Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature D...Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(CSTJ),focusing on expert consensus statements and check-lists for TCM case reports.Relevant items were extracted,and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale.Items were screened based on measures of central tendency and coordination(including total score,mean score,percentage of items rated as unimportant,and coefficient of variation).The weighted average method was used to determine item weights and construct the appraisal tool.Internal consistency was assessed using Cronbach’sαcoefficient.The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports,with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency.Results A total of 9513 articles were retrieved,and 96 items from 25 articles were extracted.After two rounds of the Delphi method,27 items across 10 domains were retained.The Cron-bach’sαcoefficient was 0.72 in the first round(acceptable range),and 0.96 in the second round,indicating strong internal consistency.The tool was piloted by six reviewers,achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845,demonstrating high consistency among reviewers.Conclusion The developed TCM case report quality appraisal tool,consisting of 27 items in 10 domains,offers a scientific and reliable means of assessing the quality of TCM case reports.The tool showed high consistency and practical utility,and its application is expected to en-hance the standardization,scientific rigor,and evidence quality of TCM case reports,facilitat-ing the integration of traditional medical knowledge with modern evidence-based standards.展开更多
Mass movements are very common problems in the eastern Black Sea region of Turkey due to its climate conditions, geological, and geomorphological characteristics. High slope angle, weathering, dense rainfalls, and ant...Mass movements are very common problems in the eastern Black Sea region of Turkey due to its climate conditions, geological, and geomorphological characteristics. High slope angle, weathering, dense rainfalls, and anthropogenic impacts are generally reported as the most important triggering factors in the region. Following the portal slope excavations in the entrance section of Cankurtaran tunnel, located in the region, where the highly weathered andesitic tuff crops out, a circular toe failure occurred. The main target of the present study is to investigate the causes and occurrence mechanism of this failure and to determine the feasible remedial measures against it using finite element method(FEM) in four stages. These stages are slope stability analyses for pre-and postexcavation cases, and remediation design assessments for slope and tunnel. The results of the FEM-SSR analyses indicated that the insufficient initial support design and weathering of the andesitic tuffs are the main factors that caused the portal failure. After installing a rock retaining wall with jet grout columns and reinforced slope benching applications, the factor of safety increased from 0.83 to 2.80. In addition toslope stability evaluation, the Rock Mass Rating(RMR), Rock Mass Quality(Q) and New Austrian Tunneling Method(NATM) systems were also utilized as empirical methods to characterize the tunnel ground and to determine the tunnel support design. The performance of the suggested empirical support design, induced stress distributions and deformations were analyzed by means of numerical modelling. Finally, it was concluded that the recommended stabilization technique was essential for the dynamic long-term stability and prevents the effects of failure. Additionally, the FEM method gives useful and reasonably reliable results in evaluating the stability of cut slopes and tunnels excavated both in continuous and discontinuous rock masses.展开更多
Objective To reevaluate the age limit for heart transplantation ( HTX) and the long-term outcomes in el derly patients. Methods From Oct. 1984 to Dec. 1996, 161 cases of HTX were performed in Hartford Hospital, wit...Objective To reevaluate the age limit for heart transplantation ( HTX) and the long-term outcomes in el derly patients. Methods From Oct. 1984 to Dec. 1996, 161 cases of HTX were performed in Hartford Hospital, with 35 pa tients aged 60～68 years (mean: 63.5±2.7, group A) and 126 under 60 years (mean: 47.6±11.3, group B). The causes of HTX for group A and group B were ischemic : 60% vs 48%, idiopathic: 29% vs 45%, valvular: 6% vs 4 %, congenital: 0 vs 2%, and graft failure : 6 % vs1% . Results The operative mortality (within 30d) were5.7%(2/35) in group A , and1. 6% (2/126) in group B. The overall late death were 13 (37%) in group A, and 50(40% ) in group B. The main causes of dea th were ( group A vs group B) infection: 46 % vs 24 %, rejection: 0 vs 28 % (P<0.05), malignancy: 23 % vs 8 %, multi-or gan system failure:23% vs 2%, cardiac events:8% vs 10%. The 1-,3-,5- ,8- and 10- year survival rate in group A and group B was 74% vs 88%, 67% vs 77%, 60% vs 65%, 49% vs 43%, and 49% vs 34% respectively. The quality of life for both groups was improved remarkably. Conclusion The survival rate for patients over 60 is as good as that of the younger group. HTX could be successfully performed in patients around 65 years old.展开更多
