central role of comprehensive risk factor management in microvascularcomplicated T2D.
文摘Background A five-year follow-up study of intensive multifactorial intervention was undertaken to assess the changes of circulating serum amyloid A （SAA） levels and the incidence of atherosclerosis （AS） in patients with short-duration type 2 diabetes mellitus （T2DM） without macroangiopathy, and whether intensive multifactorial intervention could prevent or at least postpone the occurence of macroangiopathy. Methods Among 150 patients with short-duration T2DM, 75 were assigned to receive conventional outpatient treatment （conventional group） and the others underwent intensive multifactorial integrated therapy targeting hyperglycemia, hypertension, dyslipidemia and received aspirin simultaneously （intensive group）. Results Plasma SAA levels were higher in diabetic patients than those in healthy control subjects, and decreased obviously after intensive multifactorial intervention. The levels of SAA were positively correlated with body mass index （BMI）, waist hip ratio （WHR）, triglyceride （TG）, high sensitive C-reactive protein （hs-CRP） and common carotid intima-media thickness （CC-IMT）. The standard-reaching rates of glycemia, blood pressure and lipidemia were significantly higher in intensive group than those of conventional group. The incidence of macroangiopathy decreased by 58.96% in intensive group compared with conventional group. Conclusions Intensive multifactorial intervention may significantly reduce the SAA levels and prevent the occurrence of AS in short-duration patients with T2DM. SAA might be one of the risk factors of T2DM combined with AS.
基金supported by State Key Program of National Natural Science Foundation of China(Grant No.40830957)
文摘Aerodynamic roughness length is an important physical parameter in atmospheric numerical models and microme- teorological calculations, the accuracy of which can affect numerical model performance and the level of micrometeorological computations. Many factors influence the aerodynamic roughness length, but formulas for its parameterization often only con- sider the action of a single factor. This limits their adaptive capacity and often introduces considerable errors in the estimation of land surface momentum flux (friction velocity). In this study, based on research into the parameterization relations between aerodynamic roughness length and influencing factors such as windrow conditions, thermodynamic characteristics of the sur- face layer, natural rhythm of vegetation growth, ecological effects of interannual fluctuations of precipitation, and vegetation type, an aerodynamic roughness length parameterization scheme was established. This considers almost all the factors that af- fect aerodynamic roughness length on flat land surfaces with short vegetation. Furthermore, using many years' data recorded at the Semi-Arid Climate and Environment Observatory of Lanzhou University, a comparative analysis of the application of the proposed parameterization scheme and other experimental schemes was performed. It was found that the error in the friction velocity estimated by the proposed parameterization scheme was considerably less than that estimated using a constant aero- dynamic roughness length and by the other parameterization schemes. Compared with the friction velocity estimated using a constant aerodynamic roughness length, the correlation coefficient with the observed friction velocity increased from 0.752 to 0.937, and the standard deviation and deviation decreased by about 20% and 80%, respectively. Its mean value differed from the observed value by only 0.004 m s-l and the relative error was only about 1.6%, which indicates a significant decrease in the estimation error of surface-layer momentum flux. The test results show that the multifactorial universal parameterization scheme of aerodynamic roughness length for flat land surfaces with short vegetation can offer a more scientific parameteriza- tion scheme for numerical atmospheric models.
文摘Background and objective: Coronary angioplasty is one of the techniques introduced in 1976 by Andreas Grüntzig in Zurich. It is a revolutionary procedure that allows coronary circulation to be restored by inserting a stent. This new technique has considerably evolved over time, but sometimes has limitations, such as the development of neo-pathologies like stent thrombosis. The aim of our case report is to highlight one of the limitations of coronary angioplasty, although rare, and to encourage greater clinical and electrical monitoring after each procedure. Case report: We report the case of a patient who presented with early stent thrombosis barely an hour after placement of a pharmacoactive stent. Chest pain reported by the patient after the procedure and electrical changes prompted an urgent repeat procedure. Aetiologies of stent thrombosis are multifactorial, including patient-, procedure- and stent-dependent factors. Conclusion: Although rare, there is a risk of stent thrombosis after coronary angioplasty. Careful monitoring and rigorous follow-up of patients after coronary angioplasty are therefore required, as the prognosis for stent thrombosis is fairly poor.