As a critical water source for the central route of the South-to-North Water Diversion Project,the Danjiangkou Reservoir has consistently achieved a water quality rating of Gradell or above,thanks to its efforts to ke...As a critical water source for the central route of the South-to-North Water Diversion Project,the Danjiangkou Reservoir has consistently achieved a water quality rating of Gradell or above,thanks to its efforts to keep enhancing water qualityprotection.展开更多
This review discusses the application scenarios of the machine learning-supported performance prediction and the optimization effi-ciency of tunnel boring machines(TBMs).The rock mass quality ratings,which are based o...This review discusses the application scenarios of the machine learning-supported performance prediction and the optimization effi-ciency of tunnel boring machines(TBMs).The rock mass quality ratings,which are based on the Chinese code for geological survey,were used to provide"labels"suitable for supervised learning.As a result,the generation of machine prediction for rock mass grades reason-ably agreed with the ground truth documented in geological maps.In contrast,the main operational parameters,i.e.,thrust and torque,can be reasonably predicted based on historical data.Consequently,18 collapse sections of the Yinsong project have been successfully predicted by several researchers.Preliminary studies on the selection of the optimal penetration rate and cost were conducted.This review also presents a summary of the main achievements in response to the initiatives of the Lotus Pool Contest in China.For the first time,large and well-documented TBM performance data has been shared for joint scientific research.Moreover,the review discusses the technical problems that require further study and the perspectives in the future development of intelligent TBM construction based on big data and machine learning.展开更多
基金General Program of National Natural Science Foundation of China (82274412)Natural Science Foundation of Hunan Province (2020JJ4062)Science and Technology Innovation Program of Hunan Province (2020RC2061)。
文摘Objective To develop a quality appraisal tool for case reports in traditional Chinese medicine(TCM)based on their characteristics.Methods An extensive literature search was conducted in Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(CSTJ),focusing on expert consensus statements and check-lists for TCM case reports.Relevant items were extracted,and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale.Items were screened based on measures of central tendency and coordination(including total score,mean score,percentage of items rated as unimportant,and coefficient of variation).The weighted average method was used to determine item weights and construct the appraisal tool.Internal consistency was assessed using Cronbach’sαcoefficient.The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports,with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency.Results A total of 9513 articles were retrieved,and 96 items from 25 articles were extracted.After two rounds of the Delphi method,27 items across 10 domains were retained.The Cron-bach’sαcoefficient was 0.72 in the first round(acceptable range),and 0.96 in the second round,indicating strong internal consistency.The tool was piloted by six reviewers,achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845,demonstrating high consistency among reviewers.Conclusion The developed TCM case report quality appraisal tool,consisting of 27 items in 10 domains,offers a scientific and reliable means of assessing the quality of TCM case reports.The tool showed high consistency and practical utility,and its application is expected to en-hance the standardization,scientific rigor,and evidence quality of TCM case reports,facilitat-ing the integration of traditional medical knowledge with modern evidence-based standards.