文摘The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis(CP).In this context,pain represents the most common and debilitating symptom,and it deeply affects patient’s quality of life.Multiple rating scales(unidimensional,bidimensional and multidimensional)have been proposed to quantify CP pain.However,it represents the result of complex mechanisms,involving genetic,neuropathic and neurogenic factors.Considering all these aspects,the treatment should be discussed in a multidisciplinary setting and it should be approached in a stepwise manner.First,a lifestyle change is recommended and nonsteroidal anti-inflammatory drugs represent the gold standard among medical treatments for CP patients.The second step,after medical approach,is endoscopic therapy,especially for complicated CP.In case of failure,tailored surgery represents the third step and decompressive or resection procedures can be chosen.In conclusion,CP pain’s management is challenging considering all these complex aspects and the lack of international protocols.
基金Supported by A Grant from Novo Nordisk Pharma,to Kitada MA Grant-in-Aid for Scientific Research(C)to Kitada M,No.24591218+4 种基金A Grant for Promoted Research from Kanazawa Medical University to Kitada M,No.S2012-4A Grant-in-Aid for Scientific Research(B)to Koya D,No.25282028A Grant-in-Aid for Challenging Exploratory Research to Koya D,No.25670414A grant for Specially Promoted Research from Kanazawa Medical University to Koya D,No.SR2012-06the 4th Annual Research Award Grant of the Japanese Society of Anti-Aging Medicine,to Koya D
文摘Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in parallel with the increasing global pandemic of type 2 diabetes. Based on landmark clinical trials, DKD has become preventable by controlling conventional factors, including hyperglycemia and hypertension, with multifactorial therapy; however, the remaining risk of DKD progression is still high. In this review, we show the importance of targeting remission/regression of microalbuminuria in type 2 diabetic patients, which may protect against the progression of DKD and cardiovascular events. To achieve remission/regression of microalbuminuria, several steps are important, including the early detection of microalbuminuria with continuousscreening, targeting HbA1c < 7.0% for glucose control, the use of renin angiotensin system inhibitors to control blood pressure, the use of statins or fibrates to control dyslipidemia, and multifactorial treatment. Reducing microalbuminuria is therefore an important therapeutic goal, and the absence of microalbuminuria could be a pivotal biomarker of therapeutic success in diabetic patients. Other therapies, including vitamin D receptor activation, uric acid-lowering drugs, and incretin-related drugs, may also be promising for the prevention of DKD progression.
文摘With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.
基金the University Grants Commission(UGC-BSR Research Start-up-Grant No.F30-409/2018)the Deanship of Scientific Research,King Khalid University,Saudi Arabia(No.R.G.P.2/11/42)for their financial assistance。
文摘Plants in their natural environment are constantly subjected to various abiotic and biotic stressors and,therefore,have developed several defense mechanisms to maintain fitness.Stress responses are intricate and require various physiological,biochemical,and cellular changes in plants.The reaction mechanisms in plants subjected to drought,salinity,or heat stress alone have been explained in numerous studies.However,the field conditions are significantly different from the controlled laboratory conditions.In the field,crops or plants are simultaneously exposed to two or more abiotic and/or biotic stress conditions,such as a combination of salinity and heat,drought and cold,or any of the abiotic stresses combined with pathogen infection.Studies have shown that plants’reactions to combinations of more than two stress factors are distinct and cannot be explicitly deduced from their responses to different stresses when applied separately.Therefore,additional research is needed to understand the complete mechanism of plant responses to stress by analyzing data between single stress and multiple stress responses.This review aims to provide an overview of current research on plant responses to a combination of various stress conditions and their influence on the metabolic,transcriptional,and physiological characteristics of plants.
文摘BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.AIM To verify the relationship between a body shape index(ABSI)and the functional prognosis of the knee after ACLR in athletes with ACL injuries.METHODS We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020,with a follow-up period of more than 24 mo.First,all populations were divided into a High-ABSI group(ABSI>0.835,n=38)and a Low-ABSI group(ABSI<0.835,n=38)based on the arithmetic median(0.835)of ABSI values.The primary exposure factor was ABSI,and the outcome indicators were knee function scores as well as postoperative complications.The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.RESULTS The preoperative knee function scores of the two groups were similar.The surgery and postoperative rehabilitation exercises,range of motion(ROM)compliance rate,Lysholm score,and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased,whereas the quadriceps atrophy index gradually decreased.The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up(P<0.05).In multifactorial logistic regression,ABSI was a risk factor of low knee joint function score after surgery,specifically low ROM scores(odds ratio[OR]=1.31,95%confidence interval[CI][1.10-1.44];P<0.001),low quadriceps atrophy index(OR=1.11,95%CI[0.97-1.29];P<0.05),low Lysholm scores(OR=2.34,95%CI[1.78-2.94];P<0.001),low symptoms(OR=1.14,95%CI[1.02-1.34];P<0.05),low activity of daily living(OR=1.34,95%CI[1.18-1.65];P<0.05),low sports(OR=2.47,95%CI[1.78-2.84];P<0.001),and low quality of life(OR=3.34,95%CI[2.88-3.94];P<0.001).ABSI was also a risk factor for deep vein thrombosis of the lower limb(OR=2.14,95%CI[1.88-2.36],P<0.05]and ACL recurrent rupture(OR=1.24,95%CI[0.98-1.44],P<0.05)after ACLR.CONCLUSION ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR,and the risk of poor knee function after ACLR,deep vein thrombosis of lower limb,and ACL recurrent rupture gradually increases with the rise of ABSI.
文摘<strong>Introduction:</strong> The goal of this study was to utilize physical characteristics instead of placing subjects in arbitrary diagnostic categories to test for associations with genetic variants. <strong>Methods:</strong> Forty-four single nucleotide polymorphisms were tested for association with specific cephalometric measurements in thirty-nine University of Pittsburgh Dental Registry and DNA Repository orthodontic subjects. Cephalometric measurements included an evaluation of FMA, a Wits appraisal, and a Steiner’s ANB analysis. Genetic markers were genotyped using polymerase chain reaction and Taqman chemistry. Chi-square and Fischer’s exact tests (α = 0.05) were used in investigation of overrepresentation of marker alleles. Samples were divided into groups based upon having an FMA, Wits, or ANB measurement above or below the mean of the cohort studied. Secondary analysis was done for sex and ethnicity to determine their effect on FMA, Wits, or ANB. <strong>Results: </strong>An association between FMA measurements was discovered in the following genes: ACTN3, CASP4, ESR1, FGF13, KRT7, and PITX2. An association between Wits measurements was discovered in the following genes: ACTN2, BTBD11, CASP4, FGF3, and FGF10. No associations were found with ANB.<strong> Conclusions: </strong>Genetic markers in several genes at different loci may contribute to craniofacial deformities in humans. This approach of using physical measurements may be an advantage to placing patients in arbitrary diagnostic categories.
文摘Approaches to the study of the genetic basis of common complex diseases and their clinical applications are con-sidered. Monogenic Mendelian inheritance in such conditions is infrequent but its elucidation may help to detect pathogenic mechanisms in the more common variety of complex diseases. Involvement by multiple genes in complex diseases usually occurs but the isolation and identification of specific genes so far has been exceptional. The role of common polymorphisms as indicators of disease risk in various studies is discussed.
文摘N_2O emission from soil is affected by many factors. In this study, N_2O flux, soil temperature, water content, NO_3^- and NH_4^+ concentrations were simultaneously measured in winter wheat field. N_2O flux, NO_3^- and NH_4^+ concentrations were all lognormally distributed, while water content was normally distributed. The relationship between N_2O flux and soil factors was also studied. N_2O flux was most highly correlated with soil temperature. Regression model was developed to explain the variability of N_2O emission from agricultural soil using multifactorial analysis.