文摘Mass movements are very common problems in the eastern Black Sea region of Turkey due to its climate conditions, geological, and geomorphological characteristics. High slope angle, weathering, dense rainfalls, and anthropogenic impacts are generally reported as the most important triggering factors in the region. Following the portal slope excavations in the entrance section of Cankurtaran tunnel, located in the region, where the highly weathered andesitic tuff crops out, a circular toe failure occurred. The main target of the present study is to investigate the causes and occurrence mechanism of this failure and to determine the feasible remedial measures against it using finite element method(FEM) in four stages. These stages are slope stability analyses for pre-and postexcavation cases, and remediation design assessments for slope and tunnel. The results of the FEM-SSR analyses indicated that the insufficient initial support design and weathering of the andesitic tuffs are the main factors that caused the portal failure. After installing a rock retaining wall with jet grout columns and reinforced slope benching applications, the factor of safety increased from 0.83 to 2.80. In addition toslope stability evaluation, the Rock Mass Rating(RMR), Rock Mass Quality(Q) and New Austrian Tunneling Method(NATM) systems were also utilized as empirical methods to characterize the tunnel ground and to determine the tunnel support design. The performance of the suggested empirical support design, induced stress distributions and deformations were analyzed by means of numerical modelling. Finally, it was concluded that the recommended stabilization technique was essential for the dynamic long-term stability and prevents the effects of failure. Additionally, the FEM method gives useful and reasonably reliable results in evaluating the stability of cut slopes and tunnels excavated both in continuous and discontinuous rock masses.
文摘Objective To reevaluate the age limit for heart transplantation ( HTX) and the long-term outcomes in el derly patients. Methods From Oct. 1984 to Dec. 1996, 161 cases of HTX were performed in Hartford Hospital, with 35 pa tients aged 60～68 years (mean: 63.5±2.7, group A) and 126 under 60 years (mean: 47.6±11.3, group B). The causes of HTX for group A and group B were ischemic : 60% vs 48%, idiopathic: 29% vs 45%, valvular: 6% vs 4 %, congenital: 0 vs 2%, and graft failure : 6 % vs1% . Results The operative mortality (within 30d) were5.7%(2/35) in group A , and1. 6% (2/126) in group B. The overall late death were 13 (37%) in group A, and 50(40% ) in group B. The main causes of dea th were ( group A vs group B) infection: 46 % vs 24 %, rejection: 0 vs 28 % (P<0.05), malignancy: 23 % vs 8 %, multi-or gan system failure:23% vs 2%, cardiac events:8% vs 10%. The 1-,3-,5- ,8- and 10- year survival rate in group A and group B was 74% vs 88%, 67% vs 77%, 60% vs 65%, 49% vs 43%, and 49% vs 34% respectively. The quality of life for both groups was improved remarkably. Conclusion The survival rate for patients over 60 is as good as that of the younger group. HTX could be successfully performed in patients around 65 years old.
文摘As a critical water source for the central route of the South-to-North Water Diversion Project,the Danjiangkou Reservoir has consistently achieved a water quality rating of Gradell or above,thanks to its efforts to keep enhancing water qualityprotection.
基金supported by grants from the National Key R&D Program of China(Grant No.2018YFB1702504)the National Natural Science Foundation of China(Grant Nos.52179121,51879284)+3 种基金the State Key Laboratory of Simulations and Regulation of Water Cycle in River Basin,China(Grant No.SKL2022ZD05)the IWHR Research&Development Support Program,China(Grant No.GE0145B012021)the Natural Science Foundation of Shaanxi Province,China(Grant No.2021JLM-50)the National Key R&D Program of China(Grant No.2022YFE0200400).
文摘This review discusses the application scenarios of the machine learning-supported performance prediction and the optimization effi-ciency of tunnel boring machines(TBMs).The rock mass quality ratings,which are based on the Chinese code for geological survey,were used to provide"labels"suitable for supervised learning.As a result,the generation of machine prediction for rock mass grades reason-ably agreed with the ground truth documented in geological maps.In contrast,the main operational parameters,i.e.,thrust and torque,can be reasonably predicted based on historical data.Consequently,18 collapse sections of the Yinsong project have been successfully predicted by several researchers.Preliminary studies on the selection of the optimal penetration rate and cost were conducted.This review also presents a summary of the main achievements in response to the initiatives of the Lotus Pool Contest in China.For the first time,large and well-documented TBM performance data has been shared for joint scientific research.Moreover,the review discusses the technical problems that require further study and the perspectives in the future development of intelligent TBM construction based on big data and machine learning.