文摘Chronic disease management requires achievement of critical individualised targets to mitigate again long-term morbidity and premature mortality associated with diabetes mellitus.The responsibility for this lies with both the patient and health care professionals.Care plans have been introduced in many healthcare settings to provide a patient-centred approach that is both evidence-based to deliver positive clinical outcomes and allow individualised care.The Alphabet strategy(AS) for diabetes is based around such a care plan and has been evidenced to deliver high clinical standards in both well-resourced and underresourced settings.Additional patient educational resources include special care plans for those people with diabetes undertaking fasting during Ramadan,Preconception Care, Prevention and Remission of Diabetes.The Strategy and Care Plan has facilitated evidence-based,cost-efficient multifactorial intervention with an improvement in the National Diabetes Audit targets for blood pressure,cholesterol levels and glycated haemoglobin.Many of these attainments were of the standard seen in intensively treated cohorts of key randomized controlled trials in diabetes care such as the Steno-2 and United Kingdom Prospective Diabetes Study.This is despite working in a relatively under-resourced service within the United Kingdom National Health Service.The AS for diabetes care is a useful tool to consider for planning care, education of people with diabetes and healthcare professional.During the time of the coronavirus disease 2019 pandemic the risk factors for the increased mortality observed have to be addressed aggressively.The AS has the potential to help with this aspiration.
文摘This case-report underlines the difficulties of a correct diagnosis in a complex vitamin malnutrition that is seldom suspected in patients living in developed Countries with a good social and economic situation. A 79-year-old woman was admitted to hospital with progressive fatigue, dyspnea till orthopnea, pallor and lumbar pain. On physical examination the patient was awake, conscious and pale with severe dyspnea and the laboratory findings revealed severe anemia normochromic and normocytic;chest radiography shows cardiomegaly. An abdomen echography showed hepatomegaly and an increased gallbladder volume with multiple gallstones and “biliary mud”. The patients received infusion of 4 Units of blood and started terapy for secondary congestive heart failure. The third day the temperature increased till 39°C and the urine of the patient shown clear hematuria;considering the hypothesis of hemolytic anemia was started methylprednisolone EV. Blood analysis was made in order to clarify anemia etiology: low blood levels of Vit B12, hypersideremia and very low Unsatured Iron Binding Capacity. A further investigation revealed that her diet had exclusively consisted of potatoes and fresh cheese since years. We started therapy with VitB12 and Folate and the patient was discharge fourteen days after admission. We feel that the importance of this clinical case lies in the diagnostic investigation for the cause of anemia, often more difficult than generally perceived.
文摘Chemical compositions during different growing periods, preference and in vitro digestibility at the post-fruiting period of five psammophyte shrubs, which include Caragana intermedia, Caragana korshinskii, Hedysarum scoparium, Hedysarum laeve, Salix psammophylla were determined. The nutritive values were synthetically evaluated in terms of chemical composition, preference and in vitro digestibility through fuzzy multifactorial model. The crude protein (CP) concentrations of the five shrubs had the tendency to decrease with growing stage, the peak values of C. intermedia, C. korshinskii and S. psammophylla appeared at blooming period and those of H. scoparium and H. laeve appeared at vegetative period. The neutral-detergent fiber (NDF), acid-detergent fiber (ADF) and lignin concentrations of C. intermedia, C. korshinskii and S. psammophylla were all decreased before post-fruiting period and then increased significantly;while the variation tendency of those of H. scoparium and H. leave were alike, and the lowest NDF, ADF and lignin concentrations were at vegetative period or post-fruiting period. The five shrubs can be used as feedstuffs, the synthetical nutritive value at the post-fruiting period were high in order of C. intermedia, H. scoparium, H. laeve, C. korshinskii and S. psammophylla. Considering the characteristics of growth and nutritive value, the optimum time to use these shrubs as feedstuffs is the post-fruiting period in autumn. Among the five shrubs, C. intermedia is the best as feed-stuff for raising the production of livestock.
